Calcifying fibrous pseudotumor of mesentery presenting with acute peritonitis: case report with immunohistochemical study and review of literature.

Calcifying fibrous pseudotumor (CFP) is a benign soft tissue lesion composed of thick collagen bundles, scattered fibroblasts, and psammomatous and dystrophic calcifications, located most commonly in the extremities and trunk of children and young adults. The present case in a 36-year-old woman is to the best of our knowledge the first report of a large CFP confined to the mesentery, which, because of torsion, led to acute peritonitis and emergency laparotomy. The typical histologic features were accompanied by a prominent myofibroblastic proliferation along with inflammatory response at the periphery of the lesion. The spindle cells of the lesion were positive for vimentin and focally for CD34 and smooth-muscle actin. Review of the literature and discussion of differential diagnosis in this report focuses on abdominal CFP and other intraabdominal soft tissue lesions, some of which may be precursors of CFP. Int J Surg Pathol 9(3):249-253, 2001

[Diagnosis and therapeutic tactics in polycystic liver]. / Diagnostika i lechebnaia taktika pri polikistoze pecheni.

The results of clinical observations of 60 patients with polycystosis of the liver who had been treated or examined by the authors in the period from 1964 to 1989 were summarized. The clinical course of the disease was featured by scanty clinical signs: pains in the upper half of the belly and hepatomegaly were most frequent. The combination of diagnostic techniques for verification of surgical intervention necessity was established. Besides, it was stated that the diagnosis of polycystosis of the liver should be complex and based on anamnestic data and the results of clinical, laboratory and instrumental investigations. Preference should be given to ultrasonography and computed tomography. Cysts with diameter of 5 cm and more, complicated polycystosis of the liver (bleeding, suppuration, malignancy) and cystic compression of the extrahepatic bile ducts and vessels (portal and cava inferior veins) were found to be indicative signs for surgical treatment of hepatic polycystosis. A total of 41 patients were subjected to surgical treatment with 49 operational procedures employed. Fenestration of hepatic cysts (42), that were organosparing operations, predominated. Resection of the liver was performed in 2 patients who had total cyst substitution for the whole of the left lobe. The improvement registered in 85.7% of operated on patients evidenced the favorable results of surgical treatment.

[Surgical treatment of polycystic disease of the liver]. / Khirurgicheskoe lechenie polikistoza pecheni.

The authors analyse 60 cases of polycystic disease of the liver; 41 patients underwent operation, 19 were kept under dynamic follow-up. The diagnosis of polycystic disease of the liver is based on the results of ultrasonic examination and computed tomography; serological tests are conducted for differential diagnosis with hydatid disease. Twenty (33.3%) patients had affection of the kidneys, pancreas, ovaries, and brain. As the result of surgery the condition improved in 30 (85.7%) and became worse in 5 (14.3%) patients in follow-up periods of 6 months to 23 years. Complications occurred in the postoperative period in 10 patients, the mortality rate was 4%. Fenestration of the cysts is the main type of intervention, which allows maximum preservation of the functioning hepatic parenchyma. The left hepatic lobe was resected in only 2 patients with its complete cystic degeneration. Defocused laser beam and bipolar rotor electrocoagulator were used for ++de-epithelialization of the cystic walls. Experience shows the expediency of surgical treatment for decompression of the maintained hepatic parenchyma.