True superior gluteal artery aneurysm with neurovascular compromise of the lower limb: a case report and review of the therapeutic options.

Few cases of true superior gluteal artery (SGA) aneurysms have been described in the English-language literature. This is the twenty-second reported case. SGA aneurysms can pose diagnostic problems, specifically when they are non-pulsatile and also therapeutic challenges when they are large. Although more aneurysms are being subjected to endovascular therapies, SGA aneurysmectomy or aneurysmorrhaphy still remain valid therapeutic options, especially in resource-poor settings. Surgery provides quick symptom resolution and still is the only means by which tissue for definitive histological diagnosis can be obtained.

Refractory bleeding from a giant de-differentiated liposarcoma of the chest wall: An indication for neoadjuvant chemotherapy and palliative resection? - A case report.

INTRODUCTION: Dedifferentiated liposarcoma (DDLPS) is a heterogenous neoplasm of variable histological grade. DDLPS uncommonly arises from the chest wall. There are limited data available about the tumor's response to chemotherapy and accessible reports indicate minimal benefits. Surgery is thus the cornerstone of management. Here, we demonstrate an uncommon situation where chemotherapy was used to arrest bleeding from a giant DDLPS that was refractory to all available hemostatic agents. This case also presents an uncommon indication for palliative chest wall resection and reconstruction (CWRR). PRESENTATION OF CASE: A 55-year old woman presented with refractory bleeding from an ulcerated and foul-smelling mass on the anterior chest wall, confirmed histologically to be DDLPS. Chemotherapy with Doxorubicin and Ifosfamide was used to control the bleeding. She subsequently had CWRR to improve her quality of life. The patient made an uneventful recovery but later died from pulmonary embolism. DISCUSSION: The dedifferentiated component of DDLPS is vascular and may account for why we were able to exhibit a hemostatic response to chemotherapy. CWRR was then employed to improve the quality of life in an advanced, ulcerated and infected tumor of the chest wall. CONCLUSION: We were able to demonstrate a hemostatic response of DDLPS to neoadjuvant chemotherapy and anticipate that this report may serve as a reference for further studies. Furthermore, we believe that palliative resection may be carried out to improve a patient's quality of life even in the face of advanced disease.