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1.
Acta Cytol ; 65(6): 478-482, 2021.
Article in English | MEDLINE | ID: mdl-34515047

ABSTRACT

INTRODUCTION: Paraffin injections for breast augmentation once a popular form of mammoplasty are now considered obsolete. It had been abandoned by clinicians because of its associated serious complications. The practice is however still available and is being practiced by nonmedically qualified people. Paraffin injection results in the formation of multiple foreign-body granulomas known as breast paraffinoma. The clinical features of breast paraffinoma can mimic and be mistaken for breast carcinoma or inflammatory breast carcinoma. The use of fine-needle aspiration cytology (FNAC) in the evaluation of patients with breast paraffinoma has not been fully evaluated. METHODS: Retrospective review was performed on 30 patients who presented with breast paraffinoma between June 1, 2010, and June 30, 2020, who also had FNAC as part of their breast lump evaluation. RESULTS: FNAC of 73.3% patients showed multinucleated giant cells and macrophages or histiocytes containing engulfed clear, empty intracytoplasmic vacuoles of varying sizes. In 13.3% of the patients, macrophages or histiocytes with engulfed clear intracytoplasmic vacuoles of varying sizes were seen. In 6.7% of patients, multinucleated giant cells containing engulfed vacuoles of varying sizes were seen, and in 6.7% of patients, hypocellular smears with large amount of clear spaces were seen. Oily droplets were seen in the background of all the smears, and there were no malignant cells seen. These features were compatible with breast paraffinoma. CONCLUSION: Most patients with breast paraffinoma can be managed conservatively and they do not require further treatment; FNAC with its characteristic features can provide the reliable diagnosis of breast paraffinoma and therefore sparing these patients from more invasive diagnostic procedures.


Subject(s)
Breast Diseases/pathology , Granuloma, Foreign-Body/pathology , Mammaplasty/adverse effects , Paraffin/adverse effects , Adult , Aged , Biopsy, Fine-Needle , Breast Diseases/etiology , Breast Diseases/therapy , Breast Neoplasms/pathology , Databases, Factual , Diagnosis, Differential , Female , Granuloma, Foreign-Body/etiology , Granuloma, Foreign-Body/therapy , Humans , Injections , Middle Aged , Paraffin/administration & dosage , Predictive Value of Tests , Prognosis , Retrospective Studies
2.
J Surg Case Rep ; 2021(7): rjab318, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34290854

ABSTRACT

Kimura's disease is a rare chronic inflammatory disorder of unknown etiology which typically presents with subcutaneous nodules in the head and neck region and is frequently associated with regional lymphadenopathy or salivary gland enlargement. Peripheral blood eosinophilia and elevated serum immunoglobulin E levels are constant features of the disease. We present herein a 31-year-old male patient who presented with chronic neck lymphadenopathy. Kimura's disease was diagnosed on fine needle aspiration cytology, the patient initially decided not to have further intervention. He presented 6 years later with lymphadenopathy and was treated with surgery. The diagnosis of Kimura's disease was confirmed on histopathology. This patient had the disease for 6 years and did not have the typical features of peripheral eosinophilia and raise serum IgE level.

3.
World J Emerg Surg ; 15(1): 32, 2020 05 07.
Article in English | MEDLINE | ID: mdl-32381121

ABSTRACT

Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of acute left-sided colonic diverticulitis (ALCD) according to the most recent available literature. The update includes recent changes introduced in the management of ALCD. The new update has been further integrated with advances in acute right-sided colonic diverticulitis (ARCD) that is more common than ALCD in select regions of the world.


Subject(s)
Diverticulitis, Colonic/classification , Diverticulitis, Colonic/surgery , Emergency Service, Hospital , Acute Disease , Humans
4.
J Clin Oncol ; 36(19): 1913-1921, 2018 07 01.
Article in English | MEDLINE | ID: mdl-29498924

ABSTRACT

Purpose Selective internal radiation therapy or radioembolization (RE) shows efficacy in unresectable hepatocellular carcinoma (HCC) limited to the liver. This study compared the safety and efficacy of RE and sorafenib in patients with locally advanced HCC. Patients and Methods SIRveNIB (selective internal radiation therapy v sorafenib), an open-label, investigator-initiated, phase III trial, compared yttrium-90 (90Y) resin microspheres RE with sorafenib 800 mg/d in patients with locally advanced HCC in a two-tailed study designed for superiority/detriment. Patients were randomly assigned 1:1 and stratified by center and presence of portal vein thrombosis. Primary end point was overall survival (OS). Efficacy analyses were performed in the intention-to-treat population and safety analyses in the treated population. Results A total of 360 patients were randomly assigned (RE, 182; sorafenib, 178) from 11 countries in the Asia-Pacific region. In the RE and sorafenib groups, 28.6% and 9.0%, respectively, failed to receive assigned therapy without significant cross-over to either group. Median OS was 8.8 and 10.0 months with RE and sorafenib, respectively (hazard ratio, 1.1; 95% CI, 0.9 to 1.4; P = .36). A total of 1,468 treatment-emergent adverse events (AEs) were reported (RE, 437; sorafenib, 1,031). Significantly fewer patients in the RE than sorafenib group had grade ≥ 3 AEs (36 of 130 [27.7%]) v 82 of 162 [50.6%]; P < .001). The most common grade ≥ 3 AEs were ascites (five of 130 [3.8%] v four of 162 [2.5%] patients), abdominal pain (three [2.3%] v two [1.2%] patients), anemia (zero v four [2.5%] patients), and radiation hepatitis (two [1.5%] v zero [0%] patients). Fewer patients in the RE group (27 of 130 [20.8%]) than in the sorafenib group (57 of 162 [35.2%]) had serious AEs. Conclusion In patients with locally advanced HCC, OS did not differ significantly between RE and sorafenib. The improved toxicity profile of RE may inform treatment choice in selected patients.


Subject(s)
Brachytherapy/methods , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/radiotherapy , Liver Neoplasms/drug therapy , Liver Neoplasms/radiotherapy , Sorafenib/administration & dosage , Yttrium Radioisotopes/administration & dosage , Antineoplastic Agents/administration & dosage , Female , Humans , Kaplan-Meier Estimate , Male , Microspheres , Middle Aged , Prospective Studies
5.
World J Emerg Surg ; 13: 6, 2018.
Article in English | MEDLINE | ID: mdl-29416555

ABSTRACT

The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.


Subject(s)
Data Accuracy , Sepsis/classification , Severity of Illness Index , Arterial Pressure , Consensus , Glasgow Coma Scale , Humans , Organ Dysfunction Scores , Sensitivity and Specificity , Sepsis/mortality
6.
World J Emerg Surg ; 12: 37, 2017.
Article in English | MEDLINE | ID: mdl-28804507

ABSTRACT

Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.


Subject(s)
Emergency Medical Services/methods , Guidelines as Topic , Hernia, Abdominal/surgery , Abdominal Wall/surgery , Disease Management , Emergency Medical Services/trends , Humans , Polypropylenes/therapeutic use , Surgical Mesh/trends , Treatment Outcome
7.
Int J Surg Case Rep ; 2(8): 256-7, 2011.
Article in English | MEDLINE | ID: mdl-22096745

ABSTRACT

INTRODUCTION: Angiodysplasia is a term used to describe distinct mucosal vascular ectasias found mainly in the gastrointestinal tract. Angiodysplasia of the gallbladder is exceedingly rare. PRESENTATION OF CASE: We encountered a patient who presented with biliary colic and subsequently underwent an elective laparoscopic cholecystectomy. The angiodysplasia of the gallbladder was found incidentally on histopathological examination of the excised gallbladder. DISCUSSION: Review of the literature showed only one other reported case of angiodysplasia of the gallbladder. The condition may be found incidentally after histopathological examination of the gallbladder removed for gallstone; or it may present with haemobilia. CONCLUSION: We presented an extremely rare case of angiodysplasia of the gallbladder, which was found incidentally after histopathological examination of the gallbladder removed for gallstone. Angiodysplasia of the gallbladder has the potential to bleed. Laparoscopic cholecystectomy is effective in providing a definitive cure.

8.
World J Surg ; 34(7): 1517-22, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20151124

ABSTRACT

BACKGROUND: Lipoblastoma is a rare, benign, encapsulated tumor arising from embryonic white fat. On histology they typically contain variably differentiated adipocytes, primitive mesenchymal cells, myxoid matrix, and fibrous trabeculae. The tumor occurs primarily in infancy and early childhood. It often occurs in the extremities and trunk, and rarely develops in the head and neck and other sites. METHODS: Ten cases of histopathologically proven lipoblastoma presenting to our hospital during a 6-year period (2003-2008) were reviewed retrospectively for their clinical presentations, treatment, postoperative outcome, and follow-up. RESULTS: There were five males and five females ranging in age from 6 months to 20 years. The commonest presentation was a painless rapidly growing mass. Tumors occurred in an extremity (n = 5), head and neck (n = 3), trunk (n = 1), and retroperitoneum (n = 1). Preoperative diagnosis was accurate in only one case. The largest tumor measuring 25-cm x 20-cm x 7-cm and weighing 1.9 kg was excised from the retroperitoneum. All patients underwent complete surgical excision. Patient follow-up period ranging from 9 to 76 months showed no recurrences and no metastases. CONCLUSIONS: Lipoblastoma behaves benignly, occurs in both superficial and deep sites, and occasionally attains large size. Complete surgical excision is the treatment of choice and long-term follow-up is required because there is a reported tendency for these tumors to recur.


Subject(s)
Head and Neck Neoplasms/diagnosis , Lipoma/diagnosis , Adolescent , Adult , Child , Child, Preschool , Female , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Humans , Infant , Lipoma/pathology , Lipoma/surgery , Magnetic Resonance Imaging , Male , Retrospective Studies , Tomography, X-Ray Computed , Treatment Outcome , Young Adult
9.
Asian J Surg ; 28(4): 295-6, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16234083

ABSTRACT

Foreign body perforation of Meckel's diverticulum is a very rare event. We report two cases of fish bone perforation of Meckel's diverticulum that presented within 5 days of each other. Both patients presented with acute abdomen and were initially suspected to have acute appendicitis. The diagnosis was only made at surgery when the appendix was found to be normal and Meckel's diverticulum was found to be inflamed and perforated by a fish bone. Both cases were treated successfully with Meckel's diverticulectomy.


Subject(s)
Foreign Bodies/complications , Meckel Diverticulum/complications , Adult , Animals , Bone and Bones , Female , Fishes , Humans , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Meckel Diverticulum/surgery
10.
Surg Laparosc Endosc Percutan Tech ; 13(3): 168-72, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12819500

ABSTRACT

Beta-thalassemia, which results from a reduced production of beta-globin chain of hemoglobin, is a common single gene disorder with an extremely heterogeneous clinical picture. Its presentation may vary from mild anemia in beta-thalassemia minor to severe and life-threatening anemia in beta-thalassemia major. Recent advances in supportive treatment of beta-thalassemia major have resulted in substantial increase in survival in these patients, and an increasing number of these patients reach adolescence and adulthood. The incidence of cholelithiasis is reported to be increased in these patients. Although laparoscopic cholecystectomy (LC) has become the gold standard treatment of symptomatic gallstone disease, its experience in adult beta-thalassemic patients has been limited. From May 1992 through April 2000, 10 consecutive adult beta-thalassemic patients with symptomatic gallstone underwent LC at our institution. Data were obtained on the type of beta-thalassemia, presentation, preoperative laboratory findings, history of preoperative transfusion, postoperative complications, postoperative analgesic requirement, length of hospital stay, and follow-up. All operations were completed laparoscopically. The mean operative time was 98.5 minutes. The postoperative analgesic requirement was minimal. There was no mortality. One patient developed fever postoperatively due to lung atelectasis that was managed conservatively. The mean hospital stay was 3 days. Laparoscopic cholecystectomy is feasible, safe, and effective in the treatment of adult beta-thalassemic patients with symptomatic gallstone disease. Technical adjustments are required when operating on patients with beta-thalassemia major.


Subject(s)
Cholecystectomy, Laparoscopic/adverse effects , Cholecystectomy, Laparoscopic/methods , Cholelithiasis/etiology , Cholelithiasis/surgery , Outcome Assessment, Health Care , Postoperative Complications , beta-Thalassemia/complications , beta-Thalassemia/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Length of Stay , Male , Middle Aged , Retrospective Studies , Time Factors
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