A case report of hepatic angiomyolipoma, inflammatory subtype. Clinico-pathological characterization: a diagnostic challenge.

BACKGROUND: Angiomyolipoma is a benign mesenchymal neoplasm of a wide histological heterogeneity belonging to the PEComa "family." The liver, after the kidney, is their second most frequent location. However, inflammatory hepatic AMLs constitute a rare entity, with only fourteen documented cases until 2020. These neoplasms can overlap morphological features of IgG4-related diseases, being of great diagnostic relevance to demonstrating myomelanocytic-lineage differentiation of the neoplastic cells. CASE PRESENTATION: we present a new case of an inflammatory hepatic AML resembling an IgG4-related disease in a 35-year-old woman with a subcapsular 5 cm mass confined to segment VII of the right hepatic lobe. Although having reduced its size along the tumor's natural evolution, complete tumor resection was decided due to its hypermetabolic behavior (max. SUV = 12,6) assessed by PET-CT scan. Finally, the patient underwent a right hepatectomy due to spontaneous rupture and bleeding of the lesion during the intervention. All the diagnostic and therapeutic procedures occurred in the last months of the COVID-19 pandemic. CONCLUSIONS: This review aims to describe inflammatory hepatic AML histological and immunohistochemical features. We further sought to establish a clinicopathological contextualization of this tumoral subtype.

Bile reflux and marginal ulcers after one-anastomosis gastric bypass (OAGB). A narrative review.

One-anastomosis gastric bypass has now become the third most commonly performed bariatric technique worldwide. However, as a consequence of the configuration of this surgery, it can present some chronic complications (anastomotic mouth ulcers and biliary reflux) that physicians must come to better understand and assess. In this narrative review, we aimed to update our knowledge of both the diagnosis and treatment of these two complications in the context of bariatric surgeries. We concluded that a series of pre-, intra-, and postoperative preventive strategies should be considered by surgeons to help reduce the appearance of these complications.

Evolution of two unusual radiological findings in a patient with mesenteric ischemia.

Portal pneumatosis has been considered an ominous sign associated with intestinal ischemia, with a mortality rate of up to 90% as long as it is associated with sepsis. However, the prognosis of mesenteric ischemia depends on the etiology rather than the presence of portal pneumatosis. We present a patient with portal pneumatosis that disappeared 24 hours after the first surgery, but irreversible ischemic lesions were established in the terminal ileum. It should be noted that the excretion of the intravenous contrast is mainly through the kidneys, and it can be eliminated through alternative routes such as the bile duct or the mucosa of the small intestine (vicariant excretion), especially in patients with renal pathology.

Peritoneal tuberculosis mimicking colonic carcinomatosis.

Pulmonary Tuberculosis (TB) has increased in Spain in recent years due to multiple factors. Peritoneal tuberculosis represents the sixth cause of extrapulmonary tuberculosis, accounting for 11% of tuberculosis cases. We report a 28-year-old male from Mali, who arrived at our hospital with an acute abdomen due to intestinal perforation with a computed tomography scan (CT) performed peritoneal tuberculosis mimicking primary carcinomatosis. This presents a diagnostic and therapeutic challenge, since the surgical approach differs in both cases, and the prognosis is very different between them.

Epithelioid angiomyolipoma of the liver: an incidental diagnosis.

We present the exceptional case of a 76-year-old woman with an incidental finding of a liver tumor compatible with an epithelioid angiomyolipoma, a rare neoformation about which there is still controversy regarding its management, due to its presumed potential for malignancy.

Giant cavernous mesenteric lymphangioma in an adult.

We report the exceptional case of a 71-year-old patient with a giant mesenteric mass causing mass effect, dyspnea and abdominal pain. After surgical resection and histopathological analysis of the specimen, the result was a cavernous lymphangioma, an unusual diagnosis due to both the location and age of presentation.

Myolipoma of the round ligament of the liver: a diagnosis to be considered.

A 39-year-old patient consulted for an incidental finding of a mesenteric-epiploic mass measuring 11x6x9.5 cm. Laparoscopic excision of the lesion and cholecystectomy were indicated, revealing a myolipomatous mesenchymal neoplasm in the hepatic round ligament.

Surgical indication for right hemicolectomy in goblet cell adenocarcinoma of the appendix.

We have read with interest the article by Pérez Montiel CA et al., in which goblet cell adenocarcinoma (GCA) is described as a cause of acute appendicitis. Although the article is brilliant in terms of histopathological description of the appendiceal GCA, the surgical indication for right hemicolectomy should be analyzed in depth due to the great controversy that exists in the scientific literature.

Giant cystic hepatocarcinoma in the absence of cirrhosis.

The diagnosis of hepatocellular carcinoma (HCC) became easier in relation to the improved radiological examinations; however, the neoplasm may occur under atypical presentations mimicking other benign or malignant processes. Several mechanisms for the cystic changes of HCC have been suggested, including arterial thrombosis, inflammation, and rapid tumor growth. This paper reports an uncommon case of a 74-year-old patient, who presented with pain in the upper right abdomen and large cystic mass involving right lobe of the liver. He was diagnosed as cystic HCC, in the absence of cirrhosis, after surgery.