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Int J Surg Case Rep ; 8C: 107-10, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25651538


BACKGROUND: We report an adnexal lesion, which turned out to be a metastasis to the scalp from a left sided follicular variant papillary thyroid cancer. The patient has had history of right multi-nodular goiter 10 years prior to presentation. CASE PRESENTATION: A 75-year old lady presented with a cutaneous lesion about 1 year post left total thyroidectomy for FVPTC. She underwent surgical excision of the lesion and histology revealed it to be metastases from a thyroid carcinoma. DISCUSSION: Cutaneous metastases from thyroid carcinomas are relatively uncommon in clinical practice. A worldwide literature review reveals that follicular carcinoma has a greater preponderance than papillary carcinoma for cutaneous metastasis and that the majority of skin metastases from either papillary or follicular thyroid cancer are localized to the head and neck, with the scalp as the commonest site. CONCLUSION: Skin metastasis from papillary and follicular thyroid carcinoma is an uncommon occurrence and these lesions should be differentiated from primary skin tumors. They are very important to recognize as early recognition can lead to accurate and prompt diagnosis leading to timely treatment. The scalp has been found to be the commonest site of cutaneous metastasis that may appear benign.

J Surg Case Rep ; 2014(11)2014 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-25433080


Horseshoe kidney (HSK) is a very common developmental abnormality in the kidney. They are associated with abnormalities like multiple renal arteries, abnormal position of the ureter in the renal pelvis and highly placed ureteropelvic junction. These can result in urological complications. However, the ureters run their separate course and empty individually into the urinary bladder. Surprisingly, anatomical anomalies do occur and can lead to unexpected findings on investigation or surgical treatment. Such anomalies can present diagnostic and management challenges to unsuspecting clinicians. This report deals with one of such anomalies that seem not to have been reported before in the literature. This case is a rare finding of fused ureters over the renal isthmus in a patient with HSK who also has aortic abdominal aneurysm (AAA). Simultaneous occurrences of HSK and AAA have been reported severally in the past, and the authors are paying attention on the ureteral anomaly.

J Surg Case Rep ; 2014(8)2014 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-25084790


A lump in the scrotum is a common presentation in most surgical clinics. However, myoepithelial tumours may not be up on the list of differentials. Although they may look benign, myoepithelial tumours are rare and have malignant potential. Treatment of these tumours involved total excision and adequate follow-up in cases of malignancy. These groups of tumours have not been reported in the scrotum in the past, but their occurrence in the vagina may not come as a surprise bearing in mind the embryonic origin of both organs.

JSLS ; 13(4): 581-6, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-20202401


OBJECTIVE: To analyze the preoperative factors contributing to the decision to convert laparoscopic to open cholecystectomy. METHODS: Retrospective identification of 324 consecutive patients undergoing laparoscopic cholecystectomy, with univariate and multivariate analysis of the following parameters: age, gender, obesity, previous abdominal surgery, presentation with acute cholecystitis, pancreatitis or obstructive jaundice, gallbladder wall thickening, gallbladder or common bile duct stones. RESULTS: Thirty-nine patients (12%) underwent conversion to open cholecystectomy. Patients aged over 65 years were four times more likely to require conversion than patients under 50 years of age. Under 50 years of age, males had equal conversion rates to females, and above this age there was a non-significant increased conversion rate in males. Obese patients had higher conversion rates than non-obese patients (23% versus 9%, P < 0.003). Thirty-eight percent of patients with choledocholithiasis required conversion. Age, acute cholecystitis and choledocholithiasis independently predicted conversion. A patient aged less than fifty years with neither acute cholecystitis nor choledocholithiasis had a conversion rate of just 2%, while almost 60% of those over 65 years of age with acute cholecystitis or choledocholithiasis required conversion. CONCLUSION: The parameters of age, acute cholecystitis and choledocholithiasis must be considered in the clinical decision making process when planning laparoscopic cholecystectomy.

Doenças Biliares/cirurgia , Colecistectomia Laparoscópica/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Biliares/diagnóstico , Distribuição de Qui-Quadrado , Colangiopancreatografia Retrógrada Endoscópica , Colangiopancreatografia por Ressonância Magnética , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento