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1.
Medicine (Baltimore) ; 99(3): e18797, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011482

RESUMO

RATIONALE: Schwannomas are neoplasms that originate from Schwann cells of the peripheral nerve sheath with a low malignant potential. Considering that Schwannomas often occur in the upper extremities, trunk, head, and neck, but in the hepatoduodenal ligament has seldom been reported. PATIENT CONCERNS: A 70-year-old man was referred to our hospital for further evaluation of distension in upper abdomen. Abdominal ultrasonography reported that an anechoic mass was found between the pancreatic head and portal vein, which was measured to be about 5.5 × 4 × 4 cm. No blood flow signal was found within the mass by color doppler ultrasound. Subsequently, abdominal contrast enhanced computed tomography revealed that a well-defined round soft-tissue was above the pancreatic head and adjacent to the common heapatic artery, and it had no obvious enhancement in the arterial phase and portal phase. DIAGNOSES: Schwannomas in the hepatoduodenal ligament. INTERVENTIONS: After the work-up of a multidisciplinary team, a right complete excision was carried out and schwannoma was diagnosed by pathology. OUTCOMES: The patient's postoperative course was uneventful, and he left the hospital 10 days after the operation. Additionally, at the time of writing, recurrence was not observed with a follow-up of 17 months. LESSONS: schwannomas in the hepatoduodenal ligament are extremely rare with benign behavior. Surgical resection is the gateway to cure it; however, accurate preoperative diagnosis of the schwannomas in the hepatoduodenal ligament is a huge challenge because neither the clinical symptoms nor the imaging manifestations are specific.


Assuntos
Neurilemoma/diagnóstico , Neurilemoma/cirurgia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/cirurgia , Idoso , Duodeno , Humanos , Fígado , Masculino , Neurilemoma/patologia , Neoplasias Peritoneais/patologia
2.
PLoS One ; 15(1): e0225958, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31940352

RESUMO

BACKGROUND: Peritoneal recurrence is one of the most frequent recurrent diseases in gastric cancer. Although the exposure of cancer cells to the serosal surface is considered a common risk factor for peritoneal recurrence, there are some cases of peritoneal recurrence without infiltration to the serosal surface even after curative surgery. This study sought to clarify the risk factors of peritoneal recurrence in the absence of invasion to the serosal surface. MATERIALS AND METHODS: Ninety-six patients with gastric cancer who underwent curative surgery were enrolled. In all 96 cases, the depth of tumor invasion was subserosal (T3). The microscopic distance from the tumor invasion front to the serosa (DIFS) was measured using tissue slides by H&E staining and pan-cytokeratin staining. E-cadherin expression was evaluated by immunohistochemical staining. RESULTS: Among the 96 patients, 16 developed peritoneal recurrence after curative surgery. The DIFS of the tumors with peritoneal recurrence (156±220 µm) was significantly shorter (p = 0.011) than that without peritoneal recurrence (360±478 µm). Peritoneal recurrence was significantly correlated with DIFS ≤234 µm (p = 0.023), but not with E-cadherin expression. The prognosis of DIFS ≤234 µm was significantly poorer than that of DIFS >234 µm (log rank, p = 0.007). A multivariate analysis of the patients' five-year overall survival revealed that DIFS ≤234 µm and lymph node metastasis were significantly correlated with survival (p = 0.005, p = 0.032, respectively). CONCLUSION: The measurement of the DIFS might be useful for the prediction of peritoneal recurrence in T3-gastric cancer patients after curative surgery.


Assuntos
Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Membrana Serosa/patologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Idoso , Caderinas/metabolismo , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Recidiva , Fatores de Risco , Neoplasias Gástricas/metabolismo , Análise de Sobrevida
3.
Tumori ; 106(1): 70-78, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31469058

RESUMO

BACKGROUND: Patients with intestinal cancer (colorectal, appendiceal, and small bowel) with peritoneal metastases (PM) have a poor prognosis. We assessed whether pressurized intraperitoneal aerosol chemotherapy (PIPAC) together with systemic chemotherapy is an effective treatment option for these entities in palliative intent. METHODS: Between November 2015 and February 2018, prospective data registry was performed (NCT03100708). Thirteen patients with intestinal cancer (median age 61 years [range 49-77]) underwent 26 PIPAC procedures with a median number of 2 interventions per patient (range 1-6). A chemoaerosol consisting of cisplatin/doxorubicin was administered during standard laparoscopy. RESULTS: The median peritoneal carcinomatosis index according to Sugarbaker before the first PIPAC was 14 (range 2-27), and the median ascites volume was 10 mL (range 0-6300 mL). Six patients who received 2 or more PIPAC procedures had decreased and stable ascites volumes, while only 1 patient displayed increased ascites. The median overall survival was 303 days (range 30-490) after the first PIPAC procedure. CONCLUSIONS: PIPAC offers a novel treatment option for patients with PM. Our data show that PIPAC is safe and well-tolerated. Ascites production can be controlled by PIPAC in patients with intestinal cancer. Further studies are required to document the significance of PIPAC within palliative therapy concepts. TRIAL REGISTRATION: NCT03100708.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Intestinais/patologia , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/terapia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Terapia Combinada , Feminino , Hospitalização , Humanos , Infusões Parenterais , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/mortalidade , Prognóstico , Retratamento , Resultado do Tratamento
5.
J Surg Oncol ; 120(8): 1350-1357, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31612494

RESUMO

BACKGROUND: Guidelines for gastric and gastroesophageal (GE) cancer recommend staging laparoscopy (SL) with peritoneal cytology (PC). However, the reliability of PC is unknown. The primary purpose of this study was to determine the sensitivity of PC. METHODS: We analyzed a prospectively maintained database of patients who underwent SL and PC for gastric and GE cancer. Test sensitivity of PC for detecting peritoneal disease was assessed. Survival analyses were used to examine the implication of PC. RESULTS: There were 1186 patients that underwent SL and PC; 282 (24%) were found with carcinomatosis. PC was analyzed in 214 (76%) of these patients and 77 (36%) were found to have no malignant cells. In this setting, PC had a sensitivity of 64% for confirming peritoneal disease. Those with peritoneal disease had a poorer 5-year overall survival (5.8% vs 37.7%; P < .001). Those with positive PC without carcinomatosis had a similar survival to those with gross disease with and without cytological confirmation (both P > .05). CONCLUSIONS: PC has limited sensitivity for detecting peritoneal disease. Positive PC alone carries a similar poor survival as in patients with gross carcinomatosis. Improvements in the identification of microscopic disease in peritoneal washings are needed.


Assuntos
Neoplasias Esofágicas/patologia , Estadiamento de Neoplasias/métodos , Lavagem Peritoneal , Peritônio/patologia , Neoplasias Gástricas/patologia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Neoplasias Esofágicas/mortalidade , Feminino , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico , Neoplasias Gástricas/mortalidade
7.
Dis Colon Rectum ; 62(10): 1195-1203, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31490828

RESUMO

BACKGROUND: Colorectal cancer is the second leading cause of cancer-related mortality worldwide. Peritoneal metastases carry the worst prognosis among all sites of colorectal cancer metastases. In recent years, the advent and acceptance of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have greatly improved survival for selected patients with low-volume peritoneal metastases. OBJECTIVE: Here, we report the evolution of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases at a statewide tertiary referral center over an 8-year period. DESIGN: This is a retrospective study from 2009 to 2017. SETTING: The study was conducted at a single center over 8 years. PATIENTS: Patients with colorectal peritoneal metastases undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were included. MAIN OUTCOMES: Main outcomes included evaluation of grade III/IV morbidity rate, mortality rate, overall and relapse-free survival, and prognostic factors influencing survival on a Cox multivariate analysis model. RESULTS: One hundred one cytoreductive surgeries were undertaken on 96 patients during this time for colorectal peritoneal metastases. The median patient age was 60 years with 55.2% being female. The median Peritoneal Carcinomatosis Index was 9, with complete cytoreduction achieved in 76 (75.2%) cases. Grade III or IV complications occurred in 26 cases (25.7%) with 2 (2%) perioperative mortalities. Median overall survival for the entire cohort was 32 months, with a 3-year survival of 38%. For patients who achieved a complete cytoreduction, median overall survival was 37 months, with a relapse-free survival of 13 months and a 3-year survival of 54%. Complete cytoreduction and nonmucinous histology were key factors independently associated with improved overall survival. LIMITATIONS: The main limitation this study is its retrospective nature. CONCLUSION: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for isolated low-volume colorectal peritoneal metastases is safe and effective, with low morbidity. It offers selected patients a highly favorable overall and relapse-free survival. See Video Abstract at http://links.lww.com/DCR/B2. EVOLUCIÓN DE LA CIRUGÍA CITORREDUCTIVA Y QUIMIOTERAPIA INTRAPERITONEAL HIPERTÉRMICA (HIPEC) PARA METÁSTASIS PERITONEALES COLORRECTALES: EXPERIENCIA INSTITUCIONAL DE 8 AÑOS: El cáncer colorrectal es la segunda causa de mortalidad relacionada con el cáncer en todo el mundo. Las metástasis peritoneales tienen el peor pronóstico entre todos los sitios de metástasis del cáncer colorrectal. En los últimos años, el advenimiento y la aceptación de la cirugía citorreductiva y la quimioterapia intraperitoneal hipertérmica ha mejorado enormemente la supervivencia de pacientes seleccionados con metástasis peritoneales de bajo volumen. OBJETIVO: Aquí, informamos sobre la evolución de la cirugía citorreductiva y la quimioterapia intraperitoneal hipertérmica para las metástasis peritoneales colorrectales en un centro de referencia terciario para todo el estado durante un período de ocho años. DISEÑO:: Estudio retrospectivo del 2009 a 2017. CONFIGURACIÓN:: Centro único a lo largo de ocho años. PACIENTES: Pacientes con metástasis peritoneales colorrectales sometidos a cirugía citorreductiva y quimioterapia intraperitoneal hipertérmica. RESULTADOS PRINCIPALES: Los resultados principales incluyeron la evaluación de la tasa de morbilidad de grado III / IV, la tasa de mortalidad, la supervivencia general y libre de recaída y los factores pronósticos que influyen en la supervivencia en el modelo de análisis multivariado Cox. RESULTADOS: Se realizaron el ciento uno cirugías citorreductivas en noventa y seis pacientes durante este tiempo por metástasis peritoneales colorrectales. La edad media de los pacientes fue de 60 años, con un 55.2% de mujeres. El Índice de Carcinomatosis Peritoneal mediano fue de 9, con una citorreducción completa lograda en 76 (75.2%) casos. Las complicaciones de grado III o IV ocurrieron en 26 casos (25.7%) con dos (2%) de mortalidad perioperatoria. La supervivencia mediana general para toda la cohorte fue de 32 meses, con una supervivencia de 3 años del 38%. Para los pacientes que lograron una citorreducción completa, la supervivencia global media fue de 37 meses, con una supervivencia sin recaída de 13 meses y una supervivencia de 3 años del 54%. La citorreducción completa y la histología no mucinosa fueron factores clave asociados de forma independiente con una mejor supervivencia general. LIMITACIONES: La principal limitación es la naturaleza retrospectiva del estudio. CONCLUSIÓN:: La cirugía citorreductiva y la quimioterapia intraperitoneal hipertérmica para las metástasis peritoneales colorrectales aisladas de bajo volumen son seguras y eficaces, con baja morbilidad. Ofrece a los pacientes seleccionados una supervivencia global altamente favorable y libre de recaída. Vea el Resumen del video en http://links.lww.com/DCR/B2.


Assuntos
Neoplasias Colorretais/terapia , Hipertermia Induzida/métodos , Estadiamento de Neoplasias/métodos , Neoplasias Peritoneais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Procedimentos Cirúrgicos de Citorredução , Feminino , Seguimentos , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/secundário , Peritônio/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Fatores de Tempo , Vitória/epidemiologia
8.
Zhonghua Wai Ke Za Zhi ; 57(9): 666-672, 2019 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-31474058

RESUMO

Objective: To analyze the status of domestic surgical treatment of synchronous peritoneal carcinomatosis from colorectal cancer in China. Methods: Clinicopathological data of patients who underwent surgery from October 2003 to October 2018 in 16 domestic medical centers was retrospectively analyzed. Excel database was created which covered 77 fields of 7 parts: baseline information of patients, laboratory tests, imaging tests, chemoradiotherapy information, intra-operative findings, postoperative pathology and follow-up data. The Wilcoxon rank-sum test was used for comparison of the measurement data between groups. The χ(2) test was used for comparison of the categorical data between groups. The survival curve was calculated by the Kaplan-Meier method. Results: Of the 1 003 patients, there were 575 male and 428 female patients with the age of (58.5±14.1) years (range: 18 to 92 years). In a total of 920 patients, the carcinoma of sigmoid colon was performed in 292 cases (31.8%) with the highest ratio. The proportion of patients with liver metastasis and lung metastasis were 27.9% (219/784) and 8.3% (64/769). Preoperative detection of carcino-embryonic antigen level was the most common method in China (87.74%, 880/1 003), and the positive rate was 64.5% (568/880). The correct rate of preoperative imaging tests was 40.7% (280/688). The ratio of peritoneal carcinomatosis index (PCI) scores between 0 and 10 was the highest (59.6%, 170/285). Two hundred and sixty-two (27.0%) patients were performed by totally laparoscopic operation in 971 patients. The resection of primary tumor was performed in 588 of the 817 patients (72.0%). In a total of 457 cases, 253 (55.4%) patients were performed cytoreduction which group scored completeness of cytoreduction (CCR) 0. The postoperative hyperthermic intraperitoneal chemotherapy was implemented in 70 of the 334 cases (21.0%). Among 1 003 cases, 562 cases (56.03%) had complete follow-up data and the median overall survival was 15 months. The primary tumor resection and the CCR scores were affected by the PCI scores. The patients underwent primary tumor resection (187/205 vs. 26/80, χ(2)=105.085, P=0.000) and the patients were performed cytoreduction which scored CCR 0 or CCR 1 (162/204 vs. 8/78, Z=-10.465, P=0.000) had significant difference between the groups of PCI<20 and ≥20. There was a close correlation between the surgical method and the CCR scores (Z=-3.246,P=0.001).When the maximum degree of tumor reduction was planned, most surgeons would choose laparotomy. The overall survival time was longer in patients with primary tumor resection (P=0.000). The median survival time was 18.6 months in the group of primary tumor resection. Conclusions: It is difficult to diagnose the synchronous peritoneal carcinomatosis from colorectal cancer before the operation. Primary tumor resection has an obvious effect to prolong the survival time. It is necessary to standardize the treatment of peritoneal metastasis.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/terapia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , China , Neoplasias Colorretais/terapia , Terapia Combinada , Procedimentos Cirúrgicos de Citorredução , Feminino , Humanos , Hipertermia Induzida , Laparoscopia , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/secundário , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
9.
Mymensingh Med J ; 28(3): 681-684, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31391444

RESUMO

Fibromatosis of mesentery is a very rare disease and only a few cases have been reported. Here we report a case of 40 year old man admitted on 16 October, 2017 in the Department of Surgery (Unit-3) of Mymensingh Medical College Hospital with history of recurrent abdominal pain and progressively enlarging intra-abdominal lump for 2 years. Out of different diagnostic dilemmas, finally we came to the conclusion of its being a mass lesion primarily arising from the mesentery and involving the adjoining gut according to the report of CT abdomen. Laparotomy was performed and a lump measuring about 18 cm × 20 cm arising from mesentery was found, in which distal part of jejunum and proximal part of ileum were embedded. The mass was excised with incorporated gut loops and histopathology report revealed fibromatosis of mesentery.


Assuntos
Fibromatose Abdominal , Neoplasias Peritoneais , Dor Abdominal/etiologia , Adulto , Fibromatose Abdominal/complicações , Fibromatose Abdominal/diagnóstico , Humanos , Masculino , Mesentério , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/diagnóstico
10.
BMJ Case Rep ; 12(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31413062

RESUMO

Peritoneal lymphomatosis represents a rare presentation of any type of non-Hodgkin's lymphoma, with relatively few cases reported in the literature. We present here the case of a 61-year-old man who originally presented with increased abdominal distention associated with shortness of breath and diaphoresis who was found to have evidence of peritoneal carcinomatosis on CT scan. Biopsy confirmed diffuse large B-cell lymphoma, and the working diagnosis was subsequently modified to peritoneal lymphomatosis. The patient was treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab (DA-EPOCH-R) therapy with initially good response. His course was complicated by tumour lysis syndrome. We review the limited literature discussing peritoneal lymphomatosis and discuss the importance of facilitating rapid and efficacious treatment.


Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica , Diabetes Mellitus Tipo 2 , Diagnóstico Diferencial , Evolução Fatal , Humanos , Hipertensão , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/patologia , Tomografia Computadorizada por Raios X
11.
BMJ Case Rep ; 12(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31420427

RESUMO

Acute abdominal pain is a common symptom in young women. We describe a patient with acute illness and severe lower abdominal pain. Laboratory tests were normal except for mildly deranged inflammatory markers. No abnormalities were reported on abdominal ultrasonography and MRI, whereas diagnostic laparoscopy revealed a tumour located dorsally from the uterus. We resected the tumour and pathology results showed a well-differentiated papillary mesothelioma of the peritoneum (WDPMP). Microscopy showed evidence of acute ischaemia in the resected lesion, which was likely the cause of the acute abdominal pain. WDPMP is a rare disease that arises from the serous membranes which does not seem to have a relation to asbestos exposure. Generally, WDPMP has a mild clinical course and good long-term prognosis.


Assuntos
Dor Abdominal/diagnóstico , Dor Aguda/diagnóstico , Mesotelioma/diagnóstico , Neoplasias Peritoneais/diagnóstico , Dor Abdominal/etiologia , Dor Aguda/etiologia , Adulto , Feminino , Humanos , Mesotelioma/complicações , Neoplasias Peritoneais/complicações
12.
BMJ Case Rep ; 12(8)2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31409619

RESUMO

Fetus in fetu (FIF) is an extremely rare condition in which malformed fetus is found most commonly in the retroperitoneum of living twin. It occurs in about 1 in 500 000 live births and less than 200 cases have been reported in medical literature. We report FIF in a 17-year-old woman unlike other cases which were usually detected in early age and in male gender. This is the eighth case of adult FIF and the first case of FIF in adult woman worldwide. Preoperative diagnosis of FIF on CT was made and planned for exploratory laparotomy. The excised malformed fetus in a sac was proven as FIF on the basis of histopathological examination. In view to avoid such late presentation, early detection of FIF with radiological imaging in clinically suspected case is recommended. Surgical excision is the ideal treatment even teratoma is the differential diagnosis.


Assuntos
Feto/anormalidades , Neoplasias Peritoneais/diagnóstico , Teratoma/diagnóstico , Adolescente , Diagnóstico Diferencial , Feminino , Humanos , Espaço Retroperitoneal
13.
Surgery ; 166(6): 997-1003, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31445763

RESUMO

BACKGROUND: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry-based study was to clarify the clinical implications of operative resection in patients who had positive cytology status. METHODS: Clinical data from 1,970 patients who underwent tumor resection were collected from the Pancreatic Cancer Registry in Japan. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated. RESULTS: Among the 1,970 patients analyzed, positive cytology status was found in 106 patients and negative cytology status was found in 1,864 patients. The positive cytology status group had a greater frequency of pancreatic body and tail cancer and greater preoperative serum carbohydrate antigen 19-9 levels than the negative cytology status group (P < .001 each). The ratio of peritoneal recurrence tended to be greater in the positive cytology status group (14% vs 43%; P < .001). Overall median survival times were less in the positive cytology status group (17.5 months vs 29.4 months; P < .001). The 5-year survival rates were 13.7% and 31.1% in the positive cytology status and negative cytology status groups, respectively. Multivariate analysis of positive cytology status patients revealed that adjuvant chemotherapy was an independent prognostic factor. CONCLUSION: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection. Curative resection followed by adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytology status.


Assuntos
Carcinoma Ductal Pancreático/terapia , Recidiva Local de Neoplasia/diagnóstico , Pancreatectomia , Neoplasias Pancreáticas/terapia , Lavagem Peritoneal/estatística & dados numéricos , Neoplasias Peritoneais/diagnóstico , Idoso , Carcinoma Ductal Pancreático/mortalidade , Carcinoma Ductal Pancreático/secundário , Quimioterapia Adjuvante/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/secundário , Peritônio/patologia , Prognóstico , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Taxa de Sobrevida
14.
Ethiop J Health Sci ; 29(4): 529-532, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447527

RESUMO

Background: A lipoma of the small bowel mesentery is a rare clinical entity. It rarely causes intestinal obstruction mainly due to volvulus. Case: We report a case of a 25 years old male who presented with acute exacerbation of abdominal pain, nausea and vomiting. Plain abdominal x-ray showed complete small bowel obstruction. At laparotomy, there was small bowel volvulus with a big yellow mass as an axis. Enbloc resection and end-to-end ileal anastomosis was done. Conclusion: Mesenteric lipoma are rare. They should be considered in cases of long standing abdominal pain.


Assuntos
Volvo Intestinal/etiologia , Lipoma/complicações , Mesentério , Neoplasias Peritoneais/complicações , Dor Abdominal/etiologia , Adulto , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Obstrução Intestinal/patologia , Obstrução Intestinal/cirurgia , Volvo Intestinal/diagnóstico , Volvo Intestinal/patologia , Volvo Intestinal/cirurgia , Lipoma/diagnóstico , Lipoma/patologia , Lipoma/cirurgia , Masculino , Mesentério/patologia , Mesentério/cirurgia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia
15.
Tokai J Exp Clin Med ; 44(3): 49-53, 2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31448396

RESUMO

BACKGROUND: Peritoneal serous papillary carcinoma (PSPC) is a rare disease. It is clinically and histologically similar to progressive ovarian serous adenocarcinoma and involves normal-sized ovaries, making it challenging to diagnose. In this report, we describe a case of peritoneal serous papillary carcinoma that was difficult to identify and how we made a correct diagnosis in order to begin a timely course of treatment. CASE PRESENTATION: A 63-year-old woman with chief complaints of dizziness and abdominal pain was examined, but showed no particular abnormality. Class III cytology of the endometrium was detected through magnetic resonance imaging and a laparotomy was performed on suspicion of endometrial cancer. The patient was finally diagnosed with peritoneal serous papillary carcinoma and was treated with surgical resection and the standard indicated course of chemotherapy. CONCLUSIONS: The diagnosis and treatment of peritoneal serous papillary carcinoma may be delayed or may not be performed unless Class III findings are detected through uterine mucosal cytology before surgery. Surgeons should not hesitate to perform laparotomy when necessary to identify and appropriately treat patients, even if abnormalities are not detected in the preoperative examination.


Assuntos
Cistadenocarcinoma Papilar/diagnóstico , Cistadenocarcinoma Seroso/diagnóstico , Cistadenocarcinoma Seroso/patologia , Neoplasias Peritoneais/diagnóstico , Quimioterapia Adjuvante , Cistadenocarcinoma Papilar/patologia , Cistadenocarcinoma Papilar/cirurgia , Cistadenocarcinoma Seroso/cirurgia , Citodiagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Laparotomia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Ovarianas , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia
16.
BMJ Case Rep ; 12(5)2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31154350

RESUMO

A 23-year-old man presented to the emergency department with a history of recurrent episodes of subacute intestinal obstruction. Palpation revealed a firm, non-tender, mobile, non-pulsatile mass of size 8-10 cm with indistinct margins and smooth surface in the hypogastrium. Contrast-enhanced CT scan of the abdomen showed clumping of the small bowel loops within a well-defined membrane-like structure without dilatation or thickening of bowel loops. The patient underwent a laparotomy with incision of the membrane and separation of all the small bowel loops inside the cocoon. Abdominal cocoon is the idiopathic variety of sclerosing encapsulating peritonitis and is an unusual cause of acute or subacute intestinal obstruction. Clinical diagnosis is difficult because of non-specific symptoms. CT has facilitated accurate preoperative diagnosis, long before the patient presents with full-fledged symptoms of acute intestinal obstruction. CT scan plays a significant role in excluding the secondary causes and helps in patient management.


Assuntos
Adenocarcinoma/diagnóstico , Obstrução Intestinal/diagnóstico , Neoplasias Peritoneais/diagnóstico , Dor Abdominal/etiologia , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Obstrução Intestinal/complicações , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Laparoscopia , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/cirurgia , Período Pré-Operatório , Tomografia Computadorizada por Raios X
17.
Gan To Kagaku Ryoho ; 46(4): 769-771, 2019 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-31164530

RESUMO

Leiomyosarcoma of the mesocolon is a very rare disease. Previously, there was no recommendation for chemotherapy or radiotherapy for leiomyosarcoma of the mesocolon, and only surgical resection reportedly offers a chance for cure. However, the reported cases of leiomyosarcoma of the mesocolon were not distinguished from those of gastrointestinal stromal tumor (GIST), which is the same mesenchymal tumor; thus, there is a possibility that they include cases that should be diagnosed as GIST. We report a case of leiomyosarcoma of the sigmoidal mesocolon.


Assuntos
Tumores do Estroma Gastrointestinal , Leiomiossarcoma , Mesocolo , Neoplasias Peritoneais , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/cirurgia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/cirurgia
18.
J Dermatol ; 46(8): 720-723, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31206216

RESUMO

A 61-year-old Japanese man had a gradually growing, red-colored nodule in his umbilicus from 3 years ago. He had no symptoms such as hot flush, diarrhea or wheezing. Computed tomography detected a 3.0 cm × 3.0 cm enhanced nodule on the umbilical portion, inguinal and axillary lymph node swelling, and peritoneal nodules. Upper and lower gastrointestinal endoscopy and cystoscopy did not show any other tumor. We resected the umbilical nodule and subjected the inguinal lymph node and peritoneal nodule to biopsy. Histopathological findings indicated that the cutaneous lesion was composed of variously sized nests that included small, monomorphic, round to polygonal cells, mainly in the dermis to the peritoneum. Mitotic figures were scant. The inguinal lymph node and peritoneal nodule were positive for metastasis. Immunohistochemistry was diffusely positive for cytokeratin (CK)-7, CD56, chromogranin A, synaptophysin, estrogen receptor-α, progesterone receptor, GATA3 and carcinoembryonic antigen, and focally positive for mammaglobin and gross cystic disease fluid protein 15. The Ki-67 labeling index was 1.5%. The patient was diagnosed with a case of low-grade neuroendocrine carcinoma of the skin (LGNECS) occurring on the umbilicus. This case exhibited distant peritoneal metastasis, as well as inguinal and axillary lymph node metastases; however, the patient is alive without chemotherapy at 23 months after the first visit. LGNECS is a newly proposed, extremely rare entity that has been reported under various names, including primary cutaneous carcinoid tumor. In the present case, this tumor shows a slow-growing nature and favorable prognosis, even though it harbors metastatic potential.


Assuntos
Carcinoma Neuroendócrino/diagnóstico , Metástase Linfática/diagnóstico , Neoplasias Peritoneais/diagnóstico , Neoplasias Cutâneas/patologia , Biópsia , Carcinoma Neuroendócrino/secundário , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias Peritoneais/secundário , Peritônio/diagnóstico por imagem , Peritônio/patologia , Pele/patologia , Neoplasias Cutâneas/cirurgia , Umbigo
19.
Surg Oncol ; 29: 120-125, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31196475

RESUMO

BACKGROUND: Approximately 20% of initially eligible patients in a HIPEC procedure eventually underwent a simple surgical exploration. These procedures are called 'open & close' (O & C) representing up to 48% of surgery. The objective of this study was to predict the resecability of peritoneal carcinomatosis using a machine-learning model for decision-making support, for eligible patients of HIPEC. METHODS: The study was conducted as an intention to treat based on three databases including a prospective, between January 2000 and December 2015. A propensity score allowed us to obtain two groups of comparable and matched patients. Subsequently, several algorithm models of classification were studied (simple classification, conditional tree, support vector machine, random forest) to determine the model having the best performance and accuracy. RESULTS: Two groups of 155 patients were obtained: one group without resection and one group with resection. Nine criteria of non-resecability reflecting the organ involvement have been retained. They were coded according to their importance. Five classification algorithms were tested. The training data included 218 patients and 92 test data. The random forest model exhibited the best performance with an accuracy of close to 98%. Only two errors of predictions were observed. DISCUSSION: The largest number of patients will allow us to improve the precision prediction. Gathering more data such as biologic, radiologic, and even laparoscopic features, should improve the knowledge of the disease and decrease the number of 'O & C' procedures.


Assuntos
Procedimentos Cirúrgicos de Citorredução/estatística & dados numéricos , Técnicas de Apoio para a Decisão , Laparoscopia/estatística & dados numéricos , Aprendizado de Máquina , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Adulto Jovem
20.
World J Surg Oncol ; 17(1): 108, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238937

RESUMO

BACKGROUND: The use of staging laparoscopy (SL) has become widespread in patients with advanced gastric cancer (GC). This study aimed to evaluate the predictive value of the neutrophil/lymphocyte ratio (NLR) for the presence of peritoneal metastasis during staging laparoscopy in patients with advanced GC. METHODS: This retrospective analysis was performed in 35 patients with advanced GC who underwent SL at Kanazawa Medical University Hospital between January 2009 and December 2017. Clinicopathological characteristics were examined and multivariate analyses were performed to identify preoperative laboratory parameters that were independently associated with the presence of peritoneal metastasis or cytological malignancy (P/CY positive) during SL. RESULTS: A P/CY-positive result was confirmed during SL in 16 patients (45.7%). Patients with type 4 or diffuse type 3 tumors showed a significantly higher P/CY-positive rate than those with other tumor types (58.3% vs. 18.2%, P = 0.02). In the univariate analysis for preoperative laboratory parameters, NLR (P < 0.0001) and total protein (P = 0.03) and albumin (P = 0.04) levels were significantly correlated with a P/CY-positive result. On multivariate analysis, NLR was significantly correlated with a P/CY-positive result (P = 0.0002). In patients with type 4 or diffuse type 3 tumors, a high NLR (> 3.5) was associated with a significantly higher P/CY-positive rate than a low NLR (≤ 3.5) (83.3% vs. 33.3%, P = 0.01). Moreover, in patients without type 4 or diffuse type 3 tumors, the P/CY-positive rates were 100% and 0% in patients with NLR > 3.5 and NLR ≤ 3.5, respectively. CONCLUSIONS: The preoperative NLR was a significant independent predictor of the presence of peritoneal metastasis during SL. Regardless of tumor type, patients with a high NLR could be reasonable candidates for SL. On the other hand, non-diffuse type tumor accompanied by a low NLR may not need to undergo SL.


Assuntos
Laparoscopia/métodos , Linfócitos , Neutrófilos , Neoplasias Peritoneais/diagnóstico , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Peritoneais/sangue , Neoplasias Peritoneais/secundário , Peritônio/diagnóstico por imagem , Valor Preditivo dos Testes , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/sangue
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