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1.
Isr Med Assoc J ; 22(1): 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31927807

RESUMO

BACKGROUND: Primary retroperitoneal neoplasms (PRN) arise from diverse retroperitoneal tissues. Soft tissue sarcomas (STS) comprise the majority and are well studied. Other non-sarcomatous PRN are very rare and less familiar. OBJECTIVES: To evaluate the clinicopathologic and radiologic features of non-sarcomatous PRN, as well as the outcome of complete tumor resection (TR). METHODS: Retrospective data were collected on consecutive patients (June 2006 to January 2015) who underwent resection of retroperitoneal lesions at our department. Final pathology of non-sarcomatous PRN was included. RESULTS: The study population included 36 patients (26% with PRN). PRN were neurogenic (17%), fat-containing (3%), and cystic (6%). The preoperative diagnosis was correct in only 28%. All patients underwent TR via laparotomy (72%) or laparoscopy (28%), for mean operative time of 120 ± 46 minutes. En bloc organ resection was performed in 11%. Complete TR was achieved in 97%. Intra-operative spillage occurred in 8%. Intra-operative, 90-day postoperative complications, and mortality rates were 11%, 36%, and 0%, respectively. The mean length of stay was 6.5 ± 5.5 days. The median overall survival was 53 ± 4.9 months. CONCLUSIONS: Familiarity with radiologic characteristics of PRN is important for appropriate management. Counter to STS, other PRN are mostly benign and have an indolent course. Radical surgery is not required, as complete TR confers good prognosis. Expectant management is reserved for small, asymptomatic, benign neoplasms.


Assuntos
Neoplasias Retroperitoneais/diagnóstico , Idoso , Feminino , Ganglioneuroma/diagnóstico , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/patologia , Ganglioneuroma/cirurgia , Humanos , Lipoma/diagnóstico , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neurilemoma/cirurgia , Neurofibroma/diagnóstico , Neurofibroma/diagnóstico por imagem , Neurofibroma/patologia , Neurofibroma/cirurgia , Paraganglioma/diagnóstico , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
2.
Zhonghua Zhong Liu Za Zhi ; 41(12): 943-948, 2019 Dec 23.
Artigo em Chinês | MEDLINE | ID: mdl-31874553

RESUMO

Objective: To investigate the relevant prognostic factors of liposarcoma (LPS). Methods: The data of 78 patients with LPS treated in our hospital from July 2009 to March 2017 were reviewed. The 78 patients included 41 males and 37 females, and the average age was (60.5 ±13.4) years (ranged from 18 to 85 years). Among the 78 LPS patients, 27 were well-differentiated LPS, 13 were myxoid LPS, 35 were dedifferentiated LPS and 3 were pleomorphic LPS.The distribution of lesion location included 40 cases of extremities and 38 cases of retroperitoneal. 21 cases were treated with radical excision, 57 cases were treated with marginal resection. 7 patients were treated with postoperative radiotherapy and 9 patients with postoperative chemotherapy. Progression free survival (PFS) and overall survival (OS) of LPS patients were analyzed as clinical outcomes. Prognostic factors were analyzed by univariate and multivariate analyses. Results: 43 patients had local recurrence (9 of extremities/ 34 of retroperitoneal), 18 patients with metastasis (4 of extremities/ 14 of retroperitoneal). The 5-year PFS rate was 31.4% and 5-year OS rate was 44.3%. Univariate analysis showed that the histological subtype and the tumor location were related with PFS (P<0.05), while the histological subtype, the tumor location, the tumor size, the recurrence and metastasis were related with OS (P<0.05). Multivariate cox regression analysis showed that the tumor location was the independent prognostic factor of PFS (P<0.05), while the histological subtype and metastasis were the independent prognostic factors of OS (P<0.05). The median PFS of patients with myxoid LPS treated with radiotherapy was 34.6 months, which was significantly longer than 28.3 months of myxoid LPS patients without radiotherapy (P<0.05). Conclusions: The tumor location is an independent prognostic factor of PFS in LPS patients.Retroperitoneal LPS is more prone to relapse and metastasize. OS is affected by pathological subtype and metastasis. Radiotherapy can improve the PFS of patients with myxoid LPS.


Assuntos
Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Lipossarcoma/mortalidade , Lipossarcoma/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Prognóstico , Neoplasias Retroperitoneais/mortalidade , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
4.
Zhonghua Zhong Liu Za Zhi ; 41(10): 728-733, 2019 Oct 23.
Artigo em Chinês | MEDLINE | ID: mdl-31648493

RESUMO

The incidence of retroperitoneal tumor is low, and treatment is difficult.According to the recent updates of evidence-based medical evidence at home and abroad, the consensus on the standardized treatment of retroperitoneal tumors were discussed including examination and diagnosis , surgical treatment comprehensive treatment, nutrition, rehabilitation, and review and follow-up, etc.


Assuntos
Antineoplásicos/administração & dosagem , Consenso , Assistência à Saúde/normas , Guias de Prática Clínica como Assunto , Neoplasias Retroperitoneais/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , China , Humanos , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/patologia
5.
Zhonghua Zhong Liu Za Zhi ; 41(9): 703-707, 2019 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-31550862

RESUMO

Objective: To investigate the therapeutic effects of surgical management for local retroperitoneal recurrence of renal cell carcinoma after radical nephrectomy. Methods: Clinical and follow-up data of 33 cases of local recurrence after radical nephrectomy in Renji Hospital from January 2010 to April 2018 were retrospectively analyzed. Results: In these 33 patients, 25 was male and 8 was female; The median age was 54 years old. The pathological stage of radical nephrectomy included 14 cases of pT1-2N0M0 stage, 16 cases of pT3-4 N0M0 stage, and 3 cases of pN1 stage. Only 4 relapsing patients had symptoms, the others were all found to have recurrence by imaging examination during follow up period of postoperation.The median recurrence time for all patients was 30 months, and the median diameter of recurrent tumors was 4.5 cm.Twenty-nine patients underwent complete resection of local recurrent lesions, and 4 patients whose recurrent lesions could not be completely resected converted receive palliative surgery. The median intraoperative blood loss was 500 ml and the median hospital stay after surgery was 4 days. Clavien grade Ⅰ-Ⅱ complications occurred in 5 patients after surgery, and no serious complications of Clavien grade Ⅲ-Ⅴ complications occurred. Six patients received postoperative adjuvant target therapy and distant metastasis occurred in one patient.In the 27 patients without adjuvant target therapy, postoperative distant metastases occurred in 12 patients. The median survival time for all patients after local recurrence surgery was 31 months. The 1-year and 3-year survival rates were 86.8% and 36.9%, respectively. Conclusions: The rigorous imaging examination after radical nephrectomy can detect local recurrent lesions as early as possible in most relapsing patients and imaging examination can predict the integrity of surgical resection of local recurrence.Although intraoperative bleeding of resection of local recurrence is relatively high, the operation is safe and the postoperative complications are controllable. Postoperative adjuvant therapy may also provide better survival benefit for patients with local recurrence.


Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/cirurgia , Adulto , Idoso , Carcinoma de Células Renais/patologia , Feminino , Humanos , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Resultado do Tratamento
6.
Orv Hetil ; 160(37): 1476-1479, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31495185

RESUMO

A characteristics of mediastinal disorders is that the high anatomical density of vital structures in this region represents a challenge for diagnosis and surgical treatment. Space-occupying lesions can grow without causing overt manifestations - or can progress symptom-free - hence they can reach an extreme size by the time of surgery. A 58-year-old male patient was hospitalized for pleural effusion and an extensive, space-occupying mediastinal lesion, which had been causing respiratory symptoms for 15 years. Cytology of the pleural effusion did not confirm malignancy. The CT scan depicted progression manifested as an increase in the size of the lesion with a likely site of origin in the left adrenal gland. According to the MRI, by contrast, the lesion might have originated in the region of vertebrae Th9-10, as suggested by the lack of dural continuity. However, its adrenal origin could not be excluded either; endocrine activity was not detected. An operation was performed with a neurosurgeon included in the surgical team. A spinal tumor of the size of 20.2 by 11.1 by 10.8 cm was removed through thoraco-laparotomy, and reconstruction of the diaphragm was performed. Histology confirmed a schwannoma. Postoperatively, the expansion of the lung was only partial, because the patient discontinued respiratory rehabilitation. The follow-up CT scan depicted local recurrence. In the lack of alternative therapeutic modalities, surgical resection is usually the sole option for the management of large, mediastinal space-occupying lesions diagnosed at an advanced stage. Such operations should only be performed in specialist surgical centers and with multidisciplinary collaboration. Orv Hetil. 2019; 160(37): 1476-1479.


Assuntos
Neoplasias do Mediastino/cirurgia , Mediastino , Neurilemoma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Humanos , Laparotomia , Masculino , Neoplasias do Mediastino/patologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neurilemoma/patologia , Neoplasias Retroperitoneais/patologia , Tomografia Computadorizada por Raios X
7.
J Surg Oncol ; 120(7): 1227-1234, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31486096

RESUMO

BACKGROUND: The use of radiation therapy in the treatment of retroperitoneal sarcomas has increased in recent years. Its impact on survival and recurrence is unclear. METHODS: A retrospective propensity score matched (PSM) analysis of patients with primary retroperitoneal soft tissue sarcomas, who underwent resection from 2000 to 2016 at eight institutions of the US Sarcoma Collaborative, was performed. Patients with metastatic disease, desmoid tumors, and palliative resections were excluded. RESULTS: Total 425 patients were included, 56 in the neoadjuvant radiation group (neo-RT), 75 in the adjuvant radiation group (adj-RT), and 294 in the no radiotherapy group (no-RT). Median age was 59.5 years, 186 (43.8%) were male with a median follow up of 31.4 months. R0 and R1 resection was achieved in 253 (61.1%) and 143 (34.5%), respectively. Overall 1:1 match of 46 adj-RT and 59 neo-RT patients was performed using histology, sex, age, race, functional status, tumor size, grade, resection status, and chemotherapy. Unadjusted recurrence-free survival (RFS) was 35.9 months (no-RT) vs 33.5 months (neo-RT) and 27.2 months (adj-RT), P = .43 and P = .84, respectively. In the PSM, RFS was 17.6 months (no-RT) vs 33.9 months (neo-RT), P = .28 and 19 months (no-RT) vs 27.2 months (adj-RT), P = .1. CONCLUSIONS: Use of radiotherapy, both in adjuvent or neoadjuvent setting, was not associated with improved survival or reduced recurrence rate.


Assuntos
Terapia Neoadjuvante/mortalidade , Radioterapia Adjuvante/mortalidade , Neoplasias Retroperitoneais/radioterapia , Sarcoma/radioterapia , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Pontuação de Propensão , Estudos Prospectivos , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Sarcoma/patologia , Taxa de Sobrevida
8.
Pan Afr Med J ; 33: 64, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448026

RESUMO

Malignant renal epithelioid angiomyolipoma (EAML) is a rare disease which has long been considered a hamartomatous lesion. Positive diagnosis is purely based on immunohistochemical investigation. Microscopically, it is characterized by mononuclear epithelioid cells showing a clear cytoplasm with severe cytonuclear atypies and expressing smooth muscle cell markers and melanocytic markers (HMB 45). We here report a rare case of EAML diagnosed after anatomopathological examination of a retroperitoneal tumor whose origin wasn't predetermined by CT scan.


Assuntos
Angiomiolipoma/diagnóstico , Células Epitelioides/patologia , Neoplasias Renais/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Adulto , Angiomiolipoma/patologia , Feminino , Humanos , Neoplasias Renais/patologia , Neoplasias Retroperitoneais/patologia , Tomografia Computadorizada por Raios X
9.
Medicine (Baltimore) ; 98(29): e16494, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335714

RESUMO

RATIONALE: It is difficult to discriminate malignant pheochromocytoma (PCC) from benign PCC. The requirement of abdominal aortic and inferior vena cava reconstruction is extremely rare. PATIENT CONCERNS: We here report a case of a large pheochromocytoma in a 56-year-old woman who complained of only hand trembling and had no hypertension or other symptoms. The operation was difficult because of a tight adhesion to the circumference of great vessels. A replacement of the aortocaval vessels with grafts was necessary to remove the tumor completely. DIAGNOSES: Ultrasonography, computed tomography (CT), and catecholamine assay revealed suspecting the retroperitoneal PCC. INTERVENTIONS: Tumor excision and reconstruction of the abdominal aorta and inferior vena cava by externally supported polytetrafluoroethylene (ePTFE) vessels were successfully performed. OUTCOMES: A follow-up CT angiography showed no recurrence and graft vessels presented good patency after 7years. Catecholamine in urine and serum assay was normal. LESSONS: The complete resection of the tumor and infiltrated great vessels were necessary for the long-term survival of patients with a large PCC. The ePTFE graft is a good substitute for vessel reconstruction.


Assuntos
Aorta Abdominal/cirurgia , Implante de Prótese Vascular , Feocromocitoma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Veia Cava Inferior/cirurgia , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/patologia , Angiografia por Tomografia Computadorizada , Epinefrina/análise , Feminino , Humanos , Pessoa de Meia-Idade , Invasividade Neoplásica , Norepinefrina/análise , Feocromocitoma/diagnóstico , Feocromocitoma/patologia , Politetrafluoretileno , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/patologia , Resultado do Tratamento , Ultrassonografia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologia
10.
Exp Oncol ; 41(2): 179-181, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31262150

RESUMO

The article represents current literature data on epidemiological, clinical-morphological features and diagnostic criteria of neuroblastoma. The case of large congenital neuroblastoma with multiple metastases in the newborn child is presented. The histological picture and immunohistochemical profile of the tumor allowed us to consider this type of neuroblastoma as the least differentiated variant (subtype, "neuroblastoma rich in Schwann stroma"), with rapid progression and metastasizing started before the birth of the child.


Assuntos
Neuroblastoma/congênito , Neuroblastoma/patologia , Neoplasias Retroperitoneais/congênito , Neoplasias Retroperitoneais/patologia , Feminino , Humanos , Recém-Nascido , Neuroblastoma/mortalidade , Neuroblastoma/terapia , Neoplasias Retroperitoneais/terapia
11.
Rev Chil Pediatr ; 90(3): 328-335, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31344194

RESUMO

INTRODUCTION: The inflammatory myofibroblastic tumor is an infrequent benign neoplasm with unpredictable cli nical behavior. OBJECTIVES: to describe three clinical cases at the San Borja Arriarán Clinical Hospital between March 2014 and January 2018 and to carry out an updated review of the literature. Case 1: 14-year-old male adolescent, hospitalized due to abdominal pain, diagnosed with jejunojejunal intus susception secondary to an intestinal wall tumor. The histology was compatible with an inflamma tory myofibroblastic tumor. Case 2: 12-year-old female adolescent, hospitalized due to pneumonia and low-back pain under study associated with weight loss. A retroperitoneal mass was diagnosed involving the right psoas muscle, paravertebral muscles, vertebrae, right kidney, and ipsilateral dia phragm. A puncture biopsy was performed and the result was compatible with an inflammatory myofibroblastic tumor. Case 3: 11-year-old female pre-adolescent, hospitalized to study recurrent urinary tract infection. A bladder tumor was identified, and the biopsy showed compatibility with inflammatory myofibroblastic tumor. CONCLUSION: Due to the variable behavior of the inflammatory myofibroblastic tumor, its management will depend on the location, expression of the anaplastic lymphoma kinase (ALK), tumor behavior, and the resection possibility.


Assuntos
Neoplasias Intestinais/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Neoplasias da Bexiga Urinária/diagnóstico , Adolescente , Criança , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/patologia , Neoplasias Intestinais/patologia , Masculino , Miofibroblastos/patologia , Neoplasias Retroperitoneais/patologia , Neoplasias da Bexiga Urinária/patologia
12.
Clin Nucl Med ; 44(8): 648-649, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274612

RESUMO

Findings of Tc-DTPA renal scintigraphy of a retroperitoneal malignant peripheral nerve sheath tumor are reported here. The patient was a 48-year-old woman who presented discomfort and intermittent dull pain in the left upper quadrant of the abdomen for approximately 3 weeks.


Assuntos
Rim/diagnóstico por imagem , Neurofibrossarcoma/diagnóstico por imagem , Neurofibrossarcoma/patologia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Pentetato de Tecnécio Tc 99m , Feminino , Humanos , Pessoa de Meia-Idade , Cintilografia
13.
J Surg Oncol ; 120(4): 753-760, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31355444

RESUMO

BACKGROUND: Calls for multivisceral resection (MVR) of retroperitoneal sarcoma (RPS) are increasing, although the risks and benefits remain controversial. We sought to analyze current 30-day morbidity and mortality rates, and trends in utilization of MVR in a national database. METHODS: Overall morbidity, severe morbidity, mortality rates, and temporal trends were analyzed utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). RESULTS: From 2012 to 2015, a total of 564 patients underwent RPS resection with 233 patients (41%) undergoing MVR. The MVR group had a higher rate of preoperative weight loss and larger tumors overall. When comparing MVR to non-MVR, there was no significant difference in overall morbidity (22% vs 17%, P = .13), severe morbidity (11% vs 8%, P = .18), or mortality (<1% vs 2%, P = .25). On multivariate analysis, MVR was not associated with increased overall morbidity or severe morbidity. Mortality rates were too low for meaningful statistical analysis. Annual rates of MVR ranged from 37% to 46% with no significant change over time (P = .47). RESULTS: Short-term morbidity and mortality rates after MVR for RPS remain acceptable, but rates of MVR show little change over time in NSQIP hospitals. Concerns about increased morbidity and mortality should not be viewed as a contraindication to wider implementation of MVR for RPS.


Assuntos
Mortalidade/tendências , Complicações Pós-Operatórias/mortalidade , Neoplasias Retroperitoneais/mortalidade , Sarcoma/mortalidade , Procedimentos Cirúrgicos Operatórios/mortalidade , Bases de Dados Factuais , Gerenciamento Clínico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Prognóstico , Melhoria de Qualidade , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Sarcoma/patologia , Sarcoma/cirurgia , Taxa de Sobrevida
14.
Med. clín (Ed. impr.) ; 153(2): 83-87, jul. 2019. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-183370

RESUMO

Antecedents: Perivascular epitheliod cell tumor (PEComa) is a rare mesenchymal tumor. They are rare in the field of gynecology, which makes them difficult to consider as a possible diagnostic. We aim to contribute with our experience to ease clinical practice to others gynecologists. Patients and methods: We contribute to literature with three gynecological cases; uterine, vaginal and retroperitoneal PEComas. Results: The uterine and vaginal PEComa, have required surgical treatment, and are free of disease at 9 and 5 months respectively. The retroperitoneal PEComa has recurred at 72 months of follow-up in form of retroperitoneal mass and pulmonary lymphangioleomyomatosis, continues treatment with sirolimus with good tolerance and partial response. Discussion: Given the scarcity of cases, the literature consists of case reports and mini-reviews. Some authors have categorized the PEComas based on prognostic factors, but there is no agreement regarding the follow-up and treatment. 18F-FDG-PET/CT can help characterize these lesions. The surgery is the standard. In recurrent or malignant cases, there is a lack of evidence regarding chemotherapy and radiotherapy. New therapies with inhibitory m-TOR open a hopeful therapeutic window


Antecedentes: El tumor de célula epitelioide perivascular (PEComa) es un tumor mesenquimal raro. Son entidades ginecológicas extrañas, lo que dificulta su consideración diagnóstica. Contribuimos con nuestra experiencia para facilitar la práctica clínica a otros ginecólogos. Pacientes y métodos: Aportamos 3 casos ginecológicos a la literatura: PEComas uterino, vaginal y retroperitoneal. Resultados: Los PEComas uterino y vaginal requirieron tratamiento quirúrgico y están libres de enfermedad a los 9 y 5 meses, respectivamente. El PEComa retroperitoneal recidivó a los 72 meses de seguimiento en forma de masa retroperitoneal y linfangioleiomiomatosis pulmonar, continuando tratamiento con sirolimus, con buena tolerancia y respuesta parcial. Discusión: Dada la escasez de casos, la literatura consiste en casos clínicos y mini revisiones. Algunos autores han categorizado los PEComas en base a factores pronósticos, pero no hay acuerdo respecto al seguimiento y tratamiento. La 18F-FDG-PET/TC puede ayudar a caracterizar estas lesiones. La cirugía es el tratamiento estándar. En casos de recurrencia o malignidad, hay falta de evidencia respecto a la quimioterapia y radioterapia. Nuevas terapias con inhibidores mTOR abren una ventana terapéutica esperanzadora


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias de Células Epitelioides Perivasculares/diagnóstico por imagem , Neoplasias de Células Epitelioides Perivasculares/cirurgia , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias de Células Epitelioides Perivasculares/patologia , Linfangioleiomiomatose/complicações , Linfangioleiomiomatose/tratamento farmacológico , Sirolimo/uso terapêutico , Neoplasias Uterinas/patologia , Útero/patologia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia
15.
Pol Przegl Chir ; 91(3): 43-46, 2019 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-31243169

RESUMO

A non-standard surgicall approach in malignant retroperitoneal tumor treatment was used, which includes simultaneous resection and reconstruction of the infrarenal segment of aorta and inferior vena cava. The total vascular recunstrustion time was 40 minutes and 15 minutes out of total time was arterial ischemia. The postoperative period was complicated by the right urethral fistula and the limited fluid concentration in the surgical area. On day 25th of the post-operative period patient discharged from the hospital. We believe that such a tactic can be safe and effective in case of meticulous patients selection and the multidisciplinary and multi-team approaches application.


Assuntos
Aorta Abdominal/cirurgia , Neoplasias Retroperitoneais/cirurgia , Veia Cava Inferior/cirurgia , Aorta Abdominal/fisiologia , Implante de Prótese Vascular/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Retroperitoneais/patologia , Resultado do Tratamento , Veia Cava Inferior/patologia
16.
Surg Oncol ; 29: 53-63, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31196494

RESUMO

Retroperitoneal sarcomas (RPS) are rare mesenchymal tumours. Their rarity challenges our ability to understand expected outcomes. The aim of this systematic review was to examine 30-day morbidity and mortality, overall survival rates and prognostic predictors from population-based studies for patients undergoing curative resection for primary RPS. A systematic literature review of EMBASE, MEDLINE, PUBMED and the Cochrane library was performed using PRISMA for population-based studies reporting from nationally registered databases on primary RPS surgical resections in adults. The main outcomes evaluated were 30-day morbidity and mortality and overall survival rates. The use of additional treatment modalities and predictors of overall survival were also examined. Fourteen studies (n = 12 834 patients) reporting from 3 national databases, (Surveillance, Epidemiology and End Results (SEER), the United States National Cancer Database (US NCDB) and the American College of Surgeons' National Surgical Quality Improvement Program (ACS NSQIP)) were analysed. The reported overall 30-day morbidity and mortality were 23% (n = 191/846) and 3% (n = 278/10 181) respectively. Reported use of perioperative radiotherapy was 28%. No study reported loco-regional recurrence rates. Overall reported 5-year survival ranged from 52% to 62%. Independent predictors of overall survival were age of the patient, resection margin, tumour grade and size, histological subtype and receipt of radiotherapy. This review of population-based data demonstrated relatively low 30-day morbidity rates in patients undergoing curative surgical resections for primary RPS. Thirty-day mortality rates were similar to other abdominal tumour groups. There remains a paucity of data reporting recurrence rates, however 5-year survival rates ranged from 52 to 62%.


Assuntos
Bases de Dados Factuais , Recidiva Local de Neoplasia/diagnóstico , Complicações Pós-Operatórias , Neoplasias Retroperitoneais/cirurgia , Sarcoma/cirurgia , Procedimentos Cirúrgicos Operatórios/mortalidade , Humanos , Incidência , Recidiva Local de Neoplasia/epidemiologia , Prognóstico , Neoplasias Retroperitoneais/epidemiologia , Neoplasias Retroperitoneais/patologia , Sarcoma/epidemiologia , Sarcoma/patologia , Taxa de Sobrevida
17.
Am J Case Rep ; 20: 833-837, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31189869

RESUMO

BACKGROUND Primary retroperitoneal mucinous cystadenoma (PRMC) is a rare benign tumor that occurs in the retroperitoneal space. PRMC is difficult to preoperatively diagnose, and final diagnosis requires surgical resection. CASE REPORT A 39-year-old female was referred to our hospital with a chief complaint of tension and pain in the left flank. Imaging findings revealed a large, thick-walled unilocular cystic mass dorsal to the descending colon and ventral to the left kidney. Moreover, a content-rich mural nodule measuring 20 mm was detected on the caudal wall of the cyst, which was suspected to be malignant. The tumor was successfully resected. The cystic wall was composed of thick, scarred fibrous tissue, and the inner surface was lined with a single layer of mucinous epithelium with little atypia. The mural nodule mainly comprised necrotic tissue with no epithelium. Serum carbohydrate antigen 19-9 (CA19-9) level was high (109 U/mL) preoperatively, but it returned to normal levels postoperatively. Importantly, CA19-9 expression was also confirmed using immunohistochemistry. To the best of our knowledge, this is the first case of PRMC with elevated serum CA19-9 levels confirmed by immunohistochemistry. CONCLUSIONS PRMC is only diagnosed by surgical resection. If imaging studies indicate signs of malignancy, surgeons should not hesitate to surgically confirm the diagnosis.


Assuntos
Antígeno CA-19-9/metabolismo , Cistadenoma Mucinoso/diagnóstico por imagem , Cistadenoma Mucinoso/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adulto , Biomarcadores Tumorais/metabolismo , Biópsia por Agulha , Meios de Contraste , Cistadenoma Mucinoso/parasitologia , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Laparotomia/métodos , Imagem por Ressonância Magnética/métodos , Doenças Raras , Neoplasias Retroperitoneais/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
18.
Anticancer Res ; 39(6): 2963-2968, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177136

RESUMO

BACKGROUND/AIM: This study aimed to report the location of abdominal relapse in patients with testicular cancer. MATERIALS AND METHODS: This is a retrospective cross-sectional study including patients who underwent abdominal magnetic resonance imaging (MRI) after treatment of testicular germ cell cancer. MRI reports were classified as negative or positive, and positive results were cross-checked with follow-up imaging and biopsy results. Positive histology or cytology defined a true-positive finding. The location of relapse was registered according to the anatomical site. RESULTS: In a 2-year period, 2,315 MRI examinations were performed. Relapse was detected in 0.7% (95% CI=0.4-1.1) of the examinations. Among these, 75% were seminomas and 25% were non-seminomas. Retroperitoneal lymph nodes were affected in 88% of cases, and pelvic and inguinal lymph nodes affected in 12% of cases. No metastases were found in parenchymatous organs or bony structures. CONCLUSION: All cases of abdominal relapse occurred in retroperitoneal or pelvic lymph nodes. This suggests that MRI should be directed towards the retroperitoneum and pelvis only.


Assuntos
Neoplasias Pélvicas/secundário , Neoplasias Retroperitoneais/secundário , Neoplasias Testiculares/diagnóstico por imagem , Adolescente , Adulto , Idoso , Estudos Transversais , Humanos , Metástase Linfática , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Pélvicas/diagnóstico por imagem , Neoplasias Pélvicas/patologia , Recidiva , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Neoplasias Testiculares/patologia , Adulto Jovem
19.
J Surg Oncol ; 120(3): 340-347, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31246290

RESUMO

BACKGROUND AND OBJECTIVES: Resection of primary retroperitoneal sarcomas (RPS) has a high incidence of recurrence. This study aims to identify patterns of recurrence and its impact on overall survival. METHODS: Adult patients with primary retroperitoneal soft tissue sarcomas who underwent resection in 2000-2016 at eight institutions of the US Sarcoma Collaborative were evaluated. RESULTS: Four hundred and ninety-eight patients were analyzed, with 56.2% (280 of 498) having recurrences. There were 433 recurrences (1-8) in 280 patients with 126 (25.3%) being locoregional, 82 (16.5%) distant, and 72 (14.5%) both locoregional and distant. Multivariate analyses revealed the following: Patient age P = .0002), tumor grade (P = .02), local recurrence (P = .0003) and distant recurrence (P < .0001) were predictors of disease-specific survival. The 1-, 3-, and 5-year survival rate for patients who recurred vs not was 89.6% (standard error [SE] 1.9) vs 93.5% (1.8), 66.0% (3.2) vs 88.4% (2.6), and 51.8% (3.6) vs 83.9% (3.3), respectively, P < .0001. Median survival was 5.3 years for the recurrence vs 11.3+ years for the no recurrence group (P < .0001). Median survival from the time of recurrence was 2.5 years. CONCLUSIONS: Recurrence after resection of RPS occurs in more than half of patients independently of resection status or perioperative chemotherapy and is equally distributed between locoregional and distant sites. Recurrence is primarily related to tumor biology and is associated with a significant decrease in overall survival.


Assuntos
Recidiva Local de Neoplasia/epidemiologia , Neoplasias Retroperitoneais/epidemiologia , Neoplasias Retroperitoneais/cirurgia , Sarcoma/epidemiologia , Sarcoma/cirurgia , Procedimentos Cirúrgicos de Citorredução/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Sarcoma/patologia , Estados Unidos/epidemiologia
20.
Pathologe ; 40(4): 431-435, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31240451

RESUMO

Soft-tissue sarcomas are rare malignant tumors. Surgery remains the most important treatment modality. Neoadjuvant and/or adjuvant chemo- and radiotherapy may be administered to improve the local and systemic outcome. Advances in oncological and reconstructive surgery, combined with the use of multimodal therapies, have made mutilating surgery rare events in extremity sarcomas. In retroperitoneal sarcomas, local recurrences are life-threatening events and multivisceral resection has become the standard surgical procedure. The subjects of this review are diagnostics, multimodal therapy, and resection strategy from a surgical point of view.


Assuntos
Neoplasias Retroperitoneais , Sarcoma , Neoplasias de Tecidos Moles , Terapia Combinada , Extremidades , Humanos , Recidiva Local de Neoplasia , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia
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