Ductal carcinoma of the breast in the pacemaker generator's pocket.

Authors present a case of a 78-year-old female patient with invasive ductal adenocarcinoma in the pacemaker, s pocket. A decubitus-like tumor had developed in this place, and has been missinterpretated as a benign lesion for 5 months. Diagnosis was done with a time delay. An excisional biopsy revealed annvasive ductal adenocarcinoma. The first step was the implantation of a new pacemaker generator performed on the opposite side. The second step was a modified radical mastectomy, according to Madden, and the removal of the originally implanted pacemaker generator. Radiotherapy and hormonal adjuvant therapy were applied after surgery. The patient was followed-up at an out-patient clinic, and died 25 months after diagnosis because of generalization of the disease (Fig. 2, Ref. 35). Full Text (Free, PDF) www.bmj.sk.

Reconstruction after total gastrectomy.

After total gastrectomy it is necessary to realize the reconstruction of the upper part digestive tract. It is necessary to choose the reconstruction method, which provides good life quality, and extensive physiologic regulation of gastrointestinal hormones after total gastrectomy. There is no ideal reconstruction method. Nowadays there are about 70 kinds of reconstruction methods. It is very important to preserve the duodenal passage. Also the production of reservoir is important. The conclusions of studies are not homogeneous. The patients can benefit from the reconstruction preserving duodenal passage and formed by pouch. (Fig. 1, Ref. 23.).