Acinar cell carcinoma of the pancreas: a case report and review of the literature.

The majority of pancreatic malignant tumours are adenocarcinomas of the ductal type, whereas acinar cell carcinoma (ACC) is unusual. Its management is not well codified, resulting from its low frequency. It seems however that curative operative resection represents the best first-line treatment. We present a case of ACC in a 54-year-old woman who presented with right upper quadrant pain of the abdomen due to a pancreatic mass in the head of the pancreas, detected by computer tomography (CT) and magnetic resonance imaging (MRI). In April 2008 the patient underwent a pancreatoduodenectomy (Longmire-Traverso) and received postoperative chemotherapy. We present a case of pancreatic ACC treated with a curative operation followed by chemotherapy. Our patient remains free of the disease and has a good quality of life.

Gigantic hepatic amebic abscess presenting as acute abdomen: a case report.

INTRODUCTION: Amebiasis is a parasitic disease caused by Entamoeba histolytica. It most commonly results in asymptomatic colonization of the gastrointestinal tract, but some patients develop intestinal invasive or extra-intestinal diseases. Liver abscess is the most common extra-intestinal manifestation. The large number of clinical presentations of amebic liver abscess makes the diagnosis very challenging in non-endemic countries. Late diagnosis of the amebic abscess may lead to perforation and amebic peritonitis, resulting in high mortality rates. CASE PRESENTATION: This report describes a 37-year-old white man, suffering from hepatitis B, with a gigantic amebic liver abscess presenting as an acute abdomen due to its rupture. Rapid deterioration of the patient's condition and acute abdomen led to an emergency operation. A large volume of free fluid together with debris was found at the moment of entry into the peritoneal cavity because of a rupture of the hepatic abscess at the position of the segment VIII. Surgical drainage of the hepatic abscess was performed; two wide drains were placed in the remaining hepatic cavities and one on the right hemithorax. The patient was hospitalized in the ICU for 14 days and for another 14 days in our department. The diagnosis of amebic abscess was made by the pathologists who identified E. histolytica in the debris. CONCLUSION: Acute abdomen due to a ruptured amebic liver abscess is extremely rare in western countries where the parasite is not endemic. Prompt diagnosis and treatment are fundamental to preserving the patient's life since the mortality rates remain extremely high when untreated, even nowadays.

Pain and osteolysis of the thoracic spine--a case of a rare monostotic fibrous dysplasia manifestation.

We describe a case of a young farmer from Central Macedonia, Greece suffering of a mild back pain more than one year. His medical history included hypercholesterolaemia (IIa type) and two episodes of spontaneous pneumothorax of unknown origin two and three years ago respectively. A full imaging survey revealed a single osteolytic lesion at the seventh thoracic vertebra. A CT guided needle biopsy was performed. Diagnosis based on clinical, imaging and histological findings was monostotic fibrous dysplasia of the thoracic spine. We discuss the clinical features and treatment of this non neoplastic condition which may simulate bone osteolytic tumor. Furthermore a possible correlation of concomitant conditions existing in our patient such as the metabolic disorder of hypercholesterolaemia and especially the history of spontaneous pneumothorax episodes with fibrous dysplasia within the spectrum of connective tissue disorder is discussed.