Primary Epithelioid Angiosarcoma of the Adrenal Gland: Report of a Case and Review of the Literature

2016-06-12T06-46-51Z
Source: Journal of Interdisciplinary Histopathology
Malek Mohamed Ayadi, Nadia Boujelben, Raoudha Doghri, Mouna Rezgani, Imen Abbes, maha driss, Riadh Chargui, Karima Mrad, Khaled Rahal.
Primary mesenchymal neoplasms of the adrenal gland are extremely rare. The most common primary sarcoma is adrenal angiosarcoma. We report the case of a 51-year-old patient who presented with left flank pain. After ultrasound investigations, the patient underwent surgical removal of an adrenal tumor. The gross adrenal specimen showed extensive cystic changes with old hemorrhage and necrosis. Histologically, irregular branching vascular channels were seen intermixed with solid areas of epithelioid cells. Immunohistochemical staining of tumor cells was positive with antibodies to cytokeratin and CD31. After a 12 months follow-up, the patient is still well with no sign of a relapse. Because of the epithelioid appearance and frequent expression of epithelial immunohistochemical markers, primary epithelioid angiosarcoma of the adrenal gland can be confounded with adrenal carcinomatous metastases. We report our findings with a brief literature review and discussion of differential diagnosis.


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Radiotherapy-Induced Ovarian Sarcoma Following the Treatment of Cervical Cancer: Exceptional Case Report and Review of the Literature

2016-06-12T06-46-51Z
Source: Journal of Interdisciplinary Histopathology
Malek Mohamed Ayadi, Olfa El Amine El Hadj, Ines Zemni, Hatem Bouzaiene, Jamel Ben Hassouna, Amor Gamoudi, Khaled Rahal.
Primary ovarian sarcomas are rare gynecological tumors accounting for


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Haematological splenomegaly does not directly relate to portal hypertension: From a clinical study to surgical choice

2016-06-12T06-43-06Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Antonio Manenti, Fabio Forghieri, Maurizio Zizzo, Dario Colasanto, Mario Luppi.
Background: Splenomegaly induces an increased inflow into the portal venous system; however, in the absence of pathology of the liver and of a portal vein system, secondary portal hypertension is unusual. We analyzed this problem through a clinical observational method. Methods: We selected 20 patients with splenomegaly secondary to B-cell chronic lymphocytic leukaemia; their imaging tests and clinical pathways were re-examined. Results: In the absence of diseases of the liver or of the portal venous system, an increased portal blood flow, secondary to the splenomegaly, could not be considered the sole cause of portal hypertension. Conclusions: The normal liver has a high venous capacity, and in the absence of other factors, the sole increase in portal venous flow cannot directly justify portal hypertension. This conclusion is still well founded, even if multiple humoral mediators, some of which are also released from the spleen in a number of pathological conditions, can differentially modulate the haemodynamics of hepatic sinusoids.


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Profile of autopsied homicidal victims of eastern Nepal: An observational study

2016-06-12T06-43-06Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Abhishek Karn, Birendra Kumar Mandal, Amshu Pradhan, Shivendra Jha, Bishwanath Yadav, Pramod Kumar Shrestha.
Objective: This study was performed to create a profile of the victims of intentional homicide in eastern Nepal. Methods: This is an observational study of homicidal victims autopsied from January 01, 2009 to December 31, 2011 at the Department of Forensic Medicine and Toxicology, a tertiary referral centre in Dharan, Nepal, analyzing: age, sex, educational condition, marital status and occupation of victims, homicidal method employed, motive, season of the year and toxicological study, along with few details on the victims personal history (alcohol and drug abuse). Results: The homicidal victim profile attained matched that of a man who was a young adult between 25 to 34 years of age, illiterate, unmarried, unemployed, alcoholic and was killed intentionally by sharp weapons or firearms during the September to October period. The most frequent reason for being killed was an argument that led to assault and eventually death. Conclusion: The study of this occurrence should ultimately result in enhanced prevention from these prospective evaluations of the profile. Preventive interventions at the national, social and medical level would be fundamental in saving the lives of potential victims.


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Giant-cell tumor of the patella: An uncommon cause of fracture

2016-06-12T06-43-06Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Esther Carbó-Laso, Rubén Pérez-Mañanes, Coral Sánchez-Pérez, Lydia Mediavilla-Santos, José Antonio Calvo-Haro, Miguel Cuervo-Dehesa, Javier Vaquero-Martín.
Primary patellar tumors are highly unusual. Most are benign neoplasms with giant-cell tumors being the most common, followed by chondroblastomas and aneurysmal bone cysts. Intralesional curettage and bone grafting is the treatment of choice for most giant-cell tumors in the patella. The use of adjuvants can reduce the high recurrence rate. This is a case report of a giant-cell tumor in a 61-year-old man who was diagnosed with a pathological fracture in the patella after minimal trauma. Extended curettage through an osteotomy made in the medial cortical of the patella was performed. The tumor cavity was filled with high viscosity bone cement and the medial cortical was repositioned. Histological analysis showed mononuclear cells and numerous multinucleated giant cells, confirming the diagnosis. Twenty-four months after surgery, the patient was asymptomatic and there was no evidence of local recurrence. Epidemiology, symptomatology, imagenology, histopathology, treatment options and prognoses of giant-cell tumors of the patella are discussed herein.


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Giant calculus in ileal neo-ureter constructed for iatrogenic complete ureteric avulsion: A case report and review of literature

2016-06-12T06-43-06Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Arif Akhtar, Mohammad Habib Raza.
Complete ureteric avulsion is a rare and ill-fated complication of diagnostic and therapeutic ureteroscopy. Extensive avulsion with devitalization in the proximal ureter may require ileal-ureteric substitution. Use of a bowel segment for ileal reconstruction is a proven and practical method with acceptable complications. Herein, we report a case of giant calculus formation in such an ileal neo-ureter reconstructed for complete ureteric avulsion during ureteroscopic lithotripsy. The calculus was successfully treated by laparotomy and enterotomy. To the best of our knowledge, no similar case has been previously reported in the literature.


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Metabolic abnormalities and genitourinary tract anatomical alternations in patients with recurrent urolithiasis

2016-06-12T06-43-06Z
Source: Archives of Clinical and Experimental Surgery (ACES)
John Neil, Jose Binu.
Background: Preventing the recurrence of episodes of stone formation is the focus of interest for patients. This retrospective study aimed to determine the prevalence of metabolic abnormalities and anatomical alterations of the genitourinary tract in patients with recurrent urolithiasis. Methods: Patients who had recurrent renal calculi were included. Laboratory assessment was performed on two 24-hour samples of urine. The first 24-hour urine was a random specimen and the second was obtained after the patient had been on a sodium-, oxalate- and calcium-restricted diet for at least one week. The patients with hypercalciuria further underwent fasting and calcium load testing and were assessed in terms of parathyroid hormone levels. Urine culturing was conducted to rule out urinary tract infection. All patients were evaluated with ultrasound and intravenous pyelography for any anatomical abnormalities. Results: A total of 30 patients (20 male and 10 females) were included in the study. The most frequently found metabolic alterations were hypercalciuria, low urinary volume, urinary tract infection and hyperoxaluria. Anatomic alterations were found in 26.5% of patients, mainly in the form of renal cysts, pelvi-ureteric junction obstructions, horse shoe kidneys and atrophic kidney. Conclusions: 80% of patients with recurrent stone disease had some measure of metabolic abnormality to account for the disease. The use of two 24-hour urine samples significantly improved the detection rate of metabolic abnormalities compared to a single sample. The major limitation of this study was the small number of patients as well as the short study duration.


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