1/6. tuberous sclerosis presenting for laparotomy.A 30-year-old female patient with tuberous sclerosis presented for anaesthesia and surgery for haemorrhagic renal angiomyolipoma. The anaesthetic management of this case was tailored to the prevention of seizures. Diagnostic features and possible complications of the disease are also described.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/6. Uncommon metastatic site of renal adenocarcinoma: the oral tongue.Primary tumours metastasizing to the tongue are very unusual and only anecdotal cases have been reported. An exhaustive literature review covering the period from 1970 onwards disclosed only 22 cases of renal adenocarcinoma metastasizing to the tongue. We report the case of an 87-year-old female patient with oral tongue, lung, liver, thyroid gland, pancreas and renal adenocarcinoma metastases. She had undergone contralateral nephrectomy for clear cell carcinoma 10 years before diagnosis of the metastases. The tongue lesion was surgically removed under local anaesthesia. tongue metastasis of renal adenocarcinoma is usually a manifestation of widespread disease. The prognosis for patients with lingual metastasis of renal adenocarcinoma is poor, the mean interval from diagnosis of tongue metastasis to death being 5.8 months. In our patient, metastatic involvement of the tongue was detected approximately 5 months before death. Treatment of renal adenocarcinoma metastasis to the tongue is usually palliative and aims to provide patient comfort by means of pain relief and prevention of bleeding and infection. Surgical excision is recommended as the primary treatment, with emphasis on preservation of tongue structure and function. Recent data regarding immunotherapy or immunochemotherapy for metastatic renal adenocarcinoma are encouraging.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/6. Single-session laparoscopic radical and contralateral partial nephrectomy.Renal tumor is likely to become one of the most important indications for laparoscopic surgery. We present an old woman, who underwent single-session laparoscopic nephrectomy and contralateral partial nephrectomy due to bilateral kidney tumor. The advantages of simultaneous bilateral intervention are reduced psychological stress, single anaesthesia, less medication, less blood loss, shorter hospital stay and convalescence, and considerable cost-effectiveness.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/6. Renal cell carcinoma metastasis masquerading as recurrent orbital haematoma.A 70 year old man developed orbital haemorrhage after retrobulbar anaesthesia for cataract surgery and biopsy of a persistent lateral rectus mass suggested organising haematoma. Subsequent progression of the mass was shown, on repeated biopsy, to be due to metastatic renal cell carcinoma--a tumour recognised for its angiogenic and haemorrhagic potential.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/6. Paraneoplastic syndrome of renal cell carcinoma.We report a case of renal cell carcinoma who presented with the classic triad of flank pain, hematuria and fever as well as progressively developed multisystem disease, including a massive anteroseptal myocardial infarction. This was diagnosed as paraneoplastic syndrome of renal cell carcinoma and the decision to proceed with nephrectomy was taken after 3 weeks of acute myocardial infarction, despite predicted high cardiac risk under general anaesthesia; following removal of tumour, all symptoms and signs regressed. He has remained well till the time of last follow-up 4 months later.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
6/6. Unusual presentation of phaeochromocytoma. Management of anaesthesia and cardiovascular monitoring.A case is reported in which a patient with a history of high output left ventricular failure presented for exploratory laparotomy and removal of a highly vascular tumour which was intra-operatively discovered to be a phaeochromocytoma.- - - - - - - - - - ranking = 4keywords = anaesthesia (Clic here for more details about this article) |