1/478. Embolic vascular seeding of endometrial adenocarcinoma, a complication of hysteroscopic endometrial biopsy. OBJECTIVE: A case of embolic vascular seeding of endometrial adenocarcinoma following hysteroscopy is reported. methods: This phenomenon was recognized in the uterus specimen from a hysterectomy performed 1 week after hysteroscopic endometrial biopsy. Tissue processing artifact was excluded. RESULTS: Since the patient was otherwise low risk, treatment was limited to hysterectomy. The patient was not given adjuvant therapy. Two years later she remains alive and well with no evidence of disease. The surgical, morphologic, and clinical features of this case are presented and illustrated. CONCLUSION: Previous reports of peritoneal tumor seeding associated with hysteroscopy are reviewed. Tumor embolization during hysteroscopic endometrial biopsy was not followed by tumor recurrence in this case. ( info) |
| Computed tomography-guided stereotactic biopsy is commonly used in the diagnosis of brain lesions. An uncommonly reported risk of the procedure is the potential of implantation metastasis. This phenomenon has been reported in central nervous system malignancies. Although the role of prophylactic local radiotherapy at biopsy sites is well recognized in solid tumors, it has not been reported to occur after stereotactic biopsy of a brain tumor. The authors report a case of locally progressive primary central nervous system lymphoma at an unsuspiciously underdosed biopsy site complicating radiotherapy outcome. ( info) |
3/478. Unexpected gallbladder cancer after laparoscopic cholecystectomy: an emerging problem? Reflections on four cases. gallbladder cancer (GC) has been reported in 0.3-1.5% of cholecystectomies. Since the introduction of laparoscopic surgery, cholecystectomies have increased and occult GC may therefore be more frequent. Herein we analyze our own experience to determine whether there was an increase in GC. We also evaluate the risk factors for this outcome. Four patients with GC undiagnosed before surgery (four of 602 cases, or 0.66%) were submitted to laparoscopic cholecystectomy. The percentage in patients who underwent open surgery was 0.28% (two of 714 cases). Without reoperation, three patients died in the laparoscopic group and one is alive at 12 months. Trocar site metastasis was not observed. Although the percentage of GC (0.28% versus 0.66%) increased, the percentage is still in the referred average. Undiagnosed GC is on the increase. Examination of the gallbladder and a frozen section, if necessary, are recommended. Calcified gallbladders, age >70 years, a long history of stones, and a thickened gallbladder all represent significant risk factors. ( info) |
4/478. Organ-preserving surgery of renal cell carcinoma: report of four cases. Authors removed the renal tumour of four patients by means of resection in an organ-preserving manner. Of the four patients, one had bilateral carcinoma. The right-sided carcinoma of this patient was removed by resection while the other kidney was removed radically, by transabdominal approach. In three of the four cases which were in the process of stages T1 and N0M0, organ-preserving surgery was performed in the presence of intact opposite kidneys. Authors point out the fact that the resection method might be indicated even in the case of early (T1) stage tumours with intact opposite side kidneys. Furthermore, they do not recommend the enucleation of renal carcinomas for the surgical treatment of kidney tumours, since experimental studies have proved that these tumours can be transferred into the parenchyma of the kidney through the pseudocapsule of the tumour. ( info) |
5/478. Iatrogenic breaks in Buuch's membrane in choroidal melanoma. Three patients with choroidal melanoma have been observed to develop subretinal hemorrhages associated with their ocular examinations. One hemorrhage appears to have been caused by transillumination, while two others have occurred during radioactive phosphorus testing. Histopathology confirms defects in Bruch's membrane through which blood or tumor cells have entered the subretinal space. ( info) |
6/478. Peritoneal mucinous carcinomatosis after laparoscopic-assisted anterior resection for early rectal cancer: report of a case. Minimally invasive colon surgery has been shown to be both technically feasible and a safe alternative to laparotomy. Its efficacy for the curative resection of colorectal cancer, however, remains controversial. Of major concern are the increasing reports of port-site recurrence after use of laparoscopic techniques in malignant disease. In this article a heretofore unreported complication of peritoneal mucinous carcinomatosis after laparoscopic-assisted anterior resection for early stage rectal cancer is presented. Isolated peritoneal recurrence is rare after curative resection of Stage I rectal cancer. The effect of pneumoperitoneum on tumor dissemination is discussed. ( info) |
7/478. Extraosseous metastases of hepatocellular carcinoma detection and therapeutic assessment with Tc-99m PMT SPECT. Owing to recent advances in imaging technology and radiologic intervention, survival rates in patients with hepatocellular carcinoma have improved markedly. However, such prolonged survival has resulted in an increase in extrahepatic metastases. Tc-99m (Sn)-N-pyridoxyl-5-methyltryptophan (Tc-99m PMT), developed for hepatobiliary scintigraphy, has been used to visualize extrahepatic metastases, with most related reports limited to osseous metastases. The authors report two cases of hepatocellular cancer presenting as a hypopharyngeal metastasis and intraperitoneal dissemination along the tract of a fine-needle biopsy. Lesions undetectable on planar imaging could be visualized by Tc-99m PMT SPECT. ( info) |
8/478. Port-site metastasis following laparoscopic lymphadenectomy for adenosquamous carcinoma of the cervix. Although incisional metastases following surgery for cervical cancer are extremely rare, port-site disease following minimal-access surgery is becoming increasingly reported. We report a case of a metastasis which occurred at a port site following laparoscopic removal of lymph nodes affected by cervical adenosquamous carcinoma. This report adds to the literature suggesting that cutaneous tumor deposition may be enhanced by this method of surgery. ( info) |
9/478. Intraperitoneal seeding of ruptured hepatocellular carcinoma: case report. We report a solitary intraperitoneal recurrence in a long-term survivor after rupture of hepatocellular carcinoma. ultrasonography demonstrated the finding of a lobulated mass with a "mosaic" appearance. The patient underwent resection of this implant and is currently disease free. We emphasize the importance of periodic surveillance of disseminated metastases of this condition. ( info) |
10/478. color Doppler findings of tumor seeding after US-guided liver tumor biopsy. We present two cases with tumor seeding along the needle tract occurring after a large-core needle liver tumor biopsy performed at other hospitals. color Doppler sonography showed the hypervascular nature of the lesion and increased diagnostic confidence. ( info) |