1/10. Retroperitoneal germ cell tumor treated by PVeBV chemotherapy: a case report.The extragonadal germ cell tumor are uncommon neoplasms which account for only 1-5% of germ cell tumors, and its prognosis is poor. We report here the use of combination chemotherapy with cisplatin, etoposide, bleomycin, and vinblastine (PVeBV) for the treatment of retroperitoneal germ cell tumor. A 28-year-old male with complaints of abdominal pain and lumbago, without any abnormality in both testes by physical and ultrasonographic examination, showed retroperitoneal tumor by abdominal computed tomography. The serum alpha-fetoprotein and lactate dehydrogenase were elevated. The retroperitoneal tumor was treated surgically. The pathological diagnosis was mixed germ cell tumor. The lung and supraclavicular lymph node metastases disappeared completely after 3 courses of PVeBV chemotherapy with cisplatin (40 mg/m2 per day) and etoposide (100 mg/m2 per day) for 5 consecutive days, with vinblastine (0.2 mg/kg) on day 1, and bleomycin (30 mg/body) given on days 1, 8, and 15. granulocyte colony-stimulating factor and serotonin receptor antagonist application were available on acute phase toxic effects. The patient is now alive and well, without recurrence, more than 26 months after the operation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. Presacral schwannoma with purely cystic form.STUDY DESIGN: Case report. OBJECTIVE: To point out that presacral schwannoma can display markedly cystic degeneration. SUMMARY OF BACKGROUND DATA: Benign schwannoma sometimes displays degenerative changes, such as cyst formation, calcification, hemorrhage, and hyalinization. Usually these degenerations are partially seen in the tumors. methods: Medical history, physical findings, imaging features, and histologic findings were reviewed in a case with a large presacral schwannoma. RESULTS: A 62-year-old woman presented with an 18-month history of right sciatic pain. Magnetic resonance images detected a large cystic, presacral tumor. Initially the tumor was misdiagnosed as a cystic ovarian tumor. Preoperative diagnostic workup led to the diagnosis of cystic schwannoma. Intralesional curettage achieved good pain relief. CONCLUSIONS: This tumor was unusual in its totally cystic appearance and resemblance to a cystic ovarian tumor or anterior sacral meningocele. Preoperative diagnosis is important to prevent major neurologic deficit at surgery.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/10. Retroperitoneal leiomyosarcoma mimicking acute appendicitis: laparoscopic management.BACKGROUND: Retroperitoneal leiomyosarcomas (RLMS) are a challenging clinical entity. The vast majority of patients are operated on when tumors are advanced. We report herein a case of RLMS, mimicking acute appendiceal disease and treated successfully via laparoscopy. methods: A 37-year-old woman, para 1, was admitted to our department for right lower quadrant abdominal pain, fever, and leukocytosis. She had no changes in gastrointestinal and urologic function. A physical examination revealed the presence of abdominal guarding, rebound, and a tender mass in the right lower quadrant. The abdominal ultrasound showed an inhomogeneous ovoid mass (6 cm in diameter) located below the cecum, with no definite margins, and consistent with an appendiceal abscess. The patient was referred for laparoscopy. The procedure was performed with the aid of 3 ports: a 12-mm trocar in the umbilicus (open technique), a 10-mm trocar in the left iliac fossa, and a 5-mm one in the supra-pubic space. On inspection of the abdominal cavity, a retroperitoneal 6-cm mass was immediately found below the cecum and the appendix. Neither intraperitoneal seeding nor suspected lymph nodes were present. After dissection of the parietal peritoneum, the mass appeared to be encapsulated and well demarcated from all surrounding structures. It was eventually dissected and removed via a plastic bag. A standard appendectomy was also performed. The postoperative course was uneventful, and the patient was discharged on the 3rd day. The histology analysis of the resected specimen showed a totally excised G2 leiomyosarcoma. The appendix had no signs of inflammation. Postoperatively, the patient underwent a total-body CT-scan, which had no signs of residual or distant disease. No adjuvant therapy was necessary. At an 18-month follow-up, the patient was doing well and was disease free. CONCLUSION: Surgery represents the main therapeutic option for resectable RLMS. laparoscopy is a useful diagnostic tool that allows safe resection of incidentally discovered, small and well encapsulated RLMS.- - - - - - - - - - ranking = 13.550971583023keywords = physical examination, physical (Clic here for more details about this article) |
4/10. Retroperitoneal schwannomas simulating adrenal tumors.Tumors in the area of the adrenal were detected by chance in two patients who underwent a regular physical check-up. On arteriography the tumors were found to be fed by the adrenal artery. The diagnosis was retroperitoneal schwannoma, but in both patients it was difficult to differentiate the schwannoma from an adrenal tumor preoperatively.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/10. A case of neurofibroma located in the retroperitoneum involving the uncinate process of the pancreas.A case of solitary neurofibroma in the retroperitoneum involving the uncinate process of the pancreas, which has been reported in only one case in japan and less than 20 cases in the world literature, is described. A 57-year-old male complained of back pain and microhematuria. Plain and enhanced abdominal computed tomography (CT) indicated an 8 x 6 cm hypovascular tumor located in the uncinate process. We initially assumed it to be a cancer of the pancreas. His physical examination and blood chemistry result were normal. Various diagnostic imaging methods however, disclosed a rare type of tumor. The tumor was resected by pancreaticoduodenectomy and histological examination revealed it to be neurofibroma.- - - - - - - - - - ranking = 13.550971583023keywords = physical examination, physical (Clic here for more details about this article) |
6/10. Retroperitoneal seminoma with simultaneous occurrence in the prostate.We report a case of retroperitoneal seminoma with simultaneous occurrence in the prostate. The testes were normal on physical and ultrasound examination. In this case a multicentric occurrence of seminoma was considered rather than metastasis from the retroperitoneum to the prostate. Systemic chemotherapy with vincristine, peplomycin and cisplatin was effective for the prostatic as well as the retroperitoneal lesion.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/10. Ovarian cancer manifested as exertional hypotension due to obstruction of the inferior vena cava.We have reported a case of inferior vena cava obstruction caused by recurrent ovarian carcinoma. This case is noteworthy first because it shows that physical findings in inferior vena cava obstruction may be minimal. Secondly, we believe ours is the first reported case of exertional hypotension caused by obstruction of the inferior vena cava. Finally, ovarian cancer has rarely been reported as a cause of inferior vena cava obstruction.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/10. Late seminomatous relapse of a mixed germ cell tumor of the testis on intensive surveillance.We report a case of a pure seminomatous relapse in the retroperitoneum 6 years after orchiectomy for an apparent stage I mixed germ cell tumor of the testis. The 4 cm. metastatic mass was not imaged on computerized tomography, tumor markers were negative and confounding symptoms made diagnosis difficult. The propensity for seminomatous tumors to relapse later than nonseminomatous tumors has profound implications for intensive surveillance programs for apparent stage I disease in mixed germ cell tumors. These programs often involve routine computerized tomography only for the first 2 years and rely on physical examination, simple radiology and serum tumor markers thereafter. Such programs may fail to detect pure seminomatous relapse and delay the onset of curative treatment.- - - - - - - - - - ranking = 13.550971583023keywords = physical examination, physical (Clic here for more details about this article) |
9/10. retroperitoneal fibrosis secondary to metastatic neoplasm.retroperitoneal fibrosis may occur secondary to metastatic neoplasm and may simulate the features of the idiopathic variety. A case of retroperitoneal fibrosis due to gastric carcinoma is presented and the historical, physical, cystoscopic, urographic, operative, and pathologic similarities to the idiopathic form discussed. Generous biopsy of retroperitoneal plaques and careful pathologic examination are stressed to avoid missing malignant disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/10. Sonographic diagnosis of a retroperitoneal dermoid cyst in a young girl.We describe the detection and management of a retroperitoneal dermoid cyst in a young girl. Transabdominal ultrasound revealed in the pelvis a complex mass with anechogenic and echogenic components characteristic of a dermoid cyst. Initially, it was presumed to be of ovarian origin, because extragonadal dermoid cysts are very rare in adolescence; however, the findings on physical examination were normal. laparoscopy was performed but failed to identify a cyst. Ultrasound examination was repeated intraoperatively and confirmed the presence of the cyst, which was then removed by laparotomy from the retroperitoneum. This case illustrates the significance of ultrasonography in the diagnosis of a rare condition in adolescent gynecology and demonstrates the possibility of performing ultrasound scanning intraoperatively to confirm the presence of a mass which was not identified by laparoscopy.- - - - - - - - - - ranking = 13.550971583023keywords = physical examination, physical (Clic here for more details about this article) |
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