Background: Schwannomas are generally benign neoplasms arising from the nerve sheath. Presacral schwannomas are very rare entities and difficult to diagnose, representing less than 15% of all retrorectal space tumors....Background: Schwannomas are generally benign neoplasms arising from the nerve sheath. Presacral schwannomas are very rare entities and difficult to diagnose, representing less than 15% of all retrorectal space tumors. Benign schwannoma sometimes displays degenerative changes, such as cyst formation, calcification, hemorrhage, and hyalinization. Usually these degenerations are partially seen in the tumors. Objective: To point out that presacral schwannoma can display markedly multilocular cystic degeneration. Case Report: We present this unique case of a 24-year-old man diagnosed with an unusually large pure multilocular cystic schwannoma, which is revealed by digestive, urinary, and nonspecific neurological symptoms. The patient was successfully treated with radical surgery via an anterior approach leading to the recovery of symptoms. Discussion and Conclusion: This tumor was unusual in its totally multicystic appearance and its resemblance to a wide spectrum of lesions that can occur in the pre-sacral space, such as hydatid and developmental cysts. Preoperative diagnosis is essential to prevent major neurological deficits during surgical intervention.展开更多
Benign multicystic peritoneal mesothelioma(BMPM)is a rare tumor originating from peritoneal mesothelial cells.Here,we present a case of an 18-year-old male with right lower abdominal pain.Physical examination revealed...Benign multicystic peritoneal mesothelioma(BMPM)is a rare tumor originating from peritoneal mesothelial cells.Here,we present a case of an 18-year-old male with right lower abdominal pain.Physical examination revealed a palpable mass with unclear boundaries.Laboratory tests showed elevated levels of monocytes and high-sensitivity C-reactive protein.CT scan revealed a cystic mass in the ileocecal region with multiple septations.Laparoscopic surgery confirmed a cystic solid mass resembling beads on the colon’s right side.Immunohistochemistry confirmed BMPM diagnosis.BMPM,especially in the ileocecal region,is uncommon and presents diagnostic challenges.Differential diagnosis includes lymphangioma,peritoneal metastasis,and malignant mesothelioma.CT findings,such as thin cyst walls and septations,aid in diagnosis.Recognition of BMPM’s imaging features improves diagnostic accuracy.Surgical resection remains the primary treatment.This case underscores the importance of considering BMPM in young male patients with abdominal pain and emphasizes the value of imaging modalities in accurate diagnosis and management.展开更多
Benign multicystic peritoneal mesothelioma(BMPM)is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women.A 56-year-old Caucasian male was admitted to our surgical department with a chie...Benign multicystic peritoneal mesothelioma(BMPM)is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women.A 56-year-old Caucasian male was admitted to our surgical department with a chief complaint of a painful mass in his right lower abdomen for almost 2 years.The physical examination revealed a palpable painful mass.Computed tomography demonstrated an irregular,cystic tumor in his right lower abdomen.There was no obvious capsule or internal septations.No enhancement after intravenous administration of contrast was noted.An exploratory laparotomy was performed,and a multicystic tumor and adherent to the caecum was noted.The walls of the cysts were thin and smooth,filled with clear fluid,and very friable.An en bloc resection of the tumor,including appendix and caecum,was performed.Histological examination revealed multiple cysts lined with flattened simple epithelial cells,and the capsule walls of the cysts were composed of fibrous tissue.Immunohistochemical analysis documented positive expression of mesothelial cells and calretinin.The final diagnosis was BMPM.The patient was well at 6-mo follow-up.BMPM is exceedingly rare lesion.A complete resection of the tumor is required.The diagnosis of BMPM is based on pathological analysis.展开更多
Benign multicystic peritoneal mesothelioma （BMPM） is a rare tumor that occurs mainly in women in their reproductive age. The pathogenesis of BMPM is unclear and a controversy regarding its neoplastic and reactive na...Benign multicystic peritoneal mesothelioma （BMPM） is a rare tumor that occurs mainly in women in their reproductive age. The pathogenesis of BMPM is unclear and a controversy regarding its neoplastic and reactive nature exists. The biological behavior of BMPM is characterized by its slowly progressive process and high rate of recurrence after surgical resection. In addition this lesion does not present a strong tendency to transform into malignancy. Today approximately 130 cases have been reported. We here report a 62-year-old woman who had diffuse abdominal pain, nausea and vomiting. Physical examination revealed a painful mass in her upper abdomen. She reported a mild dehydration, but the vital signs were normal. Peristaltic rushes, gurgles and highpitched tinkles were audible. Upright plain abdominal film revealed small bowel loops with air-fluid levels. She was diagnosed having an incarcerated incisional hernia that resulted in intestinal obstruction. The patient underwent surgery during which a cystic mass of the right ovary measuring 6 cm × 5 cm × 4 cm, four small cysts of the small bowel （1 cm in diameter） and a cyst at the retroperitoneum measuring 11 cm× 10 cm × 3 cm were found. Complete resection of the lesion was performed. The patient had an uneventful recovery and had no recurrence two years after surgery.展开更多
BACKGROUND Multicystic biliary hamartoma(MCBH)is a rare hamartomatous nodule of the liver,which has recently been described as a new category of hepatic nodular cystic lesion.Most of them are benign.The imaging findin...BACKGROUND Multicystic biliary hamartoma(MCBH)is a rare hamartomatous nodule of the liver,which has recently been described as a new category of hepatic nodular cystic lesion.Most of them are benign.The imaging findings are similar to those of many other hepatic cystic lesions,but MCBH also has some notable features,such as large cysts,smooth cyst walls,and lack of communication with the hepatic duct.Due to the non-specific radiology,preoperative diagnosis is difficult,and is usually diagnosed by postoperative pathology.Complete resection is the best treatment option,and the postoperative prognosis is good.CASE SUMMARY When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.CONCLUSION When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.展开更多
Cystic lymphangiomas are rare benign tumors.Most frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the abdomen.The known congenital a...Cystic lymphangiomas are rare benign tumors.Most frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the abdomen.The known congenital and acquired(traumatic)etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic spaces.This case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection.A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain,vomiting,anorexia and unintentional weight loss accompanied by rapid abdominal distension.A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process,measuring 40 cm in diameter.Exploratory laparotomy revealed an enormous cystic mass containing 6 L of serous fluid.The process appeared to originate from the lesser omentum and the lesser curvature of the stomach.Radical resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent tissues.Histological analysis confirmed the diagnosis of a multicystic lymphangioma.The postoperative recovery was uneventful and the patient was discharged after 6 d.At 3-mo follow-up,the patient was in good health with no signs of recurrence.展开更多
With the increasing use of ultrasonography,congenital anomalies are often picked in utero.Antenatally detected hydronephrosis is amongst the most commonly detected abnormality.The management of this condition has rais...With the increasing use of ultrasonography,congenital anomalies are often picked in utero.Antenatally detected hydronephrosis is amongst the most commonly detected abnormality.The management of this condition has raised considerable debate amongst clinicians dealing with it.This article is written with an idea to provide comprehensive information regarding the postnatal management of antenatally detected hydronephrosis.A detailed review of the current literature on this topic is provided.Also,guidelines have been given to facilitate the management of this condition.展开更多
Pulmonary lymphangioleiomyomatosis(LAM)is a rare cystic lung disease that targets women during their reproductive years.A confident diagnosis can often be based on clinical grounds,but diagnostic certainty requires pa...Pulmonary lymphangioleiomyomatosis(LAM)is a rare cystic lung disease that targets women during their reproductive years.A confident diagnosis can often be based on clinical grounds,but diagnostic certainty requires pathological analysis.Although surgical lung biopsy is considered the gold standard for obtaining tissue in patients with diffuse lung disease,it is also associated with higher morbidity and mortality than alternative,less invasive techniques.The objective of our study was to examine the utility of transbronchial biopsy in the diagnosis of LAM.We conducted two online surveys of over 1000 LAM patients registered with the LAM Foundation who were accessible by email.Transbronchial biopsy specimens were subsequently collected and reviewed by an expert pathologist to validate the diagnosis.We found that transbronchial biopsy has a yield of approximately 60% in patients with LAM.We conclude that transbronchial biopsy may be a safe and effective method for establishing the diagnosis of LAM,obviating the need for surgical lung biopsy in more than half of LAM patients.展开更多
文摘Background: Schwannomas are generally benign neoplasms arising from the nerve sheath. Presacral schwannomas are very rare entities and difficult to diagnose, representing less than 15% of all retrorectal space tumors. Benign schwannoma sometimes displays degenerative changes, such as cyst formation, calcification, hemorrhage, and hyalinization. Usually these degenerations are partially seen in the tumors. Objective: To point out that presacral schwannoma can display markedly multilocular cystic degeneration. Case Report: We present this unique case of a 24-year-old man diagnosed with an unusually large pure multilocular cystic schwannoma, which is revealed by digestive, urinary, and nonspecific neurological symptoms. The patient was successfully treated with radical surgery via an anterior approach leading to the recovery of symptoms. Discussion and Conclusion: This tumor was unusual in its totally multicystic appearance and its resemblance to a wide spectrum of lesions that can occur in the pre-sacral space, such as hydatid and developmental cysts. Preoperative diagnosis is essential to prevent major neurological deficits during surgical intervention.
文摘Benign multicystic peritoneal mesothelioma(BMPM)is a rare tumor originating from peritoneal mesothelial cells.Here,we present a case of an 18-year-old male with right lower abdominal pain.Physical examination revealed a palpable mass with unclear boundaries.Laboratory tests showed elevated levels of monocytes and high-sensitivity C-reactive protein.CT scan revealed a cystic mass in the ileocecal region with multiple septations.Laparoscopic surgery confirmed a cystic solid mass resembling beads on the colon’s right side.Immunohistochemistry confirmed BMPM diagnosis.BMPM,especially in the ileocecal region,is uncommon and presents diagnostic challenges.Differential diagnosis includes lymphangioma,peritoneal metastasis,and malignant mesothelioma.CT findings,such as thin cyst walls and septations,aid in diagnosis.Recognition of BMPM’s imaging features improves diagnostic accuracy.Surgical resection remains the primary treatment.This case underscores the importance of considering BMPM in young male patients with abdominal pain and emphasizes the value of imaging modalities in accurate diagnosis and management.
文摘Benign multicystic peritoneal mesothelioma(BMPM)is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women.A 56-year-old Caucasian male was admitted to our surgical department with a chief complaint of a painful mass in his right lower abdomen for almost 2 years.The physical examination revealed a palpable painful mass.Computed tomography demonstrated an irregular,cystic tumor in his right lower abdomen.There was no obvious capsule or internal septations.No enhancement after intravenous administration of contrast was noted.An exploratory laparotomy was performed,and a multicystic tumor and adherent to the caecum was noted.The walls of the cysts were thin and smooth,filled with clear fluid,and very friable.An en bloc resection of the tumor,including appendix and caecum,was performed.Histological examination revealed multiple cysts lined with flattened simple epithelial cells,and the capsule walls of the cysts were composed of fibrous tissue.Immunohistochemical analysis documented positive expression of mesothelial cells and calretinin.The final diagnosis was BMPM.The patient was well at 6-mo follow-up.BMPM is exceedingly rare lesion.A complete resection of the tumor is required.The diagnosis of BMPM is based on pathological analysis.
文摘Benign multicystic peritoneal mesothelioma （BMPM） is a rare tumor that occurs mainly in women in their reproductive age. The pathogenesis of BMPM is unclear and a controversy regarding its neoplastic and reactive nature exists. The biological behavior of BMPM is characterized by its slowly progressive process and high rate of recurrence after surgical resection. In addition this lesion does not present a strong tendency to transform into malignancy. Today approximately 130 cases have been reported. We here report a 62-year-old woman who had diffuse abdominal pain, nausea and vomiting. Physical examination revealed a painful mass in her upper abdomen. She reported a mild dehydration, but the vital signs were normal. Peristaltic rushes, gurgles and highpitched tinkles were audible. Upright plain abdominal film revealed small bowel loops with air-fluid levels. She was diagnosed having an incarcerated incisional hernia that resulted in intestinal obstruction. The patient underwent surgery during which a cystic mass of the right ovary measuring 6 cm × 5 cm × 4 cm, four small cysts of the small bowel （1 cm in diameter） and a cyst at the retroperitoneum measuring 11 cm× 10 cm × 3 cm were found. Complete resection of the lesion was performed. The patient had an uneventful recovery and had no recurrence two years after surgery.
文摘BACKGROUND Multicystic biliary hamartoma(MCBH)is a rare hamartomatous nodule of the liver,which has recently been described as a new category of hepatic nodular cystic lesion.Most of them are benign.The imaging findings are similar to those of many other hepatic cystic lesions,but MCBH also has some notable features,such as large cysts,smooth cyst walls,and lack of communication with the hepatic duct.Due to the non-specific radiology,preoperative diagnosis is difficult,and is usually diagnosed by postoperative pathology.Complete resection is the best treatment option,and the postoperative prognosis is good.CASE SUMMARY When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.CONCLUSION When the patients have MCBH,the symptoms may not very typical,and they require a combination of imaging and pathology for diagnosis.Under normal circumstances,the prognosis of MCBH is good.However,in patients with MCBH,more cases need to be observed for verification.
文摘Cystic lymphangiomas are rare benign tumors.Most frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the abdomen.The known congenital and acquired(traumatic)etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic spaces.This case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection.A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain,vomiting,anorexia and unintentional weight loss accompanied by rapid abdominal distension.A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process,measuring 40 cm in diameter.Exploratory laparotomy revealed an enormous cystic mass containing 6 L of serous fluid.The process appeared to originate from the lesser omentum and the lesser curvature of the stomach.Radical resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent tissues.Histological analysis confirmed the diagnosis of a multicystic lymphangioma.The postoperative recovery was uneventful and the patient was discharged after 6 d.At 3-mo follow-up,the patient was in good health with no signs of recurrence.
文摘With the increasing use of ultrasonography,congenital anomalies are often picked in utero.Antenatally detected hydronephrosis is amongst the most commonly detected abnormality.The management of this condition has raised considerable debate amongst clinicians dealing with it.This article is written with an idea to provide comprehensive information regarding the postnatal management of antenatally detected hydronephrosis.A detailed review of the current literature on this topic is provided.Also,guidelines have been given to facilitate the management of this condition.
文摘一、临床资料
患者,男,35岁,米-17飞行员,飞行时间4000 h.于2012年4月5日因右侧间断性腰痛1周,加重1d入院.患者曾于2006年因胆囊结石住院期间体检发现多囊肾、多囊肝;其祖父患有多囊肾病史.并于2011年12月2日因体检发现双肾结石2周,入解放军第四五二医院治疗.患者入院查体:腹平,全腹柔软,无压痛及肌紧张,双侧肾区稍叩击痛,输尿管走行区无压痛,膀胱区无膨隆,无压痛.B超检查示:右肾积液,右输尿管上段扩张,双肾结石.中下腹CT示:右肾小结石,右输尿管上段小结石,多囊肝、多囊肾.静脉肾盂造影结果示:双肾功能良好,肝、肾功能正常.诊断:右输尿管结石,双肾结石,多囊肾,多囊肝.治疗上给予多饮水,适当活动,联合给予抗感染、解痉、利尿等对症治疗,于2012年4月19日经尿道排出结石1枚,长径约0.5 cm.
文摘Pulmonary lymphangioleiomyomatosis(LAM)is a rare cystic lung disease that targets women during their reproductive years.A confident diagnosis can often be based on clinical grounds,but diagnostic certainty requires pathological analysis.Although surgical lung biopsy is considered the gold standard for obtaining tissue in patients with diffuse lung disease,it is also associated with higher morbidity and mortality than alternative,less invasive techniques.The objective of our study was to examine the utility of transbronchial biopsy in the diagnosis of LAM.We conducted two online surveys of over 1000 LAM patients registered with the LAM Foundation who were accessible by email.Transbronchial biopsy specimens were subsequently collected and reviewed by an expert pathologist to validate the diagnosis.We found that transbronchial biopsy has a yield of approximately 60% in patients with LAM.We conclude that transbronchial biopsy may be a safe and effective method for establishing the diagnosis of LAM,obviating the need for surgical lung biopsy in more than half of LAM patients.
