We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction.Only two similar cases have been reported in the English literature.Endoscopic retrograde c...We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction.Only two similar cases have been reported in the English literature.Endoscopic retrograde cholangiopancreatography showed a tuberous filling defect in the middle and superior parts of the common bile duct,and mild stenosis in the inferior duct.Computed tomography(CT) showed a well enhanced mass in the middle and superior parts of the common bile duct.A single cancer of the middle and superior bile duct was suspected and extra-hepatic bile duct resection was performed.CT eleven months after surgery revealed enhanced inferior bile duct wall and a slightly enhanced tumor within it.Retrospective review of the CT images taken before first surgery showed enhanced inferior bile duct wall without intrabiliary tumor only on the delayed phase.The inferior bile duct tumor was suspected to have originally co-existed with the middle and superior bile duct tumor.Pancreaticoduodenectomy was performed subsequently.Histopathological examination revealed that the middle and superior bile duct tumor was a moderately differentiated tubular adenocarcinoma while the inferior bile duct tumor was a papillary adenocarcinoma.The two tumors were separated and had different histological findings and growth patterns,further suggesting that they were two primary cancers.展开更多
The heart is an unusual site of metastasis from any malignancy. We report a case of cardiac metastasis from colorectal cancer. A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with...The heart is an unusual site of metastasis from any malignancy. We report a case of cardiac metastasis from colorectal cancer. A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with cardiac myxoma. Two-dimensional echocardiography showed a 4 cm x 4.5 cm mobile mass on the lateral right atrial wall, and computed tomography revealed a low attenuated Iobulating mass in the right atrium. The patient underwent anterior resection for sigmoid colon cancer （T4N2）. Thereafter, she experienced progressive shortness of breath. Therefore, a cardiac operation was performed 2 wk after the colorectal operation. Histological examination revealed adenocarcinoma, which was identical to the primary lesion. Although two- dimensional echocardiography has become the diagnostic test of choice for detecting cardiac tumors, in patients with colorectal cancer showing a cardiac mass, further diagnostic evaluation such as a magnetic resonance imaging might be necessary.展开更多
Objective.To analyze the clinical characteris tics of peripartum cardiomyopathy a nd to evaluate the different factors that influence the prognosis of the peripartum cardiomyopathy.Method.A retrospective review was un...Objective.To analyze the clinical characteris tics of peripartum cardiomyopathy a nd to evaluate the different factors that influence the prognosis of the peripartum cardiomyopathy.Method.A retrospective review was undertak en on records of women who were diagnosed with peripartum cardiomyopathy at Peking Union Medi cal College Hospital between Jan.1983and May 1999.Results.During the research period,only 16p regnant women were documented as peripartum cardiomyopa-thy.Some of the women undertook ultr asonic cardiographic(UCG)examination that showed decreased s ystolic function.Seven women were complica ted with pregnancy induced hyperten sion.Three died of disseminated intravascular coagulation,embolism and cardiogenic shock respectively.Conclusion.Early diagnosis of the peripartum ca rdiomyopathy is extremely important.The UCG can pro-vide helpful information on disease progression or regression.展开更多
Primary cardiac tumors are quite rare and most of these tumors are benign.In this report,a patient presented with chest distress and shortness of breath after activity.Echocardiography of other hospital showed a hyper...Primary cardiac tumors are quite rare and most of these tumors are benign.In this report,a patient presented with chest distress and shortness of breath after activity.Echocardiography of other hospital showed a hyperechoic right atrial mass.Electrocardiogram-gated cardiac computed tomography(ECG-Gated CT) of our hospital provided accurate information about the site and extent of the tumor,and the involvement of neighboring structures,even about the malignant nature of the lesion.The pathological study indicated angiosarcoma.The role of ECG-Gated CT in the assessment of cardiac masses and tumors was discussed.Cardiac tumors are extremely rare and can be divided into benign and malignant lesions.Myxomas are the most common type of cardiac benign tumor,while angiosarcomas are the most common type of cardiac malignant tumor.Imaging studies play an important role in the diagnosis of cardiac angiosarcomas.Echocardiogram,computed tomography(CT) and magnetic resonance imaging(MRI) are the most common imaging studies for tumors evaluation.However,the precise tumor location is often difficult to evaluate precisely on the basis of two-dimensional source images.We conducted ECG-gated cardiac CT examination with 3D reconstruction for preoperative assessment in a patient with a angiosarcoma arising in the right atrium.展开更多
文摘We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction.Only two similar cases have been reported in the English literature.Endoscopic retrograde cholangiopancreatography showed a tuberous filling defect in the middle and superior parts of the common bile duct,and mild stenosis in the inferior duct.Computed tomography(CT) showed a well enhanced mass in the middle and superior parts of the common bile duct.A single cancer of the middle and superior bile duct was suspected and extra-hepatic bile duct resection was performed.CT eleven months after surgery revealed enhanced inferior bile duct wall and a slightly enhanced tumor within it.Retrospective review of the CT images taken before first surgery showed enhanced inferior bile duct wall without intrabiliary tumor only on the delayed phase.The inferior bile duct tumor was suspected to have originally co-existed with the middle and superior bile duct tumor.Pancreaticoduodenectomy was performed subsequently.Histopathological examination revealed that the middle and superior bile duct tumor was a moderately differentiated tubular adenocarcinoma while the inferior bile duct tumor was a papillary adenocarcinoma.The two tumors were separated and had different histological findings and growth patterns,further suggesting that they were two primary cancers.
文摘The heart is an unusual site of metastasis from any malignancy. We report a case of cardiac metastasis from colorectal cancer. A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with cardiac myxoma. Two-dimensional echocardiography showed a 4 cm x 4.5 cm mobile mass on the lateral right atrial wall, and computed tomography revealed a low attenuated Iobulating mass in the right atrium. The patient underwent anterior resection for sigmoid colon cancer （T4N2）. Thereafter, she experienced progressive shortness of breath. Therefore, a cardiac operation was performed 2 wk after the colorectal operation. Histological examination revealed adenocarcinoma, which was identical to the primary lesion. Although two- dimensional echocardiography has become the diagnostic test of choice for detecting cardiac tumors, in patients with colorectal cancer showing a cardiac mass, further diagnostic evaluation such as a magnetic resonance imaging might be necessary.
文摘Objective.To analyze the clinical characteris tics of peripartum cardiomyopathy a nd to evaluate the different factors that influence the prognosis of the peripartum cardiomyopathy.Method.A retrospective review was undertak en on records of women who were diagnosed with peripartum cardiomyopathy at Peking Union Medi cal College Hospital between Jan.1983and May 1999.Results.During the research period,only 16p regnant women were documented as peripartum cardiomyopa-thy.Some of the women undertook ultr asonic cardiographic(UCG)examination that showed decreased s ystolic function.Seven women were complica ted with pregnancy induced hyperten sion.Three died of disseminated intravascular coagulation,embolism and cardiogenic shock respectively.Conclusion.Early diagnosis of the peripartum ca rdiomyopathy is extremely important.The UCG can pro-vide helpful information on disease progression or regression.
文摘Primary cardiac tumors are quite rare and most of these tumors are benign.In this report,a patient presented with chest distress and shortness of breath after activity.Echocardiography of other hospital showed a hyperechoic right atrial mass.Electrocardiogram-gated cardiac computed tomography(ECG-Gated CT) of our hospital provided accurate information about the site and extent of the tumor,and the involvement of neighboring structures,even about the malignant nature of the lesion.The pathological study indicated angiosarcoma.The role of ECG-Gated CT in the assessment of cardiac masses and tumors was discussed.Cardiac tumors are extremely rare and can be divided into benign and malignant lesions.Myxomas are the most common type of cardiac benign tumor,while angiosarcomas are the most common type of cardiac malignant tumor.Imaging studies play an important role in the diagnosis of cardiac angiosarcomas.Echocardiogram,computed tomography(CT) and magnetic resonance imaging(MRI) are the most common imaging studies for tumors evaluation.However,the precise tumor location is often difficult to evaluate precisely on the basis of two-dimensional source images.We conducted ECG-gated cardiac CT examination with 3D reconstruction for preoperative assessment in a patient with a angiosarcoma arising in the right atrium.
