简介：Splenicmetastasisisgenerallynotacommonclinicalevent.However,metastasistothespleenfromadrenalpheochromocytomaisextremelyrareandhasnotbeenreportedinliterature.Thisreportpresentsacaseofa58year-oldmalepatientwhodevelopedspleen-onlymetastasesinJuly2007.ThepatienthadaprevioushistoryofleftepinephroectomyforadrenalpheochromocytomainJanuary2003.Abdominalcomputedtomographydemonstratedmultipleenhancinglesionssuggestiveofmetastases;thussplenectomywasperformed.Pathologicalexaminationsconfirmedthediagnosisofsplenicmetastasesfrompheochromocytoma.Thepatientwasalivewithoutrecurrence48monthsaftersplenectomy.Thisstudyisthefirstreportonsplenicmetastasisfrompreviousadrenalpheochromocytoma,andlong-termsurvivalwasachievedbysplenectomy.Ahistoryofmalignancyindicatesahighindexofsuspicionforsplenicmetastasis,andlong-termsurvivalcanbeachievedbysplenectomyforspleen-onlymetastasis.

简介：Autoimmunehepatitis(AIH)hasrarelybeendescribedasanautoimmuneparaneoplasticsyndromeofthymoma.ThiscaseistheseventhcaseofAIHrevealedbycholestasisfewyearsafterthediagnosisofthymomaandthefirstcasetreatedwithchemotherapyalone.Wereportinthispaperanewapproachtothisrareseverecondition.A29year-oldmanpresentedwithchestpainanddyspneawithahistoryofthymomasurgicallyremoved4yearsago.CTscanshowedtherecurrenceofananteriormediastinalmass.Biologyshowedelevatedliverenzymesandprofoundcholestasis.Nosignofviralortoxichepatitisorbileductabnormalitieswereobserved.Autoimmuneantibodies,exceptfortheanti-nuclearantibody,werenegative.LiverbiopsyshowedactivechronicAIH.ThepatientwasdiagnosedwithrecurrentthymomawithAIHandunderwent6cyclesofchemotherapy.Acompleteresponseonthymomaandcholestasiswasobtainedafter10monthsoffollow-up.SteroidsandimmunosuppressorsarethestandardtreatmentforAIH.Theeffectofchemotherapyasaspecifictreatmentofthisparaneoplasticsyndromeneedstobeconsidered.

简介：Gingivaladenoidcysticcarcinoma(ACC)isararemalignancy.Wedescribethediagnosisandtreatmentofa43year-oldwomanwhopresentedwithapersistentoralulcerforapproximately1year,andsubsequentpainintheleftposteriormaxillaryregion.Clinicalexaminationrevealedanulcerintheleftuppermolargingiva,withswellingintheregionfromthesecondpremolartothethirdmolar.X-rayimagesdemonstratedtheinvolvementofthemaxillaryalveolarbone.ThehistopathologicalandimmunohistochemicalfeatureswerediagnosticofACC.ACCisoftenpresentedasagingivallesion;thus,itmayeasilybeneglectedbypatients.Theidentificationofthistumorusingspecificpathologicalanalysespreventsmisdiagnosisandenablesclinicianstodeterminetheappropriatetreatment.Inthiscase,norecurrenceordistantmetastasiswasobservedafter2yearsoffollow-up.

简介：Non-parasitichepaticcystswithbiliarycommunicationarerare.Theclinicalsymptomsinvolvedarenotspecifictothiscondition,therebymakingdiagnosisdifficultandtreatmentcontroversial.Here,wereportacaseof70-year-oldwomancomplainingofabdominalsatiety,combinedwithnon-specificpainintherightupperquadrant.Theabdominalcontrast-enhancedMRI-scanrevealedalargeandthick-walledseptuscysticlesionintheliver.Duringoperation,thebiliaryfistulawasconfirmedinthecystcavity.Asilicageltubewasinsertedviathecysticductforcholangiography,whichdemonstratedcommunicationbetweenthecystandbiliarytract.Weperformedwide-scalecystwallresection;thebiliaryfistulawascompletelyrepairedbytheclosureofcommunicatedbileducts.Thepostoperativecoursewasuneventful,andthepatientwasdischargedwithnosignofcholangitisoranyothersymptoms.Thenovelsurgicalmanagementviawideresectionofthecystwallandclosureofbiliarycommunicationprovedtobeanadequateandeffectiveprocedurefortreatingnonparasitichepaticcystswithbiliarycommunication.

简介：Extrapulmonarysmallcellcarcinoma(EPSCC)isarareneoplasmcomprising2.5%to5%ofsmallcellcarcinomas(SCCs).BladderSCCisthemostcommonsiteofgenitourinarytract.PrimaryrenalSCCisextremelyrare.WereportacaseofprimarySCCofthekidneywhichisrarelyreportedintheurinarytractandpresentsanaggressiveclinicalpicture.A59-year-oldfemalevisitedaurologicclinicwithcomplaintofpersistentleftflanksoreness10yearsafterundergoingrenaltransplantation.Abdominalcomputedtomographyshowedaleftrenalpelvistumor.Afterthepatientreceivedleftnephroureterectomywithbladdercuffresection,herpathologyresultsshowedSCC.Aftersurgery,shereceivedadjuvantsystemicchemotherapy,andherrecoveryhasbeenuneventfulasof8months.PrimaryrenalSCCpresentswithanadvancedtumorstageandashortmediansurvivalperiod,thereforeearlyinterventionandclosefollow-uparerecommended.

简介：A60-year-oldwomanwithsquamouscellcarcinomaintherightlungwassuccessfullytreatedwithfourcyclesofcombinationchemotherapyaftersurgery,andcompleteremissionwasachieved.However,thepatientdevelopedmyelodysplasticsyndrome(MDS)RAEB-2withmyelofibrosisafterremission,possiblybecauseofchemotherapyorDNAmethylation.Thepatientrespondedwelltodacitabine(Dacogen),suggestingthatDNAhypomethylationagentscanbeapromisingtherapytoretardtheprogressionofasecondtumororcarcinoma.

简介：Objective:Thisworkaimedtostudythesafetyandefficacyofpreoperativeintestinalstentdecompressioncombinedwithlaparoscopicsurgerytotreatleft-sidedcolorectalcancerwithobstruction(LCCO).Methods:Retrospectiveanalysiswasconductedondataobtainedfrom21LCCOpatientsadmittedtoTheFirstAffiliatedHospitalofZhejiangChineseMedicineUniversityduringMarch2008andDecember2011.Toremovetheintestinalobstruction,preoperativeintestinalstentplacementundercolonoscopicguidancewasperformed.Approximately7to10daysaftertheoperation,laparoscopicradicalsurgeryofcolorectalcancerwasconducted.Results:Amongthe21casesstudied,laparoscopicsurgerywassuccessfulin20patients.Emergentlaparotomywasconductedinonepatientbecauseoftumorinvasionintheureter.Thedurationoftheoperationrangedfrom180to320min,andtheaveragetimewas220min.Therecoverytimeforbowelfunctionrangedfrom2to5dayswithanaveragetimeof3days.Postoperativeinfectionoftheincisionoccurredinonecase.Noanastomoticleakagewasobservedinanyofthecases.Conclusion:Preoperativeintestinalstentdecompression,combinedwithprimarystagelaparoscopicsurgery,isasafeandeffectivemethodforthetreatmentofLCCO.