Facial bone, as the frame to support maxillofacial region and with several sinuses and cavities, is structurally complicated and the maxillofacial tumors,benign or malignant, in this region usually grows into the deep...Facial bone, as the frame to support maxillofacial region and with several sinuses and cavities, is structurally complicated and the maxillofacial tumors,benign or malignant, in this region usually grows into the deep tissues, sinus-cav-ities and orbit and destroys the bone. In this study, the maxillofacial tumors were subjected to a mimic operation on a computer following CT scanning and 3-dimen-sional reconstruction. The data similar to those of real operation were obtained,which could be used for developing operative plans. As compared with data on the basis of conditions in the real operation, computerized mimic operation reflected the real conditions during operation. Computerized mimic operation is valuable for the preoperative planning and the prediction of probable intraoperative events.展开更多
Neuroendocrine tumors (NETs) are often misdiagnosed because they can involve any part of the body and have non-specific symptoms. Here, we report a case of a 39-year-old man with rectal neuroendocrine tumor (RNET) and...Neuroendocrine tumors (NETs) are often misdiagnosed because they can involve any part of the body and have non-specific symptoms. Here, we report a case of a 39-year-old man with rectal neuroendocrine tumor (RNET) and hepatic metastases treated with a combination of radical surgery and Everolimus therapy. The patient complained of abdominal distension, pain, and constipation of one month duration. Enhanced CT scan of the abdomen, colonoscopy and Biopsy findings confirmed the diagnosis of rectal neuroendocrine tumor. As the anatomical structures were clear and the masses seemed to be resectable, we decided to initiate treatment with radical operation and Everolimus therapy. The patient has responded well to the treatment with no evidence of recurrence after 4 years of follow-up. This case is interesting because of the rarity of this neoplasm and its initial misdiagnosis as a giant hepatic carcinoma (hepatoma). It also demonstrates that a combination of curative surgical resection and Everolimus is a good option in a patient with large colorectal neuroendocrine tumors and massive hepatic metastases.展开更多
Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric can...Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.展开更多
Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of...Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.展开更多
Objective To investigate the procedure via pterional-orbital approach for cranio-orbital communicating tumors. Methods 13 patients with cranio-orbital communicating tumors were retrospectively analyzed. Pterional appr...Objective To investigate the procedure via pterional-orbital approach for cranio-orbital communicating tumors. Methods 13 patients with cranio-orbital communicating tumors were retrospectively analyzed. Pterional approach was adopted for the operations with resection of orbital roof,and the surgical advantages and cautions were concerned. Results In 13 patients,10 cases展开更多
Objective: To evaluate the effect of operating room nursing on the outcome of patients undergoing robot-assisted tumor surgery. Methods: This research starts from October 2021 to October 2022. The number of patients w...Objective: To evaluate the effect of operating room nursing on the outcome of patients undergoing robot-assisted tumor surgery. Methods: This research starts from October 2021 to October 2022. The number of patients with robot-assisted tumor surgery included in our hospital is 769. The patients are treated in the operating room, and the prognosis of the patients is summarized. Results: The intraoperative blood loss in patients undergoing robot-assisted tumor surgery was (57.51 ± 12.01) ml;the operation time was (3.57 ± 0.66) h;and the hospital stay was (6.04 ± 0.53) d. There were 21 cases of complications after robot-assisted tumor surgery, accounting for 2.73%. After surgery, all robot-assisted tumor surgery patients recovered and were discharged smoothly after being checked by doctors. Conclusion: Robot-assisted tumor surgery nursing has a definite effect on patients’ rehabilitation in the operating room.展开更多
Despite surgical removal of tumors with portal vein tumor thrombus(PVTT) in hepatocellular carcinoma(HCC) patients, early recurrence tends to occur, and overall survival(OS) periods remain extremely short. The role th...Despite surgical removal of tumors with portal vein tumor thrombus(PVTT) in hepatocellular carcinoma(HCC) patients, early recurrence tends to occur, and overall survival(OS) periods remain extremely short. The role that hepatectomy may play in long-term survival for HCC with PVTT has not been established. The operative mortality of hepatectomy for HCC with PVTT has also not been reviewed. Hence, we reviewed recent literature to assess these parameters. The OS of patients who received hepatectomy in conjunction with multidisciplinary treatment tended to be superior to that of patients who did not. Multidisciplinary treatments included the following: preoperative radiotherapy on PVTT; preoperative transarterial chemoembolization(TACE); subcutaneous administration of interferon-alpha(IFN-α) and intra-arterial infusion of 5-fluorouracil(5-FU) with infusion chemotherapy in the affected hepatic artery; cisplatin, doxorubicin and 5-FU locally administered in the portal vein; and subcutaneous injection of IFN-α, adjuvant chemotherapy(5-FU + Adriamycin) administration via the portal vein with postoperative TACE, percutaneous isolated hepatic perfusion and hepatic artery infusion and/or portal vein chemotherapy. The highest reported rate of operative mortality was 9.3%. In conclusion, hepatectomy for patients affected by HCC with PVTT is safe, has low mortality and might prolong survival in conjunction with multidisciplinary treatment.展开更多
AIM: To investigate the specialty of transcranial surgery through pterional approach for removal of cranio-orbital tumors, introduce the ophthalmological experiences of entering the orbit to reduce the incidence rate ...AIM: To investigate the specialty of transcranial surgery through pterional approach for removal of cranio-orbital tumors, introduce the ophthalmological experiences of entering the orbit to reduce the incidence rate of associated complications of this operation. · METHODS: We performed a retrospective analysis of a series of 37 cases involving patients who underwent transcranial surgery through pterional approach for treatment of cranio-orbital tumors in our department in the past 8 years. Pterion approach craniotomy was performed to all patients. After removing tumors in the skull by the neurosurgeon, ophthalmologist removed tumors in orbit. We took measures below to decrease complications, including grounding optic canal through an abrasive drilling when necessary, hanging various extraocular muscles to be exposed for protection, refrigerating by refrigeration heads to remove tumors, at last sewing up orbit septum after surgery. · RESULTS: Tumors were removed completely in 32 cases, and incomplete in 5 cases due to extensive invasion into the cavernous sinus or sphenoid sinus. Of all the cases, benign tumors were demonstrated in 28 cases (75.6%, 28/37) and malignant in 9(24.3%, 9/37). The most common lesion type was meningioma in 11 cases (29.7%, 11/37). Extraocular muscles (EOM) impairment, occurring in 21 cases (56.7%, 21/37), was the most frequent postoperative complication. The most serious consequence was vision loss occurred in 4 cases (10.8%, 4/37). Other complications, such as 11 cases of transient blepharoptosis 29.7%(11/37), 5 cases of mydriasis in 13.5% (5/7); 2 cases of cerebrospinal rhinorrhea in 5.4% (2/37). · CONCLUSION: Cranio-orbital tumors can be removed completely using transcranial approach, and the pterional approach offers excellent exposure. Cooperation of interdisciplinary team of neurosurgeons and ophthalmologists conduces to full use of respective professional advantages. The experience of ophthalmic operation technology can decrease occurrence of ocular complications after surgery.展开更多
AIM:To assess the clinicopathological characteristics of duodenal well-differentiated endocrine tumors.METHODS:We examined clinicopathological characteristics in 11 consecutive patients with duodenal well-differentiat...AIM:To assess the clinicopathological characteristics of duodenal well-differentiated endocrine tumors.METHODS:We examined clinicopathological characteristics in 11 consecutive patients with duodenal well-differentiated endocrine tumors treated by endoscopic therapy or surgery in our hospital from 1992 through 2007.Patients with well-differentiated endocrine tu-mors of the papilla of Vater or with gastrinoma were excluded.RESULTS:Three patients received endoscopic treatment,and 8 underwent surgery.In patients who received endoscopic treatment,the tumor diameter was less than 1.0 cm,with no histopathological evidence of lymphovascular invasion or invasion of the muscularis.There were no complications such as late bleedingor perforation after treatment.Among 8 patients with tumors less than 1.0 cm in diameter,3 underwent partial resection,and 2 underwent radical surgery.Three patients had lymphovascular invasion,1 had invasion of the muscularis,and 1 had proximal lymph node metastasis.Among 3 patients with tumors 1.0 cm or more in diameter,1 underwent partial resection,and 2 under-went radical surgery.One patient had lymphovascular invasion,with no lymph node metastasis.After treatment,all patients are alive and have remained free of metastasis and recurrence.CONCLUSION:Duodenal well-differentiated endocrine tumors less than 1.0 cm in diameter have a risk of lym-phovascular invasion,invasion of the muscularis,and lymph node metastasis,irrespective of procedural prob-lems.展开更多
BACKGROUND Surgical treatment for large carotid body tumor (CBT),particularly the Shamblin III type,is challenging and rarely reported.CASE SUMMARY In July 2014,a 63-year-old woman presented to our hospital with a lar...BACKGROUND Surgical treatment for large carotid body tumor (CBT),particularly the Shamblin III type,is challenging and rarely reported.CASE SUMMARY In July 2014,a 63-year-old woman presented to our hospital with a large CBT (130 mm × 60 mm × 70 mm).The lesion was hypervascular,spanned from the first to the seventh cervical vertebra,and adhered to the right common carotid artery (CCA),internal carotid artery (ICA) and external carotid artery (ECA).The resection was carried out in a hybrid operating theatre.First,we used Onyx gel to embolize the feeding artery.An ICA balloon was used to prevent gel entry into the ICA.After shrinkage and hardening of the CBT,we quickly resected the CBT as well as a part of the ECA that adhered to the CBT.A vascular shunt was inserted between CCA and ICA,and the part where the ICA was cut off from the CCA was directly sutured.A follow-up at four years later showed no neurological damage.CONCLUSION For large hypervascular CBT,embolization of the feeding artery prior to resection is helpful.The hybrid operating theatre is the ideal platform to carry out such operations.展开更多
BACKGROUND Parathyroid adenoma is a benign parathyroid tumor,with serum parathyroid hormone and calcium ion concentrations as the typical basis for diagnosis.Its clinical manifestations are complex and changeable;thus...BACKGROUND Parathyroid adenoma is a benign parathyroid tumor,with serum parathyroid hormone and calcium ion concentrations as the typical basis for diagnosis.Its clinical manifestations are complex and changeable;thus it is easily missed or misdiagnosed.Approximately 85%of patients with parathyroid adenoma develop primary hyperparathyroidism,and abnormalities in bones,kidneys and other organs can occur.Brown tumors are rare.CASE SUMMARY We report a rare case of fibrocystic osteitis associated with a parathyroid adenoma,which was discovered by chance due to a rib tumor.Abnormally elevated serum parathyroid hormone and calcium ion were found before surgery.We suspected primary hyperparathyroidism,and color Doppler ultrasound suggested the presence of a thyroid mass.With informed consent by the patient and her family,we first removed the rib tumor,and one week later,resection of the parathyroid adenoma and thyroid mass was performed on both sides,and the patient recovered well after surgery.CONCLUSION In the case of parathyroid adenoma combined with brown tumor,the bone cyst will gradually decrease in size with time without treatment.If not,surgery should be performed as soon as possible.展开更多
BACKGROUND Gastric glomus tumor(GGT)is rare submucosal mesenchymal tumor that lacks specific clinical manifestations and is usually treated mainly by traditional surgical resection.This paper presents a case of a GGT,...BACKGROUND Gastric glomus tumor(GGT)is rare submucosal mesenchymal tumor that lacks specific clinical manifestations and is usually treated mainly by traditional surgical resection.This paper presents a case of a GGT,exhibited both intraluminally and extraluminally growth that was removed by laparoscopy-gastroscopy cooperative surgery.CASE SUMMARY A 52-year-old male presented with epigastric discomfort accompanied by a sense of fullness for 3 mo.Upper gastrointestinal endoscopy identified a submucosal lump located in the gastric antrum.Endoscopic ultrasonography identified a 2.4 cm×1.8 cm lump located in the gastric antrum.It originated from the muscularis propria and exhibited both intraluminally and extraluminally growth,with hypoechoicity on the periphery,hyperechoicity in the middle,and unclear boundaries.Computed tomography showed nodular thickening of 3.0 cm×2.2 cm in the gastric wall of the gastric antrum,and after enhancement,the lesion exhibited obvious enhancement We suspected that it was a gastrointestinal stromal tumor(glomus tumor and schwannoma were not excluded)and planned to perform laparoscopy-gastroscopy cooperative surgery.Immunohistochemical staining after the operation revealed that spinal muscular atrophy(+),hcaldesmon(+),cluster of differentiation 34(CD34)(+),2%Ki-67-positive rate,CD56,melanoma antigen,CD117,discovered on GIST-1,leukocyte common antigen,caudal type homeobox 2,cytokeratin,and S-100 were all negative.The tumor was finally diagnosed as a GGT.CONCLUSION GGTs are rare submucosal tumors of the stomach and should be considered in the differential diagnosis of gastric submucosal tumors.Laparoscopy-gastroscopy cooperative surgery is less invasive and more precise and could be an effective method for the treatment of GGTs.展开更多
文摘Facial bone, as the frame to support maxillofacial region and with several sinuses and cavities, is structurally complicated and the maxillofacial tumors,benign or malignant, in this region usually grows into the deep tissues, sinus-cav-ities and orbit and destroys the bone. In this study, the maxillofacial tumors were subjected to a mimic operation on a computer following CT scanning and 3-dimen-sional reconstruction. The data similar to those of real operation were obtained,which could be used for developing operative plans. As compared with data on the basis of conditions in the real operation, computerized mimic operation reflected the real conditions during operation. Computerized mimic operation is valuable for the preoperative planning and the prediction of probable intraoperative events.
文摘Neuroendocrine tumors (NETs) are often misdiagnosed because they can involve any part of the body and have non-specific symptoms. Here, we report a case of a 39-year-old man with rectal neuroendocrine tumor (RNET) and hepatic metastases treated with a combination of radical surgery and Everolimus therapy. The patient complained of abdominal distension, pain, and constipation of one month duration. Enhanced CT scan of the abdomen, colonoscopy and Biopsy findings confirmed the diagnosis of rectal neuroendocrine tumor. As the anatomical structures were clear and the masses seemed to be resectable, we decided to initiate treatment with radical operation and Everolimus therapy. The patient has responded well to the treatment with no evidence of recurrence after 4 years of follow-up. This case is interesting because of the rarity of this neoplasm and its initial misdiagnosis as a giant hepatic carcinoma (hepatoma). It also demonstrates that a combination of curative surgical resection and Everolimus is a good option in a patient with large colorectal neuroendocrine tumors and massive hepatic metastases.
文摘Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.
文摘Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.
文摘Objective To investigate the procedure via pterional-orbital approach for cranio-orbital communicating tumors. Methods 13 patients with cranio-orbital communicating tumors were retrospectively analyzed. Pterional approach was adopted for the operations with resection of orbital roof,and the surgical advantages and cautions were concerned. Results In 13 patients,10 cases
文摘Objective: To evaluate the effect of operating room nursing on the outcome of patients undergoing robot-assisted tumor surgery. Methods: This research starts from October 2021 to October 2022. The number of patients with robot-assisted tumor surgery included in our hospital is 769. The patients are treated in the operating room, and the prognosis of the patients is summarized. Results: The intraoperative blood loss in patients undergoing robot-assisted tumor surgery was (57.51 ± 12.01) ml;the operation time was (3.57 ± 0.66) h;and the hospital stay was (6.04 ± 0.53) d. There were 21 cases of complications after robot-assisted tumor surgery, accounting for 2.73%. After surgery, all robot-assisted tumor surgery patients recovered and were discharged smoothly after being checked by doctors. Conclusion: Robot-assisted tumor surgery nursing has a definite effect on patients’ rehabilitation in the operating room.
文摘Despite surgical removal of tumors with portal vein tumor thrombus(PVTT) in hepatocellular carcinoma(HCC) patients, early recurrence tends to occur, and overall survival(OS) periods remain extremely short. The role that hepatectomy may play in long-term survival for HCC with PVTT has not been established. The operative mortality of hepatectomy for HCC with PVTT has also not been reviewed. Hence, we reviewed recent literature to assess these parameters. The OS of patients who received hepatectomy in conjunction with multidisciplinary treatment tended to be superior to that of patients who did not. Multidisciplinary treatments included the following: preoperative radiotherapy on PVTT; preoperative transarterial chemoembolization(TACE); subcutaneous administration of interferon-alpha(IFN-α) and intra-arterial infusion of 5-fluorouracil(5-FU) with infusion chemotherapy in the affected hepatic artery; cisplatin, doxorubicin and 5-FU locally administered in the portal vein; and subcutaneous injection of IFN-α, adjuvant chemotherapy(5-FU + Adriamycin) administration via the portal vein with postoperative TACE, percutaneous isolated hepatic perfusion and hepatic artery infusion and/or portal vein chemotherapy. The highest reported rate of operative mortality was 9.3%. In conclusion, hepatectomy for patients affected by HCC with PVTT is safe, has low mortality and might prolong survival in conjunction with multidisciplinary treatment.
文摘AIM: To investigate the specialty of transcranial surgery through pterional approach for removal of cranio-orbital tumors, introduce the ophthalmological experiences of entering the orbit to reduce the incidence rate of associated complications of this operation. · METHODS: We performed a retrospective analysis of a series of 37 cases involving patients who underwent transcranial surgery through pterional approach for treatment of cranio-orbital tumors in our department in the past 8 years. Pterion approach craniotomy was performed to all patients. After removing tumors in the skull by the neurosurgeon, ophthalmologist removed tumors in orbit. We took measures below to decrease complications, including grounding optic canal through an abrasive drilling when necessary, hanging various extraocular muscles to be exposed for protection, refrigerating by refrigeration heads to remove tumors, at last sewing up orbit septum after surgery. · RESULTS: Tumors were removed completely in 32 cases, and incomplete in 5 cases due to extensive invasion into the cavernous sinus or sphenoid sinus. Of all the cases, benign tumors were demonstrated in 28 cases (75.6%, 28/37) and malignant in 9(24.3%, 9/37). The most common lesion type was meningioma in 11 cases (29.7%, 11/37). Extraocular muscles (EOM) impairment, occurring in 21 cases (56.7%, 21/37), was the most frequent postoperative complication. The most serious consequence was vision loss occurred in 4 cases (10.8%, 4/37). Other complications, such as 11 cases of transient blepharoptosis 29.7%(11/37), 5 cases of mydriasis in 13.5% (5/7); 2 cases of cerebrospinal rhinorrhea in 5.4% (2/37). · CONCLUSION: Cranio-orbital tumors can be removed completely using transcranial approach, and the pterional approach offers excellent exposure. Cooperation of interdisciplinary team of neurosurgeons and ophthalmologists conduces to full use of respective professional advantages. The experience of ophthalmic operation technology can decrease occurrence of ocular complications after surgery.
文摘AIM:To assess the clinicopathological characteristics of duodenal well-differentiated endocrine tumors.METHODS:We examined clinicopathological characteristics in 11 consecutive patients with duodenal well-differentiated endocrine tumors treated by endoscopic therapy or surgery in our hospital from 1992 through 2007.Patients with well-differentiated endocrine tu-mors of the papilla of Vater or with gastrinoma were excluded.RESULTS:Three patients received endoscopic treatment,and 8 underwent surgery.In patients who received endoscopic treatment,the tumor diameter was less than 1.0 cm,with no histopathological evidence of lymphovascular invasion or invasion of the muscularis.There were no complications such as late bleedingor perforation after treatment.Among 8 patients with tumors less than 1.0 cm in diameter,3 underwent partial resection,and 2 underwent radical surgery.Three patients had lymphovascular invasion,1 had invasion of the muscularis,and 1 had proximal lymph node metastasis.Among 3 patients with tumors 1.0 cm or more in diameter,1 underwent partial resection,and 2 under-went radical surgery.One patient had lymphovascular invasion,with no lymph node metastasis.After treatment,all patients are alive and have remained free of metastasis and recurrence.CONCLUSION:Duodenal well-differentiated endocrine tumors less than 1.0 cm in diameter have a risk of lym-phovascular invasion,invasion of the muscularis,and lymph node metastasis,irrespective of procedural prob-lems.
基金Supported by the National Natural Science Foundation of China,No.81571144the Natural Science Foundation of Tianjin City,No.16JCZDJC35700
文摘BACKGROUND Surgical treatment for large carotid body tumor (CBT),particularly the Shamblin III type,is challenging and rarely reported.CASE SUMMARY In July 2014,a 63-year-old woman presented to our hospital with a large CBT (130 mm × 60 mm × 70 mm).The lesion was hypervascular,spanned from the first to the seventh cervical vertebra,and adhered to the right common carotid artery (CCA),internal carotid artery (ICA) and external carotid artery (ECA).The resection was carried out in a hybrid operating theatre.First,we used Onyx gel to embolize the feeding artery.An ICA balloon was used to prevent gel entry into the ICA.After shrinkage and hardening of the CBT,we quickly resected the CBT as well as a part of the ECA that adhered to the CBT.A vascular shunt was inserted between CCA and ICA,and the part where the ICA was cut off from the CCA was directly sutured.A follow-up at four years later showed no neurological damage.CONCLUSION For large hypervascular CBT,embolization of the feeding artery prior to resection is helpful.The hybrid operating theatre is the ideal platform to carry out such operations.
文摘BACKGROUND Parathyroid adenoma is a benign parathyroid tumor,with serum parathyroid hormone and calcium ion concentrations as the typical basis for diagnosis.Its clinical manifestations are complex and changeable;thus it is easily missed or misdiagnosed.Approximately 85%of patients with parathyroid adenoma develop primary hyperparathyroidism,and abnormalities in bones,kidneys and other organs can occur.Brown tumors are rare.CASE SUMMARY We report a rare case of fibrocystic osteitis associated with a parathyroid adenoma,which was discovered by chance due to a rib tumor.Abnormally elevated serum parathyroid hormone and calcium ion were found before surgery.We suspected primary hyperparathyroidism,and color Doppler ultrasound suggested the presence of a thyroid mass.With informed consent by the patient and her family,we first removed the rib tumor,and one week later,resection of the parathyroid adenoma and thyroid mass was performed on both sides,and the patient recovered well after surgery.CONCLUSION In the case of parathyroid adenoma combined with brown tumor,the bone cyst will gradually decrease in size with time without treatment.If not,surgery should be performed as soon as possible.
基金Key Program of Shandong Provincial Natural Science Foundation,No.ZR2020KE018The Project of Shandong Province Higher Educational Science and Technology Program,No.J17KA253+1 种基金The Medical Science and Technology Development Project of Shandong,No.2018WS062Weifang Science and Technology Development Plan,No.2020YX040.
文摘BACKGROUND Gastric glomus tumor(GGT)is rare submucosal mesenchymal tumor that lacks specific clinical manifestations and is usually treated mainly by traditional surgical resection.This paper presents a case of a GGT,exhibited both intraluminally and extraluminally growth that was removed by laparoscopy-gastroscopy cooperative surgery.CASE SUMMARY A 52-year-old male presented with epigastric discomfort accompanied by a sense of fullness for 3 mo.Upper gastrointestinal endoscopy identified a submucosal lump located in the gastric antrum.Endoscopic ultrasonography identified a 2.4 cm×1.8 cm lump located in the gastric antrum.It originated from the muscularis propria and exhibited both intraluminally and extraluminally growth,with hypoechoicity on the periphery,hyperechoicity in the middle,and unclear boundaries.Computed tomography showed nodular thickening of 3.0 cm×2.2 cm in the gastric wall of the gastric antrum,and after enhancement,the lesion exhibited obvious enhancement We suspected that it was a gastrointestinal stromal tumor(glomus tumor and schwannoma were not excluded)and planned to perform laparoscopy-gastroscopy cooperative surgery.Immunohistochemical staining after the operation revealed that spinal muscular atrophy(+),hcaldesmon(+),cluster of differentiation 34(CD34)(+),2%Ki-67-positive rate,CD56,melanoma antigen,CD117,discovered on GIST-1,leukocyte common antigen,caudal type homeobox 2,cytokeratin,and S-100 were all negative.The tumor was finally diagnosed as a GGT.CONCLUSION GGTs are rare submucosal tumors of the stomach and should be considered in the differential diagnosis of gastric submucosal tumors.Laparoscopy-gastroscopy cooperative surgery is less invasive and more precise and could be an effective method for the treatment of GGTs.
