Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological fe...Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological features.These include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous carcinoma.To date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated surgically.We hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct IPMN-P.Since surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and radio-therapy.This was effective in decreasing the mass size and in resolving subsequent jaundice.This is also the f irst reported case of IPMN-B successfully treated with chemoradiotherapy.Clinicians should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery.展开更多
We would like offering our experience about a very rare and underestimated type of gastrointestinal lipoma,which is the lipoma with precancerous or frankly malignant features of the mucosal epithelium,the socalled aty...We would like offering our experience about a very rare and underestimated type of gastrointestinal lipoma,which is the lipoma with precancerous or frankly malignant features of the mucosal epithelium,the socalled atypical lipoma.So far,only few cases have been described in the world literature.Recently,we grappled with what we think the first case of atypical colonic lipoma presenting with adenocarcinomatous transformation of the overlying epithelium,as discussed in more detail below.We propose a new definition and classification for this kind of lesions and discuss about their diagnosis,treatment and prognosis.展开更多
Small bowel diverticulosis represents an uncommon disorder (except for Meckel diverticulum) often misdiagnosed since it causes non-specific gastroin- testinal symptoms. Most of times the diagnosis is carried out in ca...Small bowel diverticulosis represents an uncommon disorder (except for Meckel diverticulum) often misdiagnosed since it causes non-specific gastroin- testinal symptoms. Most of times the diagnosis is carried out in case of related complications, such as diverticulitis, hemorrhage, perforation or obstruction. Intestinal obstruction can be caused by inflammatory stenosis due to repeated episodes of diverticulitis, volvulus, intussusception or jejunal stones. Herein we report a case of multiple jejunal diverticula causing chronic gastrointestinal obstruction.展开更多
A 34-year-old male with hereditary non-polyposis colon cancer with a mutation in hMSH2 line is reported. Despite regular colonoscopic follow-up, he developed cecal cancer involving the extraluminal area. Due to sub-oc...A 34-year-old male with hereditary non-polyposis colon cancer with a mutation in hMSH2 line is reported. Despite regular colonoscopic follow-up, he developed cecal cancer involving the extraluminal area. Due to sub-occlusive symptoms, the patient was submitted to further colonoscopy, however with no clear evidence of neoplasia. Thin slice multiplanar reconstruction computed tomography CT scan performed thereafter revealed a transmural mass 2.5 cm in size localized near the cecal valve. Discussion is made on the reliability of colonoscopic examinations as well as the need for further investigations in the follow-up of patients at very high risk of right-sided colon cancer, such as male hMSH2 carrier affected by hereditary non-polyposis colon cancer.展开更多
Hepatocellular carcinoma(HCC)is the most frequent primary tumor of the liver and the sixth most common cancer worldwide with more than 800,000 cases per year(1).Potentially curative treatments such as liver transplant...Hepatocellular carcinoma(HCC)is the most frequent primary tumor of the liver and the sixth most common cancer worldwide with more than 800,000 cases per year(1).Potentially curative treatments such as liver transplantation(LT),liver resection(LR),and ablation(in selected cases)currently represent the best available options to offer long-term survival to patients(2).Given the worldwide scarcity of organs for transplantation,hepatic resection(open or minimally invasive),is frequently considered as the first option upon presentation.One of the most intriguing and longstanding debated issues among the hepatobiliary surgical community is the type of surgical resection that should be performed.Should we systematically pursue an anatomical resection(AR)or non-anatomical resection(NAR)for HCC?展开更多
文摘Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological features.These include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous carcinoma.To date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated surgically.We hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct IPMN-P.Since surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and radio-therapy.This was effective in decreasing the mass size and in resolving subsequent jaundice.This is also the f irst reported case of IPMN-B successfully treated with chemoradiotherapy.Clinicians should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery.
基金Supported by The PhD University Grant program"Clinical and Experimental Research Methodologies in Oncology"provided by the Faculty of Medicine and Psychology University of Rome"La Sapienza"to La Torre M
文摘AIM: To report a meta-analysis of the studies that compared the laparoscopic with the open approach for colon cancer resection.
文摘We would like offering our experience about a very rare and underestimated type of gastrointestinal lipoma,which is the lipoma with precancerous or frankly malignant features of the mucosal epithelium,the socalled atypical lipoma.So far,only few cases have been described in the world literature.Recently,we grappled with what we think the first case of atypical colonic lipoma presenting with adenocarcinomatous transformation of the overlying epithelium,as discussed in more detail below.We propose a new definition and classification for this kind of lesions and discuss about their diagnosis,treatment and prognosis.
文摘Small bowel diverticulosis represents an uncommon disorder (except for Meckel diverticulum) often misdiagnosed since it causes non-specific gastroin- testinal symptoms. Most of times the diagnosis is carried out in case of related complications, such as diverticulitis, hemorrhage, perforation or obstruction. Intestinal obstruction can be caused by inflammatory stenosis due to repeated episodes of diverticulitis, volvulus, intussusception or jejunal stones. Herein we report a case of multiple jejunal diverticula causing chronic gastrointestinal obstruction.
基金Supported by Ricerche Ateneo 2004 n.C26A044873,University "La Sapienza",Rome,and PRIN 2003,n.2003063877_002
文摘A 34-year-old male with hereditary non-polyposis colon cancer with a mutation in hMSH2 line is reported. Despite regular colonoscopic follow-up, he developed cecal cancer involving the extraluminal area. Due to sub-occlusive symptoms, the patient was submitted to further colonoscopy, however with no clear evidence of neoplasia. Thin slice multiplanar reconstruction computed tomography CT scan performed thereafter revealed a transmural mass 2.5 cm in size localized near the cecal valve. Discussion is made on the reliability of colonoscopic examinations as well as the need for further investigations in the follow-up of patients at very high risk of right-sided colon cancer, such as male hMSH2 carrier affected by hereditary non-polyposis colon cancer.
文摘Hepatocellular carcinoma(HCC)is the most frequent primary tumor of the liver and the sixth most common cancer worldwide with more than 800,000 cases per year(1).Potentially curative treatments such as liver transplantation(LT),liver resection(LR),and ablation(in selected cases)currently represent the best available options to offer long-term survival to patients(2).Given the worldwide scarcity of organs for transplantation,hepatic resection(open or minimally invasive),is frequently considered as the first option upon presentation.One of the most intriguing and longstanding debated issues among the hepatobiliary surgical community is the type of surgical resection that should be performed.Should we systematically pursue an anatomical resection(AR)or non-anatomical resection(NAR)for HCC?
