A 77-year-old woman complained of epigastralgia,and a tumor(5 cm in diameter)of the gallbladder neck was detected by image analysis.Following cholecystectomy,the tumor was pathologically diagnosed as intraductal papil...A 77-year-old woman complained of epigastralgia,and a tumor(5 cm in diameter)of the gallbladder neck was detected by image analysis.Following cholecystectomy,the tumor was pathologically diagnosed as intraductal papillary neoplasm(IPN),gastric type,with associated invasive carcinoma.About 10 mo later,intraluminal multiple masses(3 foci,up to 1.8 cm)were noted in the extrahepatic bile duct,and the resected specimen showed that all tumors had similar gross and microscopic features as seen in gallbladder IPN without invasion,and they were synchronous multiple lesions.This case showed a papillary tumor of the gallbladder of gastric phenotype,and confirmed that the gallbladder is a target of IPN in addition to the bile ducts.展开更多
Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric populations.Despite the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct in...Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric populations.Despite the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems.A series of methods have been proposed to prevent bile duct injury,among them the use of indocyanine green(ICG)fluorescence.The most commonly reported method of ICG injection is the intravenous administration,while literature is lacking studies investigating the direct intragallbladder ICG injection.This narrative mini-review aims to assess the potential applications,usefulness,and limitations of intragallbladder ICG fluorescence in LC.Authors screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy,as well as special issues regarding its use.Literature search retrieved four prospective cohort studies,three case-control studies,and one case report.In the three case-control studies selected,intragallbladder near-infrared cholangiography(NIRC)was compared with standard LC under white light,with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography(IOC).In total,133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during LC.Literature includes several reports of intragallbladder ICG administration,but a standardized technique has not been established yet.Published data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping,overwhelming limitations of IOC including intervention and radiation exposure,as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG fluorescence.Evidence-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of further studies and multicenter data collection into large registries.展开更多
The hemorrhagic simple hepatic cyst is extremely rare and can sometimes be confused with biliary cystadenoma or cystadenocarcinoma.Here we present two cases of huge hemorrhagic simple hepatic cysts. Case 1 was a 43-ye...The hemorrhagic simple hepatic cyst is extremely rare and can sometimes be confused with biliary cystadenoma or cystadenocarcinoma.Here we present two cases of huge hemorrhagic simple hepatic cysts. Case 1 was a 43-year-old man with a cystic lesion measuring 13 cm×12 cm in the right hepatic lobe. Ultrasound and computed tomography showed several mural nodules on the irregularly thickened wall and high-density straps inside the cyst.Case 2 was a 60-year-old woman with a huge cyst measuring 15 cm ×14 cm in the central liver.Ultrasound and magnetic resonance imaging showed the cystic wall was unevenly thickened and there were some flame-like prominences on the wall.The iconographic representations of the two cases mimicked biliary cystadenoma.Cystectomy and left hepatectomy were performed for the two patients, respectively.Both patients recovered quickly after their operations and showed no recurrence.展开更多
The term "intracystic papillary ductal carcinoma in situ " constitutes only 0.5% to 1% of all breast cancers.It is usually seen in postmenopausal age group.Herein,we are presenting a minireview about this un...The term "intracystic papillary ductal carcinoma in situ " constitutes only 0.5% to 1% of all breast cancers.It is usually seen in postmenopausal age group.Herein,we are presenting a minireview about this unusual breast malignancy usually difficult to diagnose on clinical grounds and highlighting modalities of diagnosis and management.展开更多
We report here a case of a patient who underwent surgical resection of a giant pericardial cyst that was growing rapidly, causing anterior chest pain. An asymptomatic 56-year-old woman underwent a complete medical che...We report here a case of a patient who underwent surgical resection of a giant pericardial cyst that was growing rapidly, causing anterior chest pain. An asymptomatic 56-year-old woman underwent a complete medical checkup in a health-care center. Her chest X-ray showed an unusually large bulge on the left cardiac border, and she was referred to our hospital. The chest X-ray taken 2 years ago in another hospital showed similar bulge on the same left cardiac border, but it was noticeably smaller. Chest CT revealed a 9.5 × 4.5 cm pericardial cyst within the anterolateral aspect of the left cardiac border. The CT number of the mass was approximately 15 - 20 HU. The mass also showed slight hyperintensity on T1-weighted MR images and hyperintensity on T2-weighted MR images. Four weeks later, she experienced anterior chest pain for the first time, and the chest X-ray and CT showed an increase in the size of the pericardial cyst. The CT number of the mass increased to approximately 30 - 40 HU. The cyst was successfully removed by video-assisted thoracic surgery. The pericardial cyst was diagnosed as benign according to the results of histopathology. We conclude that the rapid growth of the pericardial cyst was caused by intracystic hemorrhage that originated from vascularized connective tissue in the cyst wall.展开更多
Background: Intracystic papillary breast cancer is a very rare tumor that occurs most frequently in elderly postmenopausal women. Aim: In this article we presented a case of a 66-year-old woman who underwent excisiona...Background: Intracystic papillary breast cancer is a very rare tumor that occurs most frequently in elderly postmenopausal women. Aim: In this article we presented a case of a 66-year-old woman who underwent excisional biopsy due to a right breast mass. Case presentation: Histological examination revealed the “pure” encapsulated papillary breast carcinoma without coexisting in situ neoplasm and/or invasive carcinoma. This is a rare lesion of the breast that can clinically mimic breast benign mass with only local or regionally aggressive course. Conclusion: In order to avoid misdiagnosis, both the clinician and the breast radiologist should have the possibility of diagnosing this tumor. Intracystic papillary carcinoma of the breast associated with lymph node?metastasis has rarely been reported, but the sentinel lymph node biopsy may be prudent in such cases, despite the non aggressive behavior.展开更多
Intracystic(encapsulated)papillary carcinoma of breast is a rare variant of breast cancer.It is usually a low-grade tumor showing estrogen,progesterone positivity.The authors report an unusual case of intracystic papi...Intracystic(encapsulated)papillary carcinoma of breast is a rare variant of breast cancer.It is usually a low-grade tumor showing estrogen,progesterone positivity.The authors report an unusual case of intracystic papillary carcinoma showing high nuclear grade,brisk mitosis,and necrosis with triple negativity for estrogen,progesterone,and Her-2/neu receptors,as well as negative axillary lymph nodes.Such cases need to be reported to increase awareness so that they will be managed conservatively,avoiding any overtreatment despite being high grade and triple negative.展开更多
文摘A 77-year-old woman complained of epigastralgia,and a tumor(5 cm in diameter)of the gallbladder neck was detected by image analysis.Following cholecystectomy,the tumor was pathologically diagnosed as intraductal papillary neoplasm(IPN),gastric type,with associated invasive carcinoma.About 10 mo later,intraluminal multiple masses(3 foci,up to 1.8 cm)were noted in the extrahepatic bile duct,and the resected specimen showed that all tumors had similar gross and microscopic features as seen in gallbladder IPN without invasion,and they were synchronous multiple lesions.This case showed a papillary tumor of the gallbladder of gastric phenotype,and confirmed that the gallbladder is a target of IPN in addition to the bile ducts.
文摘Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric populations.Despite the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems.A series of methods have been proposed to prevent bile duct injury,among them the use of indocyanine green(ICG)fluorescence.The most commonly reported method of ICG injection is the intravenous administration,while literature is lacking studies investigating the direct intragallbladder ICG injection.This narrative mini-review aims to assess the potential applications,usefulness,and limitations of intragallbladder ICG fluorescence in LC.Authors screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy,as well as special issues regarding its use.Literature search retrieved four prospective cohort studies,three case-control studies,and one case report.In the three case-control studies selected,intragallbladder near-infrared cholangiography(NIRC)was compared with standard LC under white light,with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography(IOC).In total,133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during LC.Literature includes several reports of intragallbladder ICG administration,but a standardized technique has not been established yet.Published data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping,overwhelming limitations of IOC including intervention and radiation exposure,as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG fluorescence.Evidence-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of further studies and multicenter data collection into large registries.
文摘The hemorrhagic simple hepatic cyst is extremely rare and can sometimes be confused with biliary cystadenoma or cystadenocarcinoma.Here we present two cases of huge hemorrhagic simple hepatic cysts. Case 1 was a 43-year-old man with a cystic lesion measuring 13 cm×12 cm in the right hepatic lobe. Ultrasound and computed tomography showed several mural nodules on the irregularly thickened wall and high-density straps inside the cyst.Case 2 was a 60-year-old woman with a huge cyst measuring 15 cm ×14 cm in the central liver.Ultrasound and magnetic resonance imaging showed the cystic wall was unevenly thickened and there were some flame-like prominences on the wall.The iconographic representations of the two cases mimicked biliary cystadenoma.Cystectomy and left hepatectomy were performed for the two patients, respectively.Both patients recovered quickly after their operations and showed no recurrence.
文摘The term "intracystic papillary ductal carcinoma in situ " constitutes only 0.5% to 1% of all breast cancers.It is usually seen in postmenopausal age group.Herein,we are presenting a minireview about this unusual breast malignancy usually difficult to diagnose on clinical grounds and highlighting modalities of diagnosis and management.
文摘We report here a case of a patient who underwent surgical resection of a giant pericardial cyst that was growing rapidly, causing anterior chest pain. An asymptomatic 56-year-old woman underwent a complete medical checkup in a health-care center. Her chest X-ray showed an unusually large bulge on the left cardiac border, and she was referred to our hospital. The chest X-ray taken 2 years ago in another hospital showed similar bulge on the same left cardiac border, but it was noticeably smaller. Chest CT revealed a 9.5 × 4.5 cm pericardial cyst within the anterolateral aspect of the left cardiac border. The CT number of the mass was approximately 15 - 20 HU. The mass also showed slight hyperintensity on T1-weighted MR images and hyperintensity on T2-weighted MR images. Four weeks later, she experienced anterior chest pain for the first time, and the chest X-ray and CT showed an increase in the size of the pericardial cyst. The CT number of the mass increased to approximately 30 - 40 HU. The cyst was successfully removed by video-assisted thoracic surgery. The pericardial cyst was diagnosed as benign according to the results of histopathology. We conclude that the rapid growth of the pericardial cyst was caused by intracystic hemorrhage that originated from vascularized connective tissue in the cyst wall.
文摘Background: Intracystic papillary breast cancer is a very rare tumor that occurs most frequently in elderly postmenopausal women. Aim: In this article we presented a case of a 66-year-old woman who underwent excisional biopsy due to a right breast mass. Case presentation: Histological examination revealed the “pure” encapsulated papillary breast carcinoma without coexisting in situ neoplasm and/or invasive carcinoma. This is a rare lesion of the breast that can clinically mimic breast benign mass with only local or regionally aggressive course. Conclusion: In order to avoid misdiagnosis, both the clinician and the breast radiologist should have the possibility of diagnosing this tumor. Intracystic papillary carcinoma of the breast associated with lymph node?metastasis has rarely been reported, but the sentinel lymph node biopsy may be prudent in such cases, despite the non aggressive behavior.
文摘Intracystic(encapsulated)papillary carcinoma of breast is a rare variant of breast cancer.It is usually a low-grade tumor showing estrogen,progesterone positivity.The authors report an unusual case of intracystic papillary carcinoma showing high nuclear grade,brisk mitosis,and necrosis with triple negativity for estrogen,progesterone,and Her-2/neu receptors,as well as negative axillary lymph nodes.Such cases need to be reported to increase awareness so that they will be managed conservatively,avoiding any overtreatment despite being high grade and triple negative.
