Neuroendocrine carcinoma(NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomogr...Neuroendocrine carcinoma(NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen.We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy.Histopathological analysis showed spindleshaped cells with scanty cytoplasm and hyperchromatic nuclei,confirming a primary pancreatic NEC.One month after the surgery,the patient experienced leg swelling.Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg,and the leg was amputated.Histopathological analysis confirmed metastasis of pancreatic NEC.The patient was followed up and received chemotherapy(etoposide and cisplatin).One month after amputation,the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion.The patient suffered from unbearable pain and we treated him with odynolysis.Four months postoperatively,the patient died of respiratory failure.展开更多
[Abstract] Objective： To report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocu- taneous flaps. Methods： Six patients with large sk...[Abstract] Objective： To report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocu- taneous flaps. Methods： Six patients with large skin and soft tissue defects were included in this report. There were 5 trauma patients and the rest one needed to receive plastic surgery for his extremity scar. All wounds were in the upper extremity. The sizes of defects ranged from 15 cmx6 cm to 30 cmx 18 cm. Pedicled latissimus dorsi myocutaneous flaps were designed according to the defect area and raised with part of latissi- mus dorsi. The thoracodorsal artery and its perforators were carefully protected during surgery. Results： All flaps healed primarily without flap congestion, margin necrosis or infection. The skin donor sites either received split-thickness skin graft （3 cases, mostly from the anterior thigh） or was closed primarily （3 cases） and had minimal morbidity. Follow-up of 6-12 months showed that the contour of flap was aesthetic and the func- tion of limb was excellent. Conclusion： Our experience indicates that the pedicled latissimus dorsi myocutaneous flap is favorable for recon- struction of large skin and soft tissue defects in the upper extremity展开更多
文摘Neuroendocrine carcinoma(NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen.We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy.Histopathological analysis showed spindleshaped cells with scanty cytoplasm and hyperchromatic nuclei,confirming a primary pancreatic NEC.One month after the surgery,the patient experienced leg swelling.Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg,and the leg was amputated.Histopathological analysis confirmed metastasis of pancreatic NEC.The patient was followed up and received chemotherapy(etoposide and cisplatin).One month after amputation,the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion.The patient suffered from unbearable pain and we treated him with odynolysis.Four months postoperatively,the patient died of respiratory failure.
文摘[Abstract] Objective： To report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocu- taneous flaps. Methods： Six patients with large skin and soft tissue defects were included in this report. There were 5 trauma patients and the rest one needed to receive plastic surgery for his extremity scar. All wounds were in the upper extremity. The sizes of defects ranged from 15 cmx6 cm to 30 cmx 18 cm. Pedicled latissimus dorsi myocutaneous flaps were designed according to the defect area and raised with part of latissi- mus dorsi. The thoracodorsal artery and its perforators were carefully protected during surgery. Results： All flaps healed primarily without flap congestion, margin necrosis or infection. The skin donor sites either received split-thickness skin graft （3 cases, mostly from the anterior thigh） or was closed primarily （3 cases） and had minimal morbidity. Follow-up of 6-12 months showed that the contour of flap was aesthetic and the func- tion of limb was excellent. Conclusion： Our experience indicates that the pedicled latissimus dorsi myocutaneous flap is favorable for recon- struction of large skin and soft tissue defects in the upper extremity
