A case of primary mesenteric fibromatosis

A case of primary mesenteric fibromatosis is reported and the current modalities of therapy are discussed. Surgery is the primary mode of treatment. Other modalities should be reserved for gross local residual disease and for unresectable recurrence.     

Surgical treatment of the primary cardiac rhabdomyoma in the neonate--a case report

A successful surgical treatment of intracardiac rhabdomyoma in a 12-day-old female is reported. The neonate was first noted to have a cardiac murmur and she was diagnosed cardiac tumor by two dimensional echocardiography. It showed multiple cardiac tumors which occupied the right ventricular outflow tract and interventricular septum. Under the routine cardiopulmonary bypass the tumor of the right ventricular outflow tract was removed. Histological examination revealed a rhabdomyoma. Follow-up evaluation 7 years after operation showed normal growth and development of the patient. A repeated two dimensional echocardiogram revealed no sign of recurrence and the left ventricular cavity was not obstructed by the residual tumor in the interventricular septum. We reviewed 10 cases treated surgically in infancy including three neonate in Japan.     

A case of nondigitalis cardiac glycoside toxicity

A case is presented of cardiac glycoside poisoning in a 1-year-old patient from the plant Nerium oleander (common oleander). The patient had bradycardia, vomiting, altered level of consciousness, and no history of ingestion. Antibody-based digoxin assays may cross-react with other cardiac glycosides nonquantitatively. Chromatographic techniques can be used in the specific diagnosis.     

A case of primary HIV-1 infection

Effects of oleic acid or triolein on lymphatic recovery of docosahexaenoic acid (DHA) given as an ethyl ester were examined in rats with cannulated thoracic ducts. Lymphatic recovery of ethyl DHA given with oleic acid or triolein was significantly higher than in rats given ethyl DHA alone. DHA distributed almost exclusively at the 1- and 3-position of triglyceride in lymph collected at 0-3 h after the administration, when it was given with oleic acid or triolein. A small part of DHA distributed at the 2-position when ethyl DHA was the sole fatty acid given. Oleic acid given as free acid or triolein with ethyl DHA was a major fatty acid at the 2-position. Intramolecular distribution of DHA and oleic acid in lymph triglyceride was similar when ethyl DHA was given with oleic acid or triolein.     

A case of primary salpinx cancer--diagnostic difficulties

In this paper the authors presents 55-years old female patient with primary carcinoma of salpinx. The special attention is payed to the possibility of clinical misdiagnosis. The low rate of appearance and not very characteristic symptoms of that type of carcinoma makes final clinical diagnosis almost impossible without intra-or postoperative histopathological study. In presented case, in the first acute appendicitis was recognized and patient was treated surgically. During the operation the large cyst near the right uterine appendages was found and after histopathological examination the primary salpinx carcinoma was revealed. In consequences pan hysterectomy was made with cytostatic all treatment just after the operation. Now, five years has gone and the patient, temporary controlled in dispensary, is still in good condition.     

Primary hemangiosarcoma of the heart

A 50-year-old woman ASA 2 underwent carbon dioxide hysteroscopy under general anaesthesia. Monitoring showed a sudden and rapid fall in end-tidal carbon dioxide followed by oxygen desaturation. She became pulseless and cyanosed. Resuscitation with oxygen, intravenous adrenaline and head-down tilt restored her to haemodynamic stability. Hyperbaric therapy was also administered as air embolism could not be excluded.     

A case of primary echinococcosis of the breast

A case of hydatid cyst of the breast is reported. Stress is laid on its extreme rarity, the aspecificity of its symptomatology and the importance of considering this type of pathology in the differential diagnosis of cystic conditions of the breast.     

A rare case of a primary intrabronchial neurofibroma

HISTORY AND CLINICAL FINDINGS: A 42-year-old woman, a smoker for many years, had suffered from dry cough for some time. She was admitted because of haemoptyses, the first one month previously. Physical examination was unremarkable. INVESTIGATIONS: Chest radiography in two planes showed no abnormality. Computed tomography revealed a space-occupying lesion adjacent to the right main bronchus, strongly suspicious of a central bronchial carcinoma. Bronchoscopy showed a smoothly circumscribed tumour in the upper lobe bronchus which almost occluded its lumen. Multiple biopsies failed to establish the benignity/malignity of the tumour. TREATMENT AND COURSE: The tumour was removed by upper lobe resection. There was no macroscopic intraoperative evidence of infiltration. Histology provided the surprising diagnosis of a benign neurofibroma. CONCLUSION: Thoracotomy should, if at all possible, be performed whenever biopsy of a pulmonary mass fails to establish its benignity. Intrapulmonary neurofibroma is very rare, unless it is part of v. Recklinghausen's disease.     

A case of cardiac lipoma in the ventricular septum

Lipoma in the ventricular septum is very rare. Our review of the English literature revealed that our case is the sixth of removal of lipoma in the ventricular septum. A 60-year-old male was admitted because a mass in the ventricular septum was found incidentally in abdominal CT taken following type B hepatitis. CT scanning of the heart showed 2 cm diameter of tumor in the ventricular septum. The tumor had very low radiodensity, so it was thought to be identical to fat tissue. The tumor was more clearly visualized by MR imaging and the signal intensity was high on the T1-weighted image. The tumor was suspected to be lipoma. The intraoperative histological diagnosis showed the tumor was lipoma. The tumor adhered strictly on the myocardium of the septum, and it was located near the left anterior descending coronary artery. It could not completely resected, in these reasons. Postoperative course was uneventful, and echocardiogram taken 9 months after the operation showed no evidence of enlargement of the residual tumor. It is necessary to follow-up rigidly for the potential of enlargement of the residual tumor.     

A case of primary fibrous histiocytoma of the lung

Fibrous histiocytoma is non-epithelial malignant tumor mainly arising from soft tissue in extremities and body. Those derived from lung are rare. A 71-year-old female was admitted to our hospital because of an abnormal shadow on chest X-ray film. Preoperative diagnosis was not obtained by various examination. The tumor was located in right upper lobe (S2) and partial resection of right upper lobe was performed. Pathological diagnosis was fibrous histiocytoma of borderline malignancy. After the operation, adjuvant therapy was not done. The patient is doing well without recurrence and metastasis, during 4 years after the operation. However, careful follow-up should be necessary for long term.     

A case of primary malignant lymphoma of the bladder

There are few reports of the sonographic appearance of Meckel's diverticulum. We present a case of torsion of a Meckel's diverticulum that was suggested by sonography and confirmed pathologically. We discuss the sonographic differential diagnosis, which includes acute appendicitis, enteric duplication cyst and intestinal volvulus.     

A case of difficult diagnosis of primary tubal carcinoma

Primary Fallopian tube cancer is a very un common cancer that appears between 40 and 65 years old, highly aggressive associate to a poor survival. In this work the authors explain a clinic case of primary Fallopian tube cancer in a woman of 57 years old operated for endometrial cancer. The authors display that the definitive diagnosis was possible only after the histological examination of the operating piece.     

A case of primary giant calculus in female urethra

Urinary calculus is rarely seen in the urethra and is usually encountered in men with urethral stricture or diverticulum. Primary urethral calculi are extremely rare in females. We describe a case of a giant urethral stone impacted in the urethra of a 103-year-old female.     

A surgical case of cardiac malignant lymphoma in right atrium

We reported a case of malignant lymphoma originating from the right atrium. The patient was a 71-year-old man who had no symptoms associated with heart failure and arrhythmias. At the time of admission the patient was suggested the presence of a tumor in the right atrium by an echocardiogram accidentally. Coronary angiography revealed a feeding artery to a tumor. Although cytological confirmation was not obtained, diagnostic extirpation of tumor was performed under cardiopulmonary bypass. The histological diagnosis was malignant lymphoma of B-cell origin. His postoperative course was uneventful and no recurrence had been observed one year postoperatively without chemotherapy.     

A clinical case of primary malignant melanoma of the oral cavity

A rare case of primary malignant melanoma of the oral cavity is reported and a literature review of etiopathogenesis, biological bases and prognosis is made. The hypotheses to explain the very severe prognosis of malignant melanoma of the oral cavity with respect to that of skin are discussed. The therapeutic approaches are described as well as the frequent difficulty to perform them in relation to the anatomical region and the wide extension of the tumoral lesion.     

An unusual case of cardiac insufficiency

A 70 year old patient with a past history of a left ventricular cardiomyopathy with concentric hypertrophy presented with an exacerbation of cardiac failure; radiology revealed bilateral lung infiltrations, predominantly on the right and a restrictive ventilatory disorder. The broncho-alveolar lavage revealed a lymphocytosis with CD4 prominence. Microbiological examination was negative. With a worsening radiological picture despite increased anti-failure treatment a video-assisted surgical biopsy was performed. The histological examination revealed diffuse interstitial pulmonary amyloidosis. This observation underlined the value of looking for this rare cause of cardiac failure and pulmonary infiltration in a situation where the pulmonary images did not improve on diuretics.