Basel Refky

Metastatic rhabdomyosarcoma of the thyroid gland, a case report

The thyroid gland is a known but an unusual site for metastatic tumors from various primary sites. Despite the fact that it is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of 3 % of secondary malignances of the organ. Nevertheless, thyroid metastases are not an exceptional finding at autopsy, they are encountered in 2 % to 24 % of the patients with malignant neoplasm.Soft tissue sarcomas metastatic to the thyroid are extremely rare as the majority of thyroid metastasis are caused by tumors of the kidneys, lungs, mammary glands, ovaries , and colon or by melanomas.We report a case of 22-years-old woman with right leg rhabdomyosarcoma metastatic to the thyroid gland.

Axillary lymph nodes metastasis in a patient with recurrent papillary thyroid cancer: a case report

IntroductionThyroid cancer is the most common endocrine malignancy; the most common type of thyroid cancer is papillary thyroid cancer which accounts for approximately 90% of all thyroid cancers. Previously defined prognostic factors of papillary thyroid cancer include age, gender, tumor size, extrathyroidal extension, and distant metastasis. Cervical lymph node metastases are very common in patients with papillary thyroid cancer. Although papillary thyroid cancer has an excellent prognosis, lymphatic spread is associated with an increased risk of locoregional recurrence.Axillary metastasis is not a common finding in the classic type of papillary carcinoma; hence, a limited number of case reports have described the exceptional and rare metastatic spread of papillary thyroid carcinomas to the axilla.Case presentationWe report a case of metastatic axillary lymphadenopathy in a 61-year-old Egyptian man with a recurrent papillary thyroid cancer. He had a history of total thyroidectomy with right radical neck dissection 18 months ago. He presented to our cancer clinic at the Oncology Centre –Mansoura University with recurrent mass at the right lower parotid region, left cervical lymphadenopathy and left axillary lymphadenopathy.Removal of the recurrent right intraparotid mass, left comprehensive neck dissection and left axillary dissection were performed and the postoperative pathology report showed infiltration of the cervical and axillary lymph nodes by metastatic papillary thyroid cancer.ConclusionsAxillary lymph node enlargement in a patient with papillary thyroid cancer should be considered metastatic from thyroid until proved otherwise. Careful thorough examination of patients with recurrent thyroid cancer is essential to address any unusual metastasis.

Absence of Neck Scars With Total Endoscopic Submandibular Sialadenectomy Using a Chest Wall Approach: A New Technique

Introduction. This study aims to demonstrate the safety, surgical feasibility, and esthetic features of total endoscopic submandibular sialadenectomy through a chest wall approach without the creation of any neck incisions. Methods. Four patients with benign submandibular gland lesions underwent a total endoscopic submandibular sialadenectomy through a chest wall approach using 3 ports (one 10-mm port for the camera and two 5-mm ports for the working instruments). Results. The operative time ranged from 140 to 170 minutes. Conversion to the open technique was only necessary in one case with good visualization of the facial vein and artery, marginal mandibular and lingual nerve. No significant perioperative complications were encountered. All patients were discharged on the third postoperative day, and they were satisfied with the cosmetic outcome. Conclusion. Total endoscopic submandibular sialadenectomy through a chest wall approach is technically feasible and safe with satisfactory cosmetic results. It may be a valid alternative to conventional surgery when performed in select patients. The absence of neck scars and the ability to avoid potential nerve injuries are the most obvious advantages of this innovative technique.

The Impact of Obesity on Performing Lymphadenectomy and Its Outcome in Ovarian Cancer Patients

Background: This study discusses the effect of obesity on the number of lymph nodes harvested during systematic LND and the LND-related complications in ovarian cancer patients. Methods: This retrospective study enrolled women with ovarian cancer who were consecutively subjected to open surgical resection that included systematic LND (pelvic and para-aortic) in the Oncology Center in Mansoura University (OCMU) during the period between January 2012 and June 2017. Patients were categorized according to the recommendations of World Health Organization by their BMI as non-obese (BMI 30.0 kg/m2) and obese (BMI ≥ 30.0 kg/m2). Results: Seventy-seven women with ovarian cancer were enrolled in the study according to our inclusion and exclusion criteria. 43 females (55.8%) were grouped as obese and 34 (44.2%) as non-obese. Lymph nodes retrieved in total and in different stations separately (pelvic and para-aortic) were all similar among patients in both groups. LND-related intraoperative complications were observed in 8 patients (18.6%) in the obese group and 3 patients in the non-obese group (8.8%) (P = 0.347). Hospital stay was the same in the two groups with a median of 4 days (IQR 3 - 5). Postoperative complications occurred in 13 patients (30.2%) in the obese group and only in one patient (3%) in the non-obese group (P = 0.004). Conclusion: Obese ovarian cancer patients may safely undergo comprehensive staging involving extensive lymph node dissection in open surgeries without significant increase in the rates of intraoperative complications. Whereas, postoperative complications (wound infection and thromboembolic events) tend to occur at higher rates with obese patients. Trial registration: This study was retrospectively registered and approved at faculty of Medicine Mansoura University, Egypt with IRB approval number R.18.02.46.

Surgery after neoadjuvant chemotherapy for muscle invasive bladder cancer: clinicopathological and surgical outcomes

In the United States, bladder cancer (BC) accounts for about 5% of newly diagnosed cancer cases. It is reported to be the 4th most common cancer in men and the 9th in women. It has the fifth highest incidence of all malignancies, with more than 74,000 newly diagnosed cases and 15,000 deaths in 2014. In Egypt, BC is considered the 2nd most common cancer in men (12.7%) after hepatocellular carcinoma (18.7%), and one of the most common cancers in women after breast cancer (38.8%), lymphoma, leukemia and ovarian cancer.

Huge retroperitoneal liposarcoma: a case report and review of literature

Introduction Liposarcoma is the most common malignant tumor of the retroperitoneum. We report a case of huge retroperitoneal liposarcoma weighing 44 kg that was successfully resected. Case presentation A 53-year-old Egyptian male patient was presented to our department with progressive abdominal enlargement. Computed tomography scans of the chest, the abdomen, and the pelvis revealed a huge pelviabdominal mass highly suggestive of liposarcoma. Abdominal exploration was performed with resection of a huge retroperitoneal mass weighing 44 kg that was proven pathologically to be liposarcoma. Conclusion Despite the huge size of retroperitoneal liposarcomas, they can be surgically resected successfully.

Epidemiological and Pathological Correlates of Postoperative Mortality of Patients with Ovarian Cancer

Background: Epithelial ovarian cancer is the most lethal gynecologic malignancy and is the fifth most common cause of cancer-related death among women. The current study was designed to investigate the epidemiological and pathological correlates of postoperative mortality of ovarian cancer at a tertiary care center in Mansoura, Egypt. Methods: An epidemiological analysis of prospectively collected data of ninety five primary ovarian cancer cases referred to the Surgical Oncology Center at Mansoura University Hospitals, Mansoura, Egypt. The association of the epidemiological, pathological data and the serum levels of the tumor marker CA-125 and 6-months and 1-year mortality was statistically tested. Results: A total of 95 ovarian cancer cases were included in the current study. The mean age of patients was 52.18 ranging from 14 to 98 years, and the median age was 53 years. Pathological examination showed that serous cancers were the most common type detected in 46 (48%), followed by adenocarcinoma in 24 (25%) and then mucinous in 9 (9 %) patients. Cases presented at late stages of the ovarian cancer disease with 51 (55%) cases presenting with stage III and IV. The majority of cases (n=83, 88.1%) received neo adjuvant chemotherapy. The average serum CA- 125 level was 325.38 U/ml with 50 % of cases had readings equal to or more than 233.15 U/ml. The mortality rate at 6 months was 4% and at 1-year was 17%. Age was positively correlated with 6 months mortality (p<0.05). Ninety percent of deaths at one year occurred in patients more than 45 years of age and 50% of deaths occurred in patients more than 60 years of age. Conclusion: In a tertiary care surgical oncology center in Mansoura, Egypt, patients with ovarian cancer are more commonly to present with later stage