Irina Balescu

Spleno-pancreatectomyEn Blocwith Parcelar Gastrectomy for Splenic Artery Aneurysm – A Case Report and Literature Review

Splenic artery aneurysms are common arterial lesions which might remain asymptomatic for a long period of time. In certain cases, these lesions might encounter a significant growth and might become symptomatic. Once diagnosed, a therapeutic strategy should be taken in consideration in order to avoid the apparition of life-threatening complications such as aneurysmal rupture. This is a case report of a 45-year-old patient diagnosed with a splenic artery aneurysm who was successfully submitted to an aneurysmal resection en bloc with distal spleno-pancreatectomy and parcelar gastrectomy.

Association Between Secondary Peritoneal Hydatidosis and Peritoneal Carcinomatosis from Ovarian Cancer – A Case Report

Peritoneal carcinomatosis from ovarian cancer is unfortunately a very common finding, especially in patients diagnosed in very late stages of the disease. Nonetheless, it is not the only pathological condition inducing a diffuse involvement of the peritoneum; other entities can have an infectious or miscellaneous origin. However, the association of peritoneal carcinomatosis and parasitic infection has never been reported so far. We present the case of a 50-year-old patient who had been submitted to surgery for a hepatic hydatid cyst. Four years later, the patient was diagnosed with disseminated peritoneal lesions, which proved to have both parasite and neoplastic origin. The patient was re-submitted to surgery, and debulking resection of all pathological lesions was achieved. Although it is very rare, the association of peritoneal carcinomatosis and peritoneal hydatidosis should be taken into consideration whenever the patient reports a suggestive medical history for those two pathological findings.

Successful Resection of a Non-functional Paraganglioma with Celiac Trunk Invasion Followed by Common Hepatic Artery Reimplantation – A Case Report and Literature Review

Paragangliomas, as well as phaeochromocytomas, are vascular neuroendocrine lesions that might be encountered between neck and pelvis. In certain cases, a preoperative diagnosis is difficult to be established, so resection might be needed whenever a suspect mass is discovered at the imaging studies. Moreover, there are cases in which resection and reconstruction of an important vascular structure might be imposed. In this case report a 59-year-old patient was investigated for upper abdominal pain with postprandial features and was diagnosed with a retroperitoneal tumor of 4/6/7cm invading the celiac trunk. The tumor was successfully resected and the common hepatic artery was reinserted in the celiac stump.

Reconstruction of Inferior Right Hepatic Veins in Living Donor Liver Transplantation

Background: A proper knowledge of the anatomy of the liver (including its vascular particularities) is mandatory in cases which are going to be submitted to major hepatic resection, including living donor liver transplantation. Case Report: We present the case of a living donor liver transplantation in which a particularity of the anatomy of the hepatic veins was reported for the donor: two inferior hepatic veins for segments 5 and 6. This particularity imposed the need for creation of a supplemental anastomosis in the recipient: a phleboplasty of the two inferior veins followed by direct re-implantation into the inferior cava vein. However, the postoperative course was uneventful for both the donor and the recipient. Conclusion: In certain cases presenting vascular particularities such as two inferior hepatic veins, phleboplasty followed by reimplantation into the inferior cava vein might be needed in order to provide a good vascular outflow of the liver graft.

The Impact on the Long-term Outcomes of Hormonal Status After Hepatic Resection for Breast Cancer Liver Metastases

Background/Aim: Breast cancer remains one of the most frequently encountered malignancies worldwide, which is in most cases diagnosed in early stages of disease. However, although surgery and adjuvant oncological treatment are performed with curative intent, a certain number of cases will develop distant metastases. In cases presenting oligometastatic disease, surgery might be tempted in order to maximize the benefit in terms of survival. The aim of this paper was to identify which cases could benefit most after liver resection for breast cancer liver metastases. Materials and Methods: The study included 67 patients submitted to surgery for breast cancer liver metastases between 2003 and 2017 in the “Dan Setlacec” Center of Gastrointestinal Diseases and Liver Transplantation, Fundeni Clinical Institute. Results: Patients diagnosed with hormone-positive breast tumors reported a significantly higher disease-free and overall survival after resection of the primary tumor. After resection for breast cancer liver metastases, patients presenting hormone receptors at the level of the metastatic sites also experienced a better outcome when compared to those in which hormonal receptors were absent. However, the difference was not statistically significant. Conclusion: Liver resection for breast cancer liver metastases seems to be associated with the best outcomes in terms of survival in patients presenting positive hormonal receptors status.

Subcutaneous metastasis from endometrial cancer; case report and literature review

Subcutaneous metastases from endometrial cancer are rare situations, only few cases being described so far. The main incriminated mechanisms leading to the apparition of such lesions include hematogenous and lymphatic spread. We present the case of a 66-year-old patient known with previous history of stage IIIA endometroid endometrial carcinoma initially treated by surgery and adjuvant chemotherapy who developed at 18 months follow-up a distant subcutaneous oligometastasis. At this time the patient was resubmitted to surgery, the lesion being successfully removed. The histopathological result confirmed the endometrial cancer origin of this lesion. Subcutaneous and cutaneous metastases from endometrial cancer are rare eventualities which are usually diagnosed as part of systemic dissemination of this malignancy; in these cases, the patient is only candidate for oncological treatment with palliative intent. In some cases, in which the lesions occur as oligometastatic disease, surgery might be performed with curative intent. In our case the diagnostic of the subcutaneous lesion as oligometastatic disease transformed the patient in a perfect candidate for curative oncological surgery.

Bilateral Massive Hematoma of Bartholin Glands after Prolonged Labour: A Case Report

1Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 2Department of General Surgery, Ponderas Hospital, Bucharest, Romania 3Department of Radiology, Unirea Medical Center, Bucharest, Romania *Corresponding author Nicolae Bacalbașa, MD Department of Obstetrics and Gynecology Carol Davila University of Medicine and Pharmacy Dimitrie Racoviță Street, no. 2 Bucharest 023991, Romania Tel. +40723540426 E-mail: nicolae_bacalbasa@yahoo.ro

Prognostic factors and outcomes in surgically treated endometrial stromal sarcomas of the uterus. A literature review

Endometrial stromal sarcomas (ESS) are rare mesenchymal tumors of the uterus characterized by an indolent behavior and favorable outcomes. However, late recurrence is a common event even in cases diagnosed in an early stage of the disease. The present review presents the largest studies which focused on determining the prognostic factors and outcomes after surgically treated ESS. In this respect, we also presents various answers for the most significant unsolved questions regarding the role of bilateral adnexectomy and the benefits of pelvic and para-aortic lymph node dissection.

Surgical Approach of Cervical Cancer Liver Metastases: Case Report

Cervical cancer is an aggressive malignancy with a high tendency of invasion of the surrounding organs and also with capacity to give birth to metastases on both lymphatic and hematogenous routes. Cases who present distant metastases at the moment of diagnosis are generally referred to the medical oncologist than to the surgeon; however increasing reports on the benefit of liver surgery in non-colorectal non-neuroendocrine liver metastases have decreased the general reluctance to perform radical visa surgery on such cases. We present the case of a 53 years old female diagnosed with cervical cancer and liver metastases in which a radical resection was performed with good oncologic outcomes.