RESUMO
Pseudomyxoma peritonei (PMP) is a condition presenting with tumors of the abdominal cavity presenting which could lead abdominal distention and ascites secondary to mucus production. Tumors of this type are potentially fatal due to their obstructing of abdominal structures. The current management of the condition includes surgical debulking with intraoperative or postoperative chemotherapy with protocols such as hyperthermic intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy (EPIC), respectively. We describe herein a case in which a tumor debulking surgery was performed. Afterwards, we placed intraperitoneal catheters so that a 4-day regimen of bedside intraperitoneal 5-fluorouracil chemotherapy could be administered on her bedside. Chemotherapy was infused and removed with the use of Hemovac and Jackson-Pratt drainage catheter systems attached to suction, for the intrahospital management of recurrent PMP in a young Hispanic female patient. Though it requires further study, we propose this method as a safe and effective alternative to current strategies at low income or resources centers.
Assuntos
Hipertermia Induzida , Neoplasias Peritoneais , Pseudomixoma Peritoneal , Terapia Combinada , Feminino , Humanos , Hipertermia Induzida/métodos , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Pseudomixoma Peritoneal/tratamento farmacológico , Estudos RetrospectivosRESUMO
Gastric schwannomas are rare peripheral nerve sheath tumors which are usually found incidentally while undergoing workup for other conditions. Despite their benign nature, they require surgical resection with negative margins. It is important to differentiate gastric schwannomas from gastrointestinal stromal tumors prior to surgical excision, as this can alter the recommended surgical plan. This can be achieved with endoscopic ultrasound and fine needle aspiration with analysis of the sampled tissue using immunohistochemical stains. We present the case of a 68-year-old female patient with an incidental finding of a gastric fundus schwannoma. Laparoscopic gastric wedge resection was performed with complete excision of the tumor and negative margins. Pathology was confirmed with immunohistochemical stains positive for S-100 and negative for CD117 and DOG1. Post-operative recovery was uneventful without tumor recurrence.
RESUMO
Parapharyngeal space tumors are extremely uncommon. A 43-year-old man presents with a painless upper neck and face mass, airway obstruction and dysphagia. Physical evaluation revealed a firm, non-mobile mass extending from the right auricular region to the mandibular region of the neck. Radical parotidectomy was scheduled and muscle biopsy was done yielding undifferentiated sarcoma of the parotid gland. Parapharyngeal space tumors represent a problem for physicians in making an accurate diagnosis and determining management options available. Extensive knowledge of the anatomical boundaries of the parapharyngeal space, diversity of pathological problems and common clinical manifestations should help avoid delayed diagnosis and improve patient's outcome.