Acostakornum2197
A 44-year-old male without any significant past medical history presented to the emergency department (ED) with the chief complaint of severe constant epigastric pain for three hours. On physical examination, the abdomen was distended and tender, particularly in the epigastric region. The lab work showed an elevation of the lipase (12,405 U/L) and triglycerides (5,837 mg/dL). An abdominal CT scan with contrast was ordered, which revealed non-necrotic pancreatitis. In addition, the liver ultrasound showed no evidence of gallstones. Subsequently, fluid infusion, meropenem, pain medication, and an insulin drip were started, and the patient was transferred to the intensive care unit (ICU). After six hours in the ICU, he complained of abdominal pain despite taking a high hydromorphone dose. On further physical examination, the abdomen was tender and distended but without rebound tenderness. The gastric distention on kidneys, ureter, and bladder (KUB) and a bladder pressure of 34 mmHg raised the suspicion for intratitis (HTGP), which progressed to PVT and IAH. Physicians should be aware that patients with HTG are inclined to have severe pancreatitis. In addition, the degree of triglyceride elevation is correlated with the severity of acute pancreatitis.A 68-year-old female patient diagnosed with lung cancer in the left upper lobe with associated mediastinal adenopathy. The cancer was pathologically diagnosed as stage pT1bN0 typical carcinoid. Investigation of the mediastinal lymph nodes revealed an isolated metastatic non-small cell squamous cell carcinoma (NSCLC). A primary NSCLC was not found. The patient underwent successful surgical resection of both synchronous tumors, with no residual disease or recurrence. This case not only expands the histological field of combined neuroendocrine tumors, but it also highlights the importance of distinguishing various tumor types for disease treatment and prognosis.
Open adrenalectomy (OA) is considered to be the standard care for large adrenal tumors. Minimally invasive surgery (MIS)using laparoscopic technique is considered for many patients in the modern era. Robot assisted laparoscopicadrenalectomy (RALA) can bean extremely usefultool which will negate thedisadvantage oflaparoscopic method. The aim of the present study is to determine whether adrenal tumor size and lateralityhave an impact on patients undergoing RALA with respect toperioperative and postoperative outcomes. MethodsDuring the study period, 38 patients who underwentRALAin a tertiary care center were considered for retrospectively analysis. The study populations were subdivided into distinctive groups based on the tumor size (<5 cm and ≥5 cm, <8 cm and ≥8 cm), and side (right and left side). For all the subgroups, perioperative and postoperative outcomes were analyzed. Perioperative and postoperative outcomes were assessed between patient groups, group a) <5 cm and ≥5 cm tumor, group b) <8 cm and ≥8 cm, and group c) laterality (right vs left).
None of the patients showed any differences. In the current study, the conversion rate, readmission, and mortality were not observed. No major complications were noted.
RALAappears to be an extremely viable alternative to MIS using laparoscopic technique. The operative time, console time, blood loss, complication rates, and stay were extremely minimal irrespective of the size or laterality of the adrenal tumor.
RALA appears to be an extremely viable alternative to MIS using laparoscopic technique. The operative time, console time, blood loss, complication rates, and stay were extremely minimal irrespective of the size or laterality of the adrenal tumor.The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a global health crisis. This virus uses angiotensin converting enzyme 2 (ACE2) receptors to facilitate cellular entry. ACE2 receptors appear to be highly expressed in pancreatic exocrine glands and islet cells, more so than in lung tissues, suggesting that pancreatic injury can occur despite having only mild COVID-19 symptoms. We report a patient with COVID-19 who presented with only gastrointestinal symptoms and discuss the importance of identifying pancreatitis early to improve prognosis.Introduction Ewing sarcoma (ES) family of tumors is one of the most common groups of malignancies arising in children, adolescents, and young adults. Although characteristic histology with immunohistochemical expression of CD99 and FLI1 after exclusion of other small round blue cell tumors is considered diagnostic of ES, frequency of typical ES translocation, i.e., t(11;22)(q24;q12) is not known in our population. Therefore, in this study, we aimed to evaluate the frequency of this translocation in histologically and immunohistochemically diagnosed cases of ES along with its association with other pathological parameters. Methods A total of 43 morphologically and immunohistochemically diagnosed cases of ES were included in the study. Fluorescence in situ hybridization (FISH) was performed on representative paraffin blocks to identify t(11;22)(q24;q12) translocation. Association with various clinicopathological characteristics was determined. Results Mean age of the patients was 18.23±9.57 years. Amredobresib nmr Bone was the most commonly involved site (22; 51.2%) followed by soft tissue (17; 39.5%) and parenchymal organs (4; 9.3%). A total of 88.4% of cases were found to be FISH-positive for t(11;22)(q24;q12). No significant association of translocation positive cases was noted with tumor size or disease-free survival. Similarly, no significant association of tumor size with disease-free survival was found. Conclusions A significant proportion of cases of histologically diagnosed cases of ES exhibited characteristic t(11;22)(q24;q12). This signifies that histology along with immunohistochemistry is reliable for the diagnosis of this tumor; however, in difficult cases, FISH can be performed to detect characteristic translocation. Moreover, we did not find tumor size to be a significant prognostic indicator of survival in ES.
