Perivascular epithelioid cell tumors （PEComas） are a family of rare mesenchymal neoplasms. The PEComas, composed of epithelioid and spindle cells, have the same cellular and immtmohistocherrtical features but are fo...Perivascular epithelioid cell tumors （PEComas） are a family of rare mesenchymal neoplasms. The PEComas, composed of epithelioid and spindle cells, have the same cellular and immtmohistocherrtical features but are found in different visceral and soft tissue sites. Here, we report the histological and immunohistochemical features of one case of PEComa restricted in the pelvic visceral peritoneum of a male patient. The patient was treated with radical surgery, and was well and on follow-up visits without tumor recurrence.展开更多
BACKGROUND Low-grade appendiceal mucinous neoplasm(LAMN)is extremely rare and easily misdiagnosed before surgery.CASE SUMMARY We report the treatment of an asymptomatic case of LAMN diagnosed by magnetic resonance ima...BACKGROUND Low-grade appendiceal mucinous neoplasm(LAMN)is extremely rare and easily misdiagnosed before surgery.CASE SUMMARY We report the treatment of an asymptomatic case of LAMN diagnosed by magnetic resonance imaging(MRI)and surgical findings.A 70-year-old woman presented with an adnexal mass found by physical examination in July 2020.Gynecologic ultrasonography revealed a cystic mass in the right adnexa,and computed tomography showed a cystic mass in the pelvic cavity.All tumor markers were normal.A further MRI examination suggested mucinous neoplasm in the right pelvic cavity,excluding the possibility of adnexal cyst.Laparoscopic exploration found a huge cystic mass of about 10 cm×7 cm that originated from the apex of the appendix,with spontaneous rupture.LAMN was confirmed by pathological examination.As of May 2021,no disease recurrence occurred after an open appendectomy.CONCLUSION This case indicates that we should pay more attention to female patients who are clinically diagnosed with an adnexal mass at admission,.The physical examination should be done carefully,and the laboratory and imaging examination results should be comprehensively analyzed to avoid misdiagnosis and to ensure prompt diagnosis and treatment,and to improve prognosis.MRI may be a better option for the diagnosis of appendiceal mucinous neoplasm.展开更多
BACKGROUND Rectal cancer has increased in incidence,and surgery remains the cornerstone of multimodal treatment.Pelvic anatomy,particularly a narrow pelvis,poses challenges in rectal cancer surgery,potentially affecti...BACKGROUND Rectal cancer has increased in incidence,and surgery remains the cornerstone of multimodal treatment.Pelvic anatomy,particularly a narrow pelvis,poses challenges in rectal cancer surgery,potentially affecting oncological outcomes and postoperative complications.AIM To investigate the relationship between radiologically assessed pelvic anatomy and surgical outcomes as well as the impact on local recurrence following rectal cancer surgery.METHODS We retrospectively analyzed 107 patients with rectal adenocarcinoma treated with elective rectal surgery between January 1,2017,and September 1,2022.Pelvimetric measurements were performed using computed tomography(CT)-based two-dimensional methods(n=77)by assessing the pelvic inlet area in mm²,and magnetic resonance imaging(MRI)-based three-dimensional techniques(n=52)using the pelvic cavity index(PCI).Patient demographic,clinical,radiological,surgical,and pathological characteristics were collected and analyzed in relation to their pelvimetric data.RESULTS When patients were categorized based on CT measurements into narrow and normal/wide pelvis groups,a significant association was observed with male sex,and a lower BMI was more common in the narrow pelvis group(P=0.002 for both).A significant association was found between a narrow pelvic structure,indicated by low PCI,and increased surgical morbidity(P=0.049).Advanced age(P=0.003)and male sex(P=0.020)were significantly correlated with higher surgical morbidity.Logistic regression analysis identified four parameters that were significantly correlated with local recurrence:older age,early perioperative readmission,longer operation time,and a lower number of dissected lymph nodes(P<0.05).However,there were no significant differences between the narrow and normal/wide pelvis groups in terms of the operation time,estimated blood loss,or overall local recurrence rate(P>0.05).CONCLUSION MRI-based pelvimetry may be valuable in predicting surgical difficulty and morbidity in rectal cancer surgery,as indicated by the PCI.The observed correlation between low PCI and increased surgical morbidity suggests the potential importance of a preoperative MRI-based pelvimetric evaluation.In contrast,CT-based pelvimetry did not show significant differences in predicting surgical outcomes or cancer recurrence,indicating that the utility of pelvimetry alone may be limited in these respects.展开更多
Objective To explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine(CM)in colorectal cancer patients.Methods Totally 112 colorectal cancer patient...Objective To explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine(CM)in colorectal cancer patients.Methods Totally 112 colorectal cancer patients undergoing open abdominal surgery or laporoscopic surgery were syndrome typed as five fypes,i.e.,inner-accumulation of damp and heat,blockage of展开更多
Presacral cysts are cystic or cyst–solid lesions between the sacrum and rectum,almost involving adjacent pelvic floorstructures including sacrococcygeal fascia,rectum,and anal sphincter.Presacral cysts are usually be...Presacral cysts are cystic or cyst–solid lesions between the sacrum and rectum,almost involving adjacent pelvic floorstructures including sacrococcygeal fascia,rectum,and anal sphincter.Presacral cysts are usually benign,currently believed to arise from aberrant embryogenesis.Presacral cysts are clinically rare and the true incidence is unknown.Surgical resection remains the major treatment for presacral cysts.Unless the cysts are completely resected,recurrence is unavoidable.Recurrent cysts or hard-to-heal sinuses in the sacrococcyx cause patients extreme pain.However,the current knowledge of presacral cysts is insufficient.They are occasionally confused with other diseases such as ovarian cysts and perianal abscesses.Moreover,lack of the correct surgical concept and skills leads to palliative treatment for complex presacral cysts and serious complications such as impairing the function of the anal sphincter or important blood vessels and nerves.The consensus summarizes the opinions and experiences of multidisciplinary experts in presacral cysts and aims to provide clinicians with a more defined concept of the treatment,standardize the surgical approach,and improve the efficacy of presacral cysts.展开更多
文摘Perivascular epithelioid cell tumors （PEComas） are a family of rare mesenchymal neoplasms. The PEComas, composed of epithelioid and spindle cells, have the same cellular and immtmohistocherrtical features but are found in different visceral and soft tissue sites. Here, we report the histological and immunohistochemical features of one case of PEComa restricted in the pelvic visceral peritoneum of a male patient. The patient was treated with radical surgery, and was well and on follow-up visits without tumor recurrence.
文摘BACKGROUND Low-grade appendiceal mucinous neoplasm(LAMN)is extremely rare and easily misdiagnosed before surgery.CASE SUMMARY We report the treatment of an asymptomatic case of LAMN diagnosed by magnetic resonance imaging(MRI)and surgical findings.A 70-year-old woman presented with an adnexal mass found by physical examination in July 2020.Gynecologic ultrasonography revealed a cystic mass in the right adnexa,and computed tomography showed a cystic mass in the pelvic cavity.All tumor markers were normal.A further MRI examination suggested mucinous neoplasm in the right pelvic cavity,excluding the possibility of adnexal cyst.Laparoscopic exploration found a huge cystic mass of about 10 cm×7 cm that originated from the apex of the appendix,with spontaneous rupture.LAMN was confirmed by pathological examination.As of May 2021,no disease recurrence occurred after an open appendectomy.CONCLUSION This case indicates that we should pay more attention to female patients who are clinically diagnosed with an adnexal mass at admission,.The physical examination should be done carefully,and the laboratory and imaging examination results should be comprehensively analyzed to avoid misdiagnosis and to ensure prompt diagnosis and treatment,and to improve prognosis.MRI may be a better option for the diagnosis of appendiceal mucinous neoplasm.
文摘BACKGROUND Rectal cancer has increased in incidence,and surgery remains the cornerstone of multimodal treatment.Pelvic anatomy,particularly a narrow pelvis,poses challenges in rectal cancer surgery,potentially affecting oncological outcomes and postoperative complications.AIM To investigate the relationship between radiologically assessed pelvic anatomy and surgical outcomes as well as the impact on local recurrence following rectal cancer surgery.METHODS We retrospectively analyzed 107 patients with rectal adenocarcinoma treated with elective rectal surgery between January 1,2017,and September 1,2022.Pelvimetric measurements were performed using computed tomography(CT)-based two-dimensional methods(n=77)by assessing the pelvic inlet area in mm²,and magnetic resonance imaging(MRI)-based three-dimensional techniques(n=52)using the pelvic cavity index(PCI).Patient demographic,clinical,radiological,surgical,and pathological characteristics were collected and analyzed in relation to their pelvimetric data.RESULTS When patients were categorized based on CT measurements into narrow and normal/wide pelvis groups,a significant association was observed with male sex,and a lower BMI was more common in the narrow pelvis group(P=0.002 for both).A significant association was found between a narrow pelvic structure,indicated by low PCI,and increased surgical morbidity(P=0.049).Advanced age(P=0.003)and male sex(P=0.020)were significantly correlated with higher surgical morbidity.Logistic regression analysis identified four parameters that were significantly correlated with local recurrence:older age,early perioperative readmission,longer operation time,and a lower number of dissected lymph nodes(P<0.05).However,there were no significant differences between the narrow and normal/wide pelvis groups in terms of the operation time,estimated blood loss,or overall local recurrence rate(P>0.05).CONCLUSION MRI-based pelvimetry may be valuable in predicting surgical difficulty and morbidity in rectal cancer surgery,as indicated by the PCI.The observed correlation between low PCI and increased surgical morbidity suggests the potential importance of a preoperative MRI-based pelvimetric evaluation.In contrast,CT-based pelvimetry did not show significant differences in predicting surgical outcomes or cancer recurrence,indicating that the utility of pelvimetry alone may be limited in these respects.
文摘Objective To explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine(CM)in colorectal cancer patients.Methods Totally 112 colorectal cancer patients undergoing open abdominal surgery or laporoscopic surgery were syndrome typed as five fypes,i.e.,inner-accumulation of damp and heat,blockage of
文摘Presacral cysts are cystic or cyst–solid lesions between the sacrum and rectum,almost involving adjacent pelvic floorstructures including sacrococcygeal fascia,rectum,and anal sphincter.Presacral cysts are usually benign,currently believed to arise from aberrant embryogenesis.Presacral cysts are clinically rare and the true incidence is unknown.Surgical resection remains the major treatment for presacral cysts.Unless the cysts are completely resected,recurrence is unavoidable.Recurrent cysts or hard-to-heal sinuses in the sacrococcyx cause patients extreme pain.However,the current knowledge of presacral cysts is insufficient.They are occasionally confused with other diseases such as ovarian cysts and perianal abscesses.Moreover,lack of the correct surgical concept and skills leads to palliative treatment for complex presacral cysts and serious complications such as impairing the function of the anal sphincter or important blood vessels and nerves.The consensus summarizes the opinions and experiences of multidisciplinary experts in presacral cysts and aims to provide clinicians with a more defined concept of the treatment,standardize the surgical approach,and improve the efficacy of presacral cysts.
