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Savelli L, De Iaco P, Ceccaroni M, Ghi T, Ceccarini M, Seracchioli R, Cacciatore B. Transvaginal sonographic features of peritoneal carcinomatosis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 26:552-7. [PMID: 16184510 DOI: 10.1002/uog.2587] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVES Peritoneal carcinomatosis involves the dissemination of intra-abdominal tumor tissue often associated with gynecological malignancies. The objective of this study was to describe the transvaginal sonographic appearance of this condition. METHODS The data of 60 patients with surgically and histologically proven peritoneal carcinomatosis were analyzed. Transvaginal sonograms performed within 7 days of admission to the operating theater were re-evaluated in order to identify the sonographic features associated with peritoneal carcinomatosis. RESULTS Carcinomatosis was revealed in 53/60 cases (88%) by the presence of hypoechoic nodules attached to the peritoneum and visible on transvaginal sonography (TVS). The pouch of Douglas was the site most frequently involved. Power Doppler sonography showed the presence of blood vessels in 48 (91%) of these metastases. Ascites was found in 50 (83%) women. An adnexal mass suggestive of being the primary tumor was present in only 41 women (68%). CONCLUSIONS Peritoneal carcinomatosis has typical features on TVS and, in the vast majority of cases, its genital origin can be correctly hypothesized. Power Doppler sonography strengthens the diagnosis by showing vascularity of the peritoneal implants. In a patient with a known pelvic malignancy or whenever peritoneal carcinomatosis is suspected, TVS can give useful information in order to better assess the presence and extension of metastatic nodules within the abdominal cavity.
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102
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Coulier B. A new case of intraperitoneal fat focal infarction (IFFI) of the lesser omentum. Eur Radiol 2005; 16:954-5. [PMID: 16187063 DOI: 10.1007/s00330-005-0002-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Revised: 07/11/2005] [Accepted: 08/18/2005] [Indexed: 10/25/2022]
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103
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Chou CK, Mak CW, Wu RH, Chang JM. Combined transmesocolic-transomental internal hernia. AJR Am J Roentgenol 2005; 184:1532-4. [PMID: 15855111 DOI: 10.2214/ajr.184.5.01841532] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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104
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El Hajj II, Otrock ZK, Sharara AI. Primary omental torsion: radiologic diagnosis in a young woman. Dig Dis Sci 2005; 50:1169. [PMID: 15986877 DOI: 10.1007/s10620-005-2727-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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105
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Stelter L, le Coutre P, Stroszczynski C. Peritoneale Manifestation eines Plasmozytoms. ROFO-FORTSCHR RONTG 2005; 177:580-1. [PMID: 15838767 DOI: 10.1055/s-2005-857906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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106
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Iusco D, Donadei E, Sgobba G, Sarli L. Giant fibroma of the lesser omentum: report of a rare case. ACTA BIO-MEDICA : ATENEI PARMENSIS 2005; 76:42-4. [PMID: 16116825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
UNLABELLED We report a case of a 43 years old male that presented to emergency room for epigastric and mesogastric pain associated with a palpable abdominal mass. Explorative laparotomy showed a well capsulated tumour of the lesser omentum, sized 20 x 16 x 10 cm. Histologically the mass was charaterized by thick fibrous capsula, with areas of moderate cellularity alternated to areas of sclerosis, spots of hemorragies and infartual necrosis, spindle-shaped cells within collagen bundles that did not present mitotic activity or atipies and showed a low proliferation index with Ki 67 and histochemical positivity for CD 34 and negativity for C-Kit, anti-smooth cell and S100 antigen. FINAL DIAGNOSIS solitary fibroma of the lesser omentum. To our knowledge only one case of lesser omentum fibroma has been reported in litterature.
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Abstract
Metastatic clear cell carcinomas are relatively common from primary tumors arising in the kidney, female genital tract, adrenal cortex, and lung, but they rarely occur from primary tumors of the pancreas. We report a case of metastatic pancreatic tumor with marked clear cell changes in a 46-year-old white man presenting with a pseudocyst of the pancreas. At laparotomy, there was a hard area in the head of the pancreas and another hard nodule was present in the omentum. The histologic and immunohistochemical test of the excised omental nodule exhibited features consistent with clear cell carcinoma from pancreatic primary. To our knowledge, this is the first report of a metastatic clear cell pancreatic tumor with such an unusual presentation.
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Basile A, Kettenbach J, Kettenback J, Mundo E, Natoli A, Caloggero S, Minciullo M, Garito A. Primitive mesenteric gastrointestinal stromal tumor with autonomic nerve/ganglionic differentiation presenting as a huge mass with small synchronous nodules. Eur Radiol 2005; 16:422-7. [PMID: 15726376 DOI: 10.1007/s00330-005-2680-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2004] [Revised: 08/28/2004] [Accepted: 01/13/2005] [Indexed: 10/25/2022]
Abstract
We present a case of a primary mesenteric ectopic gastrointestinal stromal tumor. The pathologic characteristics of this neoplasm, autonomic nerve/ganglionic differentiation and presentation as a huge mass with small synchronous nodules, have not been previously described in the literature.
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MESH Headings
- Angiography
- Autonomic Nervous System/pathology
- Biomarkers, Tumor/genetics
- Cell Transformation, Neoplastic/pathology
- Choristoma/diagnostic imaging
- Choristoma/pathology
- Choristoma/surgery
- Embolization, Therapeutic
- Follow-Up Studies
- Ganglia, Autonomic/pathology
- Gastrointestinal Stromal Tumors/blood supply
- Gastrointestinal Stromal Tumors/diagnostic imaging
- Gastrointestinal Stromal Tumors/pathology
- Gastrointestinal Stromal Tumors/surgery
- Humans
- Image Enhancement
- Image Processing, Computer-Assisted
- Male
- Mesentery/blood supply
- Mesentery/diagnostic imaging
- Mesentery/pathology
- Mesentery/surgery
- Middle Aged
- Neoplasm Recurrence, Local/blood supply
- Neoplasm Recurrence, Local/diagnostic imaging
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasms, Multiple Primary/pathology
- Omentum/diagnostic imaging
- Omentum/pathology
- Peritoneal Neoplasms/blood supply
- Peritoneal Neoplasms/diagnostic imaging
- Peritoneal Neoplasms/pathology
- Peritoneal Neoplasms/surgery
- Reoperation
- Tomography, X-Ray Computed
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109
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Bachar GN, Shafir G, Postnikov V, Belenky A, Benjaminov O. Sonographic diagnosis of right segmental omental infarction. JOURNAL OF CLINICAL ULTRASOUND : JCU 2005; 33:76-79. [PMID: 15674838 DOI: 10.1002/jcu.20091] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE The purpose of this study was to identify the characteristic features of omental infarction so that this entity can be differentiated from other acute conditions in the right lower quadrant of the abdomen. METHODS A retrospective review was undertaken. We searched our hospital medical records and found 6 patients with the diagnosis of omental infarction in the last 3 years. Clinical, sonographic, and CT findings at the time of hospital admission and at follow-up were studied. RESULTS In 5 of the 6 patients (83%) sonography demonstrated a moderately hyperechoic, noncompressible ovoid mass located in the omental fat between the umbilicus and the right colon corresponding to the point of maximal tenderness or to the site of a palpable lesion on physical examination. In 1 patient, sonography revealed no abnormalities. In all patients, the diagnosis of omental infarction was confirmed by CT. One patient underwent laparoscopy because of intractable pain; laparoscopy revealed a necrotic segment in the omentum, and pathologic analysis confirmed the original diagnosis. CONCLUSIONS Omental infarction is a benign self-limited disease that can mimic acute abdomen. The diagnosis can be established preoperatively with sonography and CT, which may avoid unnecessary laparotomy.
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Conzo G, Giovanni C, Vacca R, Riccardo V, Grazia Esposito M, Grazia EM, Brancaccio U, Umberto B, Celsi S, Salvatore C, Livrea A, Antonio L. Laparoscopic Treatment of an Omental Cyst. Surg Laparosc Endosc Percutan Tech 2005; 15:33-5. [PMID: 15714155 DOI: 10.1097/01.sle.0000148472.97417.ca] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The authors evaluated the role of a laparoscopic approach on a complete resection of an omental cyst. A young female patient (25 years of age) underwent a complete resection of a 12-cm omental cyst via a laparoscopic approach. The patient presented with vomiting, nausea, and pain in the periduodenal area. The lesion was diagnosed via CT and MRI. The authors used four trocars (2 x 10 mm, 2 x 5 mm). After complete resection and aspiration, the cyst was removed in a bag. The postoperative period was uneventful, and the patient was discharged after 48 hours. There was no sign of relapse after 30 months of follow-up. Mesenteric and omental cysts are congenital abdominal lesions. Therefore, a complete resection is mandatory because of the high incidence of relapse. A laparoscopic operation proves a suitable approach because of the advantages of lower costs and comparable results to open surgery.
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Kerem M, Bedirli A, Mentes BB, Sakrak O, Pala I, Oguz M. Torsion of the greater omentum: preoperative computed tomographic diagnosis and therapeutic laparoscopy. JSLS 2005; 9:494-6. [PMID: 16381377 PMCID: PMC3015640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Primary or idiopathic segmental infarction of the greater omentum is a rare surgical condition. We describe a case of omental torsion in an adult patient who was diagnosed preoperatively by contrast-enhanced computed tomography and managed by laparoscopy.
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113
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Xinghui Y, Jing H, Mingju L, Weizhong G. Endodermal sinus tumour of the omentum in a child. Pediatr Radiol 2004; 34:985-7. [PMID: 15289951 DOI: 10.1007/s00247-004-1240-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2004] [Accepted: 05/12/2004] [Indexed: 10/26/2022]
Abstract
Endodermal sinus tumour usually arises in a gonad; extragonadal endodermal sinus tumours are rare. We report a 3-year-old boy with an endodermal sinus tumour arising in the greater omentum, which may be the second reported case in the English literature. He presented with a solid mass in the upper abdomen and a markedly raised serum alpha-fetoprotein (AFP) level. Following percutaneous needle biopsy and omentectomy, histological examination revealed classic morphological features of an endodermal sinus tumour. This rare diagnosis is possible from the imaging features in association with a raised serum level of AFP.
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Hosoya Y, Nagai H, Koinuma K, Yasuda Y, Kaneko Y, Saito K. A case of aggressive neuroendocrine carcinoma of the stomach. Gastric Cancer 2004; 6:55-9. [PMID: 12673427 DOI: 10.1007/s101200300007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
An 18 cm x 16 cm x 10 cm tumor of the stomach, invading the left lobe of the liver, pancreatic body and tail, and transverse colon, with peritoneal deposits on the major omentum, was resected by total gastrectomy plus left hepatic lobectomy, transverse colectomy, distal pancreatectomy, splenectomy, and omentectomy. Histopathologically, the tumor consisted of large uniform cells with significant nuclear atypia, showing solid growth patterns with occasional small nests without adenocarcinoma components. Immunohistochemical investigations of the neoplastic cells confirmed the tumor as a neuroendocrine (NE) carcinoma. molecular analyses disclosed loss of heterozygosity at the MEN1 gene locus on chromosome 11q13. Recurrence occurred at the hepatic hilus and incurred obstructive jaundice 2 months after surgery. Following percutaneous transhepatic biliary drainage, intensive chemotherapy (20 mg/m(2) cisplatin on days 1-5 div, 100 mg/m(2) etoposide on days 1, 3, and 5 div, and 800 mg/m(2) 5-fluorouracil on days 1-5 bolus iv) was started. The recurrent tumor shrank dramatically, and could not be detected on image modalities after five courses of chemotherapy. The patient was well and free of symptoms without biliary drainage for 5 months. Then he began to present with jaundice again, and died of acute massive dissemination 7 months after surgery. An aggressive form of NE carcinoma has been known to be associated with an extremely poor prognosis. However, it is notable that treatment with extensive surgery and intensive chemotherapy could contribute to an improvement in quality of life even if the beneficial effect lasted for only half a year.
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Abadir JS, Cohen AJ, Wilson SE. Accurate diagnosis of infarction of omentum and appendices epiploicae by computed tomography. Am Surg 2004; 70:854-7. [PMID: 15529836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Segmental infarction of the omentum and epiploic appendages presents with acute abdominal findings that may be confused with a surgical illness. Computed tomography, however, demonstrates a consistent and well-recognized pattern that allows safe, nonoperative treatment. Infarction of omental or mesenteric fat may present clinically as localized peritonitis, mimicking appendicitis, diverticulitis, or cholecystitis. Spontaneous recovery without operation is to be expected if an accurate diagnosis is established. We describe the diagnosis, treatment, and outcome of 15 patients who had infarction of the greater omentum (eight) and epiploic appendage (seven) and presented with localized abdominal pain and tenderness, with six demonstrating regional peritonitis and fever. All underwent CT imaging during their initial evaluation, and 12 of the 15 patients were diagnosed with focal omental or mesenteric fat infarction radiographically and managed nonoperatively. Three patients who had characteristic CT findings nevertheless underwent operation. All patients had complete resolution of their abdominal pain regardless of treatment. The clinical presentation of infarction of the omental or epiploic appendages may be difficult to differentiate from surgical causes of acute abdominal pain. The characteristic findings on computed tomography are diagnostic and allow safe, conservative management in the majority of patients.
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116
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Bataille L, Baillieux J, Remy P, Gustin RM, Denié C. Spontaneous rupture of omental varices: an uncommon cause of hypovolemic shock in cirrhosis. Acta Gastroenterol Belg 2004; 67:351-4. [PMID: 15727080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
In cirrhotic patients, esophageal and esophagogastric varices are the most common sites of bleeding, often responsible for hypovolemic shock. Hepatocellular carcinoma, blunt abdominal trauma and postprocedural complications are classical causes of hemoperitoneum in hepatic cirrhosis. Rupture of omental varices is another and rarely reported cause of shock in cirrhosis. We report a case of hypovolemic shock caused by ruptured omental varices. Selective review of literature regarding presentation, diagnosis and management of ruptured intraabdominal varices is also part of presentation.
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118
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Kim J, Kim Y, Cho OK, Rhim H, Koh BH, Kim YS, Han DS, Baek HK. Omental torsion: CT features. ACTA ACUST UNITED AC 2004; 29:502-4. [PMID: 15136892 DOI: 10.1007/s00261-003-0155-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2003] [Accepted: 12/17/2003] [Indexed: 12/21/2022]
Abstract
A 33-year-old male presented to the emergency department complaining of right upper quadrant pain and was initially diagnosed with acute cholecystitis. Abdominal computed tomography showed a whirling pattern of fatty streaks and vessels within the greater omentum, and surgery confirmed infarction of the omentum secondary to torsion. We report a case of surgically and pathologically proven omental torsion that demonstrated the typical whirling appearance on computed tomography.
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119
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Ibukuro K, Ishii R, Fukuda H, Abe S, Tsukiyama T. Collateral Venous Pathways in the Transverse Mesocolon and Greater Omentum in Patients with Pancreatic Disease. AJR Am J Roentgenol 2004; 182:1187-93. [PMID: 15100116 DOI: 10.2214/ajr.182.5.1821187] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The purpose of this study was to describe the radiologic findings of the collateral venous pathways in the transverse mesocolon and the greater omentum associated with pancreatic diseases and to correlate these venous pathways and the accompanying arterial anatomy. CONCLUSION The collateral pathway in the transverse mesocolon consists of the inferior mesenteric vein, left transverse colic vein, marginal vein of the transverse colon, and middle colic vein. The pathway in the greater omentum consists of anastomosis of the left and right epiploic veins deriving from the gastroepiploic vein. The former pathway is the vena comitans of Riolan's arch and the latter is the vena comitans of the arch of Barkow.
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Suzuki K, Kaneko G, Kubota K, Horigome N, Hikita H, Senga O, Miyakawa M, Shimojo H, Uehara T, Itoh N. Malignant tumor, of the gastrointestinal stromal tumor type, in the greater omentum. J Gastroenterol 2004; 38:985-8. [PMID: 14614607 DOI: 10.1007/s00535-003-1182-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2002] [Accepted: 01/10/2003] [Indexed: 02/04/2023]
Abstract
We report herein a rare case of gastrointestinal stromal tumor (GIST) type, arising from the greater omentum. A 65-year-old man who had a large abdominal tumor was referred to our hospital. Ultrasonography (US) and computed tomography (CT) scans showed a mass occupying almost the entire abdomen anterior to the bowel loops. Abdominal angiography showed that the main feeding artery of the tumor was the right gastroepiploic artery. The preoperative diagnosis was suspected gastric leiomyosarcoma. Laparotomy revealed a large mass arising from the greater omentum, and the tumor seemed to be completely excised. Histopathological and immunohistochemical studies indicated the tumor had the same characteristics as GIST. Twelve months after the operation, the tumor recurred in the peritoneal cavity at the site of the stomach, and was associated with multiple liver metastases. The patient died of hypovolemic shock. Necropsy revealed that rupture of one of the metastatic liver tumors had resulted in a massive intraperitoneal hemorrhage.
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Coulier B, Van Hoof M. Intraperitoneal fat focal infarction of the lesser omentum: case report. ACTA ACUST UNITED AC 2004; 29:498-501. [PMID: 15024519 DOI: 10.1007/s00261-003-0140-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Intraperitoneal fat focal infarction (IFFI) represents a relatively rare acute abdominal condition essentially characterized by infarction and/or torsion of the greater omentum or an epiploic appendage. The spontaneous clinical evolution is favorable under medical treatment, and the imaging findings have been proved sufficiently typical to avoid unnecessary surgery in the great majority of cases. To our knowledge, we report the first case of IFFI of the lesser omentum. Despite the absence of definitive histologic proof, the diagnosis was possible through typical imaging findings extremely similar to those of more classic cases of IFFI but also through the spontaneous benign evolution.
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Barauskas V, Malcius D, Jazdauskiene V. Lipoma of the greater omentum in a child. MEDICINA (KAUNAS, LITHUANIA) 2004; 40:860-3. [PMID: 15456972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Lipoma of the greater omentum is observed very rarely, particularly in the childhood. We report a case of large 10x11x8 cm asymptomatic lipoma of the greater omentum, which was diagnosed incidentally. Well-encapsulated mass with a homogeneous internal structure and high echogenicity--these signs of ultrasound and computed tomography allowed us to suggest a lipoma. At laparotomy lipoma of greater omentum in torsion was found. The excision of the tumor and omentectomy was performed. The histopathological diagnosis was lipoma with focal necrosis areas.
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Ryu JK, Lee SB, Kim KH, Yoh KT. Surgical treatment in a patient with multiple implanted intraperitoneal metastases after resection of ruptured large hepatocellular carcinoma. HEPATO-GASTROENTEROLOGY 2004; 51:239-42. [PMID: 15011873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
We report a case with multiple disseminated intraperitoneal metastases caused by the rupture of large hepatocellular carcinoma. A 52-year-old man was admitted due to sudden abdominal pain with progressive abdominal distention. Computed tomography showed a 5x7-cm low-attenuation mass in the right hepatic lobe and hemoperitoneum was demonstrated. He was taken for emergency hepatic angiography and hepatic arterial chemoembolization was done. Ten days after embolization, right lobectomy was performed successfully. Microscopic examination confirmed hepatocellular carcinoma. After 4 months, follow-up computed tomography showed a 2-cm-sized irregular-shaped mass at the right great omentum. A second surgery for omentectomy with mass excision was performed. Three months later, splenectomy and segmental resection of the colon was performed. Five months later, metastatic lymph node was detected around the head of the pancreas. Mass excision was then performed. Microscopically, all resected tumors were confirmed as metastatic hepatocellular carcinoma. The patient underwent resection of multiple intraperitoneal metastases three times for 1 year after resection of ruptured hepatocellular carcinoma and is currently disease free for 15 months. Hepatic resection is the treatment of choice for ruptured hepatocellular carcinoma but dissemination of tumor cells in the peritoneal cavity should be kept in mind. Even if intraperitoneal metastases develop, long-term survival could be possible with aggressive surgical treatment.
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