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Loh CK, Chui JN, Zhuo KY, Canagasingham A, Guminski A, Delprado W, Eade T, Winter M. An elusive prostate tumour: Metastatic microcystic cribriform carcinoma presenting with imaging-histologic discordance. Urol Case Rep 2024; 53:102676. [PMID: 38420334 PMCID: PMC10900826 DOI: 10.1016/j.eucr.2024.102676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/30/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
Microcystic adenocarcinoma is an uncommon histologic variant of prostate carcinoma. Despite its rarity, it has gained increasing recognition over the past decade for its diagnostic challenges and unclear prognostic significance. Herein, we describe a rare case of metastatic microcystic prostate adenocarcinoma, presenting with discordance between imaging and histologic findings. This report highlights the diagnostic and therapeutic challenges of this pathological entity and the importance of multidisciplinary collaboration in the management of intermediate-risk prostate cancer.
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Affiliation(s)
- Chun Khai Loh
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Juanita Noeline Chui
- North Shore Urology Research Group, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Kevin Yinkit Zhuo
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
| | - Ashan Canagasingham
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
| | - Alexander Guminski
- University of Sydney, Sydney, NSW, Australia
- Department of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Warick Delprado
- Douglas Hanly Moir Pathology (Sonic Healthcare), Macquarie Park, NSW, Australia
| | - Thomas Eade
- University of Sydney, Sydney, NSW, Australia
- Department of Radiation Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Matthew Winter
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
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Mohtashami A, Badiani S, Chui JN, De Silva K, Salama Y. Idiopathic myointimal hyperplasia of the mesenteric veins: a rare and poorly understood disease. ANZ J Surg 2024; 94:478-480. [PMID: 38010844 DOI: 10.1111/ans.18788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Ali Mohtashami
- Department of Colorectal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Sarit Badiani
- Department of Colorectal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Juanita Noeline Chui
- Department of Colorectal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Keshani De Silva
- Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Yasser Salama
- Department of Colorectal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
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Chui JN, Kotecha K, Gall TMH, Mittal A, Samra JS. Surgical management of high-grade pancreatic injuries: Insights from a high-volume pancreaticobiliary specialty unit. World J Gastrointest Surg 2023; 15:834-846. [PMID: 37342855 PMCID: PMC10277947 DOI: 10.4240/wjgs.v15.i5.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/22/2023] [Accepted: 03/16/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The management of high-grade pancreatic trauma is controversial.
AIM To review our single-institution experience on the surgical management of blunt and penetrating pancreatic injuries.
METHODS A retrospective review of records was performed on all patients undergoing surgical intervention for high-grade pancreatic injuries [American Association for the Surgery of Trauma (AAST) Grade III or greater] at the Royal North Shore Hospital in Sydney between January 2001 and December 2022. Morbidity and mortality outcomes were reviewed, and major diagnostic and operative challenges were identified.
RESULTS Over a twenty-year period, 14 patients underwent pancreatic resection for high-grade injuries. Seven patients sustained AAST Grade III injuries and 7 were classified as Grades IV or V. Nine underwent distal pancreatectomy and 5 underwent pancreaticoduodenectomy (PD). Overall, there was a predominance of blunt aetiologies (11/14). Concomitant intra-abdominal injuries were observed in 11 patients and traumatic haemorrhage in 6 patients. Three patients developed clinically relevant pancreatic fistulas and there was one in-hospital mortality secondary to multi-organ failure. Among stable presentations, pancreatic ductal injuries were missed in two-thirds of cases (7/12) on initial computed tomography imaging and subsequently diagnosed on repeat imaging or endoscopic retrograde cholangiopancreatography. All patients who sustained complex pancreaticoduodenal trauma underwent PD without mortality. The management of pancreatic trauma is evolving. Our experience provides valuable and locally relevant insights into future management strategies.
CONCLUSION We advocate that high-grade pancreatic trauma should be managed in high-volume hepato-pancreato-biliary specialty surgical units. Pancreatic resections including PD may be indicated and safely performed with appropriate specialist surgical, gastroenterology, and interventional radiology support in tertiary centres.
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Affiliation(s)
- Juanita Noeline Chui
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, NSW, Australia
| | - Krishna Kotecha
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia
| | - Tamara MH Gall
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia
| | - Anubhav Mittal
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, NSW, Australia
- Department of Surgery, University of Notre Dame, Sydney 2006, NSW, Australia
| | - Jaswinder S Samra
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, NSW, Australia
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Tree K, Kotecha K, Reeves J, Aitchison L, Noeline Chui J, Gill AJ, Mittal A, Samra JS. Meckel's diverticulectomy: a multi-centre 19-year retrospective study. ANZ J Surg 2023; 93:1280-1286. [PMID: 36821518 DOI: 10.1111/ans.18351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Meckels diverticulum (MD) causes a number of acute surgical pathologies and can contain ectopic tissue with the surgical aim to resect all ectopic mucosa. This has traditionally implied a small bowel resection (BR); though contemporary literature has demonstrated Meckel's diverticulectomy to be safe. The aim of this study was to determine optimal resection strategy, and assess MD histopathological features and their relationship to outcomes. METHODS A 19-year retrospective review of patient medical records across seven hospitals was conducted with demographic, clinical and pathological data collected. Analysis was conducted using a student's t-test for continuous variables and chi-squared test for categorical variables. Univariate regression was performed to identify risk factors. P < 0.05 was considered statistically significant. RESULTS One hundred and sixty patients underwent resection of MD, 70 (44%) had Meckel's diverticulectomy and 90 (56%) had BR. No significant difference in length (P = 0.486), width (P = 0.238), or ratio (P = 0.188) of diverticulectomy compared to BR, with fewer complications in diverticulectomy. In all, 24 (15.3%) MD were perforated, of whom 5 had gastric mucosa, 2 had mixed ectopic mucosa and 1 carcinoid tissue. There were no cases of ectopic mucosa in the resection margin requiring re-operation, or causing base perforation. MD specimen with greater length: width ratio was a risk factor for perforation OR 1.437 P = 0.042 but not for malignancy P = 0.813 or ectopic tissue P = 0.185. CONCLUSION Meckel's diverticulectomy is safe via laparoscopic or open approach compared with BR. Despite higher perforation rates in MD with greater length: width ratio, no malignancy or ectopic risk was identified, supporting diverticulectomy as a safe operative approach.
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Affiliation(s)
- Kevin Tree
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Krishna Kotecha
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jenna Reeves
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Lucy Aitchison
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Juanita Noeline Chui
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anubhav Mittal
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Jaswinder S Samra
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
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Chui JN, Chui AKK. Amoebic liver abscesses with an unusual source: a case report. Hong Kong Med J 2021; 27:450-451. [PMID: 34949733 DOI: 10.12809/hkmj209157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- J N Chui
- School of Medicine, University of Sydney, Sydney, Australia
| | - A K K Chui
- Private Practice, 12/F, Emperor Commercial Centre, Central, Hong Kong
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Chui JN, Kotecha K, Deng G, Lim CSH, Chou A, Gill AJ, Samra JS, Mittal A. Sheep in wolf's clothing: squamoid cysts of the pancreatic ducts. ANZ J Surg 2021; 92:1235-1237. [PMID: 34605139 DOI: 10.1111/ans.17239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Juanita Noeline Chui
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Krishna Kotecha
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Grace Deng
- Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Christopher Seng Hong Lim
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Angela Chou
- Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Jaswinder S Samra
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anubhav Mittal
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Surgery, University of Notre Dame, Sydney, New South Wales, Australia
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Chui AKK, Chui JN, Antonio GE, Lam KC. Extended middle pancreatectomy for a large pancreatic cystic neoplasm: a case report. Hong Kong Med J 2020; 26:535-537. [PMID: 33350968 DOI: 10.12809/hkmj208372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
| | - J N Chui
- School of Medicine, University of Sydney, Sydney, Australia
| | - G E Antonio
- Department of Radiology, St Teresa's Hospital, Hong Kong
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