Giant teratoma with isolated intestinal duplication in adult: A case report and review of literature

BACKGROUND

A combination of diseases is a rare phenomenon. Their clinical manifestations can vary, and the diagnosis can be challenging. Intestinal duplication is a rare congenital malformation, whereas retroperitoneal teratoma is a tumor in the retroperitoneal space, derived from the remaining embryonic tissue. There are relatively few clinical findings on adult retroperitoneal benign tumors. It is hard to believe that these two rare diseases can happen to the same person.

CASE SUMMARY

A 19-year-old woman complaining of abdominal pain with nausea and vomiting was admitted. Abdominal computed tomography angiography was suggested for invasive teratoma. Intraoperative exploration revealed that the giant teratoma was connected to an isolated intestinal tract in the retroperitoneum. The postoperative pathological examination revealed that mature giant teratoma was present with intestinal duplication. This was a rare intraoperative finding that was successfully treated surgically.

CONCLUSION

The clinical manifestations of intestinal duplication malformation are various, and difficult to diagnose before the operation. The possibility of intestinal replication should be considered when intraperitoneal cystic lesions are present.

[Clinical application of robotic plat form in the treatment of early ovarian cancer]

Objectives: To evaluate the feasibility and safety of robotic system in early ovarian cancer surgery. Methods: The clinical data of 131 patients with early ovarian cancer undergoing surgical treatment from November 2014 to November 2015 were reviewed retrospectively. There were 27 cases of early ovarian cancer, of which 9 cases of robotic group, 10 cases of laparoscopic group, 8 cases of laparotomy group. Age, Body Mass Index (BMI), preoperative neoadjuvant chemotherapy, operating time, operating method, intraoperative blood loss, intraoperative and postoperative complications, pathological type, lymph node dissection, postoperative exhaust time and postoperative hospital stay of all the patients were analyzed. Results: In the robot group, the mean operating time was( 251.4±58.7) minutes, the intraoperative blood loss was (208.9±202.7) ml, and the number of the main abdominal and pelvic lymph nodes was 27.8±8.9. The mean postoperative hospital stay was (11.1±3.5) days, and the mean postoperative hospital stay was( 2.0±0.5) days. All the patients were followed up for 12-24 months. There was no differences were observed among the three groups for operating time, complications, the blood loss, the number of lymph nodes, the hospital stay and survival time (P≥0.05). Conclusion: A robotic approach for the early ovarian cancer is feasible and effective. Compared with traditional laparoscopic surgery and laparotomy, there is no significant difference in operative effect and tumor-free survival. The robotic approach provides a new method for surgical treatment of early ovarian cancer.

Investigation for role of tissue factor and blood coagulation system in severe acute pancreatitis and associated liver injury

This study aims to investigate the molecular mechanisms underlying the pathogenesis of severe acute pancreatitis (SAP) and SAP-associated liver injury, we performed an association analysis of the functions of tissue factor (TF) and blood coagulation system in both SAP patients and mouse SAP model. Our results showed that serum TF and tissue factor-microparticle (TF-MP) levels were highly up-regulated in both SAP patients and SAP mouse model, which was accompanied by the dysfunction of blood coagulation system. Besides, TF expression was also highly up-regulated in the Kupffer cells (KCs) of SAP mouse model. After inhibiting KCs in SAP mouse model, the amelioration of blood coagulation system functions was associated with the decrease in serum TF and TF-MPs levels, and the reduction of SAP-associated liver injury was associated with the decrease of TF expression in KCs. In conclusion, the dis-regulated TF expression and associated dysfunction of blood coagulation system are critical factors for the pathogenesis of SAP and SAP-associated liver injury. TF may serve as a potential and effective target for treating SAP and SAP-associated liver injury.

Levels of serum leptin, cholecystokinin, plasma lipid and lipoprotein differ between patients with gallstone or/and those with hepatolithiasis

BACKGROUND

A significant relationship exists among food intake and nutritional status and cholelithiasis, including gallstone and hepatolithiasis. Leptin is associated with obesity. This study was to investigate the differences in serum leptin levels in patients with gallstone and hepatolithiasis and to evaluate the relationships among leptin, cholecystokinin (CCK), lipid and lipoprotein concentrations.

METHODS

Body mass index (BMI), serum leptin, CCK, insulin, lipid and lipoprotein concentrations, and liver function were measured in 382 patients with gallstone (GS group), 83 patients with hepatolithiasis (HS group) and 30 healthy controls (control group). The values of these indices were compared among the groups. In each group, Pearson's product-moment correlation coefficient among these indices were evaluated.

RESULTS

There were notable differences in serum leptin, CCK, total cholesterol, total triglycerides, apolipoprotein-a (APO-a), globulin, direct reacting bilirubin, and BMI between the GS and HS groups (P<0.05). Positive correlations between serum leptin and BMI, CCK, total cholesterol, gamma-glutamyl transpeptidase (GGT), aminotransferase, and insulin were found in the GS group (P<0.05). Positive correlations were observed between serum leptin and CCK, bilirubin, aminotransferase, GGT, in the HS group (P<0.05), but negative correlations between serum leptin and albumin or APO-a (P<0.05).

CONCLUSIONS

Leptin participates in modulating lipid metabolism. There are notable differences in leptin, serum lipid, and CCK between patients with gallstone and those with hepatolithiasis. The role of leptin in the pathophysiological course of cholelithiasis needs further investigation.