Volvulus of the jejunum occurring in bowel with a normal mesentery: a report of two cases.
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Smooth-muscle tumors, benign and malignant, are increasingly recognized in children who are immunocompromised because of HIV infection and organ transplantation. We report a case of an EBV-associated smooth-muscle tumor, of unusual location arising in a seven-year-old post-transplant patient who was previously treated for a lymphoproliferative disease. Five years after liver transplantation, a mesenteric tumor was diagnosed. The tumor was composed of spindle cells with smooth-muscle features. Immunohistochemical analysis was positive for muscle-specific actin and desmin, negative for EBV latent membrane protein (LMP-1). In situ hybridization revealed nuclear EBV sequences. This case underlines the role of EBV infection in the development of unusual smooth-muscle tumors after organ transplantation. The evolution of these rare tumors is uncertain.
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Desmoid tumours are rare lesions with a local invasive potential and a risk of recurrence, considered to be benign due to the absence of metastases. They are classified as fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 33-year-old woman, of a desmoid tumour invading the right ureter with upper tract dilatation. Etiologic factors (traumatic, hormonal, auto-immune...) are discussed, together with the treatment of choice to lower the risk of recurrence.
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A 65-year-old male reported with a freely mobile abdominal lump and hypertension. Though pre-operatively and intra-operatively, we have suspected the lump to be a mesenteric cyst, postoperative histopathological examination revealed it to be phaeochromocytoma which is rare. In view of its extra-adrenal site of presentation and rarity, this case is reported herein.
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BACKGROUND: The cystic mesenteric lymphangioma is a rare benign neoplasia, that can be misdiagnosed with others cystic intra-abdominal tumors. AIM: To shown the clinical and histopathological features of a cystic mesenteric lymphangioma. MATERIAL AND METHODS: A 17-year old male with a past history of 17 days of right lower abdominal pain, palpable mass, fever, nausea and vomitus. The initial clinical diagnosis was appendicitis, during the appendectomy a mesenteric tumor was found. The patient was then sent to a third level cancer center for further diagnosis and treatment. In an abdominal CT scan a multicystic retroperitoneal tumor was found and diagnosed as a cystic pancreatic tumor. At midline exploratory celiotomy a cystic tumor infiltrating the right colon mesenterium, duodenum, proximal jejunum, and pancreas head was found. A pancreatoduodenectomy in bloc with right hemicolectomy was performed. During the postoperative period the patient developed cholestasis due to endovenous parenteral nutritional support that improved when it was suspended. The patient was discharged without complications at the 15th postoperative day. The histopathologic diagnosis was cystic mesenteric lymphangioma. At 12 months of follow-up the patient is healthy. CONCLUSION: The cystic mesenteric lymphangioma is a rare benign tumor and its diagnosis should be included in the differential diagnosis of cystic intra-abdominal neoplasias. Due to the tumor's location, as in the current patient, the surgeon should plan the appropriate surgery as to avoid morbidity, since the objective of such treatment is curative.