Schwannomas of the colon are rare and difficult to diagnose preoperatively. We report a case of schwannoma of the ascending colon that was resected laparoscopically. A 64-year-old woman was referred to our hospital by her local clinic for further evaluation and management of a submucosal tumor of the ascending colon. A definitive preoperative diagnosis could not be reached despite examinations. Gastrointestinal stromal tumor, leiomyoma and lymphoma were the differential diagnoses. We performed a laparoscopic right hemicolectomy with D2 lymph node dissection. Histological findings with hematoxylin-eosin staining revealed spindle-like tumor cells, and immunohistochemical analysis showed that the tumor was positive for S-100 but negative for c-kit, CD34, smooth muscle actin and desmin, with a Ki-67 index of <5%. Thus, the diagnosis in this case was benign schwannoma of the ascending colon.
HighlightsA very rare case of large retroperitoneal mucinous cystadenocarcinoma and little-known clinical course of the disease is reported.The disease took unexpectedly aggressive progression despite the small portion of adenocarcinoma for the multiple and large cysts.Informative findings in imaging of primary retroperitoneal mucinous cyst adenocarcinoma, and impressive imaging after recurrence are presented.
Melanoma is a malignant tumor derived from melanocytes. Esophageal melanomas occur infrequently, especially primary amelanotic malignant melanoma of the esophagus (PAMME), which is extremely rare. Here, we report the case of a 74-year-old man with an esophageal amelanotic melanoma on the esophagogastric junction (EGJ) found on esophagogastroduodenoscopy. Radical surgery for the tumor at the EGJ was performed with total gastrectomy and D2 lymph node dissection. Diagnosis of PAMME was confirmed postoperatively by immunohistochemical staining. Four months after the surgery, abdominal computed tomography revealed multiple liver metastases. The patient received seven cycles of nivolumab monotherapy and two subsequent cycles of nivolumab and ipilimumab, and these metastases diminished. Recently, new therapeutic agents including immunotherapy have been developed for malignant melanoma and these agents have the potential of improving the prognosis of PAMME. Here, we present new insights into the diagnosis and therapeutic methods that can be used against primary esophageal melanoma.
Port-site hernia is a rarely encountered abdominal wall scar hernia that occurs at the port insertion site after laparoscopic surgery. We encountered a case of a 5-mm port-site hernia that developed near a transabdominal ureterostomy. The patient was a 75-year-old woman who had undergone laparoscopic right nephroureterectomy and left transabdominal ureterostomy. We successfully repaired the hernia by inserting a slit mesh into the retromuscular position without causing stenosis of the ureterostomy. The retromuscular method could be useful for managing hernias occurring near a transabdominal ureterostomy.
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