Laparoscopic surgery for rectal cancer, especially laparoscopic APR, after nCRT is safe and associated with earlier recovery of bowel function, a shorter hospital stay, and an oncologically adequate specimen compared with conventional open surgery.
Laparoscopic surgery following NCRT for low and mid third rectal cancers was associated with similar long-term oncological outcomes when compared to open surgery.
A 75-year-old male presented with history of abdominal pain and generalised weakness for about three months. Clinically he was anaemic and per abdomen examination was unremarkable. Oesophagogastroduodenoscopy revealed an ulceroproliferative polypoidal growth involving the gastric antrum [Table/ Fig-1] and few scattered small sessile nodules in the body and antrum of stomach. Colonoscopy revealed a polyp in the rectum. The gastric antral lesion was biopsied and rectal polyp was excised and sent for histopathological examination. The patient also had an enlarged left supraclavicular lymph node which was also biopsied. Gastric antral lesion was reported as a moderately differentiated adenocarcinoma with papillary pattern and the rectal polyp was reported as ganglioneuroma [Table/ Fig-2]. The supraclavicular lymphnode showed a necrotising granulomatous inflammation, however the special stains such as Zeihl-Neelsen and Periodic Acid Schiff (PAS) for tuberculosis and fungi were negative.A radical subtotal gastrectomy with D2 lymphadenectomy and Billroth I anastomosis with feeding jejunostomy was done. Specimen was fixed in 10% neutral buffered formalin and representative sections were taken. Grossly, there was a raised ulcerated lesion involving the gastric antrum along the greater curvature measuring 5.0 x 3.0
AbSTRACTAlpha Fetoprotein (AFP) producing gastric carcinomas are very rare and have unique clinicopathological features and an extremely poor prognosis. Here, we report a case of AFP producing gastric carcinoma with three distinct histomorphologic patterns such as yolk sac like, hepatoid, tubular and papillary adenocarcinoma components. The uniqueness of this case is absence of metastases and associated findings such as fundic gland polyposis with varying degrees of dysplasia, gastric and duodenal well differentiated neuroendocrine tumour and rectal ganglioneuroma. The patient is symptom free as of two and half year's postoperative period.
Ovarian endometrioid malignancies with sex cord like elements are extremely rare. These neoplasms often get misdiagnosed as sex cord stromal tumors. Although Sertoliform variant of endometrioid adenocarcinoma has been well documented, an endometrioid adenofibroma with sertoliform tubules has not been reported so far in the literature. We report a case of postmenopausal woman with endometrial growth which has been reported as Malignant Mixed Mullerian tumor. She also had an incidental ovarian mass which showed features of an endometrioid adenofibroma with areas resembling sertoli like tubules. This case report is to emphasize the potential of misdiagnosing these entities as sex cord stromal tumors.
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