Introduction: Cancer of the gallbladder is described as one of the most important and deadly disease that affects the biliary tract occupying the 5th place among malignant diseases of the digestive system. The aim of the study was to determine the incidence of cancer in elective cholecystectomies performed in the hospital of Teresina, Piauí in 2012. Methods: Documentary research, retrospective, descriptive and quantitative approach. Data collection occurred by reviewing the histopathological records of patients undergoing elective cholecystectomy. The parameters evaluated were gender, age and histological type. HGV authorized by the ethics committee. Results: Of the 948 patients there was an incidence of 0.8% (8 patients) with gallbladder cancer, 93.8% (889 patients) with chronic calculous cholecystitis, 3.2% (30 patients) with chronic cholecystitis, 2.1% (20 patients) with acute exacerbation chronic cholecystitis and only 0.1% (1 patient) with mucosal polyps. Of patients with bladder cancer 87.5% (7 patients) were female and 12.5% (1 patient) were male, aged 49e82 years, mean 66 years. As for the histological pattern, we found that 6 cases were well-differentiated type of adenocarcinoma (75%), 1 mucinous type (12.5%) and 1 biliary malignancy metastatic poorly differentiated (12.5%). Conclusion: The prevalence of gallbladder cancer in elective cholecystectomy was 0.8% in the study, the most prevalent histological type was adenocarcinoma. Thus the outpatient follow-up with the appreciation of the histopathological after discharge is extremely important for the prognosis of the disease.
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a history of oral contraceptive use. The malignant transformation of HCA in Hepatocellular Carcinoma (HCC) is still unclear. We review the literature and summarize what is currently believed to be the possible pathway of malignant transformation. We also describe a well-documented case of asymptomatic 63 years old men with initial diagnosis of HCA that after 4 years and 3 months of follow-up had a right hepatectomy for hepatocellular carcinoma.Background: Well-differentiated hepatocellular carcinomas (HCCs) are considered as early form of HCCs in hepatocarcinogenesis and the average diameter is less than 20mm. Among the benign liver lesions, angiomyolipoma (AML) is a rare mesenchymal tumor which is composed of smooth muscle cells, adipose tissues and blood vessels.Here we report a case of large well-differentiated HCC mimicking AML preoperatively. Case: An 84-year old man presented with dyspepsia for several weeks. He was known hepatitis B carrier and had subtotal gastrectomy for gastric cancer 20 years ago. Serum alpha-fetoprotein and PIVKA II level were 3.72 ng/ml and 2055 mAU/ml. Abdominal CT scans found 10cm sized fatcontaining hypervascular heterogeneous mass that showed irregular enhancement without wash-out in portal and venous phases. Needle biopsy showed coagulation necrosis without cancer cell. Hepatic tumor was considered as benign AML. 4 months later, follow-up abdominal CT scans showed increase in tumor size to 11.7cm and he underwent left lateral sectionectomy. Gross findings showed expanding nodular patterned bulging mass with large amount of necrosis. Microscopic findings were atypical cells with trabecular patterns and pseudoglandular structures which were compatible with well-differentiated HCC. In contrast to preoperative imaging studies, fat component was less than 1% of the tumor. Conclusions: Large well-differentiated fat-containing HCCs are very rare. In our case, preoperative imaging studies showed a large heterogeneous hepatic tumor with fatty component which showed irregular enhancement in delayed phases that differ from typical features of HCCs. Because preoperative diagnosis of AML is difficult, we should consider proper treatment for large hepatic tumors.
human) successfully. The patient was discharged on the 8th PO uneventful. The patient presented positive serology for hepatitis B and histopathology showed hepatocellular carcinoma and the patient was referred for liver transplantation center. Conclusion: The diagnosis is very difficult in emergency treatment and sets a challenge to the surgeon. The evolution of hemostatic agents has enabled greater security in the control of bleeding during surgery.
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