Primary leiomyosarcoma of the mediastinum involving the superior vena cava system. Surgical resection and venous reconstructionMediastinal tumors have multiple presentation forms and various pathological origins. Sometimes they reach a large size and can involve the system of superior vena cava by compression or infi ltration. We present a 48 year old man admited for dyspnea, headache and palpitations in decubitus, for the last two months. The X-ray and chest computed tomography showed an anterior mediastinal tumor and the tru-cut pathological study concluded leiomyosarcoma. He underwent surgical treatment; the tumor compromised the system of the superior vena cava and was resected with ligation and resection the left brachiocephalic trunk. Part of the superior vena cava was reconstructed with autologous pericardium. The right phrenic nerve was surrounded by the tumor mass and was resected in block. The patient recovered satisfactorily and was discharged on the eleventh day post surgery. The histopathologic study of the surgical specimen confi rmed a leiomyosarcoma G2 (3,100 gr). Full adjuvant radiotherapy was done. At 15 months after surgery the patient is in good condition without evidence of recurrence or superior vena cava syndrome.Key words: Leiomyosarcoma, mediastinum, vena cava superior, thoracic surgery, cardiovascular surgical procedures.
ResumenLos tumores del mediastino pueden tener múltiples formas de presentación y diversos orígenes anatomopatológicos. A veces alcanzan gran tamaño y pueden comprometer por compresión o infi ltración el sistema de la vena cava superior. Presentamos el caso de un hombre de 48 años que consultó por disnea, cefalea y Rev. Chilena de Cirugía.
Revista Facultad de Salud -RFS -Julio -Diciembre 2012
Palabras clave: toxoplasmosis cerebral, VIH-SIDA, mielotox i c i d a d , e x a n t e m a , p i r i m e t a m i n a -s u l f a d o x i n a , t r i m e t o p r i msulfametoxazol.
No association between serum D Dimer levels and lymph node involvement among patients with gastric cancer Background: D Dimer levels can be predictors of lymph node involvement in gastric cancer. Aim: To evaluate the association between D Dimer levels and lymph node involvement among patients with gastric cancer. Material and Methods: In 32 patients with gastric cancer, aged 38 to 86 years (24 males), subjected to a curative surgery, D Dimer was measured in the preoperative period. Its levels were associated with the number of regional lymph nodes involved and the tumor stage, according to the pathological report of the surgical piece. Results: There was no signifi cant correlation between D Dimer levels and the number of involved lymph nodes (r = 0.18, p = NS). Conclusions: In this series of patients with gastric cancer, there was no association between serum D Dimer levels and the number of involved regional lymph nodes.
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