Diffuse cavernous hemangioma of the rectum (DCHR) is a rare benign tumor of vascular origin. Approximately 200 such cases have been reported in the literature. Here we present a case of a 49-year old female patient who underwent a surgical procedure due to a mass of the rectum with a history of recurrent, painless gastrointestinal bleeding and anemia in whom DCHR was diagnosed postoperatively. This paper is intended as a metaanalysis of available diagnostic and therapeutic methods to be used in patients with DCHR.
Breast cancer is the most commonly diagnosed cancer worldwide and the fifth leading cause of cancer death. In 2020, there were 2.3 million new cases, and 685,000 women died from it. Breast cancer among young women under 40 years of age accounts for 5% to 10% of all cases of this cancer. The greater availability of multi-gene sequence analysis by next-generation sequencing has improved diagnosis and, consequently, the possibility of using appropriate therapeutic approaches in BRCA1/2 gene mutation carriers. Treatment of young breast cancer patients affects their reproductive potential by reducing ovarian reserve. It can lead to reversible or permanent premature menopause, decreased libido, and other symptoms of sex hormone deficiency. This requires that, in addition to oncological treatment, patients are offered genetic counseling, oncofertility, psychological assistance, and sexological counseling. Given the number of BRCA1/2 gene mutation carriers among young breast cancer patients, but also thanks to growing public awareness, among their healthy family members planning offspring, the possibility of benefiting from preimplantation testing and performing cancer-risk-reduction procedures: RRM (risk-reducing mastectomy) and RRSO (risk-reducing salpingo-oophorectomy) significantly increase the chance of a genetically burdened person living a healthy life and giving birth to a child not burdened by the parent’s germline mutation. The goal of this paper is to show methods and examples of fertility counselling for BRCA1/2 gene mutation carriers, including both patients already affected by cancer and healthy individuals.
Introduction. Breast cancer is the most common malignancy among women in Poland and in the world, with a mortality rate second only to that of lung cancer. Breasts are one of the most important symbols of femininity and sexuality. Cancer surgery, but also systemic therapy (chemotherapy and hormone therapy) cause a change in the perception of one's body. The aim of the survey proposed by us was to assess interest in sex by breast cancer patients during and after oncological treatment, as well as to identify ways to improve the quality of patients' sex lives. Materials and methods. The proposed survey consisted of 3 parts: the first part included questions about the demographic, in the second part there were the author's questions about sexual dysfunction (12 questions), in the third part there was the Female Sexual Function Index (FSFI) form assessing the sexual functioning of women. The questionnaires were made available online from October 13, 2020 to December 20, 2020 through the social networks of patient organizations involved in breast cancer care. 287 women diagnosed with breast cancer were included in the survey. Results. Before the disease almost all patients were sexually active and had a partner (95.5%; n = 274); at the time of filling the questionnaire only slightly more than half of the patients remained sexually active ( 57.1%; n = 164). About 30.7% (n = 88) stated that the disease was the main reason for not being sexually active. More than 60% of patients (60.9%; n = 137) used products to improve the comfort of sexual intercourse, mainly lubricants (39.7%; n = 114). Only about 1 / 3 of the patients (32.1%; n = 92) were satisfied with their sex life, 48.1% (n = 138) stated they were not satisfied with their sex life, 19.9% (n = 57) did not answer this question. The main reasons for lack of satisfaction with sex life included: decreased libido (65.9%; n = 189), vaginal dryness (55.1%; n = 158). The mean score of forms filled out by the respondents was 24.50 in FSFI form. Conclusions. Assessment of sexual dysfunction in patients with breast cancer should be performed on a routine basis before treatment and regularly during treatment.
For many years, laparoscopic cholecystectomy remains the method of choice for both the treatment of symptomatic cholelithiasis, and chronic and acute cholecystitis (1). The experience of the surgeon grows with each laparoscopic procedure, which enables to operate in case of difficult anatomical conditions and associated anatomical variants. The aim of the study was to present a case of a 47-year old male patient with total situs inversus and several months history of recurrent left epigastric pain, radiating to the left scapula, being accompanied by nausea and vomiting. The study presented the operative technique of laparoscopic cholecystectomy and postoperative period data. In conclusion, laparoscopic cholecystectomy in a patient with total situs inversus is possible and safe, providing relevant precautions. The main issues certainly include a good and feasible plan of the operation, discussion concerning the possible intraoperative and postoperative complications, a good plan considering the localization of the trocars, as well as an experienced surgical team. One should also not forget that early conversion to classical cholecystectomy is not considered as failure, but might prevent accidental damage of the biliary ducts and long-term complications.
The co-existence of a chondrosarcoma of the chest wall and a desmoid tumor in the gastrointestinal tract is rare. In both Polish and global literature, cases of chest wall chondrosarcomas are presented in the form of case reports. Desmoids of the gastrointestinal tract are more common; notwithstanding, their incidence in Europe is estimated at approximately 2 cases per 1 million inhabitants per year.We present the case of a 62-year-old female patient who suffered from both a chest wall chondrosarcoma and a desmoid tumor of the intestine; both neoplasms were operated on simultaneously.The former tumor was located in the region of the right costal margin, whereas the latter was located in the mesojejunum. The surgery was performed with two independent surgical incisions. The postoperative period was uneventful. The case is noteworthy in view of the extremely rare synchronous occurrence of the described tumors and due to the fact that any such operation requires an individualized surgical approach.
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