Patient: Male, 82Final Diagnosis: Intrahepatic squamous cell carcinomaSymptoms: NoneMedication: —Clinical Procedure: —Specialty: OncologyObjective:Rare diseaseBackground:Cholangiocarcinoma is a rare, aggressive biliary tract malignancy. On histopathology, most tumors are adenocarcinomas, while squamous cell carcinoma of the biliary tract is extremely rare.Case Report:An 82-year-old male was admitted due to the detection of a space-occupying lesion at S6 of the liver. On abdominal dynamic computed tomography, there was an irregular mass with inhomogeneous density associated with mild delayed enhancement in the tumor’s peripheral zone, measuring approximately 22×25 mm, at S6, with secondary dilated biliary ducts of B6. Endoscopic retrograde cholangiopancreatography showed a severe stricture at B6. Brush cytology of B6 was positive for both adenocarcinoma and squamous cell carcinoma. Furthermore, mucous brushing cytology of the papilla of Vater was also positive for adenocarcinoma. Finally, the preoperative diagnosis of primary intrahepatic cholangiocarcinoma, combined with a cancer of the papilla of Vater, was made. The patient underwent both extended right lobectomy and pancreaticoduodenectomy. Histological examination showed that the majority (>99%) of this liver tumor was composed of keratinizing squamous cell carcinoma.Conclusions:Squamous cell carcinoma of the biliary tree is very rare, since the majority of biliary tree tumors are adenocarcinomas. Cholangiocarcinoma containing a squamous cell component has a poor prognosis. To the best of our knowledge, this is the first case report of a primary intrahepatic squamous cell carcinoma that presented as a solid tumor showing clear histological collision between adenocarcinoma and squamous cell carcinoma and was successfully treated with hepatic resection and achieved disease-free survival of more than one year.
Purpose: To evaluate the surgical outcomes of transabdominal rectopexy for rectal prolapse. Subjects: 94 cases between 2012 and 2019. Results: 24 patients underwent laparotomy and 70 patients underwent laparoscopy. Mean age was 72.3 years (17-93), with 10 males and 84 females. Mean prolapse length was 4.3 cm (1-10). 55 cases were operated for the first time, and 39 were recurrent cases (8 second recurrence or more). The mean operative time was 148 minutes for open suture fixation, 143 minutes for laparoscopic suture fixation, and 229 minutes for laparoscopic ventral rectopexy. Recurrence was observed in 8 patients (8.5%). In all cases of recurrence with suture rectopexy as the previous treatment, the fixation on the intestinal side had dislocated, suggesting that the intestinal serosal muscle layer at the fixation site had torn due to tissue fragility or a shallow and narrow needle, resulting in recurrence. Conclusion: In transabdominal rectopexy, it is important to pay close attention to tissue fragility of the intestinal tract, especially during suture fixation, to ensure secure fixation.
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