Introduction. Von Hippel-Lindau (VHL) syndrome is a pathological condition that causes various clinical symptoms and is difficult to diagnose. The most common pathological lesions are hemangioblastomas of the central nervous system, retinal angiomas, renal clear cell carcinomas, and pheochromocytomas. Case Report. A 23-year-old female had a syncope episode in 2008. Magnetic resonance imaging (MRI) revealed a right temporal hemangioblastoma, which was treated surgically. Genetic screening identified a VHL gene mutation, and computed tomography (CT) revealed a left adrenal mass. Since it was unclear whether the mass was a pheochromocytoma, or another benign or malignant tumors, laparoscopic adrenalectomy was performed. A month after surgery, the patient complained of general fatigue, poor concentration, loss of appetite, and insomnia. After careful clinical investigation, the patient was referred to a psychiatrist due to suspected depression, which was confirmed. Conclusions. VHL genetic screening should be performed in cases of hemangioblastoma. In VHL syndrome cases, pheochromocytoma cannot always be diagnosed by biochemical catecholamine analyses; therefore, CT or MRI scanning of the abdomen must be performed. Due to the long treatment period, some patients may develop episodes of depression, which can simulate VHL syndrome.
This study revealed that the incidence, prevalence and mortality rates increased between 1990 and 2012, and although the 5- and 10-year overall and cancer-specific survival rates improved over the reviewed period they still needed to get better.
Aim of th,. study w:u to identi~" the effectiveness of laparoscopy f~ detection 1he inflammatory changes of the appendix durh~g diaguostk hpawscopy in c~c of suspect appendicitis. Methods. The laparmcopic findings and results of hystolu~cal examination where compared in 52 eases after urgent laparoscopic appendectomies in time period from 1997. 10. 01 till 1998. 08. 01. Laparoscoplt where pgfforraed hy 5.5 mm 35 ~ optical de~ico and one additional. 5.5 mm instrummt. When appendidtis was ascertained, Ihe 12ram troac.'tr for endoscopic stapler iu the hfpogsstrium was introduced. Laparoscopic appcndectom 7 where done on I9 male patients and 33 female patients under 50 with suspect appendicitis. 1.aparoscopie diagnoses, morphological diagnoses and variance bet,,con hpatosc~pie .-tad morphological diagnoses where anaIyzed &Jfing prospective comparative rest:etch.Results. in fi~de gro~ (n-33, 100%) 28 (90%) different acute appcndidti~ forms (1.4(43%) -phlegmtmose, 10(30%) -chronic with e:,:acerbadtm, 3 (9%) -gangrenose)) and 6 (18%) nonacute inflamatioo forms (5 (15%) -chronic, l(3%)-secondary) where escort:dried. In fllis group ms ~ptndettom 3 due to variance ~vas made in 6(18%) cases. In ~ak gmtp (a-Ig) following acute appendicitis forms where ascertained: iti(85%) -phlcgmonosq 2 (10%) -gangrcnosc, in 1 (5%) c~e d~:onic appendidds was identifi=L Variance between lap.xoscopic and ,norphologieaI diagnoses in male group where ~eertain~ in I(5%) c~ses, when rtgalhr aflptr~b#oray was mad,"Conclusions. Due to Iaparoscopic mist~e negative appendectomy rate nn female padcnts under 50 is 1deer (18%) than on male padents grtmp under 50 t' s' /o).The aim of this study is to evaluate the advantages of laparoseopic appcndicectomy compared to the open technique. We studied retrospectively 301 appendlcectomles performed at the Patologia Chlrurgiea of the University of Ancona: 193 laparoscopic (83 females and 110 ma]es) and 108 by open technique (37 females and 71 males). Tile conversions (I5 cases) (7.7%) were due to abdominal abscess or to difficult mobilisation of appendix. We pcrformed associated laparoscopic operations (ovariectomy, choleeistectomy, hemi.', repair) in 10 cases (5.2%). The difli'rence of men= postoperative lime was not significant. The postoperative pair was minimal in the laparoscopic appendicectmny. The meat postoperative stay was 2.5 days for the laparoscu,lic appmact' and 5 days for the open surgery. The bowel movement startec in the first day and in the third day respectively "die die era intake began in the second day for the laparoscopk appendicectomy and in third day for the open surgery. Mine. complications were 3.6% in laparoscopic approach and 5.2% in open.. Major complications, which required reoperation where: 3 (1.5%) postoperative abdominal abscess, hcmopcritoneum (0.5%) in laparoscopic access and 3 (2.8 ~ in open. At the follow up there were 2 (1%) hernia at the pot sldo and 4 (3.7%) incislonal hernia in open technique whicl required reoperation. Laparoscopic appcndicectomy is a saf technique whi...
Thyroid metastases from extra-thyroid primary tumours are reported to be rare, mostly originating from lung, breast or renal cancer. Renal clear cell cancer (RCCC) is a tumour with great metastatic potential, but solitary metastases, especially in the thyroid gland, are uncommon. Here we report an unusual clinical case. In our patient, metastatic thyroid lesion was diagnosed before the primary RCCC. Surgical treatment yielded cancer-free survival, at present lasting already for 1.5 years.
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