Anal mucinous adenocarcinoma is a rare entity, representing approximately 5-11% of all anal cancers. Sometimes it is associated with chronic inflammation of long-standing anal fistula as it may occur in patients with Crohn's disease. In this case, cancer usually goes unnoticed owing to the inflammatory disease; therefore, a degree of uncertainty surrounds initially the diagnosis. We report a case of a 62-year-old man with A2 L3 B3p Crohn’s disease who also presents a perianal mucinous pseudocyst that is removed. Histological examination reveals a mucinous pseudocyst. At the two-year follow-up, we observe the recurrence of the cyst within an anal fistula. Scheduled non-oncologic surgery is performed with resection of the cyst and tutoring of the fistula with seton. Histological examination reveals mucinous adenocarcinoma. With no evidence of metastasis in the extension study, the patient is subjected to radical surgery with abdominoperineal resection. After 3 years and 11 months, a follow-up is carried out and there is no evidence of recurrence or distant metastasis. Mucinous adenocarcinoma within an anal fistula is a challenge in its diagnosis and its treatment due to the anecdotal nature of the cases. Given the high local risk of recurrence, radical surgery is recommended, occasionally associating neoadjuvant chemoradiotherapy if the neoplasm is locally advanced.

Background: Nerve damage after abdominal and pelvic surgery is rare but potentially serious. The incidence of peripheral nerve injury is difficult to assess, and rates of between 0.02% and 21% have been cited in the literature. Signs and symptoms of this type of injury may appear immediately after surgery or a few days later.Purpose: This study was developed to assess the rate of peripheral nerve injury after pelvic laparoscopy and to identify associated risk factors.Methods: A pilot prospective cohort study was conducted between March 2018 and April 2019 on 101 patients with a 1-month follow-up using two semistructured clinical interviews. We carried out a descriptive analysis followed by univariable and multivariable logistic regression analyses.Results: Thirteen patients were found to have peripheral nerve injuries, representing a rate of 12.9%. Overall, 14 injuries (five severe and nine mild) were detected. One patient had two mild injuries. In this study, the risk of injury was found to increase 1.77-fold (OR = 1.77, 95% CI [1.13, 2.76], p = .007) for each hour the patient was in the Trendelenburg position.Conclusions/Implications for Practice: The longer the patient is in the Trendelenburg position, the greater the risk of peripheral nerve damage. Patients aged 60 years or less also face a higher risk of nerve injury.

No abstract

No abstract

INTRODUCCIÓNLos rabdomiomas son tumores benignos de músculo estriado que se dividen en dos grandes grupos: rabdomiomas cardiacos y rabdomiomas extracardiacos, asociándose el primero a otras anormalidades congé-nitas entre las que se incluyen la esclerosis tuberosa, adenomas sebáceos y angiomiolipomas renales (1).El rabdomioma extracardiaco se divide en cuatro categorías basadas en sus características clínicas y morfológicas: a) De tipo adulto, suelen aparecen en adultos en la zona de cabeza y cuello; b) tipo fetal, ocurre en niños y adultos en la zona de cabeza y cuello; c) hamartoma mesenquimal rabdomiomatoso, aparecen en niños en la región perioral y periorbitaria; y d) el tipo genital que suele presentarse como una masa polipoide en vagina y vulva de mujeres de edad media, aunque se han descrito aislados casos en cervix, labios mayores, próstata, túnica vaginal testicular, cordón espermático y epidídimo (1,2); perteneciendo a este últi-mo grupo el caso que presentamos.Los tumores mesenquimales escrotales son raros, siendo los tumores benignos más frecuentes el hemangioma, linfangioma, leiomiomas y lipomas, existiendo solo aislados casos descritos en la literatura de rabdomioma de región paratesticular epidídimo o cordón espermático (2,3). Describimos un caso de rabdomioma de cordón espermático en un paciente de 28 años de edad que se presenta con un cuadro de tumoración dolorosa a la palpación. PRESENTACIÓN DEL CASOSe trata de un paciente de 28 años de edad, sin antecedentes de interés, que acude a consulta de urología RABDOMIOMA DE CORDÓN ESPERMÁTICO.