Karakousis’s abdominoinguinal approach for the treatment of a primary retroperitoneal parasitic leiomyoma with inguinal extension. A case report

Portilla, Alberto Gómez; Echenagusía, Victor; Cendoya, Iñaki; Maqueda, Aintzane; Heredia, Eduardo López de

doi:10.1016/j.ijscr.2018.01.003

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…In this case, surgical resection STF was successful using this approach. This approach must be present in every surgeon's arsenal, allowing a resectability rate of up to 95% of abdominal lower-quadrant tumors which are otherwise considered unresectable [19].…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Surgical Resection of a Presacral Solitary Fibrous Tumor with Extension to Iliac Vessels using Karakousis’s Abdominoinguinal Approach: Report of a Rare Case

Pachajoa

Huatuco

Sambuelli

et al. 2021

Preprint

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Background: The solitary fibrous tumor (SFT) is a rare tumor of mesenchymal origin, with a reported incidence of 2.8 cases per 100.000 tumors and with distinctive histopathological and immunohistochemical characteristics. It was initially described as a pleural lesion and subsequently, it was found in different organs and tissues. The abdominoinguinal incision described by Karakousis allows a radical reliable approach for abdominal-pelvic tumors in lower quadrants. We present the case of a patient with a presacral STF extending to iliac vessels, which required the Karakouis’s approach for its surgical resection.Case Presentation: Forty-seven-year-old man with pain in lumbosacral region radiating to left leg since 5 months. MRI and CT show evidence of a 10cm-retroperitoneal mass (presacral space) extending to left iliac vessels. The early diagnosis corresponded to a sarcomatous retroperitoneal tumor. It was decided to carry out the abdominal scan through the Karakousis’s approach for surgical resection with permanent neurovascular control. The immunohistochemistry and histopathological study revealed a CD-34 positive spindle-cell neoplasia, vimentin, Bcl-2, and β-catenin, compatible with a SFT. It was categorized as low risk for developing metastasis and death from disease, according to the new criteria for malignancy. At present, the patient is asymptomatic and disease-free at 17 months after surgery.Conclusion: Presacral SFT is a rare entity, with a scant incidence reported regarding this location and long-term treatment. Surgical resection is needed as the immediate treatment.

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Surgical Resection of a Presacral Solitary Fibrous Tumor with Extension to Iliac Vessels using Karakousis’s Abdominoinguinal Approach: Report of a Rare Case

Pachajoa

Huatuco

Sambuelli

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Generally, most authors use a midline abdominal incision. This incision does not allow a good exposure of the caudal portion of the external iliac vessels, as the presence of tumor hinders further visibility [ 18 ]. The Karakousis's abdominal-inguinal approach the only one that warrants the radical resection of retroperitoneal tumors with pelvic extension by allowing an exposure in continuity from the abdominal aorta to iliofemoral vessels, thus facilitating the en-bloc resection and dissection of the tumor mass with vascular control and preservation of vascular-nervous package [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…This approach must be present in every surgeon's arsenal, allowing a resectability rate of up to 95% of abdominal lower-quadrant tumors which are otherwise considered unresectable [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical resection of a presacral solitary fibrous tumor with extension to iliac vessels using Karakousis's abdominoinguinal approach: Report of a rare case

Pachajoa

Huatuco

Sambuelli

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance The solitary fibrous tumor (SFT) is a rare tumor of mesenchymal origin, with a reported incidence of 2.8 cases per 100,000 tumors and with distinctive histopathological and immunohistochemical characteristics. It was initially described as a pleural lesion and subsequently, it was found in different organs and tissues. The abdominoinguinal incision described by Karakousis allows a safe and radical approach for lower quadrants abdominopelvic tumors. Case presentation A 47-year-old man was referred to us with a 5-months history of lower backache radiating to the left lower limb. MRI and CT revealed a retroperitoneal mass of 10 cm extending to left iliac vessels. The initial diagnosis corresponded to a sarcomatous retroperitoneal tumor. It was decided to perform an abdominal exploration using Karakousis's approach for surgical resection. The immunohistochemistry and histopathological study revealed neoplasia compatible with a SFT. It was categorized as low risk for developing metastasis and death from disease, according to the new malignancy criteria. Currently, the patient is asymptomatic and disease-free at 19 months after surgery. Clinical discussion Most patients with SFTs present symptoms derived from the tumor growth and the compression on adjacent structures with clinical manifestations that are frequently insidious and precede the tumor discovery. The diagnosis is based on histopathological studies. Nonetheless, when they present an extrathoracic location, they represent a diagnostic challenge, due to their variable histological characteristics. Conclusion Presacral SFT is a rare entity, with a scant incidence reported regarding this location and long-term treatment. Surgical resection is needed as the immediate treatment.

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Karakousis’s abdominoinguinal approach for the treatment of a primary retroperitoneal parasitic leiomyoma with inguinal extension. A case report

Cited by 2 publications

References 10 publications

WITHDRAWN: Surgical Resection of a Presacral Solitary Fibrous Tumor with Extension to Iliac Vessels using Karakousis’s Abdominoinguinal Approach: Report of a Rare Case

WITHDRAWN: Surgical Resection of a Presacral Solitary Fibrous Tumor with Extension to Iliac Vessels using Karakousis’s Abdominoinguinal Approach: Report of a Rare Case

Surgical resection of a presacral solitary fibrous tumor with extension to iliac vessels using Karakousis's abdominoinguinal approach: Report of a rare case

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