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RISS 인기검색어
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- 저자 : Sanchez-Morales German Esteban (검색결과 3 건)
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Undifferentiated embryonal sarcoma of the liver in adult patient
Sanchez-Morales German Esteban,Clemente-Gutierrez Uriel Emili,Alvarez-Bautista Francisco Emm,Santes-Jasso Oscar,Carpinteyro-Espin Paulina,Mercado Miguel Angel 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.3
Primary sarcomas of the liver are unusual neoplasms developing in adults. They constitute a heterogeneous group of neoplasms including undifferentiated embryonal sarcoma. Patients usually present with an abdominal mass and abdominal pain. Case 1: A 53-year-old woman presented with abdominal pain. Computed tomography showed an occupying mass in the right lobule and an intra-auricular multi-lobulated mass suggestive of a secondary deposit. Biopsy of the hepatic lesion revealed undifferentiated embryonal sarcoma. Despite radiotherapy and supportive measures, her overall status progressively worsened until cardiac arrest. Case 2: A 41-year-old woman presented with hepatomegaly. Abdominal imaging showed cystic lesions in the right hepatic lobule with multiple septae. The patient underwent extended right hepatectomy and a histopathological study reported high-grade undifferentiated embryonal sarcoma. Two years after surgery, a new cystic lesion in the surgical site was recorded and chemotherapy was scheduled. The lesion remained stable for three years when disease progression was observed and second-line chemotherapy was initiated. Although undifferentiated embryonal sarcoma of the liver has poor prognosis, early diagnosis is essential to increase the chances of survival. Currently, surgical resection and chemotherapy are the primary treatment modalities.
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Adult pancreatoblastoma: A rare malignant tumor of the pancreas
German Esteban Sanchez Morales,Hillary Lizarraga Payan,Roberto Andre Moguel Valladare,Ismael Dominguez Rosado,Carlos Chan 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.3
Pancreatoblastoma (PB) is a rare malignant tumor in adults. It has an overall incidence of 0.004 per 100,000 inhabitants. Its diagnosis with fine-needle aspiration (FNA) is difficult due to multiple differentiation lines present on PB that overlap with other tumors. A 76-year-old male patient presented with jaundice, weight loss of 10 kg in 6 months, and appetite loss. Abdominal computed tomography scan showed a tumor in the pancreas head. Transendoscopic ultrasound with FNA biopsy revealed a malignant epithelial neoplasia compatible with PB with immunohistochemistry CK19 (+), P63(+), synaptophysin (–), and Ki67 50%. The patient underwent surgical resection and adjuvant chemotherapy. Currently, the patient is in follow-up with the latest imaging showing no evidence of disease at 32 months after his initial diagnosis. PB is an uncommon malignant neoplasia with an aggressive behavior. Its diagnostic and therapeutic protocols are unclear. Its preoperative diagnosis may be difficult since its imaging features and serological markers are non-specific. However, FNA may be useful in some situations. Surgical resection is currently the recommended treatment that is associated with the best long-term survival.
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Acute cholecystitis in neutropenic patients
Uriel Clemente-Gutierrez,German Esteban Sanchez Morales,Paulina Moctezuma Velazquez,Alexandra Rueda de Leon Aguirr,Jesus Morales Maza,Ismael Dominguez-Rosado,Heriberto Medina-Franco 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.3
Backgrounds/Aims: The frequency of acute cholecystitis reported in neutropenic patients is between 0.4-1.65%. Clinical manifestations differ from general population as well as clinical approach, diagnosis and treatment. The aim of this work is to describe clinical characteristics, diagnostic approach, and outcomes of patients with hematological diseases that presented with neutropenia and fever associated with acute cholecystitis in a tertiary referral hospital. Methods: We performed a retrospective analysis of patients with diagnosis of neutropenia and fever associated with acute cholecystitis in the period between January 2000 and January 2017. Quantitative variables were analyzed with mean and standard deviation, and qualitative variables with frequency and percentage. Results: During the study period, 2007 patients presented with neutropenia and fever. Twelve of them (0.59%) had associated acute cholecystitis. The most common hematologic disease among these patients was lymphoblastic leukemia. Acute acalculous cholecystitis was diagnosed in 6 cases (50%). Eleven patients (91.6%) had a severe presentation and cholecystostomy was performed in 9 (75%) cases. The main cause of mortality was septic shock (33.3%). Conclusions: Treatment of acute cholecystitis in patients with neutropenia must be individualized. Cholecystostomy should be considered as a bridge therapy for an interval cholecystectomy.
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