coagulopathy debulking

INTRODUCTION AND IMPORTANCE: Pituitary apoplexy is a clinical syndrome that occurs secondary to abrupt haemorrhage or infarction and can cause a presentation with headache, visual disturbances, and various neurological deficits. Pituitary apoplexy is a rare clinical syndrome that is often misdiagnosed or discovered late in its clinical course due to its relatively nonspecific clinical presentation. CASE PRESENTATION: The case describes patient with a giant prolactinoma which developed haemorrhagic progression in the context of previously undiagnosed coagulopathy from idiopathic thrombocytopaenia...

PURPOSE OF REVIEW: Adequate visualization during endoscopic sinus surgery (ESS) is one of the most critical aspects of performing well tolerated and successful surgery. The topic of visualization encompasses a broad spectrum of preoperative and intraoperative manoeuvres the surgeon can perform that aid in the understanding of the patient's anatomy and in the delivery of efficient surgical care. RECENT FINDINGS: Preoperative considerations to improve visualization include optimization of haemostasis through management of comorbidities (e...

BACKGROUND: Diffuse venous malformations that involve all tissues in the upper limb and ipsilateral chest wall are known as "phlebectasia of Bockenheimer." The authors describe their experience with management of this uncommon vascular anomaly. METHODS: The authors' Vascular Anomalies Center registry comprised 18,766 patients over a 40-year period. This review identified 2036 patients with venous malformations of the extremities (10.8 percent), of whom only 80 (0...

PURPOSE: Diffuse venous malformations (VMs) that involve all tissues in the upper limb and ipsilateral chest wall are known as "phlebectasia of Bockenheimer." We describe our experience with management of this uncommon vascular anomaly. METHODS: Our Vascular Anomalies Center registry comprises 18,766 patients over a 40-year period. This review identified 2,036 patients with venous malformations of the extremities (10.8%), of whom only 80 (0.43%) had Bockenheimer disease...

Capillary lymphatic venous malformations (CLVM) are complex vascular anomalies characterized by aberrant and enlarged lymphatic and blood vessels. CLVM appear during fetal development and enlarge after birth, causing life-long complications such as coagulopathy, pulmonary embolism, chronic pain, and disfigurement. Treatment includes surgical debulking, amputation, and recurrent sclerotherapy. Somatic, mosaic mutations in the 110-kD catalytic α-subunit of phosphoinositide-3-kinase (PIK3CA) gene have been previously identified in affected tissues from CLVM patients; however, the cell population harboring the mutation is still unknown...

•Ovarian cancer, particularly clear cell carcinoma, creates a hypercoagulable state.•This state can predispose to non-bacterial thrombotic endocarditis (NBTE).•NBTE can embolize and cause widespread arterial infarction.•NBTE is sometimes associated with a treatment refractory disseminated coagulopathy.•Surgical removal of the primary mass can sometimes reverse the coagulopathy.

INTRODUCTION: Percutaneous destruction of cancer cells using a radiofrequency energy source has become an accepted part of the modern armamentarium for managing malignancies. Radiofrequency ablation (RFA) is a relatively novel procedure for treating recurrent and metastatic tumors. It is used for debulking tumors and as adjuvant therapy for palliative care apart from its role as a pain management tool. Its use in the third world countries is limited by various factors such as cost and expertise...

Orbital metastasis of hepatocellular carcinoma is exceedingly rare and caries a grave prognosis. Three cases of metastatic orbital hepatocellular carcinoma in which the primary tumor was initially unknown and the diagnostic challenges encountered are presented. With hepatocellular carcinoma, open biopsy and palliative tumor debulking has an increased bleeding risk due to the highly vascular nature of the tumor and coagulopathy associated with chronic liver disease. As an alternative, fine needle aspiration biopsy should be considered for hepatocellular carcinoma with a readily accessible mass and the availability of an experienced cytopathologist...

Visceral leishmaniasis (VL), also known as Kala-azar, is a systemic infection caused by a protozoan (Leishmania) and, in its classic form, is a serious illness associated with malnutrition, anemia, hepatosplenomegaly, infectious processes and coagulopathies. The effect of splenectomy in patients with visceral leishmaniasis is not well defined; however, it is known that the spleen is the largest reservoir of infected cells belonging to the reticulo endothelial system. Therefore, the surgical procedure is an option for the debulking of parasites, providing a cure for refractory VL and minimizing the complications of hypersplenism...

INTRODUCTION: Internal jugular vein thrombosis (IJVT) is a rare but potentially fatal condition. It usually arises following trauma to the internal jugular vein but is also seen in association with coagulopathies and advanced malignancies as part of a para-neoplastic syndrome. CASE PRESENTATION: We report a case of a 44 year old woman with a strong past medical history and family history of thrombotic disease who presented with abdominal pain and ascites. A stage III ovarian carcinoma was diagnosed and she underwent debulking of the tumour...

Peripheral neuropathy of the femoral nerve is extremely rare. In the literature, we found descriptions of only 50 similar patients, mainly as a complication of coagulopathies, and none of intrapelvic tumors. Three children with a rare peripheral neuropathy of the femoral nerve as a complication of extraperitoneal pelvic masses are described in this report. In all three, the neuropathy was caused by stretching of the femoral nerve over a huge intrapelvic mass. None was related to coagulopathy. After removal of the masses, full recovery from the neurological symptoms was observed in two children and the recovery of the patient with Ewing's sarcoma is satisfying, at the 2-year follow-up and at the time of writing...

PURPOSE: Laparoscopic radical nephrectomy is being performed more commonly. To our knowledge intentional resection of the diaphragm during laparoscopic radical nephrectomy for large renal tumors has not yet been described. We detail the laparoscopic management of diaphragmatic resection. MATERIALS AND METHODS: From March 1996 to February 2001, 36 patients underwent cytoreductive laparoscopic radical nephrectomy at our institution in preparation for systemic immunotherapy...

BACKGROUND: An isolated cardiac metastasis from cervical carcinoma is very rare. This report describes the unusual presentation in a patient diagnosed and successfully treated for stage IB squamous cell carcinoma of the cervix, presenting six months later with disease metastatic to the heart. CASE: A 44-year-old woman presented with hand swelling and bruising. She had undergone successful surgical treatment of a stage IB squamous cell cervical carcinoma six months previously...

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In mature women, the most common histological cell type of ovarian cancer is of epithelial origin. In children and adolescents, germ cell tumors are the most frequent. We report a case of a serous papillary cystadenocarcinoma FIGO stage IIIC in a 19-year-old female. She presented with a 6-month history of vague lower abdominal pain. Preoperative CA-125 was elevated at 296 kU/liter. At laparotomy, she was found to have stage IIIC disease. A debulking procedure including total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymph node sampling was performed...