1/22. A novel technique for giant left atrium reduction.We herein describe a safe and reproducible technique for left atrial volume reduction in patients with a giant left atrium. In a 56-year-old patient undergoing redo mitral valve replacement, the left atrium measured 18 x 20 x 17 cm occupying the middle-lower segment of the right hemithorax with compression of the adjacent organs. The left atrial volume was reduced by triangular resections of the atrial wall and the mitral valve was replaced using a mechanical prosthesis. The postoperative course was uneventful and the left atrial diameter was 11.2 cm at the latest control.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/22. Successful management of a symptomatic fusiform dilatation of the internal carotid artery following surgery of childhood craniopharyngioma.INTRODUCTION: The development of fusiform dilatation of internal carotid artery is one of the vascular complications that can follow surgery for craniopharyngioma and other suprasellar tumours in children, but its pathogenesis and the line of management are still controversial. CASE REPORT AND DISCUSSION: We report a child who presented with a giant fusiform aneurysm involving the supraclinoid portion of the internal carotid artery after total removal of a craniopharyngioma and review the literature on related cases. The treatment of this phenomenon and its possible pathogenesis are discussed.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
3/22. Giant esophageal leiomyoma with secondary megaesophagus.A 25-year-old woman presented with a giant leiomyoma in the lower third of the esophagus. She had no digestive symptoms, although there was a severe esophageal dilation. Such a megaesophagus secondary to a leiomyoma has not been described previously. Esophagogastric resection was performed, followed by an uneventful recovery period. The literature on esophageal leiomyoma is reviewed.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
4/22. Cholesterol hepatolithiasis with peribiliary cysts.A 78-year-old man was admitted to our clinic because of fatigue. Imaging modalities showed beaded stricture and dilation of the intrahepatic left segmental bile duct. Anomalous pancreatico-biliary ductal union and polycystic kidney disease were absent. Resection of the hepatic left lobe was performed. Grossly, cholesterol stones were impacted in the dilated intrahepatic large bile ducts, and multiple tiny cysts measuring 2-8 mm were noted in the peribiliary areas (peribiliary cysts). Histologically, the cholesterol hepatoliths consisted of cholesterol empty spaces and fibrinous materials, and, in places, foreign body giant cells were seen around the cholesterol crystals. The peribiliary cysts were lined by a layer of cuboidal epithelia. They were intimately intermingled with intrahepatic peribiliary glands, and a close association between the two components was recognized in some places. A mild degree of ascending cholangitis was noted. bile duct anomalies including von-Meyenburg complexes and simple cysts were not recognized. Peribiliary cysts have been reported in various liver diseases, including portal hypertension, portal thrombosis, cirrhosis, hepatocellular carcinoma, and adult polycystic kidney disease. However, to the best of our knowledge, there have been no reports on peribiliary cysts developing in hepatolithiasis. The present case indicates that peribiliary cysts occur in cholesterol hepatolithiasis, and suggests that they are derived from cystic dilations of intrahepatic peribiliary glands.- - - - - - - - - - ranking = 0.2keywords = giant (Clic here for more details about this article) |
5/22. Successful surgical repair of a giant left main coronary artery aneurysm with arteriovenous fistula draining into a persistent left superior vena cava and coronary sinus: role of intraoperative transesophageal echocardiography.We report the case of a 74-year-old woman with a history of hypertension, hypercholesterolemia, and pacemaker who presented to the hospital with new onset new york Heart association class IV congestive heart failure. Transthoracic echocardiography revealed a markedly dilated right ventricle with normal right ventricular systolic function. There was moderate pulmonary hypertension with an estimated pulmonary artery systolic pressure of 60 mm Hg. Her echocardiogram 1 year earlier had demonstrated normal right ventricular size and systolic function, and no pulmonary hypertension. Additional transthoracic imaging with saline contrast study through a left peripheral vein demonstrated the presence of a dilated coronary sinus with a persistent left superior vena cava. color Doppler demonstrated turbulent flow within the coronary sinus with evidence of significant left-to-right shunting. cardiac catheterization revealed a massively dilated left main coronary artery aneurysm with an arteriovenous fistula into the left superior vena cava and coronary sinus. The calculated Qp/Qs was 2:1. The patient underwent 2 unsuccessful attempts at percutaneous intervention to occlude the arteriovenous fistula. She then underwent successful surgical closure of the coronary arteriovenous fistula. The important role of intraoperative transesophageal echocardiography in guiding this technically challenging surgical case is discussed.- - - - - - - - - - ranking = 0.8keywords = giant (Clic here for more details about this article) |
6/22. Acute respiratory insufficiency and giant coronary artery aneurysm with fistula.Several causes of acute respiratory insufficiency have been reported in the literature. We describe a case in which it was caused by a rare combination of a giant right coronary artery aneurysm with fistula that occurred in a 56-year-old woman with concomitant congenital hypothyroidism. Diagnostic tools, differential diagnosis, surgical techniques, and follow-up at 1 year are discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/22. Surgical considerations regarding giant dilations of the perivascular spaces.OBJECT: Dilations of brain perivascular spaces (PVSs), also known as Virchow-Robin spaces, are routinely identified on magnetic resonance imaging studies of the brain and recognized as benign normal variants. Giant dilations occur only rarely and can be easily misdiagnosed as central nervous system tumors. The relevant surgical literature was reviewed to help establish indications for surgical intervention in these typically benign lesions. methods: Giant dilations of the PVSs in 12 patients who had undergone surgery for several different indications were identified. Both clinical and radiographic presentations of these patients were reviewed along with the surgical procedures. CONCLUSIONS: Dilations of the PVSs can become giant lesions that may necessitate surgical intervention to relieve mass effect or hydrocephalus. The relationship of these lesions to neurological symptoms such as tremor and seizures remains unclear.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/22. Osteoclast-like giant cell tumor of the liver: a rare neoplasm with an aggressive clinical course.Osteoclast-like giant cell tumors (OCGTs) usually involve the bone and rarely affect the alimentary tract. Within the gastrointestinal tract the liver has been one of the most infrequently reported locations for this neoplasm to occur. In this article we report the occurrence of an OCGT arising in the liver of a 61-year-old woman. The patient presented with abdominal pain and a rapidly enlarging hepatic mass. magnetic resonance imaging (MRI) indicated a multilocular solid lesion in the right lobe of the liver. A small extrahepatic lobulation at the lateral aspect of the lesion with penetration of the capsule was visible. Local extension into adjacent organs was not evident. Positron emission tomography (PET) did not indicate a tumor in the pancreas or elsewhere in the body. The tumor was removed by performing a formal right hepatic lobectomy. Histologic and immunohistochemical examinations revealed an OCGT. Within 3 months of the hemihepatectomy, widespread intraabdominal and pulmonary metastasis developed and the patient succumbed to her illness shortly thereafter. This report contributes further evidence to the aggressive biological behavior with regard to this rare neoplasm. The absence of metastatic disease indicated when using magnetic resonance imaging and positron emission tomography does not seem to change the overall dismal prognosis of this tumor.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/22. Giant schwannoma of the cauda equina with dural ectasia: a case report.We describe a rare case of giant cauda equina tumor in the upper lumbar spine with dural ectasia in the lumbosacral region. This patient had a long history of acromegaly due to pituitary adenoma, for which bromocriptine was administered. The cauda equina tumor was surgically resected en bloc and proved to be a benign schwannoma. Postoperatively, with the exception of the left L5 dermatome, sensory disturbance decreased markedly and motor function slowly improved. Although resection of a giant schwannoma of the cauda equina often sacrifices other cauda equina spinal nerves involved by the tumor, neurological deterioration was not observed in the case presented.- - - - - - - - - - ranking = 0.4keywords = giant (Clic here for more details about this article) |
10/22. Unilateral agenesis of the facial artery with compensation by a giant transverse facial artery.During routine dissections carried out in the course of our medical gross anatomy work, an unusual structure was found unilaterally on the left side of an adult male cadaver. Upon investigation, this was determined to be a hugely dilated transverse facial artery. Also noted was the complete absence of the ipsilateral facial artery. To our knowledge, this is the first report of complete agenesis and not simply diminution of the facial artery with compensatory enlargement of the transverse facial artery.- - - - - - - - - - ranking = 0.8keywords = giant (Clic here for more details about this article) |
| | Next -> |