1/5. Gastric adenocarcinoma associated with granulomatous gastritis. Case report and review of the literature.AIMS: We describe the fourth reported case of granulomatous gastritis associated with gastric adenocarcinoma, with a review of the literature and considerations about the prognostic implications of this association. RESULTS: A 48-year-old woman who had been suffering from gastritis for ten years was admitted to our institute for increasing left epigastric pain associated with vomiting. After an endoscopic biopsy had revealed an ulcerated signet ring cell carcinoma, the patient was submitted to subtotal gastrectomy with regional lymph node dissection. Pathological examination of the resected specimen revealed a superficial signet ring cell carcinoma (early cancer) associated with multiple granulomas. The granulomas, which were observed within the mucosa and the submucosa at the periphery of the carcinoma, were composed of CD68-positive, CD15-negative epithelioid and giant cells of the Langhans type, confirming their true histiocytic nature, and were also extensively found within the dissected lymph nodes. Since no ocular, skin, pulmonary or other gastrointestinal lesions were found and the granulomas were negative for acid-fast and fungal stain, a diagnosis of granulomatous gastritis was made. CONCLUSIONS: To the best of our knowledge this is the fourth example of gastric adenocarcinoma and granulomatous gastritis. These cases suggest an association between granulomatous gastritis and early gastric cancer.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/5. A case of giant appendiceal mucocele.Appendiceal mucocele is a rare clinical condition that causes distension of the appendix lumen with mucus. A seventy-three-year-old female patient presented with complaints of abdominal pain, nausea, and vomiting. Abdominal examination revealed mild tenderness, right lower quadrant pain upon palpation, rebound tenderness and muscular rigidity, and a palpable mass. Abdominal ultrasonography and computed tomography scans demonstrated a cystic lesion in the right iliac fossa, adherent to the cecum, suggesting an abdominal abscess. An emergency operation was performed, during which a diagnosis of a mucocele of the appendix was made. Surgical treatment included appendicectomy, partial resection of the ileum, and resection of the cecum. Histopathologic examination confirmed the operative diagnosis. The role of imaging and clinical approach is emphasized in the treatment of an appendiceal mucocele, especially in emergency settings.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
3/5. Symptomatic giant Mullerian duct cyst in an infant: radiographic and CT findings.We report an unusual case of Mullerian duct cyst in an 8-month-old infant who presented with frequent vomiting and recurrent urinary tract infections. Computed tomography showed a midline giant cyst in the pelvic floor. Delayed enhanced computed tomography demonstrated contrast filling of the cyst, indicating a communication with the urotract. Subsequent cystourethrogram and surgery confirmed a giant Mullerian duct cyst.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
4/5. Protracted vomiting as the presenting sign of posterior fossa mass lesions.Four patients with mass lesions of the posterior fossa experienced protracted vomiting as their only symptom for extended periods of time. The responsible lesions were a cerebellar tumour in two patients, a ventricular cysticercus in one patient, and a giant vertebral artery aneurysm in another. All four cases had compression or displacement of the floor of the fourth ventricle, where the "vomiting centre" has been located. The value of vomiting as a sign of a posterior fossa lesion is emphasised.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/5. External compression as initial management of giant omphaloceles.The authors describe a noninvasive technique for the management of giant omphaloceles. Two patients with giant omphaloceles were managed with external compression. Dry sterile dressings were used, buttressed by an Ace bandage in the first case and by a handcrafted Velcro abdominal binder in the second. The binder was tightened every 2 or 3 days. Renal, cardiovascular, respiratory, and gastrointestinal parameters were measured regularly to determine whether the binder was too tight. The first patient had only occasional emesis, and the defect was repaired after 40 days of compression. The second patient experienced intermittent hypertension, occasional emesis, and mild oxygen desaturation, which resolved when the binder was loosened slightly. The fascia muscle and skin were closed after 30 days of external compression. Both patients are currently living at home and doing well. This form of external compression is an effective, inexpensive, and low-risk method for the gradual reduction of giant omphaloceles, and should be considered for patients born with this problem.- - - - - - - - - - ranking = 7keywords = giant (Clic here for more details about this article) |