Cases reported "Neoplasm Seeding"

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11/12. The case against aspirating ovarian cysts.

    BACKGROUND. Developments in ultrasonographic technology have increased the possibilities of ovarian cyst aspiration. The risk of an extension of indications for ovarian cyst aspiration, however, is iatrogenic spread of malignant cells. methods. In this article, the diagnostic accuracy and therapeutic effectiveness of ovarian cyst aspiration are discussed, and the potential risk from different forms of tumor spill are considered. RESULTS. Two cases are presented in which a laparoscopic puncture and aspiration of a malignant ovarian cyst were performed. In both cases, there were diagnostic problems with the cytologic assessment. In one case, aspiration of an apparently benign cyst, based on ultrasonographic and laparoscopic findings, yielded cytologically negative fluid, but 8 weeks later an extensively disseminated ovarian carcinoma was found at laparotomy. It is postulated that the time interval between first tumor spill and eventual removal of the diseased ovary is the most important determinant of prognosis. CONCLUSIONS. The conclusion of these case reports is that aspiration of ovarian cysts, except for the purposes of oocyte retrieval, is potentially dangerous and should not be regarded as routinely acceptable clinical practice.
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12/12. Partial hepatectomy for metastatic seeding complicating pancreatoduodenectomy.

    We present a case report of metastatic seeding at the percutaneous transhepatic biliary drainage tract in a 68 year-old man who previously underwent pancreatoduodenectomy with bile duct resection for distal bile ductal carcinoma. Three years and 5 months after the initial operation, dilation of the left lateral segmental bile ducts was detected by abdominal ultrasonography. Percutaneous transhepatic cholangiography disclosed a stricture at the confluence of the ventral and dorsal branches of the left lateral anterior segmental duct. This region corresponded to the punctured point of the previous percutaneous transhepatic biliary drainage. Implantation of the bile duct carcinoma at the percutaneous transhepatic biliary drainage sinus tract was diagnosed, and the recurrent tumor was successfully resected by an extended left hepatic lobectomy with a total caudate lobectomy. Currently, 8 years and 3 months after the second surgery, the patient is in good health without any signs of tumor recurrence. This case report discusses the entity of metastatic seeding, a rare but serious complication of percutaneous transhepatic biliary drainage. An aggressive surgical approach is important for recurrent biliary tract malignancies.
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keywords = puncture
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