This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ http://www.wjso.com The latest articles from World Journal of Surgical Oncology (ISSN 1477-7819) published by BioMed Central Background: Very little data about the conservative treatment of early stage glassy cell cervical cancer have been reported. Case presentationA 30-year old patient, nulligravida was admitted to the Gynecologic Oncology Unit of the Catholic University of Campobasso for irregular post-coital vaginal bleeding. The patients was staged as having FIGO stage IB1 (tumor diameter=2 cm) squamous cervical cancer. After extensive counseling of the patient and her family, laparoscopic pelvic lymphadenectomy and cold knife conization were performed. The final diagnosis was FIGO Stage IB1 glassy cell carcinoma. Currently, after a follow-up of 38 months, she has no evidence of disease. Conclusions: We reported a case of early stage glassy cell cancer patient, who was conservatively treated by conization and laparoscopic pelvic lymphadenectomy. http://www.wjso.com/content/6/1/92 Gabriella Ferrandina, Vanda Salutari, Marco Petrillo, Arnaldo Carbone and Giovanni Scambia World Journal of Surgical Oncology 2008, 6:92 2008-08-28 doi:10.1186/1477-7819-6-92 World Journal of Surgical Oncology 1477-7819 6 92 2008-08-28 Background: Primary carcinoid tumors of the liver are uncommon and rarely symptomatic. The diagnosis of primary hepatic etiology requires rigorous workup and continued surveillance to exclude a missed primary. Case presentationWe present a case of a 62-year-old female with a primary hepatic carcinoid tumor successfully resected, now with three years of disease-free follow-up. We present a review of the current literature regarding the diagnosis, pathology, management, and natural history of this disease entity. Conclusion: Primary carcinoid tumors of the liver are rare, therefore classifying their nature as primary hepatic in nature requires extensive workup and prolonged follow-up. All neuroendocrine tumors have an inherent malignant potential that must be recognized. Management remains surgical resection, with several alternative options available for non-resectable tumors and severe symptoms. The risk of recurrence of primary hepatic carcinoid tumors after resection remains unknown. http://www.wjso.com/content/6/1/91 Gary Schwartz, Agnes Colanta, Harold Gaetz, John Olichney and Fadi Attiyeh World Journal of Surgical Oncology 2008, 6:91 2008-08-27 doi:10.1186/1477-7819-6-91 World Journal of Surgical Oncology 1477-7819 6 91 2008-08-27 Background: Up to 15% of colorectal cancer (CRC) patients present with obstructive or perforated tumours, and require emergency surgery. The Hartmann's procedure (HP) provides the opportunity to achieve a potentially curative (R0) resection, while minimizing surgical trauma in poor-risk patients. The aim of this study was to assess the surgical (operative mortality), and oncological (long-term survival after curative resection) results of emergency HP for obstructive or perforated left-sided CRC. Methods: A retrospective review of 50 patients who underwent emergency HP for perforated/obstructive CRC in our institution between 1995 and 2006. Results: Median age of patients was 75 (range 22-95) years and the indications for HP were obstruction (32) and perforation (18 patients). Operative mortality and morbidity were 8% and 26% respectively. 35 patients (70%) were operated with a curative intent; in this group, overall 1-, 3- and 5-year survival rates were 80%, 54% and 40%. In univariate analysis, the presence of lymph node metastases was associated with poor 5-year survival (62% [Stage II] vs. 27% [Stage III], log-rank test, p=0.02). Eleven patients (22%) had their operation reversed with a median delay of 225 (range 94-390) days. In this subgroup, two patients died from distant metastases, but there were no instances of loco-regional recurrence. Conclusion: Hartmann's operation remains a good option to palliate symptoms in 30% of patients with left-sided CRC who are not candidates to a curative resection. For those who have a curative resection, the oncological outcome is acceptable, especially stage II patients, who appear to benefit the most from this surgical strategy. http://www.wjso.com/content/6/1/90 Pierre Charbonnet, Pascal Gervaz, Axel Andres, Pascal Bucher, Beatrice Konrad and Philippe Morel World Journal of Surgical Oncology 2008, 6:90 2008-08-23 doi:10.1186/1477-7819-6-90 World Journal of Surgical Oncology 1477-7819 6 90 2008-08-23 Background: Magnetic resonance imaging (MRI) is used for preoperative local staging in patients with rectal cancer. Our aim was to retrospectively study the effects of the imaging protocol on the staging accuracy. Patients and methods MR-examinations of 37 patients with locally advanced disease were divided into two groups; compliant and noncompliant, based on the imaging protocol, without knowledge of the histopathological results. A compliant rectal cancer imaging protocol was defined as including T2-weighted imaging in the sagittal and axial planes with supplementary coronal in low rectal tumors, alongside a high-resolution plane perpendicular to the rectum at the level of the primary tumor. Protocols not complying with these criteria were defined as noncompliant. Histopathological results were used as gold standard. Results: Compliant rectal imaging protocols showed significantly better correlation with histopathological results regarding assessment of anterior organ involvement (sensitivity and specificity rates in compliant group were 86% and 94%, respectively vs. 50% and 33% in the noncompliant group). Compliant imaging protocols also used statistically significant smaller voxel sizes and fewer number of MR sequences than the noncompliant protocols Conclusions: Appropriate MR imaging protocols enable more accurate local staging of locally advanced rectal tumors with less number of sequences and without intravenous gadolinium contrast agents. http://www.wjso.com/content/6/1/89 Chikako Suzuki, Michael R Torkzad, Soichi Tanaka, Gabriella Palmer, Johan Lindholm, Torbjorn Holm and Lennart Blomqvist World Journal of Surgical Oncology 2008, 6:89 2008-08-20 doi:10.1186/1477-7819-6-89 World Journal of Surgical Oncology 1477-7819 6 89 2008-08-20 Background: The optimal operative approach for carcinoma at the lower esophagus and esophagogastric junction remains controversial. The aim of this study was to assess a single unit experience of transhiatal esophagectomy in an era when the use of systemic oncological therapies has increased dramatically. Study Design: Between January 2000 and November 2006, 215 consecutive patients (182 males, 33 females, median age= 65 years) underwent transhiatal esophagectomy; invasive malignancy was detected preoperatively in 188 patients. 90 patients (42%) received neoadjuvant chemotherapy. Prospective data was obtained for these patients and cross-referenced with cancer registry survival data. Results: There were 2 in-hospital deaths (0.9%). Major complications included: respiratory complications in 65 patients (30%), cardiovascular complications in 31 patients (14%) and clinically apparent anastomotic leak in 12 patients (6%). Median length of hospital stay was 14 days. The radicality of resection was inversely related to T stage: an R0 resection was achieved in 98-100% of T0/1 tumors and only 14% of T4 tumors. With a median follow up of 26 months, one and five year survival rates were estimated at 81% and 48% respectively. Conclusions: Transhiatal esophagectomy is an effective operative approach for tumors of the infracarinal esophagus and the esophagogastric junction. It is associated with low mortality and morbidity and a five survival rate of nearly 50% when combined with neoadjuvant chemotherapy. http://www.wjso.com/content/6/1/88 Andrew R Davies, Matthew J Forshaw, Aadil A Khan, Alia S Noorani, Vanash M Patel, Dirk C Strauss and Robert C Mason World Journal of Surgical Oncology 2008, 6:88 2008-08-20 doi:10.1186/1477-7819-6-88 World Journal of Surgical Oncology 1477-7819 6 88 2008-08-20 Background: Littoral cell angioma (LCA) is a recently described primary vascular neoplasm of the spleen that may be associated with other malignancies and may itself also have malignant potential.Case presentationWe present a case of LCA that was discovered incidentally in a 52-year-old woman who presented with biliary colic at the time of consultation for cholecystectomy. This vascular neoplasm was evaluated by ultrasound, CT, MRI, Tc-99m labelled red blood cell scintigraphy, and core biopsy. A splenectomy revealed LCA by pathological evaluation. Post-operative outcome was favourable with no evidence of complication or recurrent disease. Following this case presentation, clinical, radiographic, and pathological features of LCA will be reviewed as well as recent advances in our understanding of this uncommon splenic lesion. Conclusion: LCA is a rare, generally benign, primary vascular tumour of the spleen that typically is discovered incidentally. Individuals diagnosed with this tumour must be carefully evaluated to exclude primary, secondary, and synchronous malignancies. http://www.wjso.com/content/6/1/87 May Tee, Patrick Vos, Peter Zetler and Sam M Wiseman World Journal of Surgical Oncology 2008, 6:87 2008-08-19 doi:10.1186/1477-7819-6-87 World Journal of Surgical Oncology 1477-7819 6 87 2008-08-19 Background: Solitary fibrous tumor of the pleura is a rarely encountered clinical entity which may have different clinical pictures. Although the majority of these neoplasms have a benign course, the malignant form has also been reported. Case presentationWe herein describe a case of 72 year-old man with head, facial, and thoracic traumas caused by neurally-mediated situational syncope when coughing. The diagnostic work-up including chest x-ray, CT and PET, revealed a large solitary mass of the left hemithorax. Radical surgical resection of the mass was performed through a left lateral thoracotomy and completed with a wedge resection of the lingula. Hystological examination of the surgical specimen showed an encapsulated mass measuring 12 x 11.5 x 6 cm consistent with a solitary fibrous tumor of the pleura. It's surgical removal definitively resolved the neurologic manifestations. The patient had no postoperative complications. At two years follow-up the patient is free from recurrence and without clinical manifestations. Conclusions: In our case its resection definitively resolved the episodes of situational syncope due, in our opinion, to the large thoracic mass compressing the phrenic nerve http://www.wjso.com/content/6/1/86 Luigi Santambrogio, Mario Nosotti, Alessandro Palleschi, Lorenzo Rosso, Davide Tosi, Matilde De Simone, Michele M Ciulla, Marco Maggioni and Ugo Cioffi World Journal of Surgical Oncology 2008, 6:86 2008-08-19 doi:10.1186/1477-7819-6-86 World Journal of Surgical Oncology 1477-7819 6 86 2008-08-19 Background: Pleural or peritoneal effusions (ascites) are frequent in terminal stage malignancies. Medical management may be hazardous.Case presentationA 60-year-old man with metastatic malignant melanoma presented with refractory ascites as well as bilateral pleural effusions. After failure of the medical treatment, bilateral pleural aspiration and paracentesis became necessary, two to three times every week. A multi perforated 15F silicone catheter connected with a subcutaneous port was implanted in peritoneal and both pleural cavities surgically under general anesthesia. Leakage around the catheter was prevented by subcutaneous tunneling. Surgical technique is described and illustrated in a video. Implanted systems were immediately operational. Follow-up period was 41 days. Each port was accessed 10 times and a total of 65'200 ml of fluid was drained. By the end of the forth week, pleural effusions diminished, systems were controlled for permeability and chest X-rays confirmed absence of effusion. Conclusions: Implanted port systems for refractory ascites and pleural effusions avoid morbidity and the patient's anxiety related to repeated puncture-aspiration. Large catheter diameter allows an easy and fast drainage of large volumes. Compared to chronic indwelling catheters, subcutaneous location of port system allows an entire integration, giving the patient a total liberty in daily life between two sessions of drainage. Drainage can be performed on an outpatient basis as an ambulatory procedure. This patient-friendly technique may be a treatment option in case of failure of other techniques. http://www.wjso.com/content/6/1/85 Ihsan Inan, Sandra De Sousa, Patrick O Myers, Brigitte Bouclier, Pierre-Yves Dietrich, Monika E Hagen and Philippe Morel World Journal of Surgical Oncology 2008, 6:85 2008-08-18 doi:10.1186/1477-7819-6-85 World Journal of Surgical Oncology 1477-7819 6 85 2008-08-18 Background: Epithelioid sarcoma is an uncommon high-grade sarcoma, mostly involving the extremities. Case presentationA 33-year-old man was referred to our institute with a diagnosis of Volkmann's contracture with the symptom of flexion contracture of the fingers associated with swelling in his left forearm. Magnetic resonance imaging (MRI) showed abnormal signal intensity, comprising iso-signal intensity on T1- and high-signal intensity on T2-weighted images surrounding the flexor tendons in the forearm. Diagnosis of epithelioid sarcoma was made by open biopsy, and amputation at the upper arm was then undertaken. [18F]-2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) detected multiple lesions with an increased uptake in the right neck, the bilateral upper arms and the right thigh, as well as in the left axillary lymph nodes, with maximum standardized uptake value (SUVmax) ranging from 2.0 to 5.5 g/ml. Magnetic resonance imaging confirmed that there was a lesion within the right thigh muscle which was suggestive of metastasis, even though the lesion was occult clinically. Conclusion: Increased uptake on FDG-PET might be representative of epithelioid sarcoma, and for this reason FDG-PET may be useful for detecting metastasis. Muscle metastasis is not well documented in epithelioid sarcoma. Accordingly, the frequency of muscle metastasis, including occult metastasis, needs to be further analyzed. http://www.wjso.com/content/6/1/84 Akio Sakamoto, Osamu Jono, Minako Hirahashi, Masafumi Oya, Yukihide Iwamoto and Ken Arai World Journal of Surgical Oncology 2008, 6:84 2008-08-15 doi:10.1186/1477-7819-6-84 World Journal of Surgical Oncology 1477-7819 6 84 2008-08-15 Background: Among human neoplasms thymomas are associated with highest frequency with paraneoplastic autoimmune diseases. Case presentationA case of a 42-year-old woman with paraneoplastic pemphigus as the first manifestation of thymoma is reported. Transsternal complete thymoma resection achieved pemphigus regression. The clinical correlations between pemphigus and thymoma are presented. Conclusions: Our case report provides further evidence for the important role of autoantibodies in the pathogenesis of paraneoplastic skin diseases in thymoma patients. It also documents the improvement of the associated pemphigus after radical treatment of the thymoma. http://www.wjso.com/content/6/1/83 Nikolaos Barbetakis, Georgios Samanidis, Dimitrios Paliouras, Ioannis Boukovinas, Christos Asteriou, Eleni Stergiou, Kostas Laschos and Christodoulos Tsilikas World Journal of Surgical Oncology 2008, 6:83 2008-08-12 doi:10.1186/1477-7819-6-83 World Journal of Surgical Oncology 1477-7819 6 83 2008-08-12