Complicated Hepatic Cyst Research Articles

Diagnóstico por imagen de abscesos hepáticos y pulmonares por estreptococos del grupo viridans. Presentación de caso

Streptococcus viridans is more commonly known as an infectious agent in endocarditis, however, little is known about its infectious potential in other organs or systems, where it has shown high mortality. The recognition of Streptococcus viridans as an abscess-producing agent in other locations, such as the liver or lungs, will allow timely diagnosis using different imaging methods, reducing serious consequences for the patient and hospitalization times. We present the case of a 33-year-old male patient with no chronic degenerative history, who started symptoms 7 months prior to admission, with intermittent fever, fatigue, asthenia, anorexia and weight loss, on physical examination he presented pain at the medium and deep palpation in the right hypochondrium, in the laboratory panel I present striking neutrophilia, in the tomography of the thorax and abdomen a cavernous lesion in the lung and complicated hepatic cysts are shown, to which percutaneous drainage guided by ultrasound is performed, with sending of cultured samples with a positive result for Streptococcus viridans. Thus, allowing treatment to be provided to the patient, thereby achieving remission of the disease. Key words: Liver abscess; lung abscess; streptococcal infections; residual abscess; cavitary lung injury; Streptococcus viridans.

Undifferentiated Embryonal Sarcoma of the Liver: A Case Report

Undifferentiated embryonal sarcoma of the liver((UESL) is a very rare primary hepatic tumor, of mesenchymal origin. Primary malignant mesenchymal tumors of the liver are relatively rare compared with carcinomas originating from hepatocytes or cholangiocytes. UESL is usually observed in children, and cases of adults are very uncommon. It was first reported in 1978. Because of rarity of the disease, there were few reported cases. Herein we report an our experience of UES of the liver patient. A 33-year-old woman visit our outpatient department presented with epigastric pain for 2 weeks. Huge complex cystic mass of the left liver(about 12cm) was identified on computed tomography(CT) of the abdomen. Compared with CT of 8 months ago, the size of the lesion was increased by 5 cm. Her laboratory study including tumor marker at initial presentation revealed no abnormal findings. We considered the lesion to be a complicated hepatic cyst. Since an increase in the size of the lesion was observed and she also had epigastric pain, we decided to proceed with surgery. We performed laparoscopic left hepatectomy. Microscopically, the tumor was composed of spindle cell proliferation, nuclear pleomorphism, myxoid stroma and frequent mitosis. The pathologic report revealed undifferntiated embryonal sarcoma. This case presented as a cystic lesion in the liver and had typical histological features of UESL. It is a rare case of a malignant pediatric tumor occurring in an adult patient.

Embryonal sarcoma of the liver in an adult mimicking complicated hepatic cyst: MRI findings

Radiologically, embryonal sarcoma reveals a characteristic spectrum of both solid and cystic features. However, MRI is sometimes unable to reveal the solid components. Here, we describe a case in which intracystic hemorrhage revealed a solid mural nodule obscured with the cystic lesion. Knowledge of this feature is helpful when making a prospective diagnosis of this important, albeit rare, hepatic malignancy.

Surgical treatment of bilateral hydatid disease of the lung.

To evaluate the various tactics and approaches in the surgical treatment of bilateral pulmonary hydatidosis (BPH). Between 1969 and 2000, a total of 127 BPH patients underwent surgery. The operative techniques of choice were parenchyma-preserved methods. Up to 1988, two-stage operations via thoracotomies were performed on 30 patients. One-stage operations with successive thoracotomies were carried out on two patients. Since 1988, only four patients underwent two-stage operations. One-stage surgery was carried out on 91 patients: 82 via median sternotomy (MS), one via clamshell incision, four through successive thoracotomies and three through video-assisted thoracic surgery (VATS) and mini-thoracotomies. One-stage bilateral lower lobectomies via MS were performed on one patient. In 11 cases, the concomitant dome localized liver cysts were extirpated via right phrenotomy during MS. Sterno-laparotomy was performed on 11 patients: for associated hepatic (seven), and hepatic and spleen cystectomies (four). In eight cases, abdominal echinococcosis was operated on a second stage, and in one case, a complicated hepatic cyst was extirpated on a first stage. No intraoperative deaths occurred. The postoperative mortality rate was 0.78%; one patient died of pulmonary embolism. No fatal complications have appeared in eight cases (skin suppuration, residual pleural cavity and atelectasis). Adult respiratory distress syndrome was successfully treated in one case after MS. The long-term postoperative results are considered very good, with no recurrences observed. One-stage surgery is superior to a classic two-stage approach as it decreases the morbidity, hospital stay and costs. MS is an excellent approach, but in some cases, VATS mini-thoracotomies could be indicated.