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ABSTRACT: Primary retroperitoneal mucinous cystadenomas (RMCs) are very rare and their biological behavior and histogenesis remain speculative. An accurate preoperative diagnosis of these tumors is difficult because no effective diagnostic measures have been established. We describe a 29-year-old woman with abdominal pain and a palpable mass. Computed tomography (CT) of the abdomen revealed a retroperitoneal cystic mass which was resected successfully at laparotomy. Histopathological examination of the resected mass confirmed the diagnosis of RMC. There was no evidence of disease 2 years after surgery.
World Journal of Gastroenterology 11/2008; 14(37):5769-72. · 2.47 Impact Factor
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ABSTRACT: The accuracy and clinical significance of sonography (US) in demonstrating fatty liver and hepatic fibrosis in chronic hepatitis C (CHC) are rarely reported. US had sensitivity 71.1%, specificity 72.9%, 58.7% positive predictive value (PPV), and 82.3% negative predictive value (NPV) in demonstrating histological steatosis > or =5%. US had sensitivity 85.7%, specificity 60.4%, 13% PPV, and 98.4% NPV in demonstrating histological steatosis > or =30% with clinical significance in predicting prognosis and therapeutic response in CHC. Subjects with fatty liver on US had a greater prevalence of body mass index (BMI) > or =25 kg/m2, inflammation-necrosis grade >2, and total bilirubin <1.2 mg/dl in multivariate analyses. US had sensitivity 27.4%, specificity 62.5%, 71.9% PPV, and 19.7% NPV in demonstrating histological fibrosis of stage II or above, and sensitivity 13.6%, specificity 66.3%, 9.4% PPV, and 75.0% NPV in demonstrating fibrosis of stage III or above. There was no correlation between fibrotic sonographic patterns and histological stage of fibrosis (r = -0.167, P = 0.083). Besides hepatic steatosis, clinicians should be alert to the possibility of advanced necrosis-inflammation grade in interpreting a report of bright liver on gray-scale US. Gray-scale US cannot replace liver biopsy as the optimal diagnostic procedure for the prediction of hepatic steatosis and fibrosis prior to initiating therapy for CHC.
Digestive Diseases and Sciences 07/2008; 53(6):1699-706. · 2.12 Impact Factor
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The Journal of trauma 04/2007; 62(3):770-3; discussion 773-4. · 2.48 Impact Factor
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ABSTRACT: Minimally invasive surgery has revolutionized the treatment of gastrointestinal tumors. Submucosal tumors of the stomach can be resected using laparoscopic techniques. We report here a case of ectopic pancreas tissue in the gastric wall that was removed using robotic-assisted laparoscopic resection. The patient was a 15-year-old female who presented with abdominal discomfort and tarry stools. Laboratory analysis showed iron deficiency anemia. Preoperative endoscopy revealed a submucosal lesion in the posterior wall of the gastric high body. Intraoperative upper endoscopy clearly located the lesion. A robotic-assisted laparoscopic wedge resection of the putative gastric submucosal tumor was performed. The pathology results showed an ectopic pancreas. The patient had an uneventful recovery and we believe that this is a valid treatment option for this benign condition.
World Journal of Gastroenterology 01/2006; 11(48):7694-6. · 2.47 Impact Factor
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ABSTRACT: A 60-year-old female patient suffered unhealed wounds over left flank for around 30 years after surgical removal of left renal stones. Fecal material spilled from the two small openings of the scar, bothered her all day long. During the course of the 30 years, she suffered from intermittent fever, diarrhea and wound pain and presented with malnourished condition. After serial examinations, tumor associated with iatrogenic colo-cutaneous fistula was impressed and she received en bloc resection. Pathology revealed squamous cell carcinoma arising from the fistula with colon and spleen invasion. To the best of our knowledge, no such case has been reported, as yet.
World Journal of Gastroenterology 10/2005; 11(33):5251-3. · 2.47 Impact Factor
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Clinical Nuclear Medicine 11/2004; 29(10):667-9. · 3.67 Impact Factor
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ABSTRACT: Gastric glomus tumors are rare submucosal lesions that typically occur in the fourth endosonographic layer. We describe a 69-year-old patient who presented with intermittent epigastric pain and in whom a submucosal tumor was encountered during upper gastrointestinal endoscopy. Endosonography revealed a heterogeneous, hypoechoic fourth-layer tumor. Power Doppler imaging revealed prominent intratumoral vascular signals demonstrating its hypervascular nature. A diagnosis of glomus tumor was made via histopathologic evaluation of the resected tumor.
Journal of Clinical Ultrasound 35(3):164-8. · 0.81 Impact Factor
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ABSTRACT: Alpha-fetoprotein is often measured in subjects with chronic hepatitis C for diagnosing hepatocellular carcinoma. However, its prevalence and clinical significance remain inconclusive in subjects without hepatocellular carcinoma. The study was to assess the clinical, virologic, and histopathological significance of elevated AFP in chronic hepatitis C without the presence of hepatocellular carcinoma.
The retrospective study enrolled 102 consecutive subjects with a histological diagnosis of chronic hepatitis C. None had evidence of hepatocellular carcinoma by image study at enrollment and for at least 6 months' follow-up. The correlation between serum alpha-fetoprotein level and clinical, virologic, or histopathological records was reviewed.
The prevalence of elevated serum alpha-fetoprotein (> or = 13.6 ug/L) was 28.4% (29/102) in this study. Hepatic steatosis (> or = 5% hepatocytes), hepatic fibrosis (> or = stage II), uric acid > or = 6.3 mg/dL, asparate aminotransferase > or = 40 IU/L, albumin < 3.5 g/dL, and fasting plasma glucose < 126 mg/dL were significantly associated with elevated AFP in multivariate analysis. However, neither hepatitis C virus genotype Ib infection nor viral load > or = 1x10(6) copies/ml was related to elevated AFP. A serum alpha-fetoprotein level of 15.6 ug/L was 34.3% sensitive and 83.6% specific for hepatic steatosis, was 28.2% sensitive and 95.8% specific for > or = stage II hepatic fibrosis in Chronic hepatitis C.
Elevated alpha-fetoprotein is independently associated with hepatic steatosis (> or = 5% hepatocytes), > or = stage II hepatic fibrosis, increased level of uric acid (> or = 6.3 mg/dL) or asparate aminotransferase (> or = 40 IU/L), and decreased level of albumin (< 3.5 g/dL) or fasting plasma glucose (< 126 mg/ dL). Viral factors, including hepatitis C virus genotype 1b infection and viral load, are not related to elevated alpha-fetoprotein in hepatitis C virus-infected subjects.
Hepato-gastroenterology 55(85):1423-7. · 0.66 Impact Factor
