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Biomedical subjects

Igor Mishin

Publications and source records attributed to Igor Mishin.

8 recordsLinked to original sources

Liposarcoma of the colon: a case report and review of literature.

Liposarcoma is a malignant mesenchymal tumor frequently located in the retroperitoneum and rarely presents as an isolated lesion in the colon. To our knowledge, only three cases of primary colon liposarcoma have been reported in the world literature to date. In this article, we report a case of liposarcoma of the colon in a 46-year-old man. The patient presented with abdominal pain and a palpable mass. Abdominal ultrasonography and computed tomogram confirmed the presence of a large intra-abdominal fatty tissue mass, but the colon origin of the tumor was revealed only on laparotomy. During surgery, a voluminous (12 cm x 11 cm x 10 cm) lesion situated in the subserosa of the ascending colon was found, and a right hemicolectomy with radical lymph node dissection was performed. The pathological diagnosis of the resected tumor revealed primary colon liposarcoma (myxoid subtype). The postoperative course was uneventful, and the patient remained free of disease for 12 months. No adjuvant therapy was performed. Diagnostic and therapeutic problems related to this type of neoplasm as well as literature reviews are reported. Curative R0 resection remains the main treatment for primary and recurrent liposarcomas.

Colonic Neoplasms↗

Gallbladder varices.

Gallbladder varices are relatively rare ectopic varices in patients with portal hypertension. We present here a case of gallbladder varices accurately diagnosed by color Doppler sonography. A 51-year-old woman was admitted to our unit with recurrent esophageal varices bleeding due to extrahepatic portal vein occlusion after splenectomy. Bleeding was controlled by endoscopic band ligation and esophageal varices were eradicated after the second endoscopic session. Doppler imaging showed the existence of portal cavernoma and gallbladder varices. The close follow-up period after complete eradication of esophageal varices showed no enlargement of varices of the gallbladder or complications related to them. Color Doppler sonography is a valuable noninvasive imaging technique for assessment of portal hemodynamic profile in patients with portal cavernoma as well as useful in detecting gallbladder varices. Preoperative correct diagnosis of gallbladder varices should increase the surgeon's vigilance during biliary tract surgery in patients with portal hypertension in order to avoid hazardous complications.

Blood Flow Velocity↗

Giant submucosal lipoma of the cecum: report of a case and review of literature.

Lipoma of the colon is a relatively rare benign tumor. A case with intermittent subacute colon obstruction due to a giant lipoma of the cecum is reported. A 51-year-old woman presented with intermittent, abdominal crampy pain in the right upper and lower quadrants, accompanied by alternative episodes of diarrhea and constipation. She had had similar symptoms over the last three months. A double-contrast barium enema showed a large (approx. 7 cm in diameter) polypoid mass occluding the lumen of the cecum and the ascending colon. Colonoscopy revealed a submucosal mass suspected of benign tumor but too large for endoscopic resection. Surgery revealed a hard elongated mass in the right colon, which telescoped into the transverse colon and caused colo-colonic intussusception. Right hemicolectomy was performed and pathology documented a mature, submucosal lipoma of the cecum. Six years after the surgery, the patient has not showed any of the previous symptoms. Along with a review of the literature, the incidence, diagnosis complications and treatment of colonic lipomas are discussed.

Barium Sulfate↗

Accessory splenectomy with gastroesophageal devascularization for recurrent hypersplenism and refractory bleeding varices in a patient with liver cirrhosis: report of a case.

We report a case of recurrent thrombocytopenia associated with symptomatic enlargement of an accessory spleen, 2 years after splenectomy, in a 36-year-old man with posthepatitic liver cirrhosis. The patient suffered three episodes of variceal bleeding, but the esophageal varices were not eradicated by two sessions of endoscopic injection sclerotherapy and endoscopic band ligation. Abdominal ultrasonography and computed tomography showed a giant accessory spleen (6 x 6 x 5 cm), gallbladder stones, and complete postsplenectomy splenomesoportal thrombosis. Subsequent 99mTc scintigraphy confirmed the presence of a functioning residual splenic nodule. Thus, we performed gastroesophageal devascularization (Hassab-Paquet procedure) with accessory splenectomy and cholecystectomy, after which the platelet count normalized and no further variceal bleeding occurred during 17 months of follow-up. To our knowledge, this is the first report in the English medical literature of accessory splenectomy for recurrent thrombocytopenia in a patient with liver cirrhosis.

Adult↗

Gastric bleeding due to Dieulafoy's lesion, successfully treated by endoscopic hemoclipping.

Dieulafoy's lesion is a rare arterial malformation, which may produce massive gastrointestinal hemorrhage. Most commonly, the lesion occurs in the proximal part of the stomach. We present the case report of a 59-year-old man who was admitted to our emergency unit with massive hematemesis. Urgent endoscopic examination revealed a Dieulafoy's lesion with spurting bleeding, which was located in the proximal part of the stomach. Bleeding was successfully stopped by endoscopic hemoclipping without any further recurrence. Follow-up endoscopy performed 3 days later showed that the hemoclips became detached, and the protruding artery disappeared. The patient was discharged 4 days after primary endoscopic procedure without any complications. There was no recurrence of the bleeding during the 12 months of observation. Thus, we found that hemoclipping represents an alternative method of achieving endoscopic hemostasis in Dieulafoy's lesions

Arteriovenous Malformations↗

Extra-adrenal nonfunctional retroperitoneal paraganglioma: case report and review of the literature.

An extra-adrenal paraganglioma is a rare tumor derived from the chromaffin cells of sympathetic ganglia. This report documents a rare case of nonfunctional extra-adrenal paraganglioma in a 20-year-old woman with persistent flank pain. Ultrasonography and computed tomography revealed a solid mass with calcification in center, measuring 7 x 6 x 6 cm, and localized in the left upper para-aortal retroperitoneal region. Absence of typical clinical symptoms made a correct preoperative diagnosis unlikely. Tumor was successfully removed through a midline laparotomy incision, and pathological analysis of the surgical specimen revealed a paraganglioma. After 12 months, the patient is still in a good health, asymptomatic, and without evidence of tumor recurrence. This case emphasizes the necessity to include extra-adrenal paraganglioma in the differential diagnosis and management of retroperitoneal tumors, despite its rarity.

Adult↗