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Y L Wan

Publications and source records attributed to Y L Wan.

At least 91 records · Page 5Linked to original sources
PubMed1994

Gastric leiomyosarcoma: a clinicopathological review.

OBJECTIVE: To report our experience of eight patients with primary gastric leiomyosarcoma. DESIGN: Retrospective study. SETTING: Teaching hospital, Taiwan. SUBJECTS: 8 patients who presented with primary gastric leiomyosarcoma between 1986 and 1990. MAIN OUTCOME MEASURES: Endoscopic, radiological, and histopathological features, DNA ploidy, and outcome. RESULTS: Abdominal pain and gastrointestinal bleeding were the most common presenting symptoms. In 5 of the 7 patients who had endoscopy preoperatively a diagnosis of submucosal tumour was made, but a definite diagnosis of leiomyosarcoma was made in only 3. A provisional diagnosis of leiomyosarcoma was made in 3 of the 4 patients who had computed tomography. All patients underwent some form of gastric resection ranging from palliative resection to total gastrectomy. Patients in whom the tumour had invaded adjacent organs had a poor prognosis. Histopathological grading of tumours correlated well with DNA ploidy. CONCLUSION: Both histopathological grading and DNA ploidy could be helpful objective prognostic criteria in patients with primary gastric leiomyosarcoma.

Aged↗
PubMed1994

Mesenteric panniculitis: report of two cases.

Mesenteric panniculitis is a rare inflammatory process of the mesenteric fat with unknown etiology. We report two pathologically proven cases of mesenteric panniculitis. Both patients presented with abdominal pain and palpable masses. In one patient, computed tomography (CT) demonstrated a well-defined heterogenous mass containing fat density at the mesocolon. In the other patient, CT showed a fatty mass encompassing mesenteric vessels at the root of the mesentery. Although the definite diagnosis of mesenteric panniculitis depends on histopathology, recognition of CT features is helpful in the diagnosis and avoids unnecessary extensive operation.

Adult↗
PubMed1993

Intrapelvic Wilms tumor: report of 2 cases and review of the literature.

Wilms tumor arising from the renal parenchyma usually presents initially as an abdominal mass. A review of the literature revealed fewer than 10 cases manifesting as a renal pelvic mass occupying primarily the collecting system. We have treated 2 patients with this unusual presentation: 1) a 4-month-old male infant whose initial radiological investigation demonstrated a left renal neoplasm measuring 10 x 7 x 5 cm.; bisection of the kidney showed a tumor completely filling the collecting system to the proximal ureter with extreme attenuation of the renal parenchyma, and 2) a 9-year-old boy who was hospitalized due to hematuria; ultrasonography, computerized tomography and magnetic resonance imaging showed a mass in the right renal pelvis; gross pathology displayed a 7 x 6 x 5 cm. polypoid mass occupying the renal pelvis without parenchymal involvement. Microscopically, both lesions were typical Wilms tumors. We discuss the characteristic clinical manifestations, diagnosis and treatment, and review the literature.

Child↗
PubMed1993

Multiple schwannomas of the foot: report of a case.

Schwannoma, a relatively common tumor of the nerve sheath, rarely involves the foot. A review of the literature disclosed that most reports of schwannoma of the foot were solitary tumors. There has been only one reported case of multiple schwannomas of the foot. We report a case of multiple schwannomas involving both the medial and lateral plantar nerves of the right foot. The patient had been treated for plantar fasciitis for the previous eight years. After excision of one tumor, magnetic resonance imaging (MRI) was used in the diagnosis, revealing four additional tumors. These tumors were also successfully excised and the patient's symptoms relieved. Patients with prolonged intractable pain and tenderness of the foot may require examination by MRI or sonography to search for deep tumors impinging upon the plantar nerves.

Foot Diseases↗
PubMed1993

Ovarian dermoid cyst associated with tuberculosis, cystadenoma and torsion.

An 87-year-old woman who had had a lower abdominal mass for 32 years underwent a laparotomy. Surgery revealed a 21-cm left ovarian dermoid cyst with torsion. Pathologic examination showed a hemorrhagic infarct due to torsion, mucinous cystadenoma and tuberculosis within the tumor. Tuberculosis was also found in the endometrium, both ovaries, oviducts and omentum. The patient's recovery was uneventful after surgery and medical treatment. The clinical manifestations of tuberculosis can vary widely. Tuberculosis of an ovarian dermoid cyst may be silent for a long period of time unless other complications occur.

Aged↗
PubMed1993

Carcinoid tumor of the thymus: report of two cases.

Carcinoid tumors of the thymus are rare. In 1972, Rosai and Higa first described these neoplasms as a distinct entity from thymomas. Clinically, they may be asymptomatic or present with symptoms of a growing mass and/or with ectopic endocrine secretion. Two cases of thymic carcinoid tumor without endocrine manifestations are presented. Microscopically, both tumors showed typical features of carcinoid, such as ribbons, festoons and rosette-like structures. Immunohistochemically, they were immunoreactive for neuron-specific enolase (NSE), chromogranin A and keratin. Electron microscopic examination was performed only in one case and numerous dense core neurosecretory granules were demonstrated. Thymic carcinoid tumors may pursue an aggressive but protracted clinical course. Along with radiotherapy and possibly adjunctive chemotherapy, complete surgical excision remains the best treatment today either for the primary tumor or for subsequent recurrences.

Adult↗
PubMed1992

Early gastric cancer in southern Taiwan.

Between January 1986 and November 1990, 231 patients underwent resection for primary gastric adenocarcinoma at Chang Gung Memorial Hospital in southern Taiwan. Thirty-nine (17%) of these patients had early gastric cancer (limited to the mucosa or submucosa regardless of nodal metastases). Epigastric pain was the most frequent symptom (71.8%). The lesions were located in the lower third of the stomach in 84.6% of the patients and in the middle third in 15.4%. A preoperative diagnosis of gastric cancer was achieved in 94% of patients by endoscopic examination with biopsies. All of the patients underwent distal subtotal gastrectomy without mortality. Macroscopically, 84.6% of cases were included in types IIc, III, and IIc-III. One patient died of multiple liver metastases 3.2 years after operation. The cumulative survival rate at 5 years is 92.9%. We comment on these matters and place early gastric cancer in Taiwan into a more global context.

Adenocarcinoma↗
PubMed1992

Abscess of urachal remnant mimicking urinary bladder neoplasm.

Three cases of urachal abscess with extensive interstitial inflammation and fibrosis are reported. Clinically, all patients had a lower abdominal mass and CT scan and ultrasonic examination revealed a large tumour located anterior or superior to the bladder. They all underwent laparotomy and had either a partial cystectomy or an en bloc resection of the bladder and adjacent organs due to severe adhesions. Microscopic examination of the specimens revealed no evidence of carcinoma and only abscess formation with extensive chronic interstitial inflammation and fibrosis were seen. In one case, residual columnar epithelium suggestive of urachal origin was identified in the abscess cavity. Urachal abscess should be considered when dealing with lower abdominal masses.

Abscess↗
PubMed1992

Computed tomography in diagnosis of septic sacroiliitis: report of three cases.

Disorders of the sacroiliac joint are often overlooked during an initial physical examination because the patient is usually in a supine position and the posteriorly located joint is not accessible. Local pain and tenderness at the sacroiliac joint on lateral compression of the pelvis, together with Gaenslen and Fabere maneuvers, may direct the physician's attention to the joint. However, these symptoms are not specific or pathognomonic. Unusual presentation of septic sacroiliitis, which does not show radiologic changes during the early stages, may mimic gluteal, lumbar disc or intra-abdominal syndromes, leading to unnecessary abdominal exploration or lumbar discectomy. Computed tomography (CT), with its superb delineation of osseous, synovial and peri-articular structures, was applied to diagnose septic sacroiliitis in three patients. In Patient 1, septic arthritis and juxta-articular osteomyelitis with sequestrum formation were demonstrated by CT four weeks before abnormalities were shown on a roentgenogram. In Patients 2 and 3, inflammatory processes affected the synovium and peri-articular muscles; thus, abnormalities were shown by CT but not by a roentgenogram. We consider CT to be helpful and superior to conventional radiography in the diagnosis of septic sacroiliitis.

Arthritis, Infectious↗
PubMed1992

Sciatica caused by piriformis muscle syndrome: report of two cases.

The diagnosis of piriformis muscle syndrome, an unusual cause of sciatica, is difficult. However, with the advancement of imaging techniques, it has become clear that the condition is not just clinical speculation, but is a definite entity. We report on two cases with piriformis muscle syndrome, diagnosed on the basis of: a history of sciatica; physical findings, such as a tender point at the sciatic notch and around the piriformis muscle by palpation of the gluteal region, and by a digital pelvic examination; and computed tomography (CT) to demonstrate hypertrophy of the piriformis muscle. In both cases, a tenotomy of the piriformis muscle at the greater trochanter relieved entrapment of the sciatic nerve and gave satisfactory results. Since local tenderness at the piriformis muscle is the most reliable physical finding, a pelvic examination is recommended in the evaluation of suspected cases of piriformis muscle syndrome. CT is helpful in showing hypertrophy of the piriformis muscle. Detailed history taking, a careful physical examination, and versatile use of CT or magnetic resonance imaging can lead to an early, accurate diagnosis and proper treatment.

Adult↗
PubMed1991

The role of sonography in the diagnosis and management of urachal abscesses.

Eighteen cases of urachal abscess were studied with sonography. Their configurations were cone shaped in 11 cases, tubular in 4, curved club shaped, and oval and irregular in one each. Their complications, such as intraperitoneal spread, chronic cystitis, and adhesion to the omentum or the colon, could also be suggested by ultrasonography. Gas was found in 50% of the lesions, which were all larger than 1 cm in diameter. An abscess smaller than 1.2 cm in diameter (which can be as long as 5 cm) can be treated with antibiotics or incision and drainage without total excision. A lesion within the extraperitoneal fat space of abdominal wall at the midline below umbilicus suggests the diagnosis of urachal abscess in cases of umbilical discharge and/or when the lesion extends to the umbilicus.

Abscess↗
PubMed1991

Ultrasonography of adrenal lesions.

A total of 98 adrenal glands in 49 patients were prospectively investigated by ultrasonography (US). The US had a sensitivity of 76.7%, a specificity of 92.7%, and an accuracy of 85.7%. It is mainly the smaller lesions (0.5 to 2.8 cm, mean 1.2) which decrease the sensitivity of US. Large tumors in or near the glands and anatomical variants may decrease the accuracy of US as well. The ultrasound detection of a large and solid adrenal tumor, especially one with irregular border, or a tumor with invasion to the inferior vena cava, suggests the high possibility of malignancy. While a tumor with central necrosis may be suggestive of pheochromocytoma, despite its large size. US is a good primary screening modality for patients with suspected adrenal lesions; and it may help to differentiate malignant from benign tumors of the adrenal.

Adrenal Gland Diseases↗
PubMed1991

Acinar cell carcinoma of the pancreas: a rare cause of left-sided portal hypertension.

Isolated splenic vein obstruction with left-sided portal hypertension is a rare clinical condition. Owing to the close relationship of the splenic vein and the pancreas, this rare phenomenon is usually secondary to pancreatic inflammation or neoplasm. Acinar cell carcinoma has long been recognized as a distinctive, rare type of pancreatic carcinoma. A case of isolated splenic vein obstruction with left-sided portal hypertension secondary to acinar cell carcinoma of the pancreas, which we are reporting here, is thought to the first documented in the literature.

Carcinoma↗
PubMed1990

[Pyogenic liver abscess--report of 72 cases].

Seventy-two patients with pyogenic liver abscess treated from Jan. 1986 through June 1988 were reviewed retrospectively. The average age was 55 years with a male to female ratio of 1.4:1. Most patients presented with the typical fever, chills and RUQ pain, but unusual signs and symptoms were also common. The right lobe was more commonly involved than left lobe. Biliary tract stone was the most frequent etiology (44.4%) and association with DM was common (37.5%). An elevated alkaline phosphatase and leukocytosis were useful clues to a liver abscess, but diagnosis depended on imaging of an abscess cavity either by echo or CT scan. The average time from onset of Symptoms to diagnosis was 9.3 days and a delay in diagnosis by the doctors was common. The most common complication was septicemia and factors with poor prognosis were old age (greater than or equal to 60 yrs), septicemia, cancer, peritonitis, and serum bilirubin greater than or equal to 5 mg/dl. The overall mortality was 29% with no difference between the group with surgical drains (28.5%) and the group with percutaneous transhepatic aspiration or drains (29.4%).

Adolescent↗
PubMed1990

Choledochal cyst mimicking gallbladder in Tc-99m disofenin radionuclide cholescintigraphy.

A 6-year-old girl suffered from intermittent abdominal pain and bile-stained vomiting after undergoing cholecystectomy for perforated gallbladder and bile peritonitis when she was 2 years old. The interesting finding of her choledochal cyst, which was visualized 5 minutes after the injection of Tc-99m disofenin and contracted well after an egg meal, is reported. This finding is inconsistent with those of early reports, which emphasized delayed filling and stasis of radioactivity in the dilated cyst. This case, together with more recent reports in this field, suggests that nuclear images of choledochal cyst, like its clinical presentation, may be quite variable.

Child↗
PubMed1990

Exotic obstruction.

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Anesthesia, Inhalation↗