Schwannoma of the transverse mesocolon.
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A case of herniation of small bowel through a defect of the transverse meso-colon with secondary herniation through the gastrocolic ligament and re-entry into the greater peritoneal cavity is reported. This form of lesser sac hernia is rare and only one hundred half cases have been reported in literature.
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Massive hiatal hernia is a lesion at risk of incarceration, volvulus, and obstruction. The true paraesophageal type is a very rare condition and probably often mistaken with end-stage slidind hernia. Furthermore reflux and oesophagitis are always possible. In this case report a small bowel loop was incarcerated with a massive hiatal hernia. This association was only possible because of the existence of an associated transverse mesocolis hernia giving way to the small bowel. An emergency operation was necessary. The need of surgical treatment of such lesions is stressed, if possible before acute complication, even if they are asymptomatic at the time of diagnostic, which is a quite common condition.
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A rare case of malignant mesenchymoma in a 58-year-old woman is described. The tumor grew rapidly for a month and was located in the mesosigmoid. The resected tumor measured 25 X 20 X 20 cm and weighed 5,000 g. It metastasized into the great omentum within four months after operation. Histologically, this tumor was composed of undifferentiated sarcomatous elements, but in some parts revealed patterns of differentiation, including leiomyosarcoma, chondrosarcoma and osteosarcoma. In areas of osteosarcoma, the bone tissue varied from immature to mature. The histology of the recurrent tumors was similar to that of the first tumor. We considered that undifferentiated sarcomatous elements contained pluripotential cells which could differentiate multiple, mature malignant mesenchymes.
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