The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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Malignant Peripheral Nerve Sheath Tumor Relapse Detected by Positron Emission Tomography

2015-01

Mădălina Olivia Adameșteanu, I. Lascăr, M. Vâlcu, Ioana Teona Sebe

Malignant peripheral nerve sheath tumors (MPNST) are soft tissue tumors showing neuroectodermal differentiation. They arise in connection to a major nerve trunk, a peripheral nerve or a preexisting neuroma in patients with hereditary neurofibromatosis type 1. [1, 2]

They usually develop in the deep soft tissue between anatomic compartments, the root of the limbs (inguinal region, the axilla) being one of the most common sites of occurrence.

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Spontaneous Rupture of the Spleen on a Patient with Splenic Hemangioma and Multiple Cystic Lesions in Kidney and Liver...

2015-01

Spontaneous Rupture of the Spleen on a Patient with Splenic Hemangioma and Multiple Cystic Lesions in Kidney and Liver. Case Report and Literature Review

Andreea Iliesiu, Oana Cristina Ciornenchi, M. Tampa, Clara Matei, Simona-Roxana Georgescu, C. Cirstoiu, N. Zarnescu, Maria Sajin, A. Dumitru

Splenic hemangioma is a vascular malformation which is one of the most common benign neoplasms of the spleen. They may represent small, incidental lesions that can produce significant splenomegaly and predispose to splenic rupture. These tumors are rare and resemble their counterparts in other organs. The vascular spaces are usually irregular and cavernous, containing abundant red blood cells.

Differential diagnoses include benign or malignant neoplasms, metastases, lymphoma, splenic abscess or cystic lesions. The incidence of autopsy examination of their diagnosis ranges from 0.03 to 14% [1], and most often is encountered in adults between the ages of 30 and 50 [2]. Most are small lesions, usually clinically silent, diagnosed accidentally. Sometimes, however, they may be symptomatic, manifested by splenomegaly, abdominal pain, bowel disorders, anemia and thrombocytopenia, Kasabach-Merritt syndrome (anemia, thrombocytopenia and coagulopathy) and in rare cases by spontaneous rupture of the spleen [3].

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Total Pelvic Exenteration for Locally Invasive Cervical Cancer with Vesico-Vaginal Fistula

2015-01

N. Bacalbașa, Irina Bălescu

Cervical cancer still represents an important health problem, many cases still being diagnosed in an advanced stage of disease with already existing invasion of the surrounding viscera. (1,2) The presence of a locally invasive cervical tumor with aggressive surgical behaviour can produce local tumoral invasion which sometimes is associated with continuity solutions between different organs. When it comes to cervical cancer, the viscera most frequently affected by the formation of these fistulas are rectum and urinary bladder. (3,4) We present the case of a 49 year old patient diagnosed with stage IVA cervical cancer in whom a total supralevator exenteration was performed.

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Existing Controversies in Inguinal Hernia Treatment

2015-01

S. Aldoescu, T. Pătrașcu

Inguinal hernia is one of the most frequently encountered adult pathologies requiring surgical treatment, and it represents an important problem for healthcare systems, with multiple consequences on both the social and economic plan. Although its incidence and prevalence are not exactly known, the admitted possibility for an individual to get an inguinal hernia during his lifetime ranges around 27% for men compared to only 3% for women. [1] [2]. The evolution of surgery has brought to the fore multiple technical developments which, although technically alluring, could not manage to become surgical standard procedures. The 80’s saw the development of synthetic alloplastic materials and also "tension-free" repair principles, peaking with the Lichtenstein technique, which decreased the relapse rate so much that it made this procedure the "gold standard" of this type of pathology for many surgeons. The development of minimal invasive surgery gradually overtook all abdominal "organs" and the early nineties, starting with 1993, saw the rapid development of minimal invasive techniques for the treatment of inguinal hernia, which proved to be statistically as efficient as the technique Lichtenstein initially described. From that moment on, the surgical world adopted radically different positions, each surgical school offering arguments for or against classical or laparoscopy methods, a dispute which triggered many controversies, more or less backed by statistical data.

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Therapy Principles in Ischemic Mitral Regurgitation

2015-01

V. Goleanu

Ischemic mitral regurgitation (IMG) is the mitral regurgitation that is determined by the ischemic coronary disease and must be differentiated from the mitral regurgitation, which coexists with ischemic coronary disease. It appears secondary to acute myocardial infarction with angiographic or echocardiographic signs of contraction anomaly of left ventricle in a region vascularized by a critically stenosed coronary artery (1-3).

Ischemic mitral regurgitation is determined by an excess of tethering of one or both mitral valves, as a result of displacement of one or both papillary muscles. All patients have anterior acute myocardial infarction with regional anomaly of left ventricle wall contraction. Statistically, approximately 80% display posterior infarction and 20% anterior infarction (4).

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