Volume 74 - 2011 - Fasc.4 - Case reports
Solid pseudopapillary tumor of the pancreas in a pregnant woman
Solid pseudopapillary tumor (SPT) of the pancreas is a rare neo- plasm of low malignant potential that mostly affects young women in the second or third decade of life. The number of such patients reported in the literature has increased in recent years, while SPT in pregnancy is extremely rare. To the best of our knowledge, only one case of SPT in pregnancy has been reported in the English-lan- guage literature. We herein report a case of asymptomatic SPT in a 26-year-old Chinese female in the 14th week of pregnancy, and present our experience of the surgical management of SPT in preg- nancy. (Acta gastroenterol. belg., 2011, 74, 560-563).
Mechanical ileus caused by a tablet of Tralgit SR 100 stuck in a stenotic rectum affected by carcinoma : case report and literature survey
A patient with an advanced carcinoma in the recto-sigmoideum was taken for urgent operation because of abdominal pain, signif- icant distension of colon, clinical symptoms and radiological proofs of ileus. The cause of the complete obstruction of the proximal rec- tum which was significantly narrowed by a tumour was one tablet of Tralgit SR 100, which had been administered to the patient for 4 weeks after osteosynthesis of the right femur neck following frac- ture. According to the radiologist between 45 and 50 tablets of the medicament had been found in the digestive tract. The mechanical ileus was solved by operation according to Hartmann. This case has two aspects : 1) surgical - mechanical ileus resulting from a rare set of circumstances, and 2) pharmacological and metabolic - disorder of medicament absorption in the digestive tract. The cause of maldigestion (disorder of absorption) of the Tralgit tablets is further investigated. (Acta gastroenterol. belg., 2011, 74, 564-566).
Delayed liver metastasis of a meningeal solitary fibrous tumor
Solitary fibrous tumors (SFT's) are rare soft tissue neoplasms of mesenchymal origin, most commonly reported in the thoracic cav- ity. They exhibit an aggressive and infiltrative nature and have a tendency to recur either locally or distantly, the latter typically being a late event. Primary therapy consists of complete excision and prognosis is poor in case of recurrence. In this manuscript, we discuss the imaging features and treatment options for a patient presenting with delayed liver metastasis ten years after treatment for a meningeal SFT. (Acta gastroenterol. belg., 2011, 74, 567-569).
Montelukast as a treatment modality for eosinophilic gastroenteritis
Eosinophilic Gastroenteritis (EG) is a rare condition, caused by eosinophilic inflammatory infiltrates in the gastrointestinal tract. It is usually treated successfully with systemic glucocorticoids. Because of frequent relapses, however, there is need for alterna- tives.
We describe a 38-year old man with steroid-dependent EG, who was successfully treated with montelukast, a leukotriene receptor antagonist. It inhibits leukotriene D4, an important cytokine in the inflammatory cascade. Although montelukast could not replace steroid therapy, it acted as a steroid sparing agent in our patient.
Review of the literature shows that montelukast is efficient in the treatment of EG in a part of the patients. The low cost, the low number of side effects and its efficiency make it an interesting alternative in relapsing or steroid dependent EG. There is need for multicentric studies regarding the treatment of EG. (Acta gastro - enterol. belg., 2011, 74, 570-575).
Hepatic rhabdomyosarcoma in an adult : a rare primary malignant liver tumor. case report and literature review
Rhabdomyosarcomas are malignant tumors that display fea- tures of striated muscle differentiation. They are the most common soft-tissue sarcomas among children and young adults. In mature adults however there are very rare. The liver as a primary site in adults has only been described in 12 cases.
We report a case of a primary alveolar rhabdomyosarcoma of the liver in a 59 year old female, confirmed by histological exami- nation using immunohistochemical analysis (positive actin, desmin, vimentin and myogenin staining) and fluorescent in situ hybridiza- tion (FISH) analysis (positivity for PAX3/FOXO1A fusion). The patient underwent primary surgical resection, but presented a few weeks after surgery already with recurrent disease in the abdomen and bone metastasis. Despite initial good response to chemothera- py (doxorubicin/ifosfamide) and stable disease at 12 months after diagnosis, the patient died 31 months after the first presentation secondary to complicated abundant abdominal recurrent disease.
We further present a review of the literature on published similar cases since 1979. (Acta gastroenterol. belg., 2011, 74, 576- 581).