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Huge primitive neuroectodermal tumor of the pancreas:Report of a case and review of the literature

World Journal of Gastroenterology 2006年第37期12卷 6070-6073页

作者： Thilo Welsch Gunhild Mechtersheimer Sebastian Aulmann Sascha A Mueller Markus W Buechler Jan Schmidt peter kienle Deptartment of Surgery University of Heidelberg INF 110 D-69120 Heidelberg Germany Deptartment of Pathology University of Heidelberg INF 220 D-69120 Heidel- berg Germany

Primitive neuroectodermal tumor (PNET) of the pancreas is an extremely rare tumor that usually occurs in children or young adults. We report a case of a 33-year-old male patient with an 18 cm × 18 cm × 16 cm mass arising from the pancreatic body and tail with a one- day history of abdominal pain. Initial CT scan showed no signs of metastatic tumor spread. The tumor caused intrabdominal bleeding and the patient underwent primary tumor resection including partial gastrectomy, left pancreatic resection and splenectomy. Diagnosis of PNET was confi rmed by histology, immunohistochemistry and FISH analysis. All neoplastic cells were stained positive for MIC2-protein (CD99). Approximately one month after surgery, several liver metastases were observed and the patient underwent chemotherapy according to the Euro- Ewing protocol. Subsequent relaparotomy excluded any residual hepatic or extrahepatic abdominal metastases. Although PNET in the pancreas is an extremely rare entity, it should be considered in the diffential diagnosis of pancreatic masses, especially in young patients. This alarming case particularly illustrates that PNET in the pancreas although in an advanced stage can present with only a short history of mild symptoms.

关键词： Primitive neuroectodermal tumor Pancreas MIC2-protein Ewing sarcoma Abdominal mass

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Laparoscopic surgery for rectal prolapse and pelvic floor disorders

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World Journal of Gastrointestinal Endoscopy 2015年第12期7卷 1045-1054页

作者： Alexander Rickert peter kienle Department of Surgery University Medical Centre Mannheim

Pelvic floor disorders are different dysfunctions of gynaecological, urinary or anorectal organs, which can present as incontinence, outlet-obstruction and organ prolapse or as a combination of these symptoms. Pelvic floor disorders affect a substantial amount of people,predominantly women. Transabdominal procedures play a major role in the treatment of these disorders. With the development of new techniques established open procedures are now increasingly performed lapa-roscopically. Operation techniques consist of various rectopexies with suture, staples or meshes eventually combined with sigmoid resection. The different approaches need to be measured by their operative and functional outcome and their recurrence rates. Although these operations are performed frequently a comparison and evaluation of the different methods is difficult, as most of the used outcome measures in the available studies have not been standardised and data from randomised studies comparing these outcome measures directly are lacking. Therefore evidence based guidelines do not exist. Currently the laparoscopic approach with ventral mesh rectopexy or resection rectopexy is the two most commonly used techniques. Observational and retrospective studies show good functional results, a low rate of complications and a low recurrence rate. As high quality evidence is missing, an individualized approach is recommend for every patient considering age, individual health status and the underlying morphological and functional disorders.

关键词： Resection rectopexy Pelvic floor disorders Rectal

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