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Difficulties in diagnosing anorectal melanoma: A case report and review of the literature

World Journal of Clinical Cases 2021年第36期9卷 11369-11381页

作者： Raluca Cristina Apostu Elena Stefanescu radu Razvan Scurtu Gabriel Kacso radu drasovean Department of Surgery "Iuliu Hatieganu"University of Medicine and PharmacyCluj-Napoca 400006Romania Department of Anesthesia and Intensive Care Emergency County Clinical HospitalCluj-Napoca 400006Romania Department of Surgery University of Medicine and Pharmacy"Iuliu Hatieganu"Cluj-NapocaCluj Napoca 400006Romania Department of Medical Oncology and Radiotherapy “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400006Romania

BACKGROUND Anorectal melanoma is a tumour that is difficult to identify due to its rarity and variability of *** data published in the literature do not allow for diagnostic and treatment guidelines to be *** melanoma has the worst prognosis among mucosal melanomas and is frequently misdiagnosed by standard identification *** SUMMARY A 66-year-old woman presented with intermittent anal bleeding,pain,and tenesmus in the past month,with no associated weight *** revealed a cauliflower-like tumour with a diameter of 1.5 cm,with exulcerated areas and an adherent clot but without *** results identified an inflammatory rectal polyp with nonspecific chronic *** markers CA 19-9 and CEA were within the normal *** 6 mo,due to the persistence of symptoms,a pelvic magnetic resonance imaging scan was performed.A lesion measuring 2.8 cm×2.7 cm×2.1 cm was identified at the anorectal junction,along with two adjacent *** distant metastases were *** was performed on the second set of biopsies,and a diagnosis of anorectal melanoma was *** treatment by abdominoperineal resection was *** was marked by the appearance of lung metastases at 1 mo postoperatively,detected on a positron emission tomography-computer tomography scan,and perineal recurrence after 5 *** molecular testing,the patient was included in an immunotherapy *** This case highlights the difficulty of establishing a definitive early diagnosis of anorectal melanoma,the importance of performing histological analysis on a wellrepresented biopsy specimen,and the poor prognosis,even with radical surgery.

关键词： Mucosal melanoma Anorectal Immunohistochemistry Melanocytes Molecular targeted therapy Case report

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Wilkie’s syndrome as a cause of anxiety-depressive disorder:A case report and review of literature

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World Journal of Clinical Cases 2022年第5期10卷 1654-1666页

作者： Raluca Cristina Apostu Lucian Chira Doina Colcear Andrei Lebovici Georgiana Nagy radu Razvan Scurtu radu drasovean Department of Surgery “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400001Romania Department of Psychiatry Clinical Infectious Disease HospitalCluj-Napoca 400000Romania Department of Radiology “Iuliu Hatieganu”University of Medicine and PharmacyCluj-Napoca 400006Romania Department of Internal Medicine "Iuliu Hatieganu"University of Medicine and Pharmacy Cluj-Napoca400006Romania

BACKGROUND Superior mesenteric artery syndrome is a disease with a complex diagnosis,and it is associated with complications that make it even harder to ***,a frequent association with psychiatric disorders has been *** numerous case reports and case series,the variability of the disease has not allowed the development of protocols regarding diagnosis and *** SUMMARY A 33-year-old woman presented with abdominal pain,nausea,and bile vomiting over the last 15 mo,associated with a 15-kg weight loss over the last three *** the onset of the symptoms,the patient was diagnosed with anxietydepressive disorder and treated *** examinations excluded an organic cause,and the cause of the symptoms was considered *** persistence of symptoms,even under treatment,prompted a computer tomography angiography examination of the abdomen and *** examination identified emergence at a sharp angle of 13.7°of the superior mesenteric artery,with a reduced distance between the artery and the anterior wall of the aorta up to a maximum of 8 mm.A diagnosis of aortomesenteric clamp was *** treatment by laparoscopic duodenojejunostomy was *** evolution was marked by a patent anastomosis at 1 mo,with a 10-kg weight gain and improvement of the associated *** This case report underlines two major *** aspect refers to the predisposition of patients with superior mesenteric artery syndrome to develop psychiatric disorders,with an excellent outcome when proper treatment is *** second aspect underlines the key role of a multidisciplinary approach and follow-up.

关键词： Wilkie’s syndrome Weight loss Anxiety-depressive disorder Duodenojejunostomy Laparoscopy Case report

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Narrow-band imaging with magnifying endoscopy for the evaluation of gastrointestinal lesions

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World Journal of Gastrointestinal Endoscopy 2015年第2期7卷 110-120页

作者： Alina Boeriu Cristian Boeriu Silvia drasovean Ofelia Pascarenco Simona Mocan Mircea Stoian Daniela Dobru Department of Gastroenterology University of Medicine and Pharmacy Tirgu Mures University of Medicine and Pharmacy Tirgu Mures Tirgu Mures County Emergency Hospital Department of Pathology Tirgu Mures County Emergency Hospital Department of Anesthesia and Intensive Care Mures County Hospital

Narrow band imaging(NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By combining NBI with magnification endoscopy(NBI-ME), the accurate assessment of lesions in the gastrointestinal tract can be achieved, as well as the early detection of neoplasia by emphasizing neovascularization. Promising results of the method in the diagnosis of premalignant and malignant lesions of gastrointestinal tract have been reported in clinical studies. The usefulness of NBI-ME as an adjunct to endoscopic therapy in clinical practice, the potential to improve diagnostic accuracy, surveillance strategies and cost-saving strategies based on this method are summarized in this review. Various classification systems of mucosal and vascular patterns used to differentiate preneoplastic and neoplastic lesions have been reviewed. We concluded that the clinical applicability of NBI-ME has increased, but standardization of endoscopic criteria and classification systems, validation in randomized multicenter trials and training programs to improve the diagnostic performance are all needed before the widespread acceptance of the method in routine practice. However, published data regarding the usefulness of NBI endoscopy are relevant in order to recommend the method as a reliable tool in diagnostic and therapy, even for less experienced endoscopists.

关键词： Narrow band imaging magnifying endoscopy Premalignant Early cancer Mucosal patterns Vascularpatterns

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