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Leukemoid Reaction and Malignant Ascites in a Renal Carcinoma with Sarcomatoid Differentiation. Unusual Case Report and Literature Review

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Surgical Science 2019年第7期10卷 255-264页

作者： Alberto Manuel González Chávez Juan Antonio Matus Santos José de Jesús Curiel Valdés Mario Andrés González Chávez ricardo ray huacuja blanco Diego Abelardo álvarez Hernández Department of Surgery Hospital HMG Coyocán Mexico City México Department of Clinical Oncology Hospital HMG Coyocán Mexico City México Pathology Laboratory Grupo Diagnóstico Mexico City México Health Sciences Faculty Anahuac University North Campus Mexico City México

Renal cell carcinoma represents the 16th cause of death by cancer. It is one of the most frequent kidney tumors. This tumor could behave as a good mimicker, and is frequently associated with paraneoplastic syndromes. Metastases to peritoneum, mesentery or omentum are very rare. Sarcomatoid renal cell carcinoma is a high-grade undifferentiated component that can be found in any subtypes of renal cell carcinoma, and is associated with an aggressive behavior and a poor prognosis. We present the case of a 59-year-old male, diabetic patient, with nephron preserved left nephrectomy through lumbotomy seven years ago, upper pole renal carcinoma, admitted to the emergency department with indeterminate shock. He underwent a diagnostic laparoscopy and then open surgery due to findings where a greater omentum subtotal infarction. Omentum microscopic examination resulted in vaguely differentiated neoplasia, with sarcomatoid like cells, highly positive to CD10 inmunolabeling. Even though renal cell carcinomas have unusual clinical presentations, this case is unique because of the convergence of extremely rare manifestations such as the combination of malignant ascites, peritoneal carcinomatosis, and contralateral suprarenal gland metachronous metastases at the major omentum with paraneoplastic syndrome type leukemoid reaction;which have not been reported previously in literature.

关键词： Renal Cell Carcinoma Sarcomatoid Differentiation Paraneoplastic Syndrome Leukemoid Reaction Malignant Ascites

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Giant Appendicolith in Acute Exacerbation of Chronic Appendicitis: Case Report and Literature Review

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Surgical Science 2017年第11期8卷 457-463页

作者： Alberto Manuel González Chávez ricardo ray huacuja blanco Mario Andrés González Chávez Silviano Ríos Pascual Diego Abelardo álvarez Hernández José de Jesús Curiel Valdés Department of Surgery Hospital HMG Coyocán CDMX México Coordination of Medical Services Mexican Red Cross I.A.P. CDMX México Pathology Laboratory Grupo Diagnóstico CDMX México

Right iliac fossa pain remains a challenge for clinicians, since it requires considering several differential diagnoses. Acute appendicitis continues to be one of the most important diagnoses to confirm or to rule out in acute abdominal pain, due to the associated morbidity and mortality. Currently, imaging studies contribute to increase diagnostic certainty, but sometimes reveal unexpected findings, which may further complicate the diagnosis and therapeutic decisions. We present the case of an unusual image finding in the right iliac fossa, a calcification suggestive of gallstone ileus, in the context of an acute abdomen with an unusual transoperative finding, whose definitive diagnosis by pathology, was also rare.

关键词： Appendicolith Fecalith Chronic Appendicitis Acute Abdomen Abdominal Calcification Acute Appendicitis

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