Medicine
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Primary malignant melanoma of the gallbladder is an extremely rare tumor, with fewer than 40 cases reported in the literature worldwide. The majority of patients presented as a solitary lesion in the gallbladder. To our knowledge, only one case of primary malignant melanoma of the gallbladder with multiple metastases has been reported, which involved the stomach, duodenum, pancreas, jejunum and a mesenteric lymph node. ⋯ The current case was unique due to the adrenal involvement. For patients with multiple metastases of malignant melanoma, gallbladder origin should be considered in the differential diagnosis from cutaneous origin.
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Case Reports
Bilateral femoral posterior neurocutaneous perforater flap successfully treating Fournier gangrene: A case report.
Necrotizing fasciitis (NF), characterized by widespread fascial necrosis, is a rare disease in clinic. Fournier gangrene (FG) is a special type of NF involved of perineum and scrotum. To our knowledge, no article has reported on bilateral femoral posterior neurocutaneous perforater flap treating for FG. ⋯ FG is rare. Bilateral femoral posterior neurocutaneous perforater flap is an effective procedure to treat FG. The outcome of combined therapy is satisfactory.
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The initial symptoms and signs of Takayasu arteritis vary due to the heterogeneity of affected vessels. Moreover, the vascular lesions are difficult to detect at initial presentation, making diagnosis even more challenging. Although cases of aortic dissection with arteritis history have been reported, Takayasu arteritis in men with aortic dissection as initial presentation is very rare. ⋯ Timely therapy (glucocorticoid and immunosuppressive) and corrective surgery (endovascular graft exclusion) for Takayasu arteritis with aortic dissection at the inactive stage is essential and beneficial.
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Osteosarcomas are the most common primary malignant bone tumors in children and young adults; these tumors often affect the metaphyses of long bones such as the proximal humerus, proximal tibia, and distal femur. In contrast, osteosarcoma of the coracoid process is extremely rare. ⋯ A misdiagnosis or inadequate and/or delayed treatment for a coracoid process osteosarcoma could have grave consequences. Computed tomography and magnetic resonance imaging are essential for a diagnosis, and a biopsy can effectively confirm the diagnosis. Our findings suggest that considering only a single factor, or using incomplete information, can lead to an arbitrary diagnosis.
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Observational Study
Emergency obstetric hysterectomy for life-threatening postpartum hemorrhage: A 12-year review.
The aim of the study was to review the operative experiences of emergency hysterectomy for life-threatening postpartum hemorrhage (PPH) performed over a 12-year period at Fujian Provincial Maternity and Children's Hospital; to examine the incidence and risk factors for emergency obstetric hysterectomy; and to evaluate the curative effectiveness and safety of subtotal hysterectomy for life-threatening PPH. The records of all cases of emergency obstetric hysterectomy performed at Fujian Maternity and Children Health Hospital between January 2004 and June 2016 were analyzed. The incidence, risk factors, and outcomes of hysterectomy, the peripartum complications, and the coagulation function indices were evaluated. ⋯ There was no significant difference in the maternal complications after TH or STH for PPH. Cesarean deliveries were associated with an increased risk of emergency hysterectomy, and postpartum prothrombin activity < 50% was the greatest risk factor for hysterectomy in most women who underwent hysterectomy. STH was the preferred procedure for emergency obstetric hysterectomy.