In our experience, the best treatment is complete excision of the tumor with clear microscopic margins. When this is not possible, local recurrences increase and survival rate decreases.
Accessory spleens are usually asymptomatic, although they may cause hematological disorders associated with hypersplenism, usually after splenectomy. Moreover, cases of hypersplenism occurring secondary to enlargement of an accessory spleen with an unaltered normal spleen have been reported. An accessory spleen can also mimic an intra-abdominal neoplasm. We report a case of hypersplenism that occurred secondary to an increase in the size of the accessory spleen, which was located in the mesentery close to the cecum, mimicking recurrence of previously resected renal carcinoma.
Cystic retroperitoneal lymphangiomaCystic retroperitoneal lymphangioma is an unfrequent pathology. Most cases are asymptomatic, and when symptomatic, they tend to present as abdominal pain and bowel obstruction secondary to compression of the bowel loops. Treatment of choice is surgical excision. We present a case of cystic retroperitoneal lymphangioma with adhesions to the second portion of duodenum and head of the pancreas. Once separated from the pancreas, it remained denudated. To avoid an eventual pancreatic fistula, Tachosil® was placed as sealing method. Postoperative course was uneventful.Key words: Cystic retroperitoneal lymphangioma, cystic retroperitoneal lesions, Tachosil®.
ResumenEl linfangioma quístico retroperitoneal es una patología de poca frecuencia. La mayoría de los casos son asintomáticos y cuando presentan síntomas, lo más frecuente es dolor abdominal u obstrucción intestinal por compresión de asas intestinales. Su tratamiento consiste en la extirpación completa de la lesión. Presentamos un caso de linfangioma quístico retroperitoneal adherido a 2ª porción duodenal y cabeza pancreática. Al separarlo del tejido pancreático, quedó un borde cruento. Para evitar una fístula pancreática, se colocó una placa de Tachosil® a modo de sellante. No aparecieron complicaciones postoperatorias.Palabras clave: Linfangioma quístico retroperitoneal, lesiones quísticas retroperitoneales, Tachosil®.
CASOS CLÍNICOS IntroducciónEl linfangioma quístico retroperitoneal es una patología muy poco frecuente, suponiendo aproximadamente el 1% de todos los linfangiomas, habiendo menos de 200 casos descritos en la literatura 1,2 , descubierto de forma incidental durante la realización de alguna prueba de imagen por otro motivo. Cuando son sintomáticos, lo más frecuente es el dolor abdominal, seguido de la obstrucción intestinal por compresión de asas de intestino delgado; un sangrado o infección del quiste puede provocar un cuadro de abdomen agudo 3,4 .
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