Background: Hepatic hemangiomas are benign vascular tumors of the liver, most of them asymptomatic. Surgical management includes enucleation, embolization, and liver resection. We present a case with symptomatic hepatic hemangioma susceptible to surgical treatment. Case Presentation: A 73-year-old man with chronic obstructive pulmonary disease and a history of two small hemangiomas started with pain in the right upper quadrant. Computerized tomography showed multiple hypodense lesions highly suggestive of hepatic hemangioma. Tumor markers were found at normal levels. A right hepatectomy guided with indocyanine green and intraoperative ultrasound was performed minimal bleeding and pulmonary complications. Conclusion: Hepatectomy for giant hemangiomas combined with ultrasound and indocyanine green is a feasible option in patients with comorbidities, decreasing bleeding risk, and allowing complete and surgical resection.
Introduction: A metastatic tumor of the ovary known as Krukenburg Tumor (KT) is a mucin-rich signet-ring adenocarcinoma that arises from a gastrointestinal site in most cases and from other sites in less proportion. We describe a rare case presenting a Krukenberg tumor secondary to pancreatic ductal adenocarcinoma. Case Presentation: A 51-year-old female, who started her current condition 6 months ago, with 15 kg of weight loss, accompanied by nausea, vomiting, early satiety, and constipation. Computerized tomography showed dependent mass involving the body and tail of the pancreas with solid and cystic components, highly suggestive of a primary tumor as well as peritoneal carcinomatosis and a left ovarian mass, tumor (Krukenberg) as a first possibility. A laparoscopy was performed. The final pathology report was a pancreatic ductal adenocarcinoma with metastases to the ovary from the left salpingectomy. Conclusion: Pancreatic cancer presenting as Krukenberg tumor of the ovary is rare and easily misdiagnosed as primary ovary carcinomas, which leads to missed surgical opportunities. Resection of ovarian metastases combined with chemotherapy treatment may increase the overall survival even in patients with advanced pancreatic ductal adenocarcinoma.
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