Background. The benign metastasizing leiomyoma is an exceptionally rare entity; it presents with ectopic leiomyoma nodules with a benign pattern. Symptoms vary according to the anatomic location. The diagnosis is histopathological, usually in patients with history of hysterectomy. Case Presentation. A 36-year-old female with 2-month history of left knee pain was diagnosed with bone fibrosarcoma. A CT scan showed pulmonary nodules. The patient started neoadjuvant chemotherapy. Conservative surgery of pelvic limb was achieved. A new CT scan reported pulmonary nodules that remained in relation to the previous CT. A nodule resection by thoracotomy and TOB (transoperative biopsy) was performed. The final pathology report described benign proliferative lesions consistent with benign metastatic leiomyoma. Conclusions. Benign metastatic leiomyoma is a rare condition presenting with uterine and extrauterine nodules most commonly in the lung. The diagnosis is histopathological. The surgical procedure must be reserved for selected patients.
Background: Since first laparoscopic liver surgery in 1992 indications has grown, techniques improved and experience gained. This approach has proven to be feasible and safe, however there are still some challenges to overcome. This study was designed to describe our single center experience in laparoscopic liver resection. Methods: We performed a single-center retrospective chart review. Demographic information, indications, operative details, and postoperative outcome data were analyzed. Results are expressed as mean AE standard deviation. Results: We analyzed 25 laparoscopic liver resections. No one had complications. The conversion rate was 16% (4 cases). The mean blood loss was 225 mL (80e 500 mL). Measures of surgery time procedure [165 min (80e240)] and hospital length of stay [4 days (2e6)] was obtained. Discussion: Laparoscopic liver procedures have increased every year however tumor location and its relationship with liver anatomy are determining factors in decision to perform a minimal invasive approach. Despite the absence of absolute indications some recommendations include solitary lesions smaller than 5 cm and peripheral location; emphasizing that an experienced surgeon in liver and laparoscopic surgery must perform them. Conclusions: In this study was observed faster recovery of the patients combining the proven benefits of laparoscopy approach such less blood loss, minor postoperative pain, fewer days of narcotics used and shorter hospital stay. In our experience this approach is a safe and viable option for benign and malignant disease without compromising oncologic principles in properly selected patients.
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