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Giant Post-Inflammatory Pancreatic Cyst Associated with Giant Abdominal Hernia - a Case Report

100%
Murawa D., Nowaczyk P., Adamczyk B.
Polish Journal of Surgery
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2008
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vol. 80
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issue 7
389-394
EN
The case of a patient who developed a giant post-inflammatory pancreatic cyst, which resulted in the development of a giant abdominal hernia, is presented. The cyst developed as a consequence of earlier shortcomings in the diagnostic and therapeutic process; cyst development was also due to the patient's irresponsible approach to the problem. The patient did not present any typical symptoms of pancreatic pseudocyst. He reported to the Surgical Outpatient Clinic in the Wielkopolska Cancer Centre because of a reduced quality of life caused by a giant abdominal hernia. Basic laboratory tests and an abdominal CT were conducted, and a decision was reached regarding laparotomy. The pseudocyst was anastomosed with the intestinal wall on Roux-en-Y loop. A prolene net was applied simultaneously, due to the extensive defects in the abdominal integuments. In this case, treatment should have been implemented at a much earlier stage, without exposing the patient to the consequences of basic disease and the presence of a foreign body (net) in the abdominal integuments.
2
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Marjolin's Ulcers as a Consequence of Chronic Venous Ulcers and Chronic Skin Injury - Case Reports

100%
Ciesielczyk B., Murawa D., Nowaczyk P.
Polish Journal of Surgery
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2007
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vol. 79
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issue 10
667-671
EN
In the literature, Marjolin's ulcers are defined as skin cancers that develop secondarily in areas susceptible to an injury, seized by a chronic inflammation or covered by scar tissue.This paper presents three clinical cases of spinocellular carcinoma, which occurred around long-standing venous ulcers or chronic traumatic skin injury within the lower limbs. All the patients had their limbs amputated. No clinical or radiological qualities of lymphadenopathy were diagnosed. The latest checkups indicated the patients' good condition without traits of the neoplastic disease.Managing patients with chronic ulcers, regardless of their aetiology, requires that the doctor should have increased oncological alertness. In this case, one of the most important elements of diagnostics is a regular histopathological assessment of the lesion. Only this procedure enables the early and efficacious surgical treatment of potential secondary neoplastic lesions and possible saving of the limb.
3
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Brain metastasis as the first symptom of gastric cancer – case report and literature review

100%
Murawa D., Nowaczyk P., Szymkowiak M., Karaszewska B.
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vol. 85
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issue 7
401-406
EN
The study presented a patient with asymptomatic gastric cancer, in whom the first symptom was metastasis to the brain. The patient was initially diagnosed by a neurologist and subject to surgical intervention in the area of residence, where he underwent craniotomy with the excision of the metastatic lesions located in the occipital lobe. The histopathological examination revealed the presence of adenocarcinoma metastases. Following complex diagnostics the patient was diagnosed with cardial carcinoma, being subject to cerebral radiotherapy and chemotherapy. The patient was then referred to surgery at the Wielkopolska Cancer Center in Poznań. After final exclusion of disease dissemination (by means of PET-CT) the patient underwent total gastrectomy with D2 lymphadenectomy, and gastrointestinal tract reconstruction by means of the Roux-en-Y method. The histopathological examination result was as follows: tubular-papillary G2 adenocarcinoma (intestinal type), pT2 pN0 (23 evaluated lymph nodes without cancer metastasis), vascular neoplastic emboli, and positive HER2 protein expression. After surgery the patient was subject to adjuvant chemotherapy. Control brain CT examinations revealed the presence of 4 recurrent metastatic lesions-the patient was disqualified from stereotactic radiation therapy and was subject to palliative chemotherapy. The discussion presented the problem of treating patients with stage IV gastric cancer, including current management guidelines, as well as literature review concerning the treatment of patients with diagnosed gastric cancer and brain metastases.
4
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Myositis Ossificans of the Quadriceps Femoris Mimicking Sarcoma as a Diagnostic and Therapeutic Problem – Case Report and Literature Review

100%
Nowaczyk P., Murawa D., Żmudzińska M., Wasiewicz J.
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vol. 85
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issue 9
520-526
EN
Myositis ossificans (MO) may be included in the group of lesions described as pseudosarcomas. Its clinical and histological picture frequently mimics a malignant neoplasm and therefore, ultimate diagnosis and implementation of adequate treatment requires the cooperation of interdisciplinary team of physicians. The paper presents the case of 20-year old female patient suffering from severe pain in the right thigh. The patient was initially diagnosed with the lower limb overload. Rest and administration of non-steroidal anti-inflammatory drugs (NSAID) were recommended. Due to the lack of the efficacy of the recommended conservative treatment and detection of tumorous mass on ultrasound examination, the patient was referred to the cancer centre. The diagnostic procedures were extended and an open biopsy of the lesion was performed which revealed the presence of MO. The patient underwent a surgical procedure during which the pathological mass was entirely removed. Follow up examinations conducted upon the conclusion of the rehabilitation indicate no pathologies in the operated area.
5
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Splenic Site Abscess as a Symptom of Colorectal Carcinoma - Case Report

100%
Murawa D., Nowaczyk P., Murawa P.
Polish Journal of Surgery
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2007
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vol. 79
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issue 12
779-784
EN
Splenic abscess occurs only rarely. However, in recent years its frequency has been growing, which is related not only to the improvement in diagnostics but also to the increasingly common problem of immunosuppression caused by multiple factors and the occurrence of diabetes in the population. This paper presents a case of splenic flexure carcinoma, which was manifested clinically by a splenic site abscess and earlier probably by splenic abscess. Its aetiology was not specified after splenectomy had been carried out at the local hospital; only symptomatic treatment was applied. Due to the low occurrence of splenic abscess and non-specific clinical symptoms, doctors must show a great deal of prudence and alertness to make the right diagnosis. Furthermore, knowing that the presence of such lesions in the spleen is a consequence of other local or distant pathogenic processes, appropriate management and treatment of such patients requires investigating the cause and specifying the aetiology of the abscess. Failure to do so exposes the patient to the danger of serious consequences, frequently making early and successful treatment of many diseases, including neoplasms in the abdominal cavity, impossible.
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