Search

Ileo-cecal valve tumors are often clinically manifested either through transit disorders or anemic syndrome. The 88-year-old patient is admitted for abdominal pain in the left flank, vomiting, asthenia and lack of intestinal transit for feces, with a progressive onset of one week. Clinical examination: generalized affected state, wide abdomen, painful left flank and hypochondrium, lack of intestinal transit and pallor. Paraclinic: severe hypochromic microcytic anemia (hemoglobin: 5.8 g / dl). Plain radiography: hydroaeric levels in the left hypochondrium. Abdominal CT: ileocolic intussusception that completely occupies the ascending colon to the hepatic flexure, with no visible tumoral lesions. After hydroelectrolytic and hemodynamic balancing with restoration of intestinal transit, colonoscopy is performed: 5 cm ulcero-vegetative mass at the ileo-cecal valve level - biopsy with histopathological examination: moderately differentiated adenocarcinoma. Patient refuses surgery. After 3 weeks, the patient returns to the clinic for the recurrence of digestive symptoms and emergency surgery is performed: laparotomy by median suprasubumbilical incision, finding: ileo-ceco-appendico-colic invagination up to the middle third of the transverse colon, defective attachment of ascending colon, ileum dilated with thick wall. The invagination is reduced and the tumoral mass is discovered. Right hemicolectomy with ileo-transverso-anastomosis is performed. Postoperatively, the patient shows a simple evolution with discharge on the 9th postoperative day. The ileo-colic invagination in adults is most often the appearance of a tumor located on mobile segments of the intestine. The right colon invagination is possible when there is a coalescence defect, anatomical peculiarity encountered in the presented case. [ABSTRACT FROM AUTHOR]

We present a rare case of breast neoplasm, synchronous (simultaneous) bilateral breast cancer, methods of diagnosis, multimodal treatment and the standard follow-up program. Bilateral breast cancer is a rare entity, with an incidence between 0.3 and 12%, representing 1 to 2.6% of all breast cancers. Bilateral breast cancer is defined as the presence of cancer cells in both breasts at the same time or at a distance of up to 3 months from the identification of the first tumor (synchronous), or metachronous if it occurs after more than 3 months from the identification of the primary tumor. There is not a general agreement regarding the optimal treatment. The prognosis is considered more severe than that of a unilateral neoplasm and the patients are treated more frequently by undergoing bilateral mastectomy rather than conservative surgery. We present the case of a 57-year-old patient diagnosed by clinical and imaging investigations (mammography, MRI) with bilateral breast tumor formations. The 57-year-old patient was referred to our clinic for a bilateral synchronous breast pathology. The pathological examination of the biopsy revealed bilateral invasive ductal breast cancer, with an intermediate histological grade G2, ER +, PR +, HER2 - (score 0 ASCO-CAP). Therefore, the diagnosis was simultaneous bilateral breast cancer, a rare entity which represents the real bilateral cancer of the breast. Neoadjuvant therapy was started and then Madden modified radical mastectomy was performed. The histopathological examination confirmed the invasive ductal carcinoma in the left breast - pT1cN1aG2 and in the right breastpT1cN0aG2. Considering that it is a rare variant of breast cancer, with a severe prognosis, the presented case reflects the current diagnostic and treatment approaches, and the gaining of better long-term results are ensured by a correct multidisciplinary approach. [ABSTRACT FROM AUTHOR]