ObjectiveTo Summarize the clinical features of retroperitoneal ganglioneuroma.MethodsA total of 18 cases of pathologically confirmed retroperitoneal ganglioneuroma, who received surgery in The Affiliated Hospital of Xuzhou Medical University from May 2013 to July 2016, were collected to reviewe the clinical features, imaging findings, pathologic characteristics, treatments, and prognosis of retroperitoneal ganglioneuroma.Results① Clinical symptoms. Of the 18 cases, 8 cases were found by physical examination, and had no symptoms; 6 cases showed abdominal pain and discomfort; 3 cases had hypertension; 1 case had bulge and discomfort in the lower abdomen. ② Imaging performance. All of the 18 cases underwent color Doppler ultrasonography, 16 cases showed clear hypoechoic mass, and hypoechoic masses showed irregular shape in 2 cases; homogeneous echo in 12 cases and inhomogeneous echo in 6 cases could be seen. Seventeen cases underwent CT scan, and homogeneous low density in 14 cases, uneven density in 3 cases, scattered calcification in 3 cases could be seen. Fifteen cases underwent CT dynamic contrast-enhanced scan, 2 cases showed no significant enhancement both in dynamic and venous phase, 8 cases showed no significant enhancement in arterial phase, 11 cases showed heterogeneous enhancement in venous phase. Three cases underwent MRI scan, T1WI images of 3 cases showed uniform low signal; T2WI images showed high signal in 1 case, T2WI images showed high signal with moderate intensity in 2 cases. ③ Surgery and prognosis. Fifteen cases underwent laparoscopic retroperitoneal tumor resection,3 cases underwent open surgery, and all the tumors were completely resected. All cases had good postoperative recovery and no significant complication occurred. All cases were followed up for 6 to 32 months with a median of 20 months, no recurrence or distant metastasis was found during follow-up period.ConclusionsRetroperitoneal ganglioneuroma has nonspecific clinical manifestation. Imaging examinations are the most effective adjuvant ways preoperatively, but patholoy is still the gold standard of final diagnosis for ganglioneuroma. Radical tumor resection is the most effective therapy with satisfactory prognosis for ganglioneuroma.
Objective To summarize the characteristics and management of pregnancy complicated with aortic dissection, and to explore the reasonable diagnosis and treatment plan. Methods The clinical data of 10 patients of pregnancy complicated with aortic dissection in Wuhan Tongji Hospital from January 2011 to June 2017 were collected. Their age was 25.2 (21-29) years. Results In the 10 patients, the majority (8 patients) were primipara, and most of them were in the late stages of pregnancy (5 patients) and puerperal (4 patients). Among them, 1 patient had gestational hypertension, and the blood pressure of the left and right upper extremities was significantly abnormal (initial blood pressure: left upper limb blood pressure: 90/60 mm Hg, right upper limb blood pressure: 150/90 mm Hg). The major clinical manifestations were severe chest and back pain which happened suddenly, with D-dimmer and C-creative protein increased which may be associated with inflammatory reaction. All patients were diagnosed by thoracoabdominal aortic CTA, including 5 patients of Stanford type A dissection and 5 patients of Stanford type B dissection. In the 10 patients, 1 patient refused surgery and eventually died of aortic rupture with the death of fetus before birth. And the remaining 9 patients underwent surgical treatment, 3 patients of endovascular graft exclusion for thoracic aortic stent graft, 2 patients underwent Bentall operation, 1 patient with Bentall + total aortic arch replacement + vascular thoracic aortic stent graft, 1 patient with Bentall operation combined with endovascular graft exclusion for thoracic aortic stent graft, 1 patient with Bentall + coronary artery bypass grafting, 1 patient of thoracoabdominal aortic vascular replacement. Among them, 1 patient underwent endovascular graft exclusion for thoracic aortic stent graft died of severe postoperative infection, and the remaining 8 patients were discharged from hospital. Nine patients were single birth, among them 5 newborn patients had severe asphyxia, 4 patients had mild asphyxia. Finally, 3 neonates died of severe complications, and the remaining 6 survived. Conclusion The ratio of pregnancy with Stanford type A aortic dissection is far higher than in the general population, the possibility of fetal intrauterine asphyxia is larger, but through active and effective surgical and perioperative treatment, we can effectively save the life of mother and fetus.
Lung cancer is a complex disease with its own challenges, and is considered to be one of the most common causes of cancer death worldwide. The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has exacerbated these challenges. The aim of this review is to explore the impact of the COVID-19 pandemic on the screening, diagnosis and treatment of lung cancer. We hope to provide some experience and help for the whole process management of lung cancer patients.