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Highlights • A rare type of retroperineal malignant tumour is presented. • The treatment approach is on debate, the role for the pre operative embolization is not clear. • A small literature review was performed., Introduction Paragangliomas (PG) are rare tumors derived from chromaffin cells that are located outside the adrenal gland and are capable of producing catecholamines. The treatment is based on a surgical resection, and there is controversy regarding the usefulness of previously carrying out an embolization and what is the most adequate surgical approach. Clinical case We will present a 17-year-old woman with a retroperitoneal tumour in contact with the aorta and the inferior vena cava, treated with embolization prior to the surgical resection via laparotomy. Discussion The PG tumors are very infrequent and originate in the extra-adrenal chromaffin cells that exist in the vicinity of the components of the autonomic nervous system. Most of them (86%) produce catecholamines, are unique, sporadic, benign and more frequent in middle-aged women. Since they are radioresistant tumors, the only possibility for a cure is by a complete surgical excision. The preoperative embolization has been described mainly as the treatment of cervical PG, although its use in abdominal PG is more controversial and is not done in a systematic manner. Conclusion We can conclude that the embolization of abdominal PG is not free of risks and that it has not been demonstrated that it significantly reduces the peri-operative bleeding or the surgical time. Probably, the embolization should be reserved for intensively hypervascularized and larger PGs.

Myelolipoma is a very uncommon tumor and is extremely rare in the liver. Patients are usually asymptomatic and preoperative diagnosis is often difficult. We report a new case of hepatic myelolipoma and review all the cases previously reported in the literature. Clinicopathologic and radiologic findings, as well as therapeutic options, are discussed.

The presence of biliary gallstones and surgical clips in the abdominal cavity after a laparoscopic cholecystectomy can cause complications, which even though they are uncommon, can be serious. We carried out a review of the various complications, their incidence, related risk factors, ways to deal with them and recommendations to reduce morbidity associated with the presence of ectopic material (gallstones and surgical clips) in the peritoneum.

Splenic abscesses are rare but may be associated with high mortality. Usually they occur in patients with systemic infection related to some immunocompromised state. The symptoms are nonspecific and the diagnosis is often late, but the development of better imaging techniques has enabled better diagnosis of splenic abscess and percutaneous drainage is a valid and safe complementary treatment option. We report a case of a patient with splenic abscess secondary to septic emboli after tooth extractions, managed conservatively with antibiotics and percutaneous drainage.

Resumen El bazo ectopico o errante (wandering spleen) es una anomalia muy infrecuente caracterizada por una mala posicion del bazo como consecuencia de una ausencia o laxitud de los ligamentos suspensorios del bazo. Las manifestaciones clinicas suelen producirse por una torsion completa o intermitente del pediculo esplenico, con el consiguiente riesgo de isquemia del bazo. Presentamos un caso de bazo ectopico con torsion del pediculo, tratado mediante esplenectomia laparoscopica sin complicaciones. Aunque hay pocos casos comunicados en la literatura cientifica, la laparoscopia ha demostrado ser una tecnica valida y segura en el tratamiento del bazo ectopico.

Myelolipoma is a very uncommon tumor and is extremely rare in the liver. Patients are usually asymptomatic and preoperative diagnosis is often difficult. We report a new case of hepatic myelolipoma and review all the cases previously reported in the literature. Clinicopathologic and radiologic findings, as well as therapeutic options, are discussed.

The presence of biliary gallstones and surgical clips in the abdominal cavity after a laparoscopic cholecystectomy can cause complications, which even though they are uncommon, can be serious. We carried out a review of the various complications, their incidence, related risk factors, ways to deal with them and recommendations to reduce morbidity associated with the presence of ectopic material (gallstones and surgical clips) in the peritoneum.

Wandering spleen is an uncommon entity, characterized by the anomalous position of the spleen, caused by the absence or laxity of its suspensory ligaments. The most common symptoms are usually due to intermittent or complete torsion of the splenic pedicle with subsequent infarction. We report a case of torsion of a wandering spleen. Laparoscopic splenectomy was performed and recovery was uneventful. Although few cases of wandering spleen treated laparoscopically have been reported in the literature, laparoscopy has been demonstrated to be a safe technique for the treatment of this entity.

Sr. Director: La mesenteritis esclerosante (ME) es una enfermedad rara que afecta al mesenterio de etiologia desconocida. El termino de ME engloba diferentes denominaciones de! mismo proceso idiopatico inflamatorio de los mesos, que se utilizan en la literatura medica para referirse a las distintas variables histologicas de la misma entidad entre los que se incluyen: lipodistrofia mesenterica, mesenteritis retractil, enfermedad de Weber-Christian, mesenteritis xantulogranulomatosa y paniculitis nodular sistemica1. Aunque la clinica y los hallazgos radiologicos pueden hacer sospechar la enfermedad, su diagnostico definitivo exige una confirmacion histologica mediante biopsia. A continuacion se presenta un caso clinico de ME como causa excepcional de dolor abdominal. Varon de 66 anos que acude a urgencias por dolor abdominal y lumbar de varios dias de evolucion. No presenta alteraciones del transito intestinal, vomitos ni fiebre. En la exploracion fisica el abdomen es blando y depresible, doloroso en epigastrio sin defensa ni signos de peritonismo. Hemograma, bioquimica, perfil hepatico y cardiaco y radiografias de torax y abdomen normales. En la TAC abdominopelvica y RM se describen 2 imagenes de masas mesentericas que miden aproximadamente 5 y 2cm respectivamente, localizadas por detras de los vasos mesentericos, cambios inflamatorios de la grasa a raiz de mesenterio y liquido libre rodeando la pared duodenal. En la endoscopia se objetiva una sobreelevacion en la cara anterior de la segunda porcion duodenal. Los marcadores tumorales (CEA, CA 125, CA 15.3, PSA, AFP), el proteinograma y la VSG son normales. Con la sospecha diagnostica de ME se indica biopsia de la masa mediante...