1. Abstract WedescribeafemalepatientinwhomCT-guidedhookwiremarkingenabledaneasyandmini- mally invasive removal of a small abdominal wall metastasis of chromophobe renal cell carci- noma despite obesity and scars after repeat laparotomies. A50-yearoldfemalepresentedwithasmallabdominalwallmetastasis(Figure1A)afterahis-toryoffourlaparotomiesandlocalradiotherapyforabdominalrecurrencesofaleft-sidedchro-mophoberenalcellcarcinomaduringaperiodofnarrowlysevenyearsafterinitialnephrectomy. Becauseofthesmallsizeofthemetastasis,obesityandscarsafterrepeatlaparotomiestheaccess tothelesionwasconsidereddifficult.Therefore,acomputedtomography(CT)-guidedhookwire marking was requested (Figure1B). After marking, the subcutaneous fat surrounding the wire wasexcisedviaasmallincisionandtheabdominalwallwastransected.Afteropeningtheperi-toneumthelesionwaspalpatedatthetipofthewireandremovedcompletelytogetherwiththe coveringtissue(Figure2).Theabdominalwalldefectwasclosedwithasmallpartiallyabsorbable meshandtheskinincisionwithanintra-cutaneoussuture.NorecurrencewasseeninaCTscan four months later. Image-guided marking is a routine technique in breast cancer treatment [1] butitisrarelyusedinurologicsurgery[2].Inselectedcasesitmaybeasimpleandsafewayto locate metastases and to remove them rapidly with minimal tissue damage.
2. Keywords Renal cell carcinoma; Metasta-sis; CT-guided marking; Mini-mallyinvasive
3. IntroductionIncreased risk of venous thromboembolism is well recognized in patient with human immunodeficiency virus (HIV), and the dis-ease has been suggested to represent a pre-thrombotic state. Even so, little exist in literature concerning arterial thromboembolism causing upper arm ischemia in patients with HIV. We report a case report of acute embolic occlusion of non-diseased brachial and axillary artery in a 42 years old man with HIV infection.
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FroehnerM.CT-Guided Marking of A Small Abdominal Wall Meta stasis of Chromo phobe Renal Cell Carcinoma. Annals of Clinical and Medical Case Reports 2023