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a mass in the adipose tissue of the upper arm, without skin involvement and concurrent

axillary lymph node enlargement. She was treated with wide excision and lymph node
dissection; pathology led to the diagnosis of Merkel cell carcinoma, and she was subsequently
submitted to adjuvant radiotherapy. No signs of recurrence are present 8 years

postoperatively. Primary Merkel cell carcinoma can rarely be located in the adipose tissue

without skin involvement. In cases of high suspicion, preoperative MRI scan can show the
extent of the lesion, as well as lymph metastases.

50. Effraemidou E, Souftas V, Kofina K, Karanikas M, Lyratzopoulos N. Spontaneous rupture of a
splenic artery aneurysm treated with a spleen-preserving procedure: a case report. J Surg

Case Rep. 2020 Feb 12;2020(2):rjz412. doi: 10.1093/jscr/rjz412. eCollection 2020 Feb.

PMID: 32064078 [PubMed]

Abstract: Splenic artery aneurysm is a rare and life-threatening condition, in case of spontaneous
rupture. A rare case of such a rupture, treated successfully with an endovascular procedure, is
presented. A 21-year-old man presented to the emergency department after an episode of loss

of consciousness.

After initial conservative treatment, he developed hemodynamic instability 12 hours later, with
concurrent diffuse abdominal pain. Abdominal CT revealed a ruptured splenic artery aneurysm,

which was immediately treated with coil embolization. The patient had an uneventful recovery
and was discharged on the 12th day after the procedure. Although open surgery is the choice

of treatment in cases of ruptured splenic artery aneurysms, endovascular embolization can
also be considered a safe procedure with low complication and mortality rates

51. Karanikas M, Kofina K, Potolidis D, Foutzitzi S, Deftereos S, Effraemidou E, Lyratzopoulos.

Spontaneous massive duodenal perforation after ovarian cancer treatment with bevacizumab.
N.J Surg Case Rep. 2020 Jun 19;2020(6):rjaa174. doi: 10.1093/jscr/rjaa174. eCollection 2020

Jun. PMID: 32595926 [PubMed]

Abstract: Bevacizumab has been used as an effective drug for ovarian cancer. However, serious
adverse effects, such as gastrointestinal perforation, can occur. Spontaneous gastrointestinal

perforation is an uncommon, yet life-threatening complication related to bevacizumab
administration. We present the case of a 65-year-old Caucasian female who presented with

acute abdomen 10 days after the first administration of bevacizumab for ovarian cancer
treatment, and she was diagnosed intraoperatively with a massive duodenal perforation. Bowel

perforation after bevacizumab administration is a serious and potentially lethal complication.

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