Downstaging of advanced hepatocellular carcinoma followed by liver transplantation using immune checkpoint inhibitors: Where do we stand?

Liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) and chronic liver disease (CLD) is limited by factors such as tumor size, number, portal venous or hepatic venous invasion and extrahepatic disease. Although previously established criteria, such as Milan or UCSF, have been relaxed globally to accommodate more potential recipients with comparable 5-year outcomes, there is still a subset of the population that has advanced HCC with or without portal vein tumor thrombosis without detectable extrahepatic spread who do not qualify or are unable to be downstaged by conventional methods and do not qualify for liver transplantation. Immune checkpoint inhibitors (ICI) such as atezolizumab, pembrolizumab, or nivolumab have given hope to this group of patients.

Neuroendocrine tumor in a lesser sac bronchogenic cyst - A hitherto unreported entity made rarer by concomitant hepatic hydatid cyst.

Intra-abdominal bronchogenic cysts are rare entities and only a handful of cases occurring within the lesser sac have been described. Further, the development of malignancy in a bronchogenic cyst is exceptional and one arising in a lesser sac has so far not been reported. We present herein an account of a 44-year-old man who presented with recurrent upper abdominal pain.

Off-pump coronary bypass grafting in a post-pneumonectomy patient: Challenges and management.

Pulmonary complications are common in cardiac surgical patients. Limited respiratory reserves along with the pain associated with sternotomy add to the morbidity. Patients undergoing cardiac surgery who have had a pneumonectomy done before can be even more challenging to manage perioperatively due to a single-functioning lung.

OPCAB in acute coronary syndrome: predictors of intra-aortic balloon pump use.

Aim: Acute coronary syndrome (ACS) patients undergoing offpump coronary artery bypass (OPCAB) often require intra-aortic balloon pump (IABP) support. Indications and timing of IABP insertion are controversial. A study was done to determine criteria for predicting the use of IABP in these patients.