A Case of Prostatic Metastasis from Intrahepatic Cholangiocarcinoma: An Extremely Rare Event

The second most frequent primary carcinoma of the liver to emerge is intrahepatic cholangiocarcinoma (ICC), which is thought to be an incurable, rapidly proliferating tumor with a dismal prognosis. ICC is typically found at an advanced stage and is physiologically hostile. Regional lymph nodes and liver metastases are frequent tumor metastatic sites for ICC and serve as indicators of tumor recurrence. ICC metastasizing to the male urogenital tract has only seldom been documented. Typically, lymph vessels serve as the primary pathway for disseminating tumor cells. The high fatality rate associated with ICC and the rapid spread of the disease may be caused by this lymphatic route. The only curative therapeutic approach for treating these tumors is surgical removal. We report a case of prostatic metastasis from ICC.

Decision-to-delivery interval and neonatal outcomes for category-1 caesarean sections during the COVID-19 pandemic

General anaesthesia is known to achieve the shortest decision‐to‐delivery interval for category‐1 caesarean section. We investigated whether the COVID‐19 pandemic affected the decision‐to delivery interval and influenced neonatal outcomes in patients who underwent category‐1 caesarean section. Records of 562 patients who underwent emergency caesarean section between 1 April 2019 and 1 July 2019 in seven UK hospitals (pre‐COVID‐19 group) were compared with 577 emergency caesarean sections performed during the same period during the COVID‐19 pandemic (1 April 2020–1 July 2020) (post‐COVID‐19 group). Primary outcome measures were: decision‐to‐delivery interval; number of caesarean sections achieving decision‐to‐delivery interval < 30 min; and a composite of adverse neonatal outcomes (Apgar 5‐min score < 7, umbilical arterial pH < 7.10, neonatal intensive care unit admission and stillbirth). The use of general anaesthesia decreased significantly between the pre‐ and post‐COVID‐19 groups (risk ratio 0.48 (95%CI 0.37–0.62); p < 0.0001). Compared with the pre‐COVID‐19 group, the post‐COVID‐19 group had an increase in median (IQR [range]) decision‐to‐delivery interval (26 (18–32 [4–124]) min vs. 27 (20–33 [3–102]) min; p = 0.043) and a decrease in the number of caesarean sections meeting the decision‐to‐delivery interval target of < 30 min (374/562 (66.5%) vs. 349/577 (60.5%); p = 0.02). The incidence of adverse neonatal outcomes was similar in the pre‐ and post‐COVID‐19 groups (140/568 (24.6%) vs. 140/583 (24.0%), respectively; p = 0.85). The small increase in decision‐to‐delivery interval observed during the COVID‐19 pandemic did not adversely affect neonatal outcomes.