Pheochromocytomas

Introduction: Pheochromocytomas are rare neuroendocrine tumors, producing catecholamines, which usually affect the adrenal medulla region of the adrenal gland. These tumors may clinically manifest in several ways, presenting themselves in most patients with persistent hypertension or paroxysmal. Ten percent of cases are considered malignant, confirmed by the presence of metastases and approximately 24% of cases are associated with inherited syndromes. Diagnostic confirmation of these syndromes implies preparatory workup, treatment and stringent follow-up, preferably with a multidisciplinary team. Objective: This study is a survey of recent studies to clarify issues related to clinical, diagnosis, genetic and treatment aspects of these patients. Conclusion: It is widely accepted that a significant percentage of patients with sporadic pheochromocytoma may have germline mutations leading to more widespread disease development and/or malignancy, and that surgical treatment in these cases must be complemented by careful clinical surveillance for early diagnosis of recurrences. This study prioritized the importance of conducting a proper pretreatment workup in cases of pheochromocytoma, which provides the additional information required for a rational course of treatment for patients.

Tumor de células gigantes em falange proximal com metástase pulmonar: relato de caso e revisão de literatura / Giant cell tumor in proximal phalanx with pulmonary metastasis: case report and literature review

Trata-se de um relato de caso de tumor de células gigantes (TCG) em falange proximal de terceiro dedo da mão esquerda com metástase pulmonar. A paciente apresentava dor no dedo sem história prévia de trauma. Foram realizados exame clínico, estudo radiográfico e ressonância nuclear magnética. Feito o estudo histológico, a partir de biópsia incisional, com hipótese de TCG. Foi submetida à amputação do dedo, confirmando o diagnóstico pela microscopia da peça. A paciente foi acompanhada devido ao risco de metástase pulmonar, evidenciada em estudo radiográfico e tomografia computadorizada de tórax, sendo submetida à toracotomia. Desde então, houve melhora dos sintomas referidos no pré-operatório e ausência de recidiva local e novas metástases.

This is a case report on a giant cell tumor in the proximal phalanx of the third finger of the left hand, with pulmonary metastasis. The patient presented pain in the finger without any previous history of trauma. Clinical examination, radiographic imaging and magnetic resonance imaging were carried out. A histological evaluation was done from an incisional biopsy, taking the hypothesis of giant cell tumor. The patient underwent amputation of the finger and the diagnosis was confirmed by means of microscopy on the specimen. The patient was followed up because of the risk of lung metastasis, which was shown by radiographic examination and computed tomography on the chest, and thoracotomy was performed. Since then, there has been an improvement of the symptoms that had been reported preoperatively, and no local recurrence or new metastasis has been found.