ABSTRACT
Dermatomyositis (DM) is a malignancy-associated inflammatory connective tissue disease which involves muscles and skin. It accompanies many cancer types. Herein, we aimed to present a 42-year-old patient with primary signet ring cell ovarian carcinoma which has not been seen hitherto. Presentation with DM induces rapid and aggressive progression and emphasizes the importance of more comprehensive malignancy screening in these patients
ABSTRACT
ABSTRACTPostoperative fungal endophthalmitis is a rare but devastating complication of cataract surgery. Vitrectomy and intravitreal amphotericin B injection as well as administration of systemic antifungal agents have been suggested as optimal treatments for fungal endophthalmitis. However, this therapy may fail to eliminate fungal species resistant to current antifungal agents. The saprophytic fungus Trichosporon asahii is frequently observed as a cause of endogenous endophthalmitis in immunosuppressed patients. We report a case of postoperative endophthalmitis caused by T. asahii, resistant to amphotericin B. To the best of our knowledge, this is the first report of T. asahii endophthalmitis successfully treated with intravitreal and systemic voriconazole, pars plana vitrectomy, and removal of the intraocular lens and entire lens capsule.
RESUMOEndoftalmite fúngica pós-operatória é uma complicação rara mas devastadora da cirurgia de catarata. A vitrectomia e injeção intravítrea de anfotericina B, bem como agentes fungicidas sistêmicos, têm sido sugeridos como tratamentos ideais para endoftalmite fúngica. No entanto, esta terapia pode falhar em erradicar as espécies de fungos resistentes aos agentes antifúngicos atuais. Uma dessas espécies de fungos é o fungo saprófita,Trichosporon asahii, que é frequentemente observada, como causa de endoftalmite endógena, em pacientes imunodeprimidos. Relatamos um caso de endoftalmite pós-operatória causada porT. asahii que é resistente a anfotericina B. Ao nosso conhecimento, este é o primeiro relato de endoftalmite porT. asahii tratado com sucesso com voriconazol intravítreo e sistêmico, vitrectomia viapars plana, e remoção da lente intraocular e saco capsular.
Subject(s)
Aged , Humans , Male , Antifungal Agents/administration & dosage , Cataract Extraction/adverse effects , Endophthalmitis/drug therapy , Eye Infections, Fungal/drug therapy , Trichosporonosis/drug therapy , Voriconazole/administration & dosage , Endophthalmitis/microbiology , Eye Infections, Fungal/microbiology , Intravitreal Injections , Trichosporon/classification , Trichosporon/isolation & purificationSubject(s)
Female , Humans , Pregnancy , Choroid/anatomy & histology , Tomography, Optical Coherence/methodsABSTRACT
PURPOSE: The aim of this study was to evaluate the role of whole body 18F-FDG PET/CT imaging in the detection of primary tumors in patients with a metastatic cancer from an unknown primary site. METHODS: The study population consisted of 43 patients with a biopsy proven metastatic disease, negative conventional diagnostic procedures (including CT/MRI/endoscopic procedures) and a whole body 18F-FDG PET/CT examination. Patients' records were retrospectively analyzed. According to the final pathologic diagnoses, rate of detection of the primary tumor site was determined. Additionally, overall patient survival was calculated to evaluate the prognostic value of 18F-FDG PET/CT findings. RESULTS: A primary tumor site was shown by 18F-FDG PET/CT in 24 patients (24/43; 55.8%). In 18 patients 18F-FDG PET/CT scans were negative (18/43; 41.8%). In a patient with an adenocarcinoma metastasis 18F-FDG PET/CT was falsely positive for an inflammatory lesion in the lung. Among the 18F-FDG PET/CT positive and negative groups median overall survival was not significantly different (log-rank p=0.573). CONCLUSION: Whole body 18F-FDG PET/CT imaging has a high rate of detection of a primary tumor in patients with a carcinoma of unknown origin.