ABSTRACT
ABSTRACT: Type 1 autoimmune pancreatitis is a cause of chronic pancreatitis related to the systemic disease known as IgG4-related Sclerosing Disease. Case report: We report the case of a 64-year-old male patient who presented recurrentepigastric pain radiating to the back, associated with jaundice, xerostomia, nausea, and vomiting, since 2014, diagnosed two years later with an unresectable pancreatic adenocarcinoma. The diagnosis was questioned after a few follow-up months without clinical deterioration when it was suggested the possibility of type 1 autoimmune pancreatitis in its pseudotumoral form. The patient was then treated with glucocorticoids, obtaining significantclinical improvement. After two years of follow-up, he returned asymptomatic with images suggestive of sclerosingcholangitis and a large liver abscess. Importance of the issue: The present case denotes the difficulty found in this diagnosis due to clinical and radiological resemblances with pancreatic adenocarcinoma. Besides that, it presents a seldom described disease complication, the liver abscess. (AU)
RESUMO: A pancreatite autoimune tipo 1 é uma causa de pancreatite crônica relacionada à doença sistêmica conhecida como Doença Esclerosante relacionada à IgG4. Relato do caso: Relatamos o caso de um paciente do sexo masculino,64 anos, que apresentou quadros recorrentes de dor epigástrica com irradiação para as costas, associada com icterícia, xerostomia, náuseas e vômitos desde 2014, diagnosticado após 2 anos com adenocarcinoma pancreático irressecável. O diagnóstico foi questionado após alguns meses de acompanhamento sem deterioração clínica, quando aventaram a possibilidade de forma pseudotumoral da pancreatite autoimune tipo 1. Realizou tratamento com glicocorticoides, obtendo melhora clínica importante. Após dois anos de acompanhamento, retorna assintomático com imagens sugestivas de colangite esclerosante e volumoso abscesso hepático. Importância do problema: O presente caso denota uma dificuldade encontrada no diagnóstico dessa entidade devido a semelhanças clínico-radiológicas com o adenocarcinoma pancreático. Além disso, apresenta uma complicação pouco descrita da doença, o abscesso hepático. (AU)
Subject(s)
Humans , Male , Middle Aged , Pancreatitis , Autoimmune Diseases , Immunoglobulin G , Cholangitis, Sclerosing , Clinical Deterioration , Immunoglobulin G4-Related Disease , Autoimmune Pancreatitis , Liver AbscessABSTRACT
Introdução: o linfoma primário de tireoide é uma neoplasia rara, agressiva, cuja manifestação pode assemelhar-se ao carcinoma anaplásico. Relato do caso: descreveu-se o caso de uma paciente de 59 anos com crescimento de massa cervical anterior volumosa em um mês associada à disfonia. Tomografia computadorizada revelou aumento da tireoide com traqueia desviada e linfonodomegalia. Histopatológico confirmou linfoma difuso de grandes células B de alto grau. Paciente foi, celeremente, submetida à terapia e obteve boa resposta. Conclusão: em pacientes com rápido crescimento de massa em topografia tireóidea, a hipótese de linfoma deve ser elencada, sendo primordial diagnóstico precoce e conduta agressiva.
Introduction: primary thyroid lymphoma is a rare, aggressive neoplasm, whose manifestation may resemble anaplastic carcinoma. Case report: a 59-year-old patient with an increasing anterior cervical mass in one month, associated with dysphonia. Computed tomography revealed enlargement of the thyroid with tracheal deviation and lymph node enlargement. Histopathology confirmed diffuse high-grade large B-cell lymphoma. The patient was promptly submitted to therapy and obtained a good response. Conclusion: in patients with sudden mass growth in thyroid topography, the hypothesis of lymphoma should be considered, with rapid diagnosis and aggressive conduct being essential.
Subject(s)
Thyroid Gland , General Surgery , Head and Neck Neoplasms , LymphomaABSTRACT
Mucoepidermoid carcinoma (MEC) is a common malignant tumor composed of mucinous cells, clear cells and squamoid tumor cells. It is usually localized on the salivary glands, however can very rarely be intraosseous. This tumor affects women more than men and is more common in the mandible. In this report, we present a case of a 45-year-old woman with a painless intraoral mass for 10 years which was repeatedly misdiagnosed, evolving into an extensive lesion. After an appropriate approach, she was diagnosed with MEC of the mandible and submitted to a left hemimandibulectomy accompanied by microsurgical reconstruction with excellent results.