ABSTRACT
Las metástasis oculares constituyen el tumor maligno intraocular más frecuente en la población adulta. Estas tienen en su mayoría un compromiso coroideo. Se describe el caso de una paciente que presentó disminución de la agudeza visual rápidamente progresiva en el ojo derecho. Sin antecedentes personales relevantes, durante la evaluación oftalmológica se observa una lesión coroidea, la cual clínica y radiológicamente sugería una metástasis coroidea como primera impresión diagnóstica. Posterior a la realización de estudios de extensión se confirmó histopatológicamente un tumor pancreático como origen de la metástasis. Las metástasis oculares ocasionadas por el páncreas son extremadamente raras, lo cual se confirma en la revisión de la literatura realizada.
The ocular metastases are the most common intraocular malignant tumor in the adult population. These have mostly a choroid commitment. This case report describes a female patient who presented with a rapidly progressive decrease in visual acuity in the right eye, no other symptoms were referred and her medical history was no relevant. A choroidal lesion was found, which clinically and radiologically suggested a choroid metastasis as the diagnosis. With extension studies was confi rmed histopathologically a pancreatic tumor as the primary tumor. The ocular metastases that are originated for the pancreas are extremely rare; this is confirmed by the review of the literature.
Subject(s)
Humans , Eye Neoplasms , Carcinoma, Neuroendocrine , Eye Diseases , Pancreatic NeoplasmsABSTRACT
Objetivos: Revisar os principais aspectos históricos da evolução do tratamento do câncer de pâncreas.Fonte de dados: Revisão bibliográfica através do PubMed. Foram analisados artigos selecionados sobre a história do tratamento do câncer de pâncreas.Síntese dos dados: Ressecção cirúrgica completa é a única alternativa terapêutica que pode possibilitar a cura dos pacientes com câncer de pâncreas. Entretanto, a duodenopancreatectomia é um dos procedimentos cirúrgicos mais desafiadores, necessitando cirurgiões com alto nível de treinamento para sua execução com segurança. Diversos personagens estiveram envolvidos na evolução da técnica operatória na cirurgia pancreática até que o procedimento atingisse os níveis de segurança atuais.Conclusões: Apesar da segurança com a qual a duodenopancreatectomia é realizada atualmente, a sobrevida pós-operatória no câncer de pâncreas ainda é insuficiente, sugerindo que as questões técnicas operatórias representam apenas uma das etapas necessárias para progresso dos resultados. Melhora no sistema de rastreamento, diagnosticando tumores mais precoces, identificação de pacientes de alto risco e aperfeiçoamento no tratamento adjuvante são necessários para aumentar a taxa de cura dessa neoplasia.
Aims: To review the main historical aspects of the evolution of the treatment of pancreatic cancer.Source of data: Literature review through PubMed. Selected articles on the history of the treatment of pancreatic cancer were analyzed.Summary of findings: Complete surgical resection is the only therapeutic alternative that may allow cure of patients with pancreatic cancer. However, pancreaticoduodenectomy is one of the most challenging surgical procedures, requiring surgeons with a high level of training for its secure implementation. Several protagonists were involved in the evolution of the surgical technique in pancreatic surgery until the procedure reached current levels of security.Conclusions: Despite the safety with which pancreaticoduodenectomy is currently performed, postoperative survival in pancreatic cancer is still insufficient, suggesting that technical issues are just one of the steps needed to improve outcome. Better screening methods to diagnose earlier tumors, identification of high risk patients and improvement in adjuvant treatment are needed to increase the cure rate of this neoplasm.
ABSTRACT
Objetivos: descrever um caso de tumor sólido pseudopapilar de pâncreas (tumor de Frantz), neoplasia infrequente, que entretanto tem sido cada vez mais diagnosticada e relatada na literatura. Descrição do Caso: uma adolescente de18 anos consultou com queixa de dor abdominal persistente em hipocôndrio esquerdo. Ecografia abdominal e tomografia computadorizada de abdome revelaram lesão sólido-cística na transição entre o corpo e a cauda do pâncreas. A paciente foi submetida a pancreatectomia corpo-caudal com preservação esplênica. O exame anatomopatológico revelou tratar-se de um tumor sólido pseudopapilar de pâncreas. Houve excelente evolução pós-operatória, com resolução completa das queixas, estando a paciente assintomática seis meses após o procedimento. Conclusões: o tumor sólido pseudopapilar de pâncreas é uma neoplasia rara, ocorre predominantemente em mulheres jovens e é considerada uma lesão de baixo grau de malignidade. Sintoma de dor abdominal inespecífica é a apresentação clínica característica, e o diagnóstico é realizado por exames de imagem. Ressecção cirúrgica completa do tumor é o tratamento de escolha.
Aims: To present a case of solid pseudopapillary tumor (Frantz tumor), an infrequent pancreatic neoplasm, which has been increasingly diagnosed and reported in the literature. Case Description: A 18-year old woman presented with pain and tenderness in the left upper abdominal quadrant. Abdominal ultrasound and computed tomography scan revealed a solid and cystic lesion in the body of the pancreas. The patient underwent a corpo-caudal pancreatectomy with splenic preservation. Pathologic analysis of the specimen revealed a solid pseudopapillary tumor. Postoperative course was uneventful with complete resolution of the symptoms, and the patient is completely asymptomatic six months after the operation. Conclusions: Pancreatic solid pseudopapillary tumor is a rare neoplasm that predominantly occurs in young women, and is generally considered a low-grade malignant tumor. Its clinical presentation is nonspecific abdominal symptoms, and the diagnosis is performed by image tests. Complete surgical resection of primary tumor is the treatment of choice.
Subject(s)
Humans , Male , Female , Pancreatic Neoplasms , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Pancreatectomy , PancreasABSTRACT
Objective To evaluate the recent curative efficacy and security of High Intersity Focused Ultrasound(HIFU)in treating patients with advanced pancretic carcinoma.Methods 17patients with cancer of pancreas were treated by FEP-BY02,received 135(average 8)times.Results The overall response rate was 70%(CR+PR),including11.76%(2/17)complete response(CR)and 58.82%(10/17)partial response(PR).The clinical benefit response(CBR)was 82.36%.The inefficiency was 17.64%(3/17).The cancer pain was relieved in 80% patients(8/10).Nocomplications occurred.such as pancreatic juice leakage,bleeding,perforation of gastrointestinal tracts,scalding of skin in the group.Conclusions The preliminary results show that HIFU has a high efficacy and quite safety for advanced pancreatic carcinoma,it is worthy of futher clinical trail.