Lesión granulomatosa en encía insertada-metástasis de carcinoma renal de células claras. Presentación de caso / Granulomatous Lesion in Inserted Gum-Metastasis of Renal Clear Cell Carcinoma. Case Presentation

Resumen: A nivel mundial el carcinoma renal constituye el 3% de todas las formas de cáncer en el cuerpo humano. Su comportamiento biológico es variable dependiendo de la biología de cada individuo; tiende a realizar metástasis a sitios contiguos como glándulas suprarrenales, hígado, pulmón, hueso, ganglios linfáticos sin embargo la presentación a distancia en cavidad bucal es poco frecuente más aún en encía insertada. Las lesiones granulomatosas del periodonto incluyen granulomas piógenos, granulomas de células gigantes entre otros. El objetivo principal de este caso clínico es describir las características clínicas e histopatológicas de las metástasis a cavidad bucal como lesiones granulomatosas. Se presenta el caso de una paciente femenina de 60 años de edad con antecedente de carcinoma renal de células papilares en riñón derecho tratado mediante nefrectomía en el año 2017, en el año 2019 presenta metástasis a pulmón izquierdo y a cavidad bucal. En la actualidad se encuentra bajo protocolo de tratamiento para metástasis de células claras renales.

Abstract: Worldwide, renal carcinoma constitutes 3% of all forms of cancer in the human body. Its biological behavior is variable depending on the biology of each individual; it tends to metastasize to contiguous sites such as adrenal glands, liver, lung, bone, lymph nodes, however, remote presentation in the oral cavity is less frequent, even in inserted gums. Granulomatous lesions of the periodontium include pyogenic granulomas, giant cell granulomas among others. The main objective of this clinical case is to describe the clinical and histopathological characteristics of oral cavity metastases as granulomatous lesions. The case of a 60-year-old female patient with a history of renal cell papillary carcinoma in the right kidney treated by nephrectomy in 2017 is presented, in 2019 she presented metastases to the left lung and oral cavity. It is currently under treatment protocol for renal clear cell metastases.

Sinonasal sarcoidosis of the maxillary sinus and infraorbital nerve: a case report

Sinonasal sarcoidosis in the head and neck region is infrequent. Its occurrence can be either isolated in combination with other systems. The literature reveals that the occurrence of sinonasal sarcoidosis without lung involvement is rare. In general, sarcoidosis is a chronic non-caseating granulomatous disease of unknown origin, often identified after biopsy. In this article, we report on a benign tumor of the face that produced a diagnostic dilemma, necessitating refinement of the surgical access and in toto removal of the benign tumor.

A Case of Skin Infection Caused by Nontuberculous Mycobacterium after External Dacryocystorhinostomy

PURPOSE: To report a case of skin infection caused by nontuberculous mycobacterium after external dacryocystorhinostomy. CASE SUMMARY: A 53-year-old female patient presented to our clinic with a tear on the left eye, although a silicone tube was intubated. Two weeks after external dacryocystorhinostomy, swelling and redness were found on the operation wound. Therefore, the patient received oral antibiotics and steroid treatments but did not improve. The mass was irregularly shaped and became larger; thus, excisional biopsy was performed at 2 months after external dacryocystorhinostomy. A chronic granulomatous tissue was detected in the excisional biopsy, and antimycobacterial medications were started in consultation with an internist. A moderate colony was observed, and rod-shaped bacteria Mycobacterium abscessus was found in the culture 47 days after acid-fast culture was performed. The patient was diagnosed with a periocular infection caused by nontuberculous mycobacterium. Finally, the lesion improved. CONCLUSIONS: Although patients with granulomatous tissue receive numerous treatments, if the lesion is not improved, then additional excisional biopsy and culture examination to identify infection by nontuberculous mycobacterium are necessary.

Primary Lid Tuberculosis Occuring at Preaponeurotic Portion after upper Lid Blepharo plasty

Tuberculosis of the lid is a rare disease that usually extends directly from surrounding tissues such as paranasal sinuses and lacrimal glands, or occurs possibly as a result of hematogenous spread. Primary tuberculous infection of lid also rarely occurs. The earliest lesion is a brownish red, soft papule that develops into an indurated nodule or plaque that may ulcerate. There is usually prominent lymphadenopathy. The diagnosis is established through tuberculin skin testing, stains for acid-fast organisms, and cultures. If diagnosis is delayed, complications including extensive orbital tissue damages, cold abscess, cutaneous fistula, and cicatricial ectropion may ensue. Lid tuberculosis should be differentiated from other granulomatous lesions of eyelid and also from other more commonly occuring orbital tumors. The combination therapy of Isoniazid, Rifampin, and Pyrazinamide is recommended for lid tuberculosis. We experienced a patient presenting with painless upper eyelid nodule that occurred about 3 weeks following upper lid blapharoplasty and treated her with anti-tuberculous medications after histological diagnosis of lid tuberculosis has been made. So, we report this rare case of lid tuberculosis with literature.

Right Atrial Myxoma Showing Granulomatous Lesion with Pulmonary Infart: A case report

Cardiac myxoma is the most common primary tumor of the heart. The tumor contains a variety of cell types that are thought to arise from a focus of primitive pluripotential mesenchymal cells in the area of the fossa ovalis. Throughout the myxoid stroma, there are variable amounts of reticular fivers, collagen, elastic fibers and smooth muscle cells. A 38-year-old female had right atrial myxoma with multiple pulmonary infarcts. In this case, we experienced an unusual degenerative change in the tumor of granulomatous lesion consisting of hemosiderin pigments, foreign body giant cells and peculiar, spheroid, semilunar or bamboo-shaped degenerated elastic fibers. Microscopically it resembles Gamna-Gandy nodule seen in the spleen of chronic passive congestion.