ABSTRACT
Testicular germ cell tumors (GCT) are a diverse group of neoplasms, broadly divided into seminomatous and non seminomatous types, with varying histomorphology. Mixed germ cell tumors express more than one germ cell component. Somatic type malignancy occurring in testicular GCT is rare. Most often these components present as metastasis, particularly following chemotherapy, rather than primarily involving the testis. We describe a rare case of a young adult with no significant past history, who presented with testicular mass which on histology revealed a non-seminomatous mixed germ cell tumor with additional somatic type malignancy component of a rhabdomyosarcoma.
ABSTRACT
En el presente trabajo se da cuenta de la historia del síndrome delirante crónico conocido como "delirio de parasitosis o síndrome de Ekbom", sus principales características clínicas, evolutivas, la ubicación nosográfica y las estrategias terapéuticas utilizadas. Los hallazgos de la principal literatura publicada se comparan con la experiencia de los autores al haber estudiado doce pacientes portadores de esta sintomatología. Asimismo, se indaga acerca de la posible conexión con otros cuadros psicopatológicos, más específicamente con el espectro obsesivo-compulsivo.
In this paper, the history of the chronic delusional syndrome known as delusional parasitosis or Ekbom syndrome is reviewed as well as its main clinical characteristics, evolution, nosographic position and therapeutic approaches. The findings in the published literature are compared with the clinical experience of the authors who have studied twelve cases. The possible connection with other mental diseases, specifically Obsessive Compulsive Spectrum, is evaluated.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Delusions/psychology , Parasitic Diseases , Restless Legs Syndrome , Delusions/diagnosis , Delusions/therapy , Pimozide , Restless Legs Syndrome/diagnosis , Restless Legs Syndrome/therapyABSTRACT
Objetivo: Revisar e ilustrar un caso de trastorno delirante de tipo somático. Métodos: Reporte de caso. Resultados: Una paciente de 41 años presenta una ideación delirante somática crónica de infestación y de padecimiento de enfermedad grave de tipo cardiaco y de tipo oncológico en sistema nervioso central y en mama izquierda. Las conductas reiterativas de aseo en dicha mama han desencadenado una dermatitis de contacto. Su conciencia de enfermedad es nula, y su red de apoyo, pobre; por lo tanto, no se adhiere a las recomendaciones médicas ni al manejo por psiquiatría y continúa consultando de manera recurrente a diferentes especialistas y servicios médicos, aunque se han descartado neoplasias y otras patologías sistémicas. Conclusiones: El trastorno delirante somático constituye un reto diagnóstico y terapéutico para el personal médico. Se requiere un manejo integral y multidisciplinario de estos pacientes.
Objective: To review and illustrate a case of delusional disorder, somatic type. Methods: Case report. Results: A 41-year-old female patient presents with a chronic somatic delusion of infestation, of suffering a severe cardiac ailment and cancer in the central nervous system and left breast. Repeated cleansing of the left breast leads to a contact dermatitis. Her insight regarding the disease is null and her support system is precarious. Therefore, she does not adhere to medical recommendations or to psychiatric treatment and continues to consult different specialists and medical services, although neoplasia and other systemic illnesses have been discarded. Conclusions: Delusional disorder, somatic type, is a challenging illness to diagnose and treat. It warrants integral and multidisciplinary management.