ABSTRACT
Abscesso espinhal epidural é uma doença rara de diagnóstico difícil, sendo que o principal fator prognóstico é o diagnóstico breve. A maioria dos pacientes, porém, tem o diagnóstico tardio, quando já existem sintomas neurológicos que podem permanecer após o tratamento. Na maioria dos casos, os sintomas iniciais são dor nas costas, febre e paralisia. O tratamento é feito à base de antibioticoterapia empírica e, caso não haja contraindicação, descompressão e drenagem cirúrgica. Relata-se o caso de uma paciente que sofreu paralisia súbita nos membros inferiores. Inicialmente, havia suspeita de mielite transversa, mas a evolução do caso permitiu o diagnóstico de abscesso espinhal epidural emT6, T7 e T8, causada por disseminação hematogênica de Staphylococcus aureus.
Spinal epidural abscess is a rare and difficult disease to diagnose, and the main prognostic factor is the early diagnosis. Most patients, however, have their diagnosis delayed to when they already have neurological symptoms that may remain after treatment. In most cases, the initial symptoms are back pain, fever and paralysis. Treatment is based on empirical antibiotic therapy and, if there is no contraindication, decompression and surgical drainage. We report the case of a patient who suffered sudden paralysis of the inferior members. Initially suspected as transversemyelitis, the case evolved, allowing the diagnosis of spinal epidural abscess in T6, T7 and T8, caused by hematogenous spread of Staphylococcus aureus.
Subject(s)
Humans , Female , Adolescent , Epidural Abscess/diagnosis , Spinal Diseases/diagnosis , Staphylococcal Infections/complications , Staphylococcus aureus , Paralysis/etiologyABSTRACT
Tumor metastasis is one of the most important biologi-cal characteristics of malignant tumor, and it is also the main factors that cause treatment failure and poor prognosis. Clinical studies have shown that the number of platelets in patients with malignant tumor increased more significantly than that in benign tumor patients and healthy people, which indicate that platelet might be involved in the development process of tumor. Further study found that in the process of cancer spreading to blood, platelet could interact with tumor cells to form tumor emboli, helped tumor cells escape from immune surveillance, thus pro-moted the tumor metastasis. In recent years, related mechanisms on platelets in promoting tumor metastasis were revealed gradual-ly, and several targeted therapies based on platelets were also carried out. This paper reviews the role of platelet in mediating tumor metastasis by hematogenous spread and its mechanisms and discusses the therapy strategies that target platelet, which may provide references for follow-up research and clinical treat-ment.
ABSTRACT
The authors describe two cases of unusual intracranial metastatic adenoid cystic carcinomas. A 42-year-old woman had a right parietal epidural metastatic mass, presumed hematogenous, spread from a primary tumor in the parotid gland. In second case, a 32-year-old man had a intracranial metastatic adenoid cystic carcinoma mimicking calcified psammomatous meningioma on CT scans. We present the unusual cases with a review of relevant literature and a discussion of possible pathogenesis.
Subject(s)
Adult , Female , Humans , Adenoids , Carcinoma, Adenoid Cystic , Meningioma , Parotid Gland , Rabeprazole , Tomography, X-Ray ComputedABSTRACT
The authors describe two cases of unusual intracranial metastatic adenoid cystic carcinomas. A 42-year-old woman had a right parietal epidural metastatic mass, presumed hematogenous, spread from a primary tumor in the parotid gland. In second case, a 32-year-old man had a intracranial metastatic adenoid cystic carcinoma mimicking calcified psammomatous meningioma on CT scans. We present the unusual cases with a review of relevant literature and a discussion of possible pathogenesis.