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1.
Arq. bras. oftalmol ; 86(1): 71-73, Jan.-Feb. 2023. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403476

ABSTRACT

ABSTRACT We report an unusual case of fulminant endogenous Clostridium septicum panophthalmitis. A 74-year-old male patient presented with sudden amaurosis in the right eye, which in a few hours, evolved into an orbital cellulitis, endophthalmitis, anterior segment ischemia, and secondary perforation of the eye. A complete diagnostic study, which included cranial and orbital contrast-enhanced computed tomography scan, contrast-enhanced magnetic resonance imaging, blood cultures, and complete blood work, were performed. No causal agent was identified. Clostridium septicum infection caused fulminant gaseous panophthalmitis. Despite broad-spectrum antibiotic treatment, evisceration of the eyeball was necessary. The extension study showed a colon adenocarcinoma as the origin of the infection. Clostridium septicum panophthalmitis is a rare but aggressive orbital infection. This infection warrants the identification of a neoplastic process in the gastrointestinal tract in many cases not previously described.


RESUMO Este é o relato de um caso incomum de panoftalmite endógena fulminante por Clostridium septicum. Um paciente do sexo masculino, 74 anos, apresentou amaurose súbita no olho direito, que em poucas horas evoluiu para celulite orbitária, endoftalmite, isquemia do segmento anterior e perfuração secundária do olho. Foi realizado um estudo diagnóstico completo, que incluiu uma tomografia computadorizada com contraste cranial e orbital, um exame de ressonância magnética, hemocultura e hemograma completo. Nenhum agente causal foi identificado. A infecção por Clostridium septicum causou uma panoftalmite gasosa fulminante. Apesar do tratamento com antibióticos de amplo espectro, foi necessário eviscerar o globo ocular. O estudo de seguimento mostrou um adenocarcinoma de cólon como a origem da infecção. A panoftalmite por Clostridium septicum é um tipo raro, mas muito agressivo de infecção orbitária. Essa infecção deve sugerir a busca por um processo neoplásico no trato gastrointestinal, em muitos casos não diagnosticado anteriormente.

2.
Arch. Head Neck Surg ; 51: e20220008, Jan-Dec. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1401190

ABSTRACT

Adenoid cystic carcinoma (ACC) is a rare form of malignant neoplasm of the salivary glands, with slow growth and late symptoms. One of the challenges presented by this tumor is its high rate of metastasis, with tropism to the nervous system, liver and bones. Treatment is based on surgical resection of the tumor, radiotherapy, and chemotherapy ­ it varies depending on the condition of each patient. In view of the low frequency of ACC, this study aims to report a case of ACC in a female patient, with anatomopathological diagnosis of basaloid cell neoplasm

3.
Arch. Head Neck Surg ; 51: e20220014, Jan-Dec. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1401197

ABSTRACT

A 46-year-old female presented with dyspnea, dysphagia, and throat irritation with a diagnosis of tracheal metastasis resulting from a previously resected lung adenocarcinoma. Upper airway metastasis has a poor prognosis and is rarely observed. The clinical presentation manifests with cough and hemoptysis in most cases. Treatment includes surgical metastatic removal associated with combined radiotherapy and chemotherapy.

4.
Rev. cir. (Impr.) ; 74(4): 368-375, ago. 2022. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1407938

ABSTRACT

Resumen Objetivos: El sistema linfático del estómago es complejo y multidireccional, siendo difícil predecir el patrón de diseminación linfática en el adenocarcinoma (ADC) gástrico. Los objetivos de este trabajo son determinar si el analizar los grupos ganglionares de la pieza quirúrgica por separado tiene implicaciones en el estadiaje, además estudiar la afectación de diferentes grupos ganglionares. Materials y Método: Estudio observacional retrospectivo de pacientes intervenidos de gastrectomía y linfadenectomía con intención curativa por ADC en un hospital de referencia (2017-2021).,_Se han comparado aquellos pacientes cuya pieza quirúrgica se estudió en su totalidad (grupo A) con aquellos en los que se separaron los grupos ganglionares para su análisis (grupo B). En el grupo B, se ha analizado la afectación ganglionar de diferentes grupos ganglionares en base a la localización tumoral y el estadio pT. Resultados: Se incluyeron 150 pacientes. La media de ganglios analizados fue significativamente mayor cuando se separaron los grupos ganglionares (grupo B) (24,01 respecto a 20,49). La afectación ganglionar fue del 45,8%, 58,3% y 55,5% en los tumores de tercio superior, medio e inferior respectivamente, y los grupos difirieron en base a la localización tumoral. El riesgo de afectación ganglionar fue significativamente mayor y hubo más grupos ganglionares perigástricos afectos cuanto mayor era el estadio pT. Conclusiones: Separar los grupos ganglionares previo a su análisis aumenta el número de ganglios analizados mejorando el estadiaje ganglionar. Existen diferentes rutas de drenaje linfático dependiendo de la localización tumoral y la afectación ganglionar aumenta de forma paralela al estadio pT.


Objectives: The lymphatic system of the stomach is complex and multidirectional, making it difficult to predict the pattern of lymphatic spread in gastric adenocarcinoma (GAC). The aim of this paper is to determine if analyzing the lymph node groups of the surgical specimen separately has implications in the pathological staging, as well as to study the involvement rate of different lymph node groups. Material and Method: Retrospective observational study of patients who underwent curative intent gastrectomy and lymphadenectomy for GAC in a reference hospital (2017-2021). Those patients whose surgical specimen was studied as a whole (group A) were compared with those in whom the lymph node groups were separated by surgeons before analysis (group B). In group B, the involvement of different lymph node groups was analyzed based on tumor location and pT stage. Results: 150 patients were included. The mean number of lymph nodes analyzed was significantly higher when the lymph node groups were separately analyzed (group B) (24.01 compared to 20.49). Lymph node involvement was 45.8%, 58.3%, and 55.5% in tumors of the upper, middle, and lower third, respectively, and the involved groups differed depending on the tumor location. The higher the pT stage was, the risk of lymph node involvement was significantly higher and there were more perigastric lymph node groups affected. Conclusions: Separating lymph node groups prior to their analysis increases the number of lymph nodes analyzed and therefore improves lymph node staging. There are different lymphatic drainage routes depending on the tumor location and lymph node involvement increases in parallel with the pT stage.


Subject(s)
Humans , Male , Aged , Stomach Neoplasms/surgery , Adenocarcinoma/surgery , Retrospective Studies , Lymph Node Excision/methods , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Neoplasm Invasiveness/pathology , Neoplasm Staging
5.
An. Fac. Cienc. Méd. (Asunción) ; 55(2): 97-104, 20220801.
Article in Spanish | LILACS | ID: biblio-1380451

ABSTRACT

El adenocarcinoma pancreático ductal (APD) es la cuarta causa de muerte por cáncer y se proyecta que para el 2030 ocupe el segundo lugar. El pronóstico es sombrío, siendo la sobrevida menor a 9% en 5 años. Se consideró durante mucho tiempo a la resección quirúrgica como el único tratamiento curativo, sin embargo, sólo el 15 a 20% de los pacientes pueden ser beneficiados con la misma. La clasificación pre terapéutica más utilizada es la del National Comprehensive Cáncer Network (NCCN), basada en la relación del tumor con estructuras vasculares, clasificándolos en tumores "resecables", de resección límite "Borderlines" y "localmente avanzados". Se presenta el primer caso registrado en Paraguay de APD con infiltración de la Vena Mesentérica Superior (VMS) tratado con duodenopancreatectomía cefálica (DPC) asociada a resección vascular mayor.


Pancreatic ductal adenocarcinoma (PDA) is the fourth leading cause of cancer death and is projected to rank second by 2030. The prognosis is bleak, with survival being less than 9% in 5 years. For a long time, surgical resection was considered the only curative treatment, however, only 15 to 20% of patients can benefit from it. The most widely used pre-therapeutic classification is that of the National Comprehensive Cancer Network (NCCN), based on the relationship of the tumor with vascular structures, classifying them into "resectable", "borderline" and "locally advanced" tumors. We present the first registered case in Paraguay of PDA with infiltration of the Superior Mesenteric Vein (SMV) treated with cephalic duodenopancreatectomy (CPD) associated with major vascular resection.


Subject(s)
Adenocarcinoma , Pancreaticoduodenectomy , Proctectomy/methods
6.
Cir. Urug ; 6(1)jul. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1384406

ABSTRACT

Resumen: Los abscesos del psoas ilíaco secundarios a un tumor de colon fistulizado son excepcionales y potencialmente graves. La mayoría son adenocarcinomas de tipo mucinoso. Su tratamiento es complejo ya que, para lograr una resección oncológica pretendidamente curativa, es necesario realizar una resección ampliada con mayor morbimortalidad. Presentamos el caso de una paciente con un adenocarcinoma mucinoso de colon izquierdo fistulizado al músculo ilíaco y la pared anterolateral del abdomen en la que se realizó una resección multivisceral que incluyó el colon izquierdo, el músculo y la cresta ilíaca y parte de la pared anterolateral del abdomen.


Abstract: Iliopsoas abscess secondary to perforation of colon cancer is an extremely rare and potentially life-threatening condition. Most tumors are mucinous adenocarcinomas. Its treatment its complex, as most patients need radical extended resections to achieve good oncological results, which are in turn, graved with higher morbidity and mortality. We present the case of a patient with a left colon mucinous adenocarcinoma penetrating to the iliopsoas muscle and the anterolateral abdominal wall that required a multivisceral resection including left colon, iliac muscle and crest and part of the anterolateral abdominal wall.


Resumo: Abscessos do iliopsoas secundários a um tumor de cólon fistulizado são raros e potencialmente graves. A maioria são adenocarcinomas do tipo mucinoso. Seu tratamento é complexo, pois, para se obter uma ressecção oncológica supostamente curativa, é necessário realizar uma ressecção ampliada com maior morbimortalidade. Apresentamos o caso de um paciente com adenocarcinoma mucinoso de cólon esquerdo fistulizado para o músculo ilíaco e parede ântero-lateral do abdome no qual foi realizada ressecção multivisceral que incluiu cólon esquerdo, músculo e crista ilíaca e parte do a parede anterolateral do abdome.

7.
Medisan ; 26(3)jun. 2022. tab
Article in Spanish | LILACS-Express | LILACS, CUMED | ID: biblio-1405805

ABSTRACT

Introducción: El cáncer de esófago es una de las neoplasias más invasivas y significa una menor supervivencia, pues generalmente se diagnostica de manera tardía, sobre todo en personas de más de 60 años. Objetivo: Caracterizar a los ancianos con cáncer esofágico según variables clinicoepidemiológicas, endoscópicas e histológicas. Métodos: Se realizó un estudio observacional, descriptivo, de serie de casos, de 58 ancianos con cáncer de esófago atendidos en el Servicio de Endoscopia del Hospital Provincial Docente Clínico-Quirúrgico Saturnino Lora de Santiago de Cuba, durante el trienio 2015-2017. Resultados: En la serie predominaron los pacientes de 70-79 años de edad (43,1 %), fundamentalmente del sexo masculino (81,0 %), mientras que la localización más frecuente de las lesiones malignas fue el tercio distal (67,2 %) y el síntoma más relevante, la disfagia (86,2 %). En cuanto al análisis histológico, el adenocarcinoma resultó ser la forma más representativa (52,0 %). Conclusiones: A pesar de la vigilancia de los factores de riesgo asociados a la aparición del cáncer de esófago en Cuba, aún es detectado en etapas avanzadas, por lo que se debe enfatizar en la aplicación del método clínico con vistas a establecer un diagnóstico más precoz.


Introduction: The esophagus cancer is one of the most invasive neoplasms and it means a less survival, because it is generally diagnosed in a late way, mainly in people over 60 years. Objective: To characterize the elderly with esophagus cancer according to clinical epidemiological, endoscopic and histologic variables. Methods: An observational, descriptive, serial cases study, of 58 elderly with esophagus cancer was carried out; they were assisted in the Endoscopic Service of Saturnino Lora Teaching Clinical-Surgical Provincial Hospital in Santiago de Cuba, during the triennium 2015-2017. Results: In the series there was a prevalence of 70-79 years patients (43.1 %), fundamentally of the male sex (81.0 %), while the most frequent localization of the malignant lesions was the distal third (67.2 %) and the most outstanding symptom, the dysphagia (86.2 %). As for the histologic analysis, the adenocarcinoma was the most representative form (52.0 %). Conclusions: In spite of the surveillance of risk factors associated with the emergence of esophagus cancer in Cuba, it is still detected in advanced stages, reason why it should be emphasized in the application of the clinical method aimed at establishing an earlier diagnosis.


Subject(s)
Stomach Neoplasms , Endoscopy, Digestive System , Helicobacter pylori , Aged
8.
Rev. colomb. cir ; 37(3): 408-416, junio 14, 2022. tab
Article in Spanish | LILACS | ID: biblio-1378695

ABSTRACT

Introducción. A nivel mundial el cáncer colorrectal es la tercera causa de malignidad y la segunda causa de mortalidad por cáncer. En Colombia, tiene una prevalencia de 8,3 % dentro de las patologías neoplásicas, ubicándolo en el tercer lugar, después del cáncer de próstata y de mama, lo que lo cataloga como un problema de salud pública, por lo que es de gran importancia mantener datos actualizados acerca de su perfil epidemiológico. Métodos. Se realizó un estudio transversal en pacientes con cáncer colorrectal atendidos en el Hospital Universitario del Caribe, Cartagena, Colombia, durante el periodo 2015-2019. Se analizaron las variables sociodemográficas, clínicas, patológicas e histológicas. Resultados. Se encontraron un total de 268 pacientes atendidos por cáncer colorrectal, con predominio femenino en el (54,5 %) de los casos, y edad promedio de 62 años; con comorbilidades en 48,8 % y sintomatología de dolor abdominal en 56,7 %. El adenocarcinoma se encontró en el 82,1 % de los casos y la intervención más realizada fue la hemicolectomía derecha. Conclusión. El perfil epidemiológico del cáncer colorrectal encontrado en este estudio concuerda con los hallazgos de la literatura médica mundial, comprometiendo especialmente mujeres en nuestra institución.


Introduction. Worldwide, colorectal cancer is the third leading cause of malignancy and the second leading cause of cancer mortality. In Colombia, it has a prevalence of 8.3% within neoplastic pathologies, placing it in third place, after prostate and breast cancer, which classifies it as a public health problem, making it of great importance to maintain up-to-date data on its epidemiological profile. Methods. A cross-sectional study was carried out in patients with colorectal cancer treated at the Hospital Universitario del Caribe, Cartagena, Colombia, during the period 2015-2019. Sociodemographic, clinical, pathological and histological variables were analyzed. Results. A total of 268 patients treated for colorectal cancer were found, with a female predominance of 54.5% and an average age of 62 years; comorbidities in 48.8%, and symptoms of abdominal pain in 56.7%. Adenocarcinoma was found in 82.1% of cases and the most performed intervention was right hemicolectomy. Conclusion. The epidemiological profile of colorectal cancer found in this study is consistent with the findings of the world medical literature, especially involving women in our institution.


Subject(s)
Humans , Colon , Neoplasms , Rectum , Adenocarcinoma , Epidemiology
9.
Cogit. Enferm. (Online) ; 27: e82644, Curitiba: UFPR, 2022.
Article in Portuguese | LILACS-Express | LILACS, BDENF | ID: biblio-1394319

ABSTRACT

RESUMO Objetivo: descrever, na perspectiva do enfermeiro, as causas de abandono das usuárias em tratamento do adenocarcinoma cervical e analisar as propostas para diminuir esse abandono. Método: o estudo é descritivo, qualitativo, do tipo investigação narrativa. Participaram sete enfermeiros assistencialistas, atuantes em uma unidade de alta complexidade oncológica, na cidade de Macapá, capital do estado do Amapá, Brasil. O estudo foi realizado no período de três a 20 de dezembro de 2019. Os dados foram submetidos à análise temática categorial. Resultados: emergiram duas categorias: principais causas de abandono das usuárias em tratamento do adenocarcinoma cervical e estratégias do enfermeiro para a diminuição do abandono do tratamento pelas usuárias. Conclusão: para favorecer o resgate das usuárias, os enfermeiros participantes propõem consulta de Enfermagem e um plano de ação multiprofissional, respeitando as singularidades de cada mulher.


ABSTRACT Objective: to describe, from the perspective of nurses, the causes of dropout of users in treatment for cervical adenocarcinoma and analyze the proposals to reduce this dropout. Method: the study is descriptive, qualitative, of narrative research type. Seven care nurses, working in a high complexity oncology unit in the city of Macapá, capital of the state of Amapá, Brazil, participated. The study was conducted in the period from December three to 20, 2019. Data were submitted to categorical thematic analysis. Results: two categories emerged: main causes of dropout of users in treatment for cervical adenocarcinoma and nurse strategies for the reduction of treatment dropout by users. Conclusion: to promote the rescue of the users, the participating nurses propose a Nursing consultation and a multi-professional action plan, respecting the singularities of each woman.


RESUMEN Objetivo: describir, desde el punto de vista del enfermero, las causas de abandono de las usuarias en el tratamiento del adenocarcinoma de cuello uterino y analizar las propuestas para disminuir dicho abandono. Método: El estudio es una investigación descriptiva, cualitativa y narrativa. Participaron siete enfermeros asistenciales, que trabajan en una unidad de oncología de alta complejidad en la ciudad de Macapá, capital del estado de Amapá, Brasil. El estudio se realizó en el periodo comprendido entre el 3 y el 20 de diciembre de 2019. Los datos se sometieron a un análisis categórico temático. Resultados: surgieron dos categorías: principales causas de abandono de las usuarias en el tratamiento del adenocarcinoma cervical y estrategias de los enfermeros para reducir el abandono del tratamiento por parte de las usuarias. Conclusión: para favorecer el resguardo de las usuarias, los enfermeros participantes proponen una consulta de Enfermería y un plan de acción multiprofesional, resaltando las singularidades de cada mujer.

10.
Int. j. high dilution res ; 21(2): 19-19, May 6, 2022.
Article in English | LILACS, HomeoIndex | ID: biblio-1396733

ABSTRACT

Apocrine gland carcinomas are rare malignant neoplasms that occur in cats. Available treatment is surgical, would lead to total ablation of the external acoustic meatus and usually recurrent [1,2].Methodology:In December 2020, a homeopathic consultation of the feline, male, Persian, 13 years old, a history of the disease was reported, which started in 2015, adding up to six recurrences of tumor processes in the eyelids and recent formation in the left ear canal.The result of the histopathological examination confirmed apocrine adenocarcinoma.Prior to homeopathic treatment, tumors recurred despite surgical interventions and prophylactic treatment with trichloracetic acid.However, remaining formations were noted in the eyelids and ear canal. It has a rounded blackened shape in the upper right eyelid measuring 0.4 cm and the lower 0.2 cm, round. In the left ear canal, around 1.6 cm, in addition to 4 points scattered in the ear folds. Homeopathic treatment was started for two months with Arsenicum album30 cH, twice a day; Carcinosinum 200 cH, once a day, and complex containing Avena sativa4 cH, Echinacea angustifolia4 cH, Conium maculatum6 cH, Thuja officinalis6 cH and Silicea terra6 cH, four times a day. Every two months, the clinical picturewas reassessed, potenciesand frequencies readjusted.In a few months,there was complete remission of the tumor, recovery of welfare, and improvement in mood and appetite. The free and informed consent term was signed. There was no recurrence of tumors until May2022. Conclusion:This study proved to be effective, documented with photos and exams. Approaching a rare case may provide a new therapeutic possibility. The credibility of quality homeopathic case reports has been increasing due to methodological requirements using tools developed in recent studies.


Subject(s)
Animals , Adenocarcinoma, Papillary/therapy , Homeopathic Therapeutics , Felidae
11.
Int. j. high dilution res ; 21(1): 3-3, May 6, 2022.
Article in English | LILACS, HomeoIndex | ID: biblio-1396609

ABSTRACT

Considering that there are few published studies that specifically address the exclusive use of Carcinosinumin different potencies and, most of them focused on genotypic and clinical effects, the present study was proposed to identify possible phenotypic changes, including viability, expression of HER-2 and metastatic abilities, using 4T1 cells in vitroas a model. Carcinosinum was tested in different homeopathic potencies (12cH; 30cH; 200cH) mechanically prepared using sterile pure water. The time space between preparing the potencies and using them was 24 hours.The final dilutions were inserted into the culture medium in a volume equal to 10%, at the time of cell seeding. The same succussed vehicle used to prepare the drugs (70% ethanol) diluted 1:100 in sterile pure water was used as control. All treated cells were cultured in 25 mL flasks, with cell density of 5 x 105cells/mL. After 24 hours of treatment, cells were analyzed for apoptosis index using Annexin V kit and the Countess® system. The morphology of 4T1 cells was monitored by staining cell smears with hematoxylin-eosin and Giemsa methods. HER-2 expression was assessed by immunocytochemistry and metalloproteinase activity was assessed by zymography. The determination of the cytokine profile was performed using Cytometric Bead Array (CBA). The samples were evaluated in quadruplicate and the data were analyzed by one-way ANOVA. Carcinosinum30cH presented the highest apoptotic index and reduction of MMP-9-Pro expression; Carcinosinum200cH produced the highest positivity for HER-2 and no specific effect was seen after the treatment with Carcinosinum12cH. No change in cytokine expression was seen among treatments. We conclude that Carcinosinum30cH and 200cH can change phenotypic features important totumor development in vitro. The clinical meaning of these data deserves further investigation.


Subject(s)
Adenocarcinoma/chemistry , Carcinosinum , Basic Homeopathic Research
12.
MedUNAB ; 25(1): 52-58, 202205.
Article in Spanish | LILACS | ID: biblio-1372542

ABSTRACT

Introducción. El dolor abdominal agudo es una causa frecuente de consulta en los servicios de urgencias. Su incidencia es alrededor del 5%, de los cuales el 10%- 25% de los pacientes requieren tratamiento quirúrgico. Las neoplasias apendiculares primarias son infrecuentes, actualmente representan 1% de las neoplasias malignas de origen gastrointestinal. Existe un predominio en mujeres y se debe sospechar en pacientes con factores de riesgo. El objetivo es entender la importancia del diagnóstico oportuno en el abordaje del paciente con dolor abdominal agudo. Presentación del caso. Mujer con cuadro clínico de 5 días de dolor abdominal, con hallazgo en tomografía de abdomen de marcada dilatación quística del apéndice cecal con calcificaciones lineales y nodulares en la pared y su interior. Intraoperariamente, se realizó hemicolectomía derecha con resultado histológico de neoplasia mucinosa del apéndice (adenoma serrado) con pérdida de la muscularis mucosae, catalogándolo como adenocarcinoma de bajo grado. Discusión. Los tumores apendiculares representan el 1% de las neoplasias malignas de origen gastrointestinal, son un hallazgo incidental (0.7-1.4%) en los procedimientos de apendicectomía. El diagnóstico es histopatológico y el pronóstico se relaciona con la clasificación. Es importante conocer, identificar y sospechar esta patología dada su infrecuencia, con lo cual se puede mejorar el pronóstico en los pacientes. Conclusión. Los tumores apendiculares son infrecuentes, los cuales deben ser incluidos en el grupo de patologías causantes de dolor abdominal agudo.


Introduction. Acute abdominal pain is a frequent cause of consultation to emergency services. Its incidence is about 5%, of which 10%-25% of patients require surgical treatment. Primary appendiceal neoplasms are infrequent. They currently represent 1% of malignant neoplasms of gastrointestinal origin. They are predominant in women and must be suspected in patients with risk factors. The objective is to understand the importance of timely diagnosis in approaching patients with acute abdominal pain. Case report. A woman with clinical condition of 5 days of abdominal pain. Marked cystic dilation of the cecal appendix with linear and nodular calcifications on its wall and interior found in a tomography of the abdomen. Intraoperatively, a right hemicolectomy was performed with a histological result of mucinous neoplasm of the appendix (serrated adenoma) with loss of the muscularis mucosae, classifying it as a low grade adenocarcinoma. Discussion. Appendiceal tumors represent 1% of malignant neoplasms of gastrointestinal origin, with an incidental finding (0.7-1.4%) in appendectomy procedures. The diagnosis is histopathological, and prognosis is related to its classification. It is important to know, identify and suspect this pathology due to its infrequency, which can improve the patient's prognosis. Conclusion. Appendiceal tumors are infrequent and should be included in the group of pathologies that cause acute abdominal pain.


Introdução. A dor abdominal aguda é causa frequente de consulta nos serviços de emergência. Sua incidência é em torno de 5%, dos quais entre 10% e 25% dos pacientes necessitam de tratamento cirúrgico. As neoplasias primárias de apêndice são raras, representando atualmente 1% das neoplasias malignas de origem gastrointestinal. Há predominância em mulheres e deve-se suspeitar em pacientes com fatores de risco. O objetivo é compreender a importância do diagnóstico oportuno na abordagem de pacientes com dor abdominal aguda. Relato de caso. Mulher com quadro clínico de dor abdominal por 5 dias, com achado tomográfico de abdome de dilatação cística acentuada do apêndice cecal com calcificações lineares e nodulares na parede e seu interior. No intraoperatório foi realizada hemicolectomia direita com resultado histológico de neoplasia mucinosa de apêndice (adenoma serrilhado) com perda da muscularis mucosae, classificando-a como adenocarcinoma de baixo grau. Discussão. Os tumores apendiculares representam 1% das neoplasias malignas de origem gastrointestinal, sendo um achado incidental (0.7-1.4%) em procedimentos de apendicectomia. O diagnóstico é histopatológico e o prognóstico está relacionado à classificação. É importante conhecer, identificar e suspeitar desta patologia dada a sua infrequência, o que pode melhorar o prognóstico dos pacientes. Conclusão. Os tumores apendiculares são pouco frequentes e devem ser incluídos no grupo de patologias que causam dor abdominal aguda.


Subject(s)
Adenocarcinoma , Appendix , Abdominal Pain , Diagnosis, Differential , Intestinal Neoplasms
13.
Radiol. bras ; 55(3): 193-198, May-june 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1387092

ABSTRACT

Abstract Mucoceles of the appendix are rare and can have quite variable imaging and clinical presentations, sometimes mimicking an adnexal mass. The underlying cause can be neoplastic or non-neoplastic. The typical imaging appearance of a mucocele of the appendix is that of a cystic structure with a tubular morphology. This structure is defined by having a blind-ending and being contiguous with the cecum. Radiologists should be familiar with key anatomical landmarks and with the various imaging features of mucoceles of the appendix, in order to provide a meaningful differential diagnosis of a lesion in the right lower abdominal quadrant. In addition, a neoplastic mucocele can rupture, resulting in pseudomyxoma peritonei, which will change the prognosis dramatically. Therefore, prompt diagnostic imaging is crucial.


Resumo Mucoceles do apêndice são raras e podem ter uma apresentação clínica e imagiológica bastante variável, por vezes mimetizando patologia anexial. As causas subjacentes podem ser neoplásicas ou não neoplásicas. O aspecto de imagem típico de mucoceles do apêndice é o de uma estrutura de natureza cística com morfologia tubular. Esta estrutura deverá terminar "em fundo cego" e ser contígua com o ceco. Os radiologistas devem estar familiarizados com os pontos anatômicos de referência e com as diferentes características imagiológicas de mucoceles do apêndice, de modo a fornecer um adequado diagnóstico diferencial de uma lesão localizada no quadrante abdominal inferior direito. Para além disso, uma mucocele neoplásica pode sofrer ruptura, resultando em pseudomixoma peritoneal, o que altera drasticamente o prognóstico. Assim, o diagnóstico por imagem em tempo útil é crucial.

14.
Rev. colomb. gastroenterol ; 37(1): 99-102, Jan.-Mar. 2022. graf
Article in English, Spanish | LILACS | ID: biblio-1376912

ABSTRACT

Abstract Introduction: We describe the case of a patient with appendiceal metastasis as the first manifestation of a cholangiocarcinoma. Main symptoms: Abdominal pain, jaundice, hyporexia, and choluria. Methods and results: We documented an appendiceal plastron histologically compatible with metastatic appendiceal adenocarcinoma, common hepatic duct stricture, and a suspected cholangiocarcinoma, later corroborated by endoscopic retrograde cholangiopancreatography. Conclusions: Metastatic appendiceal tumors are an infrequent and poorly studied manifestation, whereas those secondary to bile duct neoplasia have rarely been reported in the literature.


Resumen Introducción: se describe el caso de una paciente con una metástasis apendicular como primera manifestación encontrada de un colangiocarcinoma. Síntomas principales: expresado con dolor abdominal, ictericia, hiporexia y coluria. Métodos y resultados: se documentó un plastrón apendicular histológicamente compatible con adenocarcinoma apendicular metastásico, estrechez del conducto hepático común, con alta sospecha de colangiocarcinoma, corroborado luego con la realización de una colangiopancreatografía retrógrada endoscópica. Conclusiones: los tumores apendiculares metastásicos son una presentación infrecuente y poco estudiada, donde los secundarios a neoplasia de vía biliar se han reportados de forma muy escasa en la literatura.


Subject(s)
Appendicitis , Cholangiopancreatography, Endoscopic Retrograde , Cholangiocarcinoma , Signs and Symptoms , Biliary Tract Neoplasms , Abdominal Pain , Jaundice , Neoplasm Metastasis
15.
J. coloproctol. (Rio J., Impr.) ; 42(1): 54-58, Jan.-Mar. 2022. tab, ilus
Article in English | LILACS | ID: biblio-1375761

ABSTRACT

Introduction: Tissue factor (TF) expression has been described in various neoplasms and was correlated with angiogenesis and metastases. Objectives: To describe TF expression in colorectal cancers, correlating it with microvessel density and clinical and pathological variables. Methods: Immunohistochemistry was used to determine TF expression and microvessel density. The Student t-test was used to compare high and low TF expression with microvessel density andwith age. The chi-squared test was used for other comparisons, and Kaplan-Meier curves were used for survival analyses. Results: Forty-three patients were operated with curative intent. Their mean age was 58.1±12.6 years old, and 62.8% were male. The rectum was the most common location (60,4%), and most tumors reached the serosa and peri-intestinal fat (72.1%). Lymph nodes were positive in 46.5%, and 72.1% of the tumors were moderately differentiated adenocarcinomas. Death occurred in 27.6±12.8months in 51.1% of the patients who had recurrence. Tissue factor expression was intense in 88.4%. There was a positive correlation between TF expression and microvessel density (p=0.02), and between TF and older age (p< 0.01). There was no correlation between TF expression and other variables (gender, histological type, penetration into the intestinal wall, and lymphatic and systemic metastases). Tissue factor expression did not correlate with survival. Conclusion: Tissue factor expression correlated with increased microvessel density and older age. Further studies are necessary to ascertain the clinical relevance of TF in colorectal cancer. (AU)


Subject(s)
Humans , Male , Female , Rectal Neoplasms , Adenocarcinoma , Colonic Neoplasms , Blood Coagulation , Thromboplastin , Microvascular Density , Neovascularization, Pathologic
16.
Rev. cir. traumatol. buco-maxilo-fac ; 22(1): 26-29, jan.-mar. 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1391750

ABSTRACT

Objetivos: O carcinoma adenoide cístico é uma lesão rara e agressiva. O presente trabalho visa relatar o caso de uma ressecção de carcinoma adenoide cístico e manutenção do arcabouço ósseo realizado por meio de sonda de Foley insuflada com soro fisiológico. Relato do caso: Um paciente submetido a ressecação de um carcinoma adenoide cístico em maxilla com destruição de soalho de órbita foi relatado. O caso foi realizado no Hospital Josina Machel em Luanda, Angola. A região apresenta uma considerável escassez de materiais de fixação e outros mais, o que impossibilita reconstruções maxilofaciais com a excelência necessária. A realização de enxertos microvascularizados ou implantes customizados torna-se inviável devido aos custos e tecnologia dispendida para tal. Conclusão: A sonda de Foley mostra-se como uma alternativa viável nos casos de reconstrução de terço médio de face com envolvimento de seio maxilar e soalho de órbita em locais de mais difícil acesso... (AU)


Objectives: Adenoid cystic carcinoma is a rare and aggressive lesion. The present work aims to report the case of a resection of adenoid cystic carcinoma and maintenance of the bone framework performed using a Foley catheter insufflated with saline solution. Case report: A patient who underwent resection of an adenoid cystic carcinoma in the maxilla with destruction of the orbital floor was reported. The case was carried out at Hospital Josina Machel in Luanda, Angola. The region has a considerable shortage of fixation materials and others, which makes maxillofacial reconstructions with the necessary excellence impossible. The realization of microvascularized grafts or customized implants becomes unfeasible due to the costs and technology used for this purpose. Conclusion: The Foley catheter is a viable alternative in cases of reconstruction of the middle third of the face with involvement of the maxillary sinus and orbital floor in areas that are more difficult to access... (AU)


Objetivos: El carcinoma adenoide quístico es una lesión rara y agresiva. El presente trabajo tiene como objetivo reportar el caso de una resección de carcinoma quístico adenoide y mantenimiento de la estructura ósea realizada mediante sonda de Foley insuflada con suero fisiológico. Caso clínico: Se reporta un paciente que fue sometido a resección de un carcinoma adenoide quístico en el maxilar con destrucción del piso orbitario. El caso se llevó a cabo en el Hospital Josina Machel de Luanda, Angola. La región tiene una escasez considerable de materiales de fijación y otros, lo que imposibilita las reconstrucciones maxilofaciales con la excelencia necesaria. La realización de injertos microvascularizados o implantes personalizados se vuelve inviable por los costes y la tecnología utilizada para tal fin. Conclusión: La sonda de Foley es una alternativa viable en los casos de reconstrucción del tercio medio de la cara con afectación del seno maxilar y suelo orbitario en zonas de más difícil acceso... (AU)


Subject(s)
Humans , Female , Middle Aged , Orbit/surgery , Orbit/pathology , Maxillary Sinus Neoplasms , Jaw Neoplasms , Carcinoma, Adenoid Cystic , Maxillary Sinus , Wounds and Injuries
17.
Rev. inf. cient ; 101(1)feb. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409513

ABSTRACT

RESUMEN Introducción: Los tumores del parénquima renal representan aproximadamente del 2-3 % de los tumores del adulto y el 85 % de los tumores primarios del riñón. Se observa una incidencia aumentada de tumores del parénquima renal de forma variable en el mundo y en Cuba en los últimos años. Es en todo el mundo el cáncer más mortal de las vías urinarias. Objetivo: Identificar la incidencia y características clínico-epidemiológicas e histopatológicas del carcinoma de células renales en la provincia de Santiago de Cuba. Método: Se realizó un estudio descriptivo y transversal sobre el adenocarcinoma renal en la provincia de Santiago de Cuba, en una serie de 88 pacientes desde el 1ro. de enero de 2012 a 1ro. de enero de 2017. El diagnóstico se fundamentó en los estudios histopatológicos de los pacientes intervenidos quirúrgicamente y fallecidos por esta enfermedad. Se estudiaron las variables: incidencia, edad, sexo, factores de riesgo, síntomas y signos, tipo histológico y estadificación. Resultados: Fue más frecuente entre la quinta y sexta décadas de la vida y en el sexo masculino. El tabaquismo fue el principal factor de riesgo. Más del 50 % de los casos fue diagnosticado de forma incidental y asintomática, aunque aparecieron síntomas como el dolor en flanco, hematuria, síntomas generales y masa abdominal palpable. El tumor de células claras resultó la variedad histológica que más afectó. Se diagnosticaron principalmente en estadio T3a. Conclusiones: Médicos de familia, clínicos, urólogos y radiólogos participan en el diagnóstico del carcinoma renal, por lo que es importante que se tenga en cuenta esta entidad ya que se pude presentar de la manera más insospechada.


ABSTRACT Introduction: Renal parenchymal tumors account for approximately 2-3% of tumors in adults' patients and in turn the 85% of primary kidney tumors. An increased incidence of renal parenchymal tumors has been observed around the world and in Cuba in the last years. It is the most deadly cancer in the urinary tract worldwide. Objective: To identify incidence and the clinical-epidemiological and histopathological features of renal cell carcinoma in the province of Santiago de Cuba. Method: A descriptive and cross-sectional study was conducted concerning renal adenocarcinoma in 88 patients from Santiago de Cuba. Period of study was from January 1, 2012 throughout January 1, 2017. The diagnosis was based on histopathological studies from patients who underwent surgery and died due to this disease. Variables studies were as follow: incidence, age, sex, risk factors, symptoms and signs, histologic type and cancer staging. Results: It was more frequent between the fifth and sixth decades of life and in males. Smoking was the main risk factor. More than 50 % of cases were diagnosed incidentally and asymptomatically, although symptoms such as flank pain, hematuria, general symptoms and palpable abdominal mass appeared. Clear cell tumor was the histologic variety most affected. They were diagnosed mainly in stage T3a. Conclusions: Family physicians, clinicians, urologists and radiologists are involved in the diagnosis of renal carcinoma, so it is important to be aware of this illness since it can present in the most unsuspected way.


RESUMO Introdução: Os tumores do parênquima renal representam aproximadamente 2-3% dos tumores adultos e 85% dos tumores renais primários. Um aumento da incidência de tumores do parênquima renal tem sido observado de forma variável no mundo e em Cuba nos últimos anos. É o câncer do trato urinário mais mortal em todo o mundo. Objetivo: Identificar a incidência e as características clínico-epidemiológicas e histopatológicas do carcinoma de células renais na província de Santiago de Cuba. Método: Foi realizado um estudo descritivo e transversal sobre adenocarcinoma renal na província de Santiago de Cuba, em uma série de 88 pacientes de 1º de janeiro de 2012 a 1º de janeiro de 2017. O diagnóstico foi baseado em estudos histopatológicos de pacientes que passou por uma cirurgia e morreu dessa doença. As variáveis estudadas foram: incidência, idade, sexo, fatores de risco, sintomas e sinais, tipo histológico e estadiamento. Resultados: Foi mais frequente entre a quinta e sexta décadas de vida e no sexo masculino. O tabagismo foi o principal fator de risco. Mais de 50% dos casos foram diagnosticados de forma incidental e assintomática, embora tenham surgido sintomas como dor no flanco, hematúria, sintomas gerais e massa abdominal palpável. O tumor de células claras foi a variedade histológica que mais acometia. Eles foram diagnosticados principalmente no estágio T3a. Conclusões: Médicos de família, clínicos, urologistas e radiologistas participam no diagnóstico do carcinoma renal, pelo que é importante ter em conta esta entidade, uma vez que pode apresentar-se da forma mais inesperada.

18.
Rev. venez. cir ; 75(1): 49-52, ene. 2022. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1391726

ABSTRACT

Los Schwannomas son tumores derivados de las células de Schwann de las vainas de los nervios periféricos. Se pueden localizar en cualquier región anatómica que contenga tejido nervioso periférico, siendo más frecuentes en la región craneofacial y las extremidades. Los Schwannomas pancreáticos son entidades sumamente infrecuentes de las cuales solo se han descrito 68 casos a nivel mundial. En el presente trabajo se presenta el caso de un paciente con hallazgo incidental de tres tumores sincrónicos dentro de los cuales se encuentra un Schwannoma pancreático.Caso clínico : Paciente femenino de 66 años de edad con antecedente de diabetes mellitus tipo 1 y enfermedad diverticular pancolónica quien acude presentando cuadro clínico compatible con absceso lumbar izquierdo. Se realiza TC de abdomen y pelvis con doble contraste que evidencia extensa área de colección heterogénea en región retroperitoneal que diseca hacia región lumbar y glútea izquierda, además de la presencia de tumor hipodenso de bordes lobulados en mesogastrio. Se realiza colonoscopia que reporta lesión exofítica ulcerada en unión rectosigmoidea. El resto de paraclínicos y estudios de extensión se encontraban dentro de límites normales. Se decide resolución quirúrgica mediante drenaje percutáneo de absceso y laparotomía exploradora. Informe histopatológico: cistoadenoma seroso microquístico de cuerpo de páncreas, Schwannoma de cola de páncreas y adenocarcinoma moderadamente diferenciado de colon sigmoides.Conclusión : Los Schwannomas pancreáticos son entidades sumamente infrecuentes que pueden presentarse con una amplia variedad de manifestaciones clínicas, sin embargo, deben tenerse en cuenta como posible diagnóstico diferencial ante el hallazgo de un tumor pancreático(AU)


Schwannomas, also called Neurilemmomas or Neurinomas, are tumors derived from Schwann cells of the peripheral nerve sheaths. They can be located in any anatomical region that contains peripheral nervous tissue, being more frequent in the craniofacial region and the extremities. Pancreatic Schwannomas are extremely rare entities of which only 68 cases have been described worldwide. In the present study we present the case of a patient with an incidental finding of three synchronous tumors, including a pancreatic Schwannoma.Clinical case : A 66-year-old female patient with a history of type 1 diabetes mellitus and pancolonic diverticular disease who presented with symptoms compatible with left lumbar abscess. A double-contrast CT of the abdomen and pelvis was performed, which revealed a large area of heterogeneous collection in the retroperitoneal region that dissected towards the left lumbar and gluteal region, in addition to the presence of a hypodense tumor with lobulated borders in the mesogastrium. A colonoscopy was performed, which reported an ulcerated exophytic lesion at the rectosigmoid junction. The rest of the paraclinical and extension studies were within normal limits. Surgical resolution is decided by percutaneous abscess drainage and exploratory laparotomy. Histopathological report: microcystic serous cystadenoma of the body of the pancreas, Schwannoma of the pancreas tail, and moderately differentiated adenocarcinoma of the sigmoid colon.Conclusion : Pancreatic Schwannomas are extremely rare entities that can present with a wide variety of clinical manifestations, however, they should be taken into account as a possible differential diagnosis when a pancreatic tumor is found(AU)


Subject(s)
Humans , Female , Aged , Schwann Cells/pathology , Neurofibrosarcoma , Carcinoma, Pancreatic Ductal , Diverticular Diseases , Colonoscopy , Colon , Cystadenoma, Serous , Nerve Tissue
19.
Rev. gastroenterol. Perú ; 42(1): 41-44, ene.-mar. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409359

ABSTRACT

RESUMEN El corioadenocarcinoma gástrico primario (PGC) constituye menos del 1% de todos los cánceres gástricos; es más común en los hombres. Aproximadamente un tercio de los pacientes ya tienen enfermedad metastásica en el momento del diagnóstico. Presentamos el caso de un paciente varón de 70 años, diagnosticado de adenocarcinoma gástrico en antropíloro, al que se le realizó gastrectomía radical distal. El diagnóstico anatomopatológico muestra un adenocarcinoma, con un 85% de diferenciación coriocarcinomatosa, un 10% con áreas de adenocarcinoma tubular y el 5% restante por componente sugestivo de tumor de saco vitelino. Nuestro paciente logró una sobrevida de 5 meses después de la cirugía, durante este tiempo estuvo en seguimiento por medicina oncológica con quimioterapia. Esta enfermedad sigue teniendo un pronóstico sombrío; menor a 6 meses.


ABSTRACT Primary gastric chorioadenocarcinoma (PGC) constitutes less than 1% of all gastric cancers; it is more common in men. Approximately one third of patients already have metastatic disease at the time of diagnosis. We present the case of a 70-yearold male patient, diagnosed as gastric adenocarcinoma in anthropylorus, who underwent radical distal gastrectomy. The pathological diagnosis shows an adenocarcinoma, with 85% choriocarcinomatous differentiation, 10% with areas of tubular adenocarcinoma and the remaining 5% per component suggestive of yolk sac tumor. Our patient achieved a survival of 5 months after surgery, during this time he was followed up by oncology medicine with chemotherapy. This disease continues to have a gloomy prognosis; less than 6 months.

20.
ABCD arq. bras. cir. dig ; 35: e1684, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1402853

ABSTRACT

ABSTRACT BACKGROUND: The enzyme methylenetetrahydrofolate reductase is engaged in DNA synthesis through folate metabolism. Inhibiting the activity of this enzyme increases the susceptibility to mutations, and damage and aberrant DNA methylation, which alters the gene expression of tumor suppressors and proto-oncogenes, potential risk factors for esophageal cancer. AIMS: This study aimed to investigate the association between methylenetetrahydrofolate reductase 677C>T and methylenetetrahydrofolate reductase 1298A>C polymorphisms and susceptibility to esophageal cancer, by assessing the distribution of genotypes and haplotypes between cases and controls, as well as to investigate the association of polymorphisms with clinical and epidemiological characteristics and survival. METHODS: A total of 109 esophageal cancer patients who underwent esophagectomy were evaluated, while 102 subjects constitute the control group. Genomic DNA was isolated from the peripheral blood buffy coat followed by amplification by polymerase chain reaction and real-time analysis. Logistic regression was used to assess associations between polymorphisms and the risk of developing esophageal cancer. RESULTS: There was no association for methylenetetrahydrofolate reductase 677C>T and methylenetetrahydrofolate reductase 1298A>C polymorphisms and haplotypes, with esophageal cancer susceptibility. Esophageal cancer patients carrying methylenetetrahydrofolate reductase 677TT polymorphism had higher risk of death from the disease. For polymorphic homozygote TT genotype, the risk of death significantly increased compared to wild-type genotype methylenetetrahydrofolate reductase 677CC (reference) cases (p=0.045; RR=2.22, 95%CI 1.02-4.83). CONCLUSIONS: There was no association between methylenetetrahydrofolate reductase 677C>T and methylenetetrahydrofolate reductase 1298A>C polymorphisms and esophageal cancer susceptibility risk. Polymorphic homozygote genotype methylenetetrahydrofolate reductase 677TT was associated with higher risk of death after surgical treatment for esophageal cancer.


RESUMO RACIONAL: A enzima metilenotetrahidrofolato redutase está envolvida na síntese de DNA através do metabolismo do folato. A inibição da sua atividade aumenta a suscetibilidade a mutações, danos e metilação aberrante do DNA, o que altera a expressão gênica de supressores tumorais e proto-oncogenes, potenciais fatores de risco para câncer de esôfago. OBJETIVOS: Investigar a associação entre os polimorfismos metilenotetrahidrofolato redutase 677C>T e metilenotetrahidrofolato redutase 1298A>C e a suscetibilidade ao câncer de esôfago, avaliando a distribuição de genótipos e haplótipos entre casos e controles, bem como investigar a associação de polimorfismos com características clínicas, epidemiológicas e sobrevida. MÉTODOS: Avaliaram-se 109 pacientes com câncer de esôfago submetidos à esofagectomia, enquanto 102 indivíduos constituaram o grupo controle. O DNA genômico do sangue periférico foi isolado e submetido à amplificação por reação em cadeia da polimerase em tempo real. A associação entre os polimorfismos e o risco de desenvolver câncer de esôfago foi avaliada por regressão logística. RESULTADOS: Não houve associação dos polimorfismos e haplótipos metilenotetrahidrofolato redutase 677C>T e metilenotetrahidrofolato redutase 1298A>C com a suscetibilidade ao câncer de esôfago. Pacientes com câncer de esôfago portadores do polimorfismo metilenotetrahidrofolato redutase 677TT apresentaram maior risco de morte pela doença. Para o genótipo TT homozigoto polimórfico, o risco de morte aumentou significativamente em comparação com os casos do genótipo selvagem metilenotetrahidrofolato redutase 677CC (referência) (p=0,045; RR=2,22, IC95% 1,02-4,83). CONCLUSÕES: Não houve associação entre os polimorfismos metilenotetrahidrofolato redutase 677C>T e metilenotetrahidrofolato redutase 1298A>C e o risco de suscetibilidade ao câncer de esôfago. O genótipo homozigoto polimórfico metilenotetrahidrofolato redutase 677TT associou-se a um maior risco de óbito após tratamento cirúrgico para câncer de esôfago.

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