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1.
Medicina (B.Aires) ; 81(4): 652-655, ago. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346521

ABSTRACT

Resumen La hemofilia adquirida A es un desorden hemorrágico inusual de origen autoinmune que resulta en la formación de autoanticuerpos dirigidos contra el factor VIII de la coagulación. Estos autoanticuer pos pueden actuar neutralizando parcial o completamente la activación o función del factor, o también pueden acelerar su eliminación de la circulación. La incidencia mundial de la enfermedad es de 1.5 casos por millón de habitantes por año. En cerca del 50% de los pacientes se puede detectar una enfermedad subyacente que se presume responsable de la producción de los autoanticuerpos. Se presenta el caso de un varón con hemofilia adquirida A, en contexto de adenocarcinoma de la ampolla de Vater.


Abstract Acquired hemophilia A is an unusual bleeding disorder of autoimmune origin resulting in the formation of autoantibodies directed against coagulation factor VIII. These autoantibodies can act by partially or completely neutralizing the activation or function of the factor, or they can also accelerate its elimination from the circulation. The global incidence of the disease is 1.5 cases per million inhabitants per year. In nearly 50% of cases, an underlying disease that is presumed responsible to produce autoantibodies can be detected. We report a case with acquired hemophilia A, in a patient with Vater's ampulla adenocarcinoma.


Subject(s)
Humans , Ampulla of Vater , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Common Bile Duct Neoplasms , Hemophilia A/complications , Hemophilia A/diagnosis , Autoantibodies
2.
Ciencia Tecnología y Salud ; 8(2): 166-183, 2021. il 27 c
Article in Spanish | LILACS-Express | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1353093

ABSTRACT

El cáncer gástrico (CG) es la neoplasia del tubo digestivo más prevalente en el mundo, asociada a factores genéticos del hospedero y externos, como infección por Helicobacter pylori. La patogénesis incluye inflamación crónica mediada por citocinas del microambiente tumoral, detectables sistémicamente. Estudios previos reportan niveles séricos de citocinas y su contribución al diagnóstico de CG. El presente estudio analiza el perfil de citocinas del tipo de Th1(IFNγ), Th2(IL-4 e IL-10), Th17(Th-17A) y otras pro inflamatorias: IL-1ß, IL-6 y TNF-α, en plasma de 70 casos de pacientes con CG comparándolos con 132 sujetos sanos equiparables en edad y sexo. Los casos provinieron del Hospital Roosevelt e Instituto Nacional de Cancerología de Guatemala (Incan) y formaron parte de un estudio previo. Se analizó la base de datos clínicos, patológicos y epidemiológicos. Se midieron los niveles de citocinas utilizando el sistema "MSD MULTI-SPOT Assay System". La edad promedio de los casos fue 59.5 años, (DE 13.0), 51%, eran positivos para IgG anti H. pylori. Un 71% presentó adenocarcinoma grado III (Borrman), según clasificación de Lauren 55% tenían tipo intestinal. Las siete citocinas cuantificadas se encontraron significativamente elevadas (p < .05) en el plasma de los casos respecto a sus controles. Los casos de CG tipo difuso presentaron niveles de IFNγ significativa-mente elevados. Por regresión logística, las citocinas IL-6 e IL-10, están asociadas significativamente a CG (p < .05) independientemente del estatus de infección por H. pylori. Se destacan la IL-6 e IL-10 como las principales citocinas asociadas a la presencia de CG.


Gastric cancer (GC) is the most prevalent gastrointestinal neoplasm in the world, associated with host and external genetic factors, such as Helicobacter pylori infection. The pathogenesis includes chronic inflammation mediated by cytokines of the tumor microenvironment, systemically detectable. Previous studies report serum levels of cyto-kines and their contribution to the diagnosis of GC. The present study analyzes the profile of cytokines of the type Th1 (IFNγ), Th2 (IL-4 and IL-10), Th17 (Th-17A) and other pro-inflammatory: IL-1ß, IL-6 and TNF-α, in plasma of 70 cases of patients with GC compared with 132 healthy subjects comparable in age and sex. The cases came from the Roosevelt Hospital and the National Cancer Institute of Guatemala -Incan- and were part of a previous study. The clinical, pathological and epidemiological databases were analyzed. Cytokine levels were measured using the "MSD MULTI-SPOT Assay System". The average age of the cases was 59.5 years, (SD 13.0), 51% were positive for IgG anti H. pylori, 71% had grade III adenocarcinoma (Borrman), according to Laurenís classification, 55% had intestinal type. The seven cytokines quantified were found to be significantly elevated (p < .05) in the plasma of the cases compared to their controls. The diffuse GC cases presented significantly elevated IFNγ levels. By logistic regression, the cytokines IL-6 and IL-10 are significantly associated with GC (p < .05) regardless of the H. pylori infection status. IL-6 and IL-10 stand out as the main cytokines associated with the presence of GC.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Plasma/chemistry , Stomach Neoplasms/complications , Cytokines/analysis , Interleukin-6/analysis , Interleukin-1/analysis , Interleukin-10/analysis , Th2 Cells , Th17 Cells , Immunoglobulin G/analysis , Adenocarcinoma/complications , Biomarkers, Tumor/analysis , Helicobacter Infections/complications , Th1 Cells , Gastrointestinal Tract/pathology , Tumor Microenvironment , Neoplasms/complications
3.
An. bras. dermatol ; 95(3): 336-339, May-June 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130869

ABSTRACT

Abstract Acquired reactive perforating collagenosis is a rare skin disorder characterized by the presence of umbilicated pruritic papules and nodules. Transepidermal elimination of altered and perforating bundles of basophilic collagen from the epidermis is a characteristic histologic feature of acquired reactive perforating collagenosis. Along with its well-known association with systemic diseases such as diabetes mellitus, chronic renal failure, and dermatomyositis, there are reports of acquired reactive perforating collagenosis being associated with malignancies. Herein, we present a case of acquired reactive perforating collagenosis associated with chronic lymphocytic leukemia, prostate adenocarcinoma, and Graves's disease. Clinicians are required to be more vigilant in evaluating patients with acquired reactive perforating collagenosis due to its unique association with malignancies and other systemic diseases.


Subject(s)
Humans , Male , Aged , Prostatic Neoplasms/complications , Skin Diseases/complications , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Adenocarcinoma/complications , Graves Disease/complications , Collagen Diseases/complications , Skin Diseases/pathology , Collagen , Collagen Diseases/pathology
4.
Rev. argent. dermatol ; 101(1): 31-40, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1092407

ABSTRACT

RESUMEN Las metástasis cutáneas (MC) constituyen una manifestación infrecuente de neoplasias internas. Su diagnóstico requiere un alto índice de sospecha clínica, pues los hallazgos pueden ser sutiles. Estas ponen de manifiesto la presencia de un tumor maligno diseminado y pueden permitir el diagnóstico de neoplasias internas no conocidas, o indicar la diseminación o recurrencia de otras ya diagnosticadas. La MC del carcinoma de ovario suele aparecer en enfermedad avanzada e indican un mal pronóstico.Su reconocimiento temprano puede llevar a un diagnóstico preciso y rápido, con el consiguiente tratamiento oportuno, aunque en la mayoría de los casos son indicativas de un pronóstico infausto.


SUMMARY Cutaneous metastases are an infrequent manifestation of internal neoplasms. Its diagnosis requires a high index of clinical suspicion, since the findings can be subtle. These reveal the presence of a disseminated malignant tumor and can allow the diagnosis of unknown internal neoplasms, or indicate the dissemination or recurrence of others already diagnosed. MC of ovarian carcinoma usually appears in advanced disease and may indicate a poor prognosis. Early recovery can carry out an accurate and rapid diagnosis, with timely emergency treatment, although in most cases they are indicators of an unfortunate prognosis.


Subject(s)
Humans , Female , Middle Aged , Ovarian Neoplasms/complications , Skin Neoplasms/diagnosis , Neoplasm Metastasis/diagnosis , Adenocarcinoma/complications
5.
Rev. bras. cancerol ; 66(1)20200129.
Article in Portuguese | LILACS | ID: biblio-1094947

ABSTRACT

Introdução: O câncer de próstata é considerado a neoplasia maligna mais comum que acomete homens em todas as Regiões do país, à exceção do câncer de pele não melanoma. Se diagnosticado e tratado precocemente, o câncer de próstata tem alta taxa de cura; contudo, terapêuticas como a radioterapia podem gerar complicações agudas que podem impactar as atividades cotidianas. Apesar das complicações no pós-tratamento, a radioterapia tem sido um método bastante praticado e que apresenta resultados positivos, ocasionando melhoria da sobrevida livre de doença. Objetivo: Avaliar os principais fatores preditores de complicações agudas que acometem pacientes em tratamento radioterápico para câncer de próstata. Método: Para identificação de fatores preditores de complicações agudas pós-radioterapia, avaliaram-se, consecutiva e prospectivamente, 208 pacientes diagnosticados com adenocarcinoma de próstata tratados com radioterapia conformacional 3D em um centro referência vinculado ao SUS entre os anos 2016 e 2017. Realizou-se ainda avaliação retrospectiva de prontuários para coleta de dados adicionais. A análise estatística foi realizada por meio dos testes qui-quadrado, exato de Fisher, Anova e regressão logística ordinal. Resultados: Após análise da amostra, evidenciou-se que, entre as complicações agudas, as de maior incidência foram radiodermite, cistite e enterite/retite, de forma que tais complicações tiveram como fatores associados volume irradiado, tratamento prévio e sintomas prévios ao tratamento. Conclusão: O estudo sugere que, apesar da existência de complicações ao final do tratamento, a grande maioria é de baixa complexidade e que pacientes submetidos a procedimentos cirúrgicos prévios podem evoluir com presença de complicações mais graves.


Introduction: Prostate cancer is considered the most common malignancy that affects men in all regions of the country, except for non-melanoma skin cancer. If diagnosed and treated early, prostate cancer has a high cure rate; however, therapies such as radiotherapy can generate acute complications that can impact daily activities. Despite post-treatment complications, radiotherapy has been a widely practiced method and has shown positive results, leading to improved disease-free survival. Objective: To evaluate the main predictive factors for acute complications that affect patients undergoing radiotherapy for prostate cancer. Method: To identify predictive factors for acute post-radiotherapy complications, 208 patients diagnosed with prostate adenocarcinoma treated with 3D conformational radiotherapy were consecutively and prospectively evaluated at a referral center linked to SUS between the years 2016 and 2017. It was carried out retrospective evaluation of medical records to collect additional data. Statistical analysis was performed using the chi-square test, Fisher's exact, Anova and ordinal logistic regression. Results: After analyzing the sample, it was evidenced that among the acute complications, those with the highest incidence were radiodermatitis, cystitis, enteritis/rectitis, so that these complications had associated predictive factors as irradiated volume, previous treatment and symptoms. Conclusion: The study suggests that despite the existence of complications at the end of the treatment, the vast majority are of low complexity and that the patients submitted to previous surgical procedures can evolve with the presence of more severe complications.


Introducción: El cáncer de próstata se considera la neoplasia maligna más común que afecta a los hombres en todas las regiones del país, con la excepción del cáncer de piel no melanoma. Si se diagnostica y trata temprano, el cáncer de próstata tiene una alta tasa de curación; sin embargo, las terapias como la radioterapia pueden generar complicaciones agudas que pueden afectar las actividades diarias. A pesar de las complicaciones posteriores al tratamiento, la radioterapia ha sido un método ampliamente practicado y ha mostrado resultados positivos, lo que lleva a una mejor supervivencia libre de enfermedad. Objetivo: Evaluar los principales predictores de complicaciones agudas que afectan a los pacientes sometidos a radioterapia para el cáncer de próstata. Método: Para identificar los factores predictivos de complicaciones agudas posteriores a la radioterapia, 208 pacientes diagnosticados con adenocarcinoma de próstata tratados con radioterapia conformacional 3D fueron evaluados consecutiva y prospectivamente en un centro de referencia vinculado al SUS entre los años 2016 y 2017. Se realizó evaluación retrospectiva de registros médicos para recopilar datos adicionales. El análisis estadístico se realizó utilizando la prueba de chi-cuadrado, exacta de Fisher, de Anova y la regresión logística ordinal. Resultados: Después de analizar la muestra, se evidenció que, entre las complicaciones agudas, las de mayor incidencia fueron radiodermatitis, cistitis, enteritis/retitis y síntomas obstructivos, por lo que estas complicaciones tenían factores predictivos asociados, como el volumen irradiado, el tratamiento previo y los síntomas. Conclusión: El estudio sugiere que a pesar de la existencia de complicaciones al final del tratamiento, la gran mayoría son de baja complejidad. Como factores predictivos encontrados, se puede mencionar el volumen irradiado, la existencia de tratamiento previo y los síntomas en la consulta inicial.


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Prognosis , Prostatic Neoplasms/radiotherapy , Adenocarcinoma/radiotherapy , Radiotherapy, Conformal/adverse effects , Radiodermatitis/radiotherapy , Brazil , Adenocarcinoma/complications , Retrospective Studies , Acute Toxicity , Cystitis/radiotherapy , Enteritis/radiotherapy
6.
Acta ortop. mex ; 33(5): 325-328, sep.-oct. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1284965

ABSTRACT

Resumen: El síndrome de Maffucci se caracteriza por la presencia de múltiples encondromas y hemangiomas que pueden afectar tejidos blandos y otros órganos. El riesgo de transformación maligna de las lesiones es de 100% durante la vida del individuo, siendo el condrosarcoma el tumor maligno más frecuentemente asociado. Se presenta el caso de un hombre de 44 años de edad con diagnóstico de síndrome de Maffucci, el cual desarrolló un doble primario sincrónico: condrosarcoma y sarcoma fusocelular de alto grado multicéntrico de región escapular y tricipital, fue tratado con desarticulación interescapulotorácica, mostró progresión acelerada y enfermedad pulmonar. Existen otras neoplasias asociadas al síndrome de Maffucci tales como adenocarcinoma de páncreas, tumores mesenquimales de ovario, gliomas, astrocitomas y tumores de la pituitaria. Por lo que resulta muy interesante reportar la asociación infrecuente entre un sarcoma fusocelular y un condrosarcoma secundario en pacientes con síndrome de Maffucci. El seguimiento en este grupo de pacientes es complejo y se basa en la búsqueda intencionada de lesiones con crecimiento acelerado, prestando atención en lesiones de crecimiento progresivo, síntomas clínicos o datos radiológicos de malignidad.


Abstract: Maffucci syndrome is characterized by the presence of multiple enchondromes and hemangiomas that can affect soft tissues and other organs. The risk of malignant transformation of lesions is 100% during the life of the individual, with chondrosarcoma being the most frequently associated malignant tumor. We present the case of a 44-year-old man diagnosed with Maffucci syndrome who developed a synchronous double primary: chondrosarcoma and high-grade multicenter fusocellular sarcoma of scapular and tricipital region, was treated with disarticulation interscapule-thoracic, presented accelerated progression and lung disease. There are other neoplasms associated with Maffucci syndrome, such as pancreatic adenocarcinoma, mesenchymal ovarian tumors, gliomas, astrocytomas and pituitary tumors. It is therefore very interesting to report the uncommon association between fusocellular sarcoma and secondary chondrosarcoma in patients with Maffucci syndrome. Follow-up in this group of patients is complex and is based on the intentional search for accelerated growing lesions, paying attention to progressive growth injuries, clinical symptoms or radiological malignancy data.


Subject(s)
Humans , Adult , Bone Neoplasms/surgery , Bone Neoplasms/complications , Adenocarcinoma/surgery , Adenocarcinoma/complications , Chondrosarcoma/surgery , Chondrosarcoma/complications , Enchondromatosis/surgery , Enchondromatosis/complications
7.
Säo Paulo med. j ; 137(1): 100-103, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-1004736

ABSTRACT

ABSTRACT CONTEXT: Non-islet-cell-tumor-induced hypoglycemia (NICTH) is caused on rare occasions by secretion of insulin from tumor cells that are reported to have a single tissue origin. CASE REPORT: A 67-year-old male patient had cardia adenocarcinoma and concomitant lung adenocarcinoma with extensive metastases and repeated episodes of intractable hypoglycemia. Immunohistochemical staining for insulin showed that lung adenocarcinoma stained positive and gastric cardia adenocarcinoma stained weakly positive. These results indicate that tumor cells of different tissue origins co-secreted insulin. CONCLUSIONS: This is the first report on intractable hypoglycemia due to co-secretion of insulin from two kinds of primary tumor cells in a single patient.


Subject(s)
Humans , Male , Aged , Stomach Neoplasms/complications , Cardia , Adenocarcinoma/complications , Hypoglycemia/etiology , Lung Neoplasms/complications , Stomach Neoplasms/diagnosis , Immunohistochemistry , Adenocarcinoma/diagnosis , Fatal Outcome , Positron Emission Tomography Computed Tomography , Lung Neoplasms/diagnosis
8.
Medicina (B.Aires) ; 79(1): 61-63, feb. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1002588

ABSTRACT

La endocarditis trombótica no bacteriana, antiguamente conocida como endocarditis marántica, es una entidad infrecuente en la que se desarrollan vegetaciones estériles, compuestas por fibrina en las válvulas del corazón. Suele diagnosticarse en el momento de la autopsia o en enfermedades oncológicas avanzadas. Las neoplasias malignas más frecuentemente asociadas con esta entidad son las de pulmón, páncreas, estómago y adenocarcinomas de origen primario desconocido. Es necesario descartar la endocarditis infecciosa y establecer la presencia de vegetaciones valvulares mediante ecocardiografía. Presentamos el caso de una paciente con diagnóstico reciente de adenocarcinoma de estómago en estadio avanzado que presentó ceguera cortical e imágenes compatibles con isquemia cerebral. El ecocardiograma transesofágico mostró dos vegetaciones en válvula mitral. Los hemocultivos fueron negativos. Se enfatiza la importancia de sospechar endocarditis trombótica no bacteriana en enfermos con cáncer y embolismo sistémico.


Nonbacterial thrombotic endocarditis, formerly known as marantic endocarditis, it is an infrequent entity in which sterile, fibrin vegetations develop on heart valve leaflets. It is often diagnosed at the time of autopsy or in late-stage malignancies. The most common malignancies associated with nonbacterial thrombotic endocarditis are lung, pancreatic, gastric cancer and adenocarcinomas of an unknown primary site. Diagnosis requires ruling out infective endocarditis and establishing the presence of valvular vegetations using echocardiography. We report the case of a patient with a recent diagnosis of advanced gastric adenocarcinoma who presented with cortical blindness. The computed tomography was compatible with cerebral ischemia. The transoesophageal echocardiogram showed two vegetations in mitral valve. Blood cultures were negative. We emphasize the importance of suspecting nonbacterial thrombotic endocarditis in patients with cancer and systemic embolism.


Subject(s)
Humans , Female , Aged , Blindness, Cortical/etiology , Endocarditis, Non-Infective/complications , Stomach Neoplasms/complications , Adenocarcinoma/complications , Tomography, X-Ray Computed/methods , Brain Ischemia/complications , Brain Ischemia/pathology , Brain Ischemia/diagnostic imaging , Blindness, Cortical/pathology , Blindness, Cortical/diagnostic imaging , Endocarditis, Non-Infective/pathology
9.
Rev. Col. Bras. Cir ; 46(6): e20192366, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1057190

ABSTRACT

RESUMO Objetivo: analisar, comparativamente, a incidência de câncer incidental de vesícula biliar em colecistectomias de urgência versus colecistectomias eletivas realizadas em hospitais públicos de Teresina-PI. Métodos: estudo observacional descritivo, quantitativo, com delineamento transversal, cujo cenário foram dois hospitais públicos de Teresina-PI. Foram analisados 6.329 prontuários de pacientes submetidos à colecistectomia, entre janeiro de 2011 e dezembro de 2017. Os dados coletados foram divididos em dois grupos e confrontados estatisticamente através do teste Z para diferença entre proporções. Resultados: detectou-se câncer incidental da vesícula biliar em 6,53% das colecistectomias de urgência e em 0,38% das eletivas. Quanto ao sexo, observou-se que, na cirurgia de urgência, 69% eram mulheres e 31%, homens, enquanto no procedimento eletivo, 78% eram mulheres e 22%, homens. Quanto à idade, a maioria dos pacientes possuía mais de 60 anos e, entre estes, 69,3% submetidos à colecistectomias de urgência e 82,6%, à eletivas. O tipo histopatológico "adenocarcinoma" foi encontrado em 84,6% das cirurgias de urgência e 100% das eletivas. Conclusão: câncer incidental de vesícula biliar foi mais frequente em colecistectomias de urgência em comparação às eletivas. O perfil dos pacientes com essa doença maligna nos dois tipos de procedimento foi do sexo feminino, maiores de 60 anos de idade e com diagnóstico histopatológico de adenocarcinoma.


ABSTRACT Objective: to comparatively analyse the incidence of incidental gallbladder cancer in emergency cholecystectomies versus in elective cholecystectomies performed in public hospitals in Teresina city, Piaui state (PI). Methods: descriptive, quantitative, observational, cross-sectional study, whose scenarios were two public hospitals in Teresina-PI. We analysed 6,329 medical records of patients undergoing cholecystectomy between January 2011 and December 2017. The collected data were divided into two groups and statistically compared using Z-test for difference between proportions. Results: incidental gallbladder cancer was detected in 6.53% of emergency cholecystectomies and in 0.38% of elective ones. Regarding gender, it was observed that in emergency surgeries 69% of patients were women and 31% men, while in elective procedures 78% were women and 22% men. Regarding age, most patients were over 60 years old, and, among these, 69.3% underwent emergency cholecystectomies and 82.6% underwent elective cholecystectomies. The histopathological type "adenocarcinoma" was found in 84.6% of patients who underwent emergency surgeries and in 100% of patients who underwent elective surgeries. Conclusion: incidental gallbladder cancer was more frequent in urgent cholecystectomies compared to elective cholecystectomies. The profile of patients with this malignant disease in both types of procedure was female, older than 60 years, and with histopathological diagnosis of adenocarcinoma.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Adenocarcinoma/surgery , Adenocarcinoma/diagnosis , Cholecystitis/surgery , Incidental Findings , Gallbladder Neoplasms/surgery , Gallbladder Neoplasms/diagnosis , Cholecystectomy/methods , Adenocarcinoma/complications , Adenocarcinoma/pathology , Cholecystitis/complications , Incidence , Cross-Sectional Studies , Risk Factors , Elective Surgical Procedures , Gallbladder Neoplasms/complications , Gallbladder Neoplasms/pathology , Middle Aged
10.
An. bras. dermatol ; 93(6): 887-889, Nov.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-973640

ABSTRACT

Abstract: Nodular vasculitis is an uncommon type of panniculitis. It was firstly associated to the infection by Mycobacterium tuberculosis and named erythema induratum of Bazin, however nowadays it has been associated with several other underlying disorders and it is better described as nodular vasculitis. Concerning its relationship with malignant conditions, there is only one reported case, in association with metastatic colon adenocarcinoma. We report a case of nodular vasculitis as the first manifestation of lung adenocarcinoma. To the best of our knowledge, this is the first reported association of both diseases.


Subject(s)
Humans , Female , Middle Aged , Adenocarcinoma/complications , Erythema Induratum/etiology , Lung Neoplasms/complications , Adenocarcinoma/diagnosis , Erythema Induratum/pathology , Fatal Outcome , Lung Neoplasms/diagnosis
11.
Rev. medica electron ; 40(5): 1577-1584, set.-oct. 2018. graf
Article in Spanish | LILACS, CUMED | ID: biblio-978688

ABSTRACT

RESUMEN Se presenta el caso de una hiperplasia prostática gigante, combinada con un adenocarcinoma que se presentó como una tumoración abdominal. El paciente presentaba una tumoración palpable en hipogastrio y un síndrome obstructivo urinario bajo. Se intervino quirúrgicamente y se realizó adenomectomía combinada, transvesical y retropúbica. La biopsia informó pequeño adenocarcinoma prostático acinar Gleason 3-4 puntos, en el contexto de una hiperplasia prostática. El paciente evolucionó satisfactoriamente y se sigue en consulta. La tumoración extraída tenía 736 g y constituye la de mayor peso reportada en Cuba y la quinta a nivel mundial (AU).


ABSTRACT We describe the case of a giant prostatic hyperplasia, combined with an adenocarcinoma presented as an abdominal tumor. The patient had a palpable tumor in the hypogastrium and a low urinary obstructive syndrome. He was operated and a combined, transvesicular and retropubic adenomectomy was performed. The biopsy informed a little 3-4 points-Gleason, acinar, prostatic adenocarcinoma, in the context of a prostatic hyperplasia. The patient evolved satisfactorily and was followed up in consultation. The removed tumor was 736 g, and is the heaviest one reported in Cuba and the fifth worldwide (AU).


Subject(s)
Humans , Male , Aged , Prostatic Hyperplasia/epidemiology , Adenocarcinoma/epidemiology , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/diagnosis , Urination Disorders/complications , Aged/physiology , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Diabetes Mellitus/diagnosis
13.
Medicina (B.Aires) ; 78(4): 290-293, ago. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-954997

ABSTRACT

El cáncer de próstata es una causa extremadamente rara de síndrome de secreción inadecuada de hormona antidiurética (SIADH). Se trata de tumores agresivos asociados a un síndrome que puede aparejar consecuencias graves. Un paciente de 64 años fue diagnosticado de adenocarcinoma de próstata Gleason 4+3: 7 en 2014 y recibió terapia de bloqueo hormonal. En 2015 debió ser ingresado por hiponatremia sintomática y se le diagnosticó un SIADH, sin otra causa probable más que el cáncer de próstata. Sufrió rápida progresión de su enfermedad oncológica, llamativamente cuando su PSA se encontraba en valores normales, y falleció al corto plazo. Existe gran variabilidad clínica e histopatológica de los casos informados en la literatura de asociación de carcinoma de próstata y SIADH, sin embargo, todos coinciden en la agresividad de estos tumores. Estas características se presentan en tumores con diferenciación neuroendocrina, frecuentemente resistentes al tratamiento hormonal y que pueden presentar síndromes paraneoplásicos como el SIADH. El perfil de sus alteraciones moleculares se encuentra en estudio para el desarrollo de terapias target. La asociación de adenocarcinoma de próstata y SIADH es muy infrecuente y podría implicar diferenciación neuroendocrina. Por tal motivo es esencial una nueva biopsia del tumor o de sus metástasis a la progresión de la enfermedad para poder conducir un tratamiento adecuado de acuerdo a sus características morfológicas, inmunohistoquímicas y, en un futuro, moleculares.


Prostate cancer is an extremely rare cause of syndrome of inappropriate antidiuretic hormone (SIADH) secretion. These tend to be aggressive tumors and SIADH can carry serious clinical consequences. A 64 years old patient was diagnosed with Gleason 4+3: 7 prostate adenocarcinoma in December 2014 and received hormonal blockade therapy. By March 2015 he was admitted for symptomatic hyponatremia and SIADH secretion was diagnosed, with no other probable cause than prostate cancer. He suffered a rapid progression of his oncologic disease, surprisingly with PSA in normal range, and died in the short term. There is great clinical and histopathological variability in the cases reported in the literature of association of prostate carcinoma and SIADH. However, they all agree on the aggressiveness of these tumors. This characteristic is present in tumors that have neuroendocrine features. They are frequently resistant to hormonal treatment and may present with paraneoplastic syndromes such as SIADH. The profile of its molecular alterations is under study for the development of target therapies. The association of prostate adenocarcinoma and SIADH is very uncommon and could involve neuroendocrine differentiation. For this reason, it is essential to perform a new biopsy of the tumor or its metastases at the progressive disease in order to conduct an appropriate treatment according to its morphological, immunohistochemical and, in the future, molecular characteristics.


Subject(s)
Humans , Male , Middle Aged , Prostatic Neoplasms/complications , Adenocarcinoma/complications , Inappropriate ADH Syndrome/etiology , Fatal Outcome , Inappropriate ADH Syndrome/diagnosis
14.
Autops. Case Rep ; 8(2): e2018011, Apr.-May 2018. ilus graf
Article in English | LILACS | ID: biblio-905587

ABSTRACT

At a time when the population shows increasing longevity, entities such as cancer and chronic kidney disease (CKD) are more frequently connected. In the United States, approximately 6% of the patients on hemodialysis have cancer. The challenge to manage oncologic patients with CKD in a hemodialytic program represents a great shortage of available information on the choice of the best drug, timing, dosage adjustments, dialysis method, and treatment safety. We present the case of a patient with prostate cancer and terminal CKD in hemodialysis, and the treatment sequence after the development of resistance to hormonal blockade therapy, which included docetaxel, enzalutamide, and radium-223.


Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma/complications , Antineoplastic Agents/administration & dosage , Dialysis , Prostatic Neoplasms/complications , Renal Insufficiency, Chronic/drug therapy , Phenylthiohydantoin/administration & dosage , Prostatic Neoplasms, Castration-Resistant/complications , Radium/administration & dosage , Renal Insufficiency, Chronic/complications , Taxoids/administration & dosage
15.
J. health med. sci. (Print) ; 4(1): 11-15, Ene.-Mar. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1151479

ABSTRACT

Las fracturas tumorales en columna vertebral son parte de la etiología de las fracturas patológicas a este nivel, que por edad de presentación, así como la clínica observada puede otorgar directrices del tipo de tumor que afecta al esqueleto axial. Por tanto, resulta importante su identificación, clasificación y terapéutica a seguir, en especial en aquellos casos donde se encuentra afectada la parte neurológica distal. Teniendo en consideración estos aspectos planteamos este caso clínico.


Tumoral fractures in spine are part of the etiology of pathologic fractures in this level, age of presentation and the observed clinical can give guidance on the type of tumor that affects the axial skeleton, it is important to identify, classification and therapeutic to follow, especially those who are affected neurological distal part. Considering this aspect propose clinical case below.


Subject(s)
Humans , Male , Middle Aged , Pancreatic Neoplasms/complications , Bone Neoplasms/complications , Adenocarcinoma/complications , Spinal Fractures/etiology , Fractures, Compression/etiology , Postoperative Period , Fluoroscopy , Radiography , Spinal Fractures/surgery , Ecuador , Laminectomy
18.
Rev. méd. Chile ; 145(11): 1421-1428, nov. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-902462

ABSTRACT

Background Imaging with F18-fluorodeoxyglucose PET/CT is used to determine sites of abnormal glucose metabolism and can be used to characterize and localize many types of tumors. Aim To assess the prevalence of multiple primary malignant neoplasms (MPMN) detected by PET/CT in cancer patients. Material and Methods F18-fluorodeoxyglucose PET/CT scans performed to 800 patients with a newly diagnosed cancer or with already treated tumors were retrospectively reviewed. In patients whose examination described incidental findings not related to the primary tumor, a research was done about further laboratory, imaging or pathological studies. Results In 188 PET/CT scans (23%) an incidental finding was found. Of these, 66 (35%) were considered as MPMN, 12 as atypical metastases of a known primary tumor, 14 as false positive images (inflammatory or physiologic uptake) and 29 as benign or low grade tumors. In 67 cases (36% of all incidental tumors), the finding was not confirmed. Seven percent of patients with a newly diagnosed tumor had a synchronic MPMN detected by PET/CT. Nine percent of patients with treated tumors developed a metachronous MPMN during their follow up. The most common incidental tumors were thyroid cancer in 15 cases, kidney cancer in 13, lung cancer in 10, colorectal carcinoma in 9, breast cancer in 6, prostate cancer in 4, non-Hodgkin lymphoma in 3 and pancreatic cancer in 2. Conclusions A MPMN is detected by PET/CT in a significant number of cancer patients.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Carcinoma/diagnostic imaging , Positron Emission Tomography Computed Tomography , Neoplasms, Multiple Primary/diagnostic imaging , Carcinoma/classification , Carcinoma/complications , Adenocarcinoma/classification , Adenocarcinoma/complications , Adenocarcinoma/diagnostic imaging , Cross-Sectional Studies , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Early Detection of Cancer/methods , Neoplasms, Multiple Primary/classification , Neoplasms, Multiple Primary/complications
19.
Medicina (B.Aires) ; 77(5): 427-429, oct. 2017. ilus
Article in Spanish | LILACS | ID: biblio-894512

ABSTRACT

El síndrome de Villaret se define por la afección de los nervios craneales glosofaríngeo (IX), vago (X), espinal (XI) e hipogloso mayor (XII), en conjunción con el síndrome de Horner homolateral a la lesión. Se produce por compresión de estos nervios y de las fibras vecinas del plexo simpático pericarotídeo en la base del cráneo, en particular, en el espacio retroparotídeo. Si bien es un hecho conocido la invasión del sistema nervioso central en el cáncer de pulmón avanzado, esta particular asociación sintomática es extremadamente infrecuente. Presentamos una paciente con diagnóstico reciente de adenocarcinoma de pulmón que desarrolló, en forma simultánea, este síndrome.


Villaret syndrome is defined by the affection of the glossopharyngeal (IX), vagal (X), accessory (XI) and hypoglossal (XII) cranial nerves associated with ipsilateral Horner syndrome. It is caused by the compression of these nerves and the neighboring sympathetic plexus fibers at the base of the skull, particularly in the retroparotid space. Even though the invasion of the central nervous system in patients with advanced lung cancer is a frequent and well known occurrence, this particular symptomatic association is extremely rare. We are reporting the case of a newly diagnosed lung adenocarcinoma patient who is simultaneously developing this syndrome.


Subject(s)
Humans , Female , Aged , Adenocarcinoma/complications , Horner Syndrome/etiology , Cranial Nerve Diseases/diagnostic imaging , Lung Neoplasms/complications , Adenocarcinoma/diagnostic imaging , Horner Syndrome/diagnostic imaging , Cranial Nerve Diseases/etiology , Adenocarcinoma of Lung , Lung Neoplasms/diagnostic imaging , Neoplasm Invasiveness
20.
Autops. Case Rep ; 7(3): 44-49, July.-Sept. 2017. ilus, tab
Article in English | LILACS | ID: biblio-905326

ABSTRACT

Pulmonary placental transmogrification (PT) is a rare entity with less than 40 cases reported in the literature. Most reported cases are associated with either bullous emphysema or with pulmonary fibrochondromatous hamartomas. We present only the second case of PT associated with adenocarcinoma of the lung. A 67-year-old female with multiple chronic medical ailments presented with shortness of breath and was found to have a 6-cm mass in the upper lobe of her right lung. A computed tomography (CT) guided core biopsy was performed that showed a well-differentiated adenocarcinoma. Interestingly the normal lung tissue showed placental villous architecture. A unique feature of our case is that the diagnosis was made on a needle core biopsy, unlike all the other cases in the literature. We also provide a comprehensive review of this rare entity.


Subject(s)
Humans , Female , Aged , Adenocarcinoma/complications , Biopsy, Needle , Hamartoma/diagnosis , Lung Neoplasms/diagnosis , Pulmonary Emphysema/diagnosis , Diagnosis, Differential , Lung Injury/pathology , Rare Diseases/pathology , Solitary Pulmonary Nodule/diagnosis
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