RESUMEN
Malignant insulinomas are frequently diagnosed at a late stage. Medical management is necessary to slow progression of the disease and control of hypoglycemic symptoms when cure by surgical treatment is not possible. Multimodal treatment, in these cases, has been used with variable clinical response. We describe a 68-yr-old woman who presented response failure to usual treatment and was alternatively treated with radiolabeled metaiodobenzylguanidine ([131I]-MIBG) analogue therapy with development of neurologic complications. We also present a review of the current role of [131I]-MIBG treatment in insulinomas.
Asunto(s)
Anciano , Femenino , Humanos , /análogos & derivados , Insulinoma/radioterapia , Neoplasias Pancreáticas/radioterapia , Radiofármacos/efectos adversos , Compresión de la Médula Espinal/etiología , /efectos adversos , Neoplasias Óseas/secundario , Terapia Combinada , Resultado Fatal , Insulinoma/secundario , Metástasis Linfática , Neoplasias Hepáticas/secundarioRESUMEN
Dermatomyositis is an autoimmune disorder that affects mainly muscles and skin. In some cases it may be associated to neoplasms occurring before the diagnosis of cancer. Its relation to germ cell tumor is not well documented, so we describe a case of a patient with history of muscle weakness and cutaneous rash that preceded cancer for 6 months. Dermatomyositis must remind of a possible occult neoplasm and its remission may follow the treatment of the tumor.
Asunto(s)
Humanos , Dermatomiositis , Neoplasias , Neoplasias CutáneasRESUMEN
O lúpus eritematoso sistêmico pode envolver o aparelho respiratório de diversas maneiras como com pleurite, pneumonite, doença intersticial ou hipertensão pulmonar. Raramente, o paciente com lúpus eritematoso sistêmico pode apresentar uma síndrome caracterizada por dispnéia, dor torácica, alteração nas provas funcionais pulmonares e ausência de alterações parenquimatosas significativas na avaliação tomográfica de tórax, a qual tem sido denominada síndrome do pulmão encolhido. Descrevemos um caso que preenche os critérios diagnósticos dessa síndrome, e enfatizamos a patogênese que tem sido proposta, assim como as opções terapêuticas disponíveis.