Résumé
Dermatomyositis is a group of connective tissue disorders characterized by non-suppurative inflammation of the skeletal muscle and skin lesions. It is associated with malignancy, especially of the stomach, lung, overy and breast. we report a case of dermatomyositis with uterine cervical concer. A 78 year old female patient was admitted because of progressive proximal muscle weakness, skin rashes, and vaginal spotting. She was bedridden because of severe proximal muscle weakness and atrophy, unable to elevate her head, and suffered from dysphagia. Gottron's patches were found on the knuckles of the hands, scaly erythematous rashes on the extensor surfaces of bilateral elbows, wrists and knees. The serum concentrations of muscle enzymes were elevated, the biopsy of quadriceps muscle showed the features comparable with myositis, and the uterine cervical biopsy revealed squamous cell carcinoma, which was determined to be in stage lib by pelvic CT. Radiotherapy(total 3240 cGy) was done for the cervical cancer and prednisolone (initially 60mg/day) was given for the dermatomyositis. The muscle power improved only a little although the concentrations of serum muscle enzmes returned to normal. She deceased of aspiration pneumonia 43 days after the admission.
Sujets)
Sujet âgé , Femelle , Humains , Atrophie , Biopsie , Région mammaire , Carcinome épidermoïde , Tissu conjonctif , Troubles de la déglutition , Dermatomyosite , Coude , Exanthème , Main , Tête , Inflammation , Genou , Poumon , Métrorragie , Faiblesse musculaire , Muscles squelettiques , Myosite , Pneumopathie de déglutition , Prednisolone , Muscle quadriceps fémoral , Peau , Estomac , Tumeurs du col de l'utérus , PoignetRésumé
Angiosarcoma is a very rare malignant tumor of endothelial cell origin. We experienced a case of angiosarcoma presented with massive pleural effusion, which was considered as a metastasis from right kidney. A 44-year-old male patient was admitted due to dyspnea for one month. He had a history of transient hematuria 3 months before admission, which disappeared spontaneously Chest roentgenography showed total haziness in left hemithorax with multiple nodular shadows in right lung. Abdominal ultrasonogram showed a single heterogeneous hyperechoic mass, measuring about 7.3×7.1×6.5cm in size in the upper and mid-pole of the right kidney, involving. renal sinus. Computed tomography of the chest revealed highly enhanced multiple pulmonary and subpleural nodules with loculated pleurisy. In bronchoscopic finding, a fungating, hypervascular tumor mass was noticed at the orifice of anterior basal segment of left lower lung after removal of tenaceous mucus Pleural and bronchoscopic biopsies showed findings of angiosarcoma confirmed by immunochemical stains with factor VIII related antigen(+), laminin(+) and vimentin(+), and by characteristic electronmicroscopic findings. Massive pleural effusion was controlled with several times of pleurodesis in both pleural spaces.