RESUMO
The presence of sarcomatous element transforms the usually innocuous spermatocytic seminoma into a highly aggressive neoplasm. We report a case of spermatocytic seminoma with undifferentiated sarcomatous component in a 43-year-old male, presented with testicular mass since two and a half years. Orchidectomy was performed and after 9 months, the patient presented with recurrent scrotal mass with bilateral pulmonary metastases.
Assuntos
Adulto , Antígenos de Neoplasias , Histocitoquímica , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundário , Masculino , Microscopia , Orquiectomia , Recidiva , Sarcoma/complicações , Sarcoma/diagnóstico , Sarcoma/patologia , Sarcoma/cirurgia , Seminoma/complicações , Seminoma/diagnóstico , Seminoma/patologia , Seminoma/cirurgia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia , Vimentina/análiseAssuntos
Ependimoma/diagnóstico , Ependimoma/patologia , Ependimoma/cirurgia , Tumores de Células Gigantes/diagnóstico , Tumores de Células Gigantes/patologia , Tumores de Células Gigantes/cirurgia , Histocitoquímica , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Medula Espinal/patologia , Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/patologia , Neoplasias da Medula Espinal/cirurgiaRESUMO
OBJECTIVE: The purpose of this study was to evaluate the effects of oral Sildenafil for treatment of pulmonary hypertension secondary to congenital heart diseases. METHODS & RESULTS: Twelve patients with un-repaired congenital heart diseases resulting in significant pulmonary hypertension were enrolled in a prospective trial of oral Sildenafil treatment for 12 weeks. The outcomes measured were change in the systemic oxygen saturations, 6-minute walk test distance, and New York Heart Association class. The systemic blood pressure and visual symptoms were monitored for evaluating the tolerability of Sildenafil. The mean age was 25.7+/-14.4 years. The mean pulmonary vascular resistance before treatment was 17.4 Wood units. After 12 weeks of sildenafil, an increase in oxygen saturations (87.8+/-5.3%-90.25+/-4%, p=0.04) with an associated increase of one New York Heart Association class (p=0.009) was noted. A non-statistically significant increase in the 6-minute walk test distance (310.33+/-42-333.75+/-54.6 meters, p=0.47) was also noted. Sildenafil was well-tolerated with no significant change in systemic blood pressure or visual side-effects. CONCLUSION: Oral Sildenafil is well-tolerated and produces some improvement in the oxygenation and functional status of patients with pulmonary hypertension secondary to congenital heart diseases.