RESUMO
Objetivo: Reportar un caso clínico de acrometástasis de cáncer de colon. Materiales y Métodos: Se obtiene información de la ficha clínica electrónica. Se realiza revisión de literatura, utilizando los términos "acrometastasis", "metástasis óseas", "metástasis en la mano", "metástasis en falanges". Resultados: Se presenta el caso de un paciente con antecedente de cáncer de colon sigmoides etapa IV sometido a resección de metástasis hepáticas, quimioterapia y radioterapia. Consulta por lesión ulcerada en dedo anular derecho, cuya biopsia indica metástasis de adenocarcinoma de colon. Se realiza amputación transfalángica proximal con biopsia que confirma diagnóstico. Discusión: Las metástasis en mano dan cuenta del 0,0070,2% de todas las metástasis a distancia. Se presentan como aumento de volumen doloroso de aspecto granulomatoso o asociado a ulceración con empeoramiento progresivo. El tratamiento tiene por objetivo el manejo del dolor y la preservación de la funcionalidad de la extremidad. Conclusión: El adenocarcinoma de colon, raramente, da metástasis falángicas. Corresponden a una manifestación tardía de la enfermedad con una alta tasa de mortalidad a 6 meses asociada. Se deben considerar como diagnóstico diferencial en pacientes oncológicos.
Objective: To report a clinical case of achrometastases of colon cancer. Materials and methods: Information is obtained from the electronic medical record. A literature review is performed, using the terms "achrometastases", "bone metastases", "hand metastases", "phalangeal metastases". Results: We present the case of a patient with a history of stage IV sigmoid colon cancer who underwent resection of liver metastases, chemotherapy and radiotherapy. Consultation due to an ulcerative lesion on the right ring finger, whose biopsy indicated colon adenocarcinoma metastases. Proximal transphalangeal amputation is performed with biopsy confirming diagnosis. Discussion: Hand metastases account for 0.007-0.2% of all distant metastases. They present as a painful increase in volume with a granulomatous appearance or associated with progressively worsening ulceration. The treatment aims to manage pain and preserve the functionality of the limb. Conclusion: Colon adenocarcinoma rarely gives phalangeal metastases. They correspond to a late manifestation of the disease with a high associated 6-month mortality rate. They should be considered as a differential diagnosis in cancer patients.
RESUMO
The dose dependent antiproliferative effect of an alkaloidal substance extracted from the sponge Amphimedon viridis was tested on Leishmania mexicana promastigotes. Sponges were collected in Isla Larga, Venezuela (10 degrees 20' 20" - 10 degrees 24" N, 64 degrees 19' - 64 degrees 22' W), cut and dipped in methanol for vacum filtering extraction every 24 hr. The aqueous extract was separated by chromatography over silica gel. The parasites were from the Venezuelan NR strain. Their growth rate was reduced by 50% with a dose of 10 microg/ml in 48 hr, whilst concentrations of 30 and 40 microg/ml induce leishmanicidal action after 110 and 20 min, respectively. Lysis is preceded by an immediate increase in cellular volume associated with progressive damage of cellular content and the destruction of organelles. These findings suggest that one important factor associated with the antiproliferative effect of this alkaloidal substance on L. mexicana promastigotes is the loss of the plasma membrane selective permeability.