RESUMO
We present a case of a 56-year-old woman with abdominal pain, normal laboratorial exams, normal carcinoembryonary antigen (CEA) and abdominal tomography exam with tumor formation in hepatic region. A tumor lesion was identified in a surgery in the medial segment of the inferior vena cava. A surgical resection was done, respecting the security limits, and reconstruction of the inferior vein with polytetrafluoroethylene (PTFE) graft was performed. The histological examination showed differentiated leiomyossarcoma of the inferior vena cava. This report points to the necessity of differential diagnoses with leiomyossarcoma in the presence of abdominal mass, supra-mesocolic, and non-specific abdominal symptoms, since its pre-surgical diagnoses occurs in only 5 percent to 10 percent of the cases.
RESUMO
A agressäo de múltiplos órgäos e sistemas por acidente ofídico é fato bem conhecido. Entretanto, acometimento miocárdico ainda näo foi descrito na literatura. Mulher de 32 anos, sem cardiopatia prévia, faleceu no 6§ dia após picada de cascavel. Durante a evoluçäo comprovou-se extensa lesäo miocárdica documentada através de evidências clínicas, eletrocardiográficas, enzímicas e histológicas
Extensive and severe myocardial lesions are reported in a patient who died due to snakebite (Crotalus Durissus Terrificus). These lesions are documented by clinical, electrocardiographic, enzymatic and histological evidences. The main pathological features are represented by sarcoplasmatic vacuoles, densely clumped myofibrils and amorphous acidophilic mass into the cardiac fibers. These lesions are identical to those which have already been described in skeletal muscle after snakebite. This seems to be the first case report that shows undoubt myocardial lesions due to snakebite with anatomopathological documentation.