RESUMO
Two cases of eumycotic mycetomas in the head and neck region are reported. The first case is the localized mycetoma which involved only the soft tissue of the neck. It was completely excised and the patient needed no further treatment. In the second case, the lesion extensively involved the structures in the parapharyngeal space, submandibular space and carotid sheath. The upper limit is the skull base. The patient was treated by combination of wide excision with radial forearm flap and antifungal agents, however, the prognosis is fair.
Assuntos
Adulto , Feminino , Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Micetoma/diagnóstico , Pescoço , Infecções dos Tecidos Moles/diagnósticoRESUMO
We describe a patient with a silent hepatocellular carcinoma in whom a progressive dysfunction developed in the brainstem, cerebrum, and cerebellum. This clinical manifestation was also associated with polyradiculopathy. The changes were microscopically unlike those seen in hepatic encephalopathy, progressive multifocal leukoencephalopathy and other metabolic encephalopathy. The findings seem to have occurred as a paraneoplastic syndrome of the nervous system. Although in the present case, the cause-and-effect relationship between the hepatocellular carcinoma and the encephaloradiculopathy is only hypothetical, we suggest that the demyelinating process which involves both central and peripheral nervous system in our case resulted from interaction of tumor with the host-immunological mechanism. The neurological presentation in our case is unique and has never been reported before.
Assuntos
Adulto , Encefalopatias/etiologia , Carcinoma Hepatocelular/complicações , Doenças Desmielinizantes/etiologia , Humanos , Neoplasias Hepáticas/complicações , Masculino , Síndromes Paraneoplásicas/complicações , Raízes Nervosas Espinhais/patologiaRESUMO
A study was made on nine hepatic carcinomas with intracranial metastases. These cases brought a total number of reported intracranial metametastatic hepatic carcinomas to 32 instances. The secondary intracranial hepatic carcinomas formed a proportion of 1.3 to 2.9 per cent among intracranial metastatic tumors. Nine patients in this series were young with an average age of 37 years. There were five hepatocellular carcinomas and four cholangiocarcinomas. An intracranial secondary hepatocellular carcinoma in a 37-year-old man produced massive intracerebral hemorrhage. Only four cases including the current one have been described as massive intracerebral hemorrhage because of secondary hepatocellular carcinoma. Our case, moreover, had a high level of hematocrits representing a paraneoplastic syndrome.