Cisto sanguíneo mitral versus abscesso roto da valva mitral: diagnóstico diferencial pelo ecocardiograma transesofágico / Mitral blood cyst versus mitral valve ruptured abcess: differential diagnosis by transesophageal echocardiography

Relatamos duas lesões pouco habituais e de difícil diagnóstico, nas quais o ecocardiograma transesofágico foi fundamental na avaliação mais detalhada da anatomia da valva mitral, permitindo o diagnóstico diferencial entre cisto sanguíneo e aneurisma roto da valva mitral, os quais, no exame inicial transtorácico, assumiam aspecto muito semelhante.

Selected Adnexal Cystic Masses in Postmenopausal Women Can be Safely Managed by Laparoscopy

The aim of this study was to assess the efficacy and safety of laparoscopic treatment for adnexal cystic masses that were predicted to be benign in postmenopausal women. Postmenopausal women found to have an adnexal cystic mass were retrospectively evaluated with transvaginal ultrasonography, and serum CA-125 levels. The selection criteria were adnexal cystic masses greater than 3 cm but less than 10 cm, the masses were in the benign range (4-8) of Sassone's scoring system for transvaginal ultrasonography, and the patients had serum CA-125 levels less than 65 IU/mL. Two hundred nineteen women fulfilled the criteria and underwent operative laparoscopy. Almost all the masses (99.5%) were accurately predicted to be benign except for one borderline ovarian tumor. Two hundreds thirteen (97.3%) women were successfully managed by operative laparoscopy and six (2.7%) required laparotomy. For the patients managed by laparoscopy, the mean operative time was 51.3 min; the mean hospital stay was 2.5 days. There was no significant morbidity and surgery-related mortality. The combination of the Sassone's scoring system for transvaginal ultrasonography and serum CA-125 level can accurately predict benign cystic masses, and operative laparoscopy is technically feasible and safe for the management of adnexal mass in postmenopausal women.

A Carcinoembryonic Antigen-Secreting Adenocarcinoma Arising in Tailgut Cyst : Clinical Implications of Carcinoembryonic Antigen

Tailgut cysts (TGCs) are rare congenital cysts that occur in the retrorectal or presacral spaces. Although most tailgut cysts have been reported as benign, there have been at least 9 cases associated with malignant change. We report herein on an unusual case of a 40-year-old woman with a carcinoembryonic antigen (CEA) -producing adenocarcinoma arising within a TGC who underwent surgical resection and local radiation therapy. Despite the complete resection, metastatic adenocarcinoma developed five months after surgery. CEA-producing adenocarcinoma from a TGC is extremely rare and only two cases, including this case, have been reported in the English medical literature. Besides CEA, the serum levels of CA 19-9 became markedly elevated in this patient. Given that the serum CEA level decreased to the normal range after complete resection of tumor and that the tumor recurrence was associated with a rebound of the CEA serum level, our case shows that serial measurements of serum CEA can be used for treatment planning and for assessing the patient's treatment response for this rare disease.

Quiste esplenico: informe de un caso y revision de la literatura / Spleenic cysts: report of a case and review of the literature

Los quistes esplenicos son una entidad rara. En la literatura mundial hay recopilados alrededor de 600 casos. Este articulo describe el caso de una paciente con una masa quistica esplenica que se considera como un quiste secundario. Se discute la revision de la literatura respecto a clasificacion , etiologia, manifestaciones clinicas, diagnostico y tratamiento de la enfermedad