ABSTRACT
We report a previously healthy 34-year-old woman, presenting with a seven-month history of arterial hypertension, amenorrhea, weight gain, facial edema, acne, hirsutism and low back pain. A CT scan showed a right adrenal mass of 18 × 13 × 12.5 cm, and multiple vertebral and rib fractures. The hormonal study confirmed Cushing's Syndrome. Ketoconazole, spironolactone, cotrimoxazole, calcium / vitamin D were started. An adrenalectomy with a right nephrectomy were performed. The excised tumor measured 16 cm and weighed 1.55 kg. There was tumor embolism and a 4 mm soft tissue involvement (pT3NxMx). The right kidney was free of tumor. The patient was treated with chemotherapy (etoposide plus cisplatin). Study of vertebral fractures with magnetic resonance (MRI) showed crush fractures, without images of metastatic bone lesions. One year after surgery, a CT scan showed no signs of tumor recurrence. The patient was lost from follow-up thereafter.
Subject(s)
Adult , Female , Humans , Carcinoma , Cushing Syndrome , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Adrenalectomy , Cushing Syndrome/etiologyABSTRACT
We report a previously healthy 34-year-old woman, presenting with a seven-month history of arterial hypertension, amenorrhea, weight gain, facial edema, acne, hirsutism and low back pain. A CT scan showed a right adrenal mass of 18 × 13 × 12.5 cm, and multiple vertebral and rib fractures. The hormonal study confirmed Cushing's Syndrome. Ketoconazole, spironolactone, cotrimoxazole, calcium / vitamin D were started. An adrenalectomy with a right nephrectomy were performed. The excised tumor measured 16 cm and weighed 1.55 kg. There was tumor embolism and a 4 mm soft tissue involvement (pT3NxMx). The right kidney was free of tumor. The patient was treated with chemotherapy (etoposide plus cisplatin). Study of vertebral fractures with magnetic resonance (MRI) showed crush fractures, without images of metastatic bone lesions. One year after surgery, a CT scan showed no signs of tumor recurrence. The patient was lost from follow-up thereafter.
Subject(s)
Carcinoma , Cushing Syndrome , Adrenalectomy , Adult , Cushing Syndrome/etiology , Female , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
La relación de los triglicéridos (TG) con la incidencia de enfermedad cardiovascular continúa siendo materia de discusión; sin embargo, la evidencia es creciente en cuanto a que sus concentraciones elevadas conllevan un mayor riesgo de eventos ateroscleróticos. El incremento posprandial de los triglicéridos indica la presencia de remanentes de lipoproteínas, que pueden favorecer la progresión de la aterosclerosis. La mayoría de los pacientes con enfermedad arterial coronaria, diabetes, obesidad o síndrome metabólico tienen una dislipemia caracterizada por la combinación de TG elevados, partículas pequeñas y densas de lipoproteínas de baja densidad y valores bajos de lipoproteínas de alta densidad, la cual es referida como fenotipo aterogénico. En la mayoría de los estudios, las cifras de TG se obtienen en ayunas; sin embargo, la hipertrigliceridemia posprandial tiene un papel importante en la aterosclerosis. El objetivo de esta revisión es determinar la relación de las concentraciones de TG (en ayunas y posprandial) y el riesgo de futuros eventos cardiovasculares (AU)
The association of triglycerides with the incidence of cardiovascular disease remains controversial; however, the evidence that elevated serum triglyceride levels are associated with increased risk for atherosclerotic events is increasing. Elevated non-fasting triglyceride levels indicate the presence of residual lipoproteins, which may promote atherosclerosis. Most patients with coronary heart disease, diabetes, obesity or metabolic syndrome have lipoprotein disorders, which include a combination of elevated triglyceride levels, small and dense LDL particles, and low levels of HDL. This is referred as the atherogenic phenotype. In most studies, triglyceride levels are obtained in the fasting state; however, postprandial hypertriglyceridemia may play an important role in atherosclerosis. The aim of this review is to determine the association between triglyceride levels (fasting vs. non-fasting) and risk of future cardiovascular events (AU)
