Metástasis única en los huesos carpianos como primera manifestación clínica de un hepatocarcinoma / A single metastasis in the carpal bones as the first clinical manifestation of a hepatocellular carcinoma

El carcinoma hepatocelular es el tumor primario más frecuente del hígado. La extensión extrahepática suele aparecer en estadios avanzados de la enfermedad y las metástasis óseas ocupan el tercer lugar en frecuencia. Presentamos un caso de carcinoma hepatocelular que comenzó con una metástasis única en los huesos del carpo. El interés del caso radica en la forma de presentación clínica del carcinoma hepatocelular y la localización poco frecuente en los huesos de la muñeca (AU)

Hepatocellular carcinoma is the most common primary tumor of the liver. Spreading outside the liver usually takes place in advanced stages of the disease, and bone is the third most common site of metastases. We present a case of hepatocellular carcinoma in which the first clinical manifestation was a single metastasis to the carpal bones. The interest of this case lies in the way this hepatocellular carcinoma manifested as well as in the unusual site of the metastasis (AU)

[A single metastasis in the carpal bones as the first clinical manifestation of a hepatocellular carcinoma]. / Metástasis única en los huesos carpianos como primera manifestación clínica de un hepatocarcinoma.

Hepatocellular carcinoma is the most common primary tumor of the liver. Spreading outside the liver usually takes place in advanced stages of the disease, and bone is the third most common site of metastases. We present a case of hepatocellular carcinoma in which the first clinical manifestation was a single metastasis to the carpal bones. The interest of this case lies in the way this hepatocellular carcinoma manifested as well as in the unusual site of the metastasis.

[Hepatic actinomycosis: radiologic findings and percutaneous drainage]. / Actinomycosis hepática: hallazgos radiológicos y drenaje percutáneo.

We report a case of hepatic actinomycosis in a woman with previous duodenal ulcer. The findings of ultrasound, computed tomography and abscess imaging are presented. The diagnosis was made by thin needle aspiration biopsy under computed tomography guidance. The treatment consisted in percutaneous drainage and intravenous antibiotic therapy.

[Ultrasonography of acute diverticulitis of the colon]. / Ecografía de la diverticulitis aguda de colon.

Ultrasonographic findings in two patients with acute diverticulitis of the left colon are described. Echographic identification of diverticula and thickened (> 4 mm) hypoechoic bowel wall were common findings. The final diagnosis was confirmed by contrast enema and colonoscopy. Patients had clinical signs and symptoms of acute diverticulitis. Diverticula were visualized as echogenic shadowing foci in thickened bowel wall (1 case) or as outpouches of the intestinal wall in the pericolonic soft tissues (1 case). One patient had edema of the pericolic fat. Additional studies are needed to confirm the usefulness of ultrasounds in the diagnosis of colonic diverticulitis.

[Ulcerative colitis and Crohn disease: echographic diagnosis with water enema]. / Colitis ulcerosa y enfermedad de Crohn: diagnóstico mediante ecografía con enema de agua.

Water enema procures a suitable acoustic window for ultrasonographic study of the colon, allowing a detail vision of the lumen and colon wall, as well as large bowel intestine surround connective tissue. In this work we present echographic findings in two patients with active and severe intestinal inflammatory disease. Ultrasound scanning results were confirmed by colonoscoy and histological test. Distinction between ulcerative colitis and colonic Crohn's disease is possible because of different echographic pattern. This findings show than colonic echography may be a very useful diagnostic technique in detection and differentation of inflammatory large bowel diseases.