ABSTRACT
INTRODUCTION: Synchronous occurrence of different types of neoplasms is not very frequent, representing around 6% of all cases of cancer. Usually there is a lack of information on how to treat these patients, especially when both types of cancers are also uncommon. No cases of synchronous gallbladder adenocarcinoma and gastric gastrointestinal stromal tumor have been published before. PRESENTATION OF CASE: We present the case, management and follow-up, of a 66-year-old female with incidental diagnosis of a pT2NxMx gallbladder adenocarcinoma after elective cholecystectomy that latter, during staging, was also diagnosed with GIST. Total gastrectomy, wedge resection of the liver and lymphadenectomy were performed due to the new findings. Adjuvant chemotherapy for 36 months was indicated. After 16 months of the treatment she has no signs of recurrence. DISCUSSION: Gastrointestinal stromal tumors (GISTs) had a turnaround in the end of the 20th century after the introduction tyrosine-kinase inhibitor to the adjuvant treatment and now the trend is to extend it up to 36 months in selected patients. Gallbladder adenocarcinoma is an uncommon cancer but the incidental diagnosis is increasing with the popularity of laparoscopic cholecystectomy and, thus, specific management should be offered for these patients, what frequently includes a complementary surgery. Although, GISTs may be associated with another synchronous tumor in 20% of the cases, the simultaneous occurrence with gallbladder cancer is incredibly rare. CONCLUSION: Simultaneous occurrence of gastric GIST and gallbladder adenocarcinoma has not been reported before and, thus, any information about it may help in the management of those patients.
ABSTRACT
Bronchogenic cysts are congenital anomalies originating from the primitive tracheobronchial tree in the fetal period. Although the middle mediastinum is the site most commonly affected (second only to the lungs), there have been reports of bronchogenic cysts at unusual sites, such as the retroperitoneum. We report the case of a 4-year-old boy with a cystic mass in the left scapular area since birth. The cyst grew progressively and was accompanied by recurrent episodes of local infection requiring drainage. It was then surgically removed. The histological findings were decisive for the diagnosis: a subcutaneous cyst lined by ciliated columnar epithelium and surrounded by a fibrous wall with smooth muscle tissue, cartilage, and bronchial glands. We also found chronic inflammatory infiltrate, which is consistent with previous episodes of infection. Bronchogenic cysts should be included in the differential diagnosis of cystic tumors of the chest wall and neck, particularly in children. Surgery is the treatment of choice because of the risk of infection, as in this case, and of malignant degeneration.
