ABSTRACT
We describe the case of a 77-year-old woman with chronic hepatitis C and well compensated cirrhosis in whom a single encapsulated 5.5 cm hepatocellular carcinoma was found in the right liver lobe. The patient was symptomatic with left upper quadrant pain and had elevated alfa-fetoprotein levels (3133 ng/ml). While she was waiting for liver resection and 2 months after the initial diagnosis the pain improved and alfa-fetoprotein levels normalized. A computerized tomography scan showed reduction in size of the lesion to 2.5 cm, with no central arterial enhancement, but with the demonstration of a peripheral rim enhancing in all dynamic phases. Follow up computerized tomography and magnetic resonance imaging examinations showed further reduction in size of the lesion to 1.3 cm with persistence of the enhancing rim 20 months after the initial diagnosis. The spontaneous and durable regression of the HCC and the persistent peripheral enhancing rim could be explained by a strong and persistent activation of the immune system directed against the neoplastic cells.
Subject(s)
Carcinoma, Hepatocellular/pathology , Liver Neoplasms/pathology , Neoplasm Regression, Spontaneous , Aged , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/diagnostic imaging , Female , Hepatitis C, Chronic/complications , Humans , Liver Neoplasms/complications , Liver Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , UltrasonographyABSTRACT
We studied the stool samples of 151 school children in a district of the city of Portoviejo (Ecuador) in order to determine the prevalence and intensity of soil-transmitted helminthiasis (STH) and their relationships with anthropometric indices. The samples were analyzed with the semiquantitative Kato-Katz technique and the intensity of infections was categorized as light, moderate or high according to the thresholds set by the World Health Organization. Prevalence of soil transmitted helmintiasis was 65 percent (92 out of 141 collected samples), Ascaris lumbricoides was the most common STH (63 percent) followed by Trichuris trichiura (10 percent) and hookworm (1.4 percent). Heavy intensity infections were found in 8.5 percent of the stool samples, with T. trichiura showing higher worm burdens than A. lumbricoides. Sixteen percent of the children were below the third percentile for weight (wasted), while 27 percent were below the third percentile for height (stunted). A significant relationship was found between the worm burden and the degree of stunting. This study suggests that the periodic administration of an antihelminthic drug should be targeted to preschool and school children to allow a normal growth spurt and prevent stunting
Subject(s)
Humans , Male , Female , Child , Helminthiasis/epidemiology , Soil , Anthropometry , Ascariasis/diagnosis , Ascariasis/epidemiology , Ascariasis/transmission , Ecuador , Feces , Helminthiasis/diagnosis , Helminthiasis/transmission , Linear Models , Parasite Egg Count , Prevalence , Severity of Illness Index , Trichuriasis/diagnosis , Trichuriasis/epidemiology , Trichuriasis/transmissionABSTRACT
We studied the stool samples of 151 school children in a district of the city of Portoviejo (Ecuador) in order to determine the prevalence and intensity of soil-transmitted helminthiasis (STH) and their relationships with anthropometric indices. The samples were analyzed with the semiquantitative Kato-Katz technique and the intensity of infections was categorized as light, moderate or high according to the thresholds set by the World Health Organization. Prevalence of soil transmitted helmintiasis was 65% (92 out of 141 collected samples), Ascaris lumbricoides was the most common STH (63%) followed by Trichuris trichiura (10%) and hookworm (1.4%). Heavy intensity infections were found in 8.5% of the stool samples, with T. trichiura showing higher worm burdens than A. lumbricoides. Sixteen percent of the children were below the third percentile for weight (wasted), while 27% were below the third percentile for height (stunted). A significant relationship was found between the worm burden and the degree of stunting. This study suggests that the periodic administration of an antihelminthic drug should be targeted to preschool and school children to allow a normal growth spurt and prevent stunting.
Subject(s)
Helminthiasis/epidemiology , Soil/parasitology , Anthropometry , Ascariasis/diagnosis , Ascariasis/epidemiology , Ascariasis/transmission , Child , Ecuador/epidemiology , Feces/parasitology , Female , Helminthiasis/diagnosis , Helminthiasis/transmission , Humans , Linear Models , Male , Parasite Egg Count , Prevalence , Severity of Illness Index , Trichuriasis/diagnosis , Trichuriasis/epidemiology , Trichuriasis/transmissionABSTRACT
The case is described of a 63-year-old female with a multilocular liver cyst diagnosed as cystadenoma after imaging and fine needle aspiration. The lesion, however, proved to be an invasive cystadenocarcinoma at surgery. Cystadenoma cannot be differentiated, preoperatively, from cystadenocarcinoma and should always be considered for surgical resection.
