ABSTRACT
El feocromocitoma quístico gigante es tumor adrenal raro en el que predomina el curso asintomático; por lo que muchos de los casos no son diagnosticados hasta el momento de la cirugía. La simple movilización del tumor se asocia con el paso a la sangre de grandes cantidades de catecolaminas y a una elevada morbimortalidad.; por esta razón la cirugía per se y su manejo perioperatorio constituyen un enorme desafío. En este artículo se presenta el caso de un feocromocitoma gigante maligno (35 cm) que ocupaba todo el hemiabdomen derecho. Aun con el diagnóstico preoperatorio de feocromocitoma, el bloqueo farmacológico preoperatorio y las medidas intraoperatorias, el paciente falleció poco antes de que finalizara la cirugía.
The giant cystic pheochromocytoma is a rare adrenal tumor in the predominantly asymptomatic course; so many cases are not diagnosed until the time of surgery. The simple mobilization of the tumor is associated with the passage to the blood of large amounts of catecholamines and high morbidity and mortality. So the surgery itself and perioperative management are a huge challenge. This article describes the case of a malignant giant pheochromocytoma (35 cm) which occupied the entire right abdomen. Even with the preoperative diagnosis of pheochromocytoma, pharmacological blockade preoperative and intraoperative measures, the patient died shortly before the end of surgery.
Subject(s)
Aged , Humans , Male , Pheochromocytoma/diagnostic imaging , Adrenal Gland Neoplasms/diagnostic imaging , Pheochromocytoma/surgery , Pheochromocytoma/metabolism , Pheochromocytoma/pathology , Preanesthetic Medication , Catecholamines/metabolism , Tomography, X-Ray Computed , Adrenal Gland Neoplasms/surgery , Adrenal Gland Neoplasms/metabolism , Adrenal Gland Neoplasms/pathology , Fatal Outcome , Adrenal Medulla/metabolism , Adrenal Medulla/pathology , Adrenergic alpha-Antagonists/administration & dosage , Adrenergic alpha-Antagonists/therapeutic use , Adrenergic beta-Antagonists/administration & dosage , Adrenergic beta-Antagonists/therapeutic use , Cysts/surgery , Cysts/metabolism , Cysts/pathology , Cysts/diagnostic imaging , Tumor Burden , Intraoperative Complications/etiology , Intraoperative Complications/physiopathologyABSTRACT
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Subject(s)
Humans , Male , Adolescent , Mediastinal Emphysema/diagnostic imaging , Chest Pain/etiology , Oxygen Inhalation TherapySubject(s)
Mediastinal Emphysema/diagnostic imaging , Adolescent , Humans , Male , Radiography, ThoracicABSTRACT
The giant cystic pheochromocytoma is a rare adrenal tumor in the predominantly asymptomatic course; so many cases are not diagnosed until the time of surgery. The simple mobilization of the tumor is associated with the passage to the blood of large amounts of catecholamines and high morbidity and mortality. So the surgery itself and perioperative management are a huge challenge. This article describes the case of a malignant giant pheochromocytoma (35 cm) which occupied the entire right abdomen. Even with the preoperative diagnosis of pheochromocytoma, pharmacological blockade preoperative and intraoperative measures, the patient died shortly before the end of surgery.
Subject(s)
Adrenal Gland Neoplasms/diagnostic imaging , Pheochromocytoma/diagnostic imaging , Adrenal Gland Neoplasms/metabolism , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/surgery , Adrenal Medulla/metabolism , Adrenal Medulla/pathology , Adrenergic alpha-Antagonists/administration & dosage , Adrenergic alpha-Antagonists/therapeutic use , Adrenergic beta-Antagonists/administration & dosage , Adrenergic beta-Antagonists/therapeutic use , Aged , Catecholamines/metabolism , Cysts/diagnostic imaging , Cysts/metabolism , Cysts/pathology , Cysts/surgery , Fatal Outcome , Humans , Intraoperative Complications/etiology , Intraoperative Complications/physiopathology , Male , Pheochromocytoma/metabolism , Pheochromocytoma/pathology , Pheochromocytoma/surgery , Preanesthetic Medication , Tomography, X-Ray Computed , Tumor BurdenABSTRACT
BACKGROUND: To determine the prevalence of Chlamydia trachomatis infection in our area by molecular methods. METHODS: We describe the combined results of three studies carried out in the city of Barcelona including a total of 408 women considered to be at high risk for acquiring a sexually transmitted disease (STD). The first study was performed in 94 women attended at a public STD clinic located downtown, the second in 112 women attended at the Hospital Clinic and the third in 202 women attended at Hospital Vall d'Hebron (both third-level hospitals). In the first and third study endocervical exudate was tested with a PCR technique, and in the second study LCR was performed in 20-ml urine samples. RESULTS: Chlamydia trachomatis was detected in 1 woman in the first study, in no women in the second and in 3 women in the third. The prevalence of Chlamydia trachomatis infection detected in the three studies using molecular biology techniques was 1.06%, 0% and 1.48% respectively, giving an overall prevalence of 0.98%. CONCLUSION: The prevalence of Chlamydia trachomatis infection in our geographic area is surprisingly low.
Subject(s)
Chlamydia Infections/epidemiology , Chlamydia trachomatis/isolation & purification , Adult , Chlamydia Infections/microbiology , Chlamydia Infections/transmission , Chlamydia trachomatis/genetics , Comorbidity , DNA, Bacterial/genetics , Female , HIV Infections/epidemiology , Humans , Polymerase Chain Reaction , Prevalence , Risk Factors , Sex Work , Sexual Partners , Spain/epidemiology , Urban Population , Uterine Cervicitis/epidemiology , Uterine Cervicitis/microbiologyABSTRACT
FUNDAMENTO. Determinar la prevalencia de la infección por Chlamydia trachomatis por métodos moleculares. MÉTODOS. Se describen conjuntamente los resultados de 3 trabajos realizados en la ciudad de Barcelona y en los que se estudiaron 408 mujeres consideradas como de alto riesgo para la adquisición de una enfermedad de transmisión sexual (ETS). El primer estudio incluyó a 94 mujeres atendidas en un centro público de ETS, el segundo a 112 mujeres atendidas en el Hospital Clínico y el tercero a 202 mujeres atendidas en el Hospital Vall d'Hebron de Barcelona. En el primer y tercer estudio se practicó toma endocervical y se realizó una técnica de reacción en cadena de la polimerasa (PCR). En el segundo se realizó reacción en cadena de la ligasa (LCR) a partir del primer chorro de orina. RESULTADOS. Chlamydia trachomatis se detectó en una sola paciente en el primer estudio, en ninguna en el segundo y en 3 pacientes en el tercero. Es decir que utilizando técnicas de biología molecular las prevalencias de infección por Chlamydia trachomatis fueron del 1,06, 0 y 1,48 por ciento, respectivamente, siendo la prevalencia total del 0,98 por ciento. CONCLUSIONES. La prevalencia de la infección por Chlamydia trachomatis en nuestra área geográfica es sorprendentemente baja (AU)
