ABSTRACT
Introdução: A incidência de câncer retal tem aumentado na última década. O adenocarcinoma de reto, vasta maioria dos cânceres retais, é uma doença com o diagnóstico relativamente simples e de desfecho positivo através de tratamento e diagnóstico precoces. Métodos: Revisamos na literatura o diagnóstico e o tratamento. O estudo foi realizado de forma qualitativa, por meio de revisão de literatura, tendo como fonte principal artigos científicos disponibilizados em diversas bases de dados. Resultados: O diagnóstico é realizado pela anamnese, exame físico e exames de imagem. A base do tratamento de tumores potencialmente ressecáveis é a cirurgia enquanto que a quimiorradioterapia neoadjuvante apresenta papel importante em casos de invasão transmural. Conclusão: O tratamento curativo do câncer retal baseia-se no procedimento cirúrgico. Neste sentido, deve-se conhecer todos os passos de estadiamento e avaliação, a fim de aumentar as chances de ressecção curativa.
Introduction: The incidence of rectal cancer is increasing in the past decade. Rectal adenocarcinoma, the majority of rectal cancers, is a relatively simple disease in terms of diagnosis and with a positive outcome through right treatment and early diagnosis. Methods: We have reviewed the diagnosis and treatment in the academic literature. The study was carried out in a qualitative way, through a literature review, having as main source scientific articles available in several databases. Results: The diagnosis of this pathology must be established associating physical examination, anamnesis and image exams. The baseline of treatment of potentially resectable tumors is surgery while neoadjuvant chemoradiotherapy plays an important role in transmural invasion. Conclusion: The curative treatment of rectal cancer is based on the surgical procedure. In this sense, it is necessary to know all steps of staging and evaluation, in order to increase the chances of curative resection.
Subject(s)
Rectal Neoplasms/diagnosis , Rectal Neoplasms/drug therapyABSTRACT
BACKGROUND CONTEXT: Aneurysmal bone cysts at the cervical spine represent a real challenge both diagnostically and therapeutically, especially in young patients. PURPOSE: We present an unusual case of a C2 aneurysmal bone cyst expanding in the entire vertebral body in a girl successfully treated with a transoral vertebroplasty. STUDY DESIGN: This is a case report study. METHODS: We report the case of a 17-year-old girl with a history of cervical pain and occipital headache after a car accident. Routine x-rays disclosed a C2 lesion. Her neurologic examination was normal. Computed tomography showed a lytic lesion occupying almost the entire body of the C2 vertebra. The cortical bone was intact but notably thinned. Magnetic resonance imaging revealed a cystic image with blood inside. Transoral vertebroplasty was selected among other surgical options for the following reasons: (1) to improve the clinical symptoms, and (2) to prevent future vertebral collapse with devastating neurologic consequences. Under general anesthesia and continuous neurophysiological monitoring, we conducted a fluoroscopic-guided transoral vertebroplasty through a Jamshidi needle. A cytology sample from the cystic lesion was taken through the needle. RESULTS: The blood smear showed no tumoral cellularity. There were no complications during surgery or postoperative infections. After 4 years of follow-up, the patient is pain-free and leads a normal life. CONCLUSIONS: Transoral vertebroplasty seems to be a direct, safe, and effective technique to stabilize cystic lesions that endanger the stability of C2 and to improve symptoms. Aneurysmal bone cysts should be included in the differential diagnosis of lytic lesions at the C2 vertebral body.
