ABSTRACT
According to autopsy data, diffuse hepatic infiltration occurs in up to 50% of cases with multiple myeloma. However, focal infiltration (single or multiple), although exceptional, is also possible. Therefore, multiple myeloma should be included in the extensive differential diagnosis of space-occupying liver lesions. We present the case of a 71-year-old man diagnosed with multiple myeloma with multiple focal lesions in the liver and spleen studied by different imaging techniques (ultrasound, multi-phase computed tomography and magnetic resonance). The definitive diagnosis was made by immunohistochemical analysis of material obtained by US-guided fine needle aspiration. We review the imaging findings reported in the literature for focal liver lesions in multiple myeloma and in extramedullary plasmacytoma of the liver.
Subject(s)
Liver Neoplasms/diagnosis , Liver Neoplasms/secondary , Multiple Myeloma/secondary , Aged , Humans , Liver Neoplasms/diagnostic imaging , Magnetic Resonance Imaging , Male , Tomography, X-Ray Computed , UltrasonographyABSTRACT
El adenoma hepático (AH) es una proliferación benigna de hepatocitos, que suele presentarse en mujeres con antecedentes de toma prolongada de anticonceptivos orales. Es muy infrecuente en varones. Actualmente las pruebas diagnósticas más útiles son la TC helicoidal y la resonancia magnética. El tratamiento es la resección hepática, tanto en los casos de AH sintomáticos como en los asintomáticos, por el riesgo de crecimiento, rotura y transformación maligna (AU)
Subject(s)
Adult , Male , Humans , Adenoma, Liver Cell/surgery , Adenoma, Liver Cell/diagnosis , Liver Neoplasms/surgery , Liver Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To evaluate the efficiency of self-expanding metal stents (SES) for the palliative treatment of malignant oesophageal strictures and fistulas. MATERIAL AND METHODS: Fifty non-operable patients with malignant oesophageal strictures and/or fistulas were treated with SES placement. All patients had dysphagia, the mean degree for the studied group being 3.36. Ten patients presented associated tumoral fistula. Uncoated SES were placed for simple stenosis cases and coated SES for cancers with associated fistulas. RESULTS: A improvement in dysphagia was obtained in 47 patients (94%). The mean degree of dysphagia after the procedure was 1.12. In nine patients (90%) the fistula closed with resolution of the associated clinical picture. Complication were observed in six patients (12%), the perioperative mortality rate being 2%. During follow-up, twelve patients (25%) had malfunction of the stent, which was successfully treated in eight patients. CONCLUSION: SES are efficient for the palliative treatment of malignant oesophageal strictures and/or fistulas, but not commonly re-interventions are necessary to maintain a long-term functionality.
