Metástasis intramedular de adenocarcinoma gástrico: caso clínico y revisión de la literatura / Intramedullary spinal cord metastasis from gastric adenocarcinoma: Case report and review of literature

Las metástasis intramedulares son entidades infrecuentes relacionadas con el cáncer de pulmón o de mama, siendo excepcional su origen gástrico. Es frecuente que desarrollen clínica más rápidamente que los tumores intramedulares primarios, con déficit motor, dolor, alteraciones esfinterianas, así como trastornos sensitivos de diversa índole, siendo altamente sugestiva la existencia de un síndrome de Brown-Séquard en pacientes con antecedentes oncológicos. El pronóstico de estos pacientes es ominoso, con una supervivencia media aproximada de 4 meses, aunque revisiones recientes postulan que la cirugía puede aportar un leve incremento en la supervivencia, así como una mayor capacidad funcional. Presentamos el caso de un paciente de 61años con una metástasis intramedular cervical de un adenocarcinoma gástrico y revisamos la literatura científica, habiendo 3 casos publicados previamente

Intramedullary spinal cord metastases are very rare and usually associated with lung or breast cancer, with gastric origin being exceptional. Their clinical onset tends to be faster than that of primary intramedullary tumours. The most common early symptoms of intramedullary spinal cord metastasis are motor deficit in one or more limbs, pain, sensory loss, and sphincter disturbances. The appearance of a rapidly progressive Brown-Séquard syndrome in an oncology patient should orientate the diagnosis of this condition. The prognosis is very poor, with a median survival of 4months. However, recent research has shown that surgery could offer a slight benefit in survival and functionality. The case is reported of a 61-year-old man with an intramedullary spinal cord metastasis from a gastric carcinoma, as well as a literature review of this topic. It has been found that this case is the fourth one reported in the literature

[Intramedullary spinal cord metastasis from gastric adenocarcinoma: Case report and review of literature]. / Metástasis intramedular de adenocarcinoma gástrico: caso clínico y revisión de la literatura.

Intramedullary spinal cord metastases are very rare and usually associated with lung or breast cancer, with gastric origin being exceptional. Their clinical onset tends to be faster than that of primary intramedullary tumours. The most common early symptoms of intramedullary spinal cord metastasis are motor deficit in one or more limbs, pain, sensory loss, and sphincter disturbances. The appearance of a rapidly progressive Brown-Séquard syndrome in an oncology patient should orientate the diagnosis of this condition. The prognosis is very poor, with a median survival of 4 months. However, recent research has shown that surgery could offer a slight benefit in survival and functionality. The case is reported of a 61-year-old man with an intramedullary spinal cord metastasis from a gastric carcinoma, as well as a literature review of this topic. It has been found that this case is the fourth one reported in the literature.

Leiomioma intraorbitario. Caso clínico y revisión de la literatura / Orbital leiomyoma. Case report and review of the literature

Los leiomiomas son lesiones de lento crecimiento originarias del músculo liso. La localización orbitaria solo ha sido descrita en 25 casos. Sus características histológicas y la ausencia de recurrencia tras la resección total apoyan su comportamiento benigno. Presentamos un caso de hemangioleiomioma intraconal en una mujer de 55 años tratado quirúrgicamente mediante craneotomía fronto-orbitaria con resección total y sin recurrencia de la lesión tras 15 meses de seguimiento. Se discuten los hallazgos histológicos y radiológicos, enfatizando en el papel pronóstico de la cirugía

Leiomyoma are slowly growing lesions arising from smooth muscle. Orbital location hasbeen reported in 25 cases. Histological findings and no recurrence after total resectionsupport their benign behaviour. We report an intraconal orbital haemangioleiomyoma ina 55-year-old female treated by total resection through fronto-orbital craniotomy, with norecurrence after 15 months of follow-up. Radiological and pathological features are discussed, emphasising the prognostic role of the surgery

[Orbital leiomyoma. Case report and review of the literature]. / Leiomioma intraorbitario. Caso clínico y revisión de la literatura.

Leiomyoma are slowly growing lesions arising from smooth muscle. Orbital location has been reported in 25 cases. Histological findings and no recurrence after total resection support their benign behaviour. We report an intraconal orbital haemangioleiomyoma in a 55-year-old female treated by total resection through fronto-orbital craniotomy, with no recurrence after 15 months of follow-up. Radiological and pathological features are discussed, emphasising the prognostic role of the surgery.

Embolismos de cholesterol en el tracto urinario inferior como manifestación clínica de la enfermedad ateroembólica. Descripción de tres casos, uno de ellos simulando una neoplasia / Cholesterol embolism of the upper urinary tract as a clinical feature of atherosclerotic embolic vascular disease. Report of three cases, one of them simulating neoplasia

OBJETIVO: Presentar tres casos de enfermedadateroembólica con debut clínico en tracto urinarioinferior. Esta enfermedad es infrecuente, afectandosobre todo piel, riñón y músculo esquelético. Otrosórganos del tracto urinario son raramente afectados yde forma extraordinaria como debut de la enfermedad,sin afectación previa conocida de otras localizaciones.MÉTODOS/RESULTADOS: El primer paciente presentabaun episodio de hematuria asociado con una imagenecográfica y cistoscópica sospechosa de neoplasia.En los fragmentos de resección transuretral la lesióncorrespondía a una cistitis polipoide con algunas arteriasde pequeño tamaño ocupadas por agujas decolesterol, asociado con inflamación, ulceración y extravasación hemática. Al segundo paciente se le realizóuna cistoprostatectomía por un carcinoma urotelial,encontrándose incidentalmente numerosos émbolos decolesterol principalmente en lámina propia, pero tambiénen otras capas de la pared vesical, próstata, uretraen el verumontanum y una vesícula seminal, estasdos últimas localizaciones no descritas en publicacionesanteriores. En el tercer paciente el émbolo seencontró en un cilindro de biopsia prostática.CONCLUSIONES: Esta enfermedad poco frecuentepuede debutar como un proceso vesical o prostático yser diagnosticado por medio de biopsia de estos órganos.Puede simular una neoplasia vesical en ecografíao cistoscopia y debería ser incluida entre las entidadesrelacionadas o causantes de cistitis polipoide, un conocidosimulador de neoplasia

OBJECTIVES: To report three cases of ;;atherosclerotic embolic vascular disease with clinical ;;presentation in the lower urinary tract. This disease is not ;;frequent; it mainly affects the skin, kidneys and skeletal ;;muscle. Other organs of the urinary tract are rarely ;;affected and they are exceptionally the clinical site of ;;debut without previous known involvement of other ;;areas. METHODS/RESULTS: The first patient presented with ;;hematuria associated with an ultrasound/cystoscopical ;;image suspicion for neoplasia. Pathologic report of the ;;transurethral resection chips showed polypoid cystitis ;;with some small size arteries occupied by cholesterol ;;needles, associated with inflammation, ulcers and ;;hematic extravasation. The second patient underwent ;;cystoprostatectomy for a transitional cell carcinoma ;;and, incidentally, numerous cholesterol emboli were ;;found, mainly in the lamina propria, but also in other ;;layers of the bladder wall, prostate, urethra, veru ;;montanum, and one seminal vesicle; this two latter sites ;;have not being reported in previous publications. The ;;third patient showed the embolus within a prostate ;;biopsy core. ;;CONCLUSIONS: This unfrequent disease may present ;;as a bladder or prostatic process and be diagnosed by ;;biopsy of these organs. It may simulate a bladder neoplasia ;;on ultrasound or cystoscopy and should be included ;;among related or etiologic entities of polypoid cystitis, ;;a well-known simulator of neoplasia

[Cholesterol embolism of the upper urinary tract as a clinical feature of atherosclerotic embolic vascular disease. Report of three cases, one of them simulating neoplasia]. / Embolismos de colesterol en el tracto urinario inferior como manifestacion clinica de la enfermedad ateroembólica. descripción de tres casos, uno de ellos simulando una neoplasia.

OBJECTIVES: To report three cases of atherosclerotic embolic vascular disease with clinical presentation in the lower urinary tract. This disease is not frequent; it mainly affects the skin, kidneys and skeletal muscle. Other organs of the urinary tract are rarely affected and they are exceptionally the clinical site of debut without previous known involvement of other areas. METHODS/RESULTS: The first patient presented with hematuria associated with an ultrasound/cystoscopical image suspicion for neoplasia. Pathologic report of the transurethral resection chips showed polypoid cystitis with some small size arteries occupied by cholesterol needles, associated with inflammation, ulcers and hematic extravasation. The second patient underwent cystoprostatectomy for a transitional cell carcinoma and, incidentally, numerous cholesterol emboli were found, mainly in the lamina propria, but also in other layers of the bladder wall, prostate, urethra, veru montanum, and one seminal vesicle; this two latter sites have not being reported in previous publications. The third patient showed the embolus within a prostate biopsy core. CONCLUSIONS: This unfrequent disease may present as a bladder or prostatic process and be diagnosed by biopsy of these organs. It may simulate a bladder neoplasia on ultrasound or cystoscopy and should be included among related or etiologic entities of polypoid cystitis, a well-known simulator of neoplasia.