Renal Lymphangiectasia: The Transcending of Serendipity.

Renal lymphangiectasia, a rare entity of the renal lymphatic system affecting both genders and all ages, can manifest bilaterally or unilaterally and has been referred to by various terms, such as renal lymphangiomatosis, renal lymphangioma, and others. Distinguishing this condition from common pathologies, such as polycystic kidney disease or hydronephrosis, is crucial. This article presents an innovative clinical case of unilateral renal lymphangiectasia in a 67-year-old woman with a relevant medical history. Detection was achieved by ultrasound in primary care using the point-of-care ultrasound (POCUS) technique under the focused assessment with sonography in trauma (FAST) protocol, revealing findings suggestive of renal lymphangiomatosis. This case highlights the utility of advanced technologies, such as bedside ultrasound, in addressing and transforming the approach to rare medical conditions, offering a compelling reminder of the positive influence of technological innovation in clinical practice.

Stauffer Syndrome: Another Strange Case of the Internist's Tumor.

Stauffer syndrome is a paraneoplastic disorder associated with renal cell carcinoma (RCC), which often can be the first manifestation of the tumor. It is characterized by nephrogenic hepatic dysfunction that reverses after removing the primary tumor. Stauffer syndrome has been associated with a worse prognosis in patients with RCC. We are presenting a case of a patient with an uncommon cholestatic jaundice variant. The patient also had hepatic profile alterations, but no metastasis existed. These findings meet the diagnostic criteria for Stauffer syndrome in the context of RCC as the first clinical manifestation in the diagnostic approach to malignancy-associated disease. A 74-year-old patient, with a history of obesity, hypertension, and type 2 diabetes mellitus, went for advice due to right upper abdominal pain, icterus accompanied by emetic episodes, and a cholestatic pattern in the hepatic profile. Autoimmune hepatitis was ruled out based on immunological testing. Imaging revealed evidence of a mass in the lower pole of the right kidney, suspicious of malignant neoplasia, and a distant paraneoplastic syndrome consistent with the cholestatic variant of Stauffer syndrome. This is an exciting case of Stauffer syndrome as the initial presentation of RCC associated with a cholestatic variant, providing relevant information about this uncommon condition in our setting.

La dermatomiositis paraneoplásica como una presentación inusual de cáncer de mama / Paraneoplastic dermatomyositis as an unusual presentation of breast cancer

Introducción: La dermatomiositis es una inflamación muscular autoinmune con presencia de rash, se manifiesta con debilidad muscular proximal, asociado a complicaciones cardiacas como miocarditis y/o trastornos de la conducción. En algunas ocasiones puede ser la única manifestación clínica de una neoplasia maligna oculta, por lo cual su detección temprana puede tener grandes repercusiones en el pronóstico del tumor oculto. Objetivo: Describir el caso de una paciente con un síndrome paraneoplásico dado por una dermatopolimiositis como presentación inusual de un cáncer de mama. Caso clínico: Se trata de una paciente en quinta década de la vida sin antecedentes personales de importancia, que debuta con una debilidad en miembros superiores de predominio proximal incapacitante, fiebre y elevación importante de la creatinquinasa (CPK), bajo un diagnóstico de una dermatopolimiositis como manifestación principal de un cáncer de mama infiltrante. Conclusiones: La dermatomiositis en mujeres de mediana edad debe hacer sospechar en una patología neoplásica oculta. Lo más importante es descastar el cáncer de mama(AU)

Introduction: Dermatomyositis is an autoimmune muscle inflammation exhibited rash, and proximal muscle weakness, associated with cardiac complications such as myocarditis and / or conduction disorders. In some cases, it can be the only clinical manifestation of hidden malignancy, so its early detection can have great repercussions on the prognosis of the hidden tumor. Objective: To describe the case of a patient with a paraneoplastic syndrome caused by dermatopolymyositis as an unusual presentation of breast cancer. Clinical case report: This is a patient in her fifties with no significant clinical personal history, who had disabling proximal weakness, predominantly in her upper limbs, fever and significant elevation of creatine kinase (CPK), under a diagnosis of dermatopolymyositis as the main manifestation of an infiltrating breast cancer. Conclusions: Dermatomyositis in middle-aged women should make us suspect an occult neoplastic pathology. The most important is to rule out breast cancer(AU)