ABSTRACT
One case of unsuspected schwannoma is reported in a 69-year old man with chronic lumbosacral pain. The tumour had been mistaken for a lumbar lipoma for a decade. The definitive diagnosis was established after surgery based on the characteristic histopathological findings. The purpose of this report is to alert primary care physicians to peripheral sheath nerve tumours, in addition to highlight the role of pain and image features in the suspicion of tumours with longterm evolution.
Se relata un caso de schwannoma insospechado en un hombre con dolor lumbosacral crónico. El tumour había estado equivocado por el lipoma lumbar durante una década. El diagnóstico definitivo puede establecerse después de la cirugía, con base en los resultados histopatológicos característicos. El propósito de este informe es dar énfasis al conocimiento de médicos del cuidado primario sobre los tumoures de la vaina de nervios periféricos, y resaltar el papel del dolor e de las imágenes en la sospecha de estos tumoures que evolucionan con equívocos diagnósticos a largo plazo.
Subject(s)
Aged , Humans , Male , Nerve Sheath Neoplasms/diagnosis , Neurilemmoma/diagnosis , Spinal Cord Neoplasms/diagnosis , Diagnosis, Differential , Lipoma/diagnosis , Nerve Sheath Neoplasms/pathology , Neurilemmoma/pathologyABSTRACT
A two-year investigation was conducted in Itaguai, State of Rio de Janeiro, an area with cases of cutaneous leishmaniasis, in order to study the ecology of sandflies and their habits and role as parasitic vector for men and animals. Capturing took place at three sites: domiciliary (human bait, walls, and light traps); peridomiciliary (walls, from baits used simultaneously: humans, dogs, and chickens; and light traps); and sylvatic (human bait and light traps). A total of 10,172 sandflies were captured, belonging to 17 species of genuses Brumptomyia França & Parrot, 1921 and Lutzomyia França, 1924. L. intermedia was predominant, 100 m above sea level, as compared to L. migonei and L. fischeri. In a drier area 300 m above sea level L. migonei was prevalent, followed by L. longipalpis and L. fischeri. The species which presented the greatest endophily was L. fischeri, showing a certain degree of eclecticism regarding the biting site. L. intermedia and L. migonei proved to be more exophilic. L. intermedia was considered to be potentially the main transmitter of the disease because of its prevalence, anthropophily, and the fact it is known to be a vector of Leishmania (V.) braziliensis in other areas of the Southeastern region of Brazil. L. fischeri, because of its anthropophily, might also be involved.