ABSTRACT
Pulmonary tumor embolism (PTE) is a rare phenomenon typically presenting as dyspnea in cancer patients. Primary pathophysiology is similar to the thromboembolic disease of the pulmonary vasculature, which involves large vessels to small arterioles. This phenomenon occurs mostly in lung, stomach, liver, and breast adenocarcinoma. The symptoms of hypoxemia and the signs of hemodynamic instability and high-resolution computed tomography (CT) scans, along with a histopathological examination, are essential to make a confirmatory diagnosis of pulmonary tumor embolism. However, treatment options to effectively treat pulmonary tumor embolus are limited and still under investigation. We present a rare case of pulmonary tumor embolism in a patient with metastatic liver carcinoma and its management in a female with primary breast carcinoma.
ABSTRACT
Aggressive treatment of hyper or hypoosmolar conditions can trigger osmotic demyelination syndrome. We describe the case of a 53-year-old male who began using carbamazepine to treat bipolar affective disorder and was later diagnosed with carbamazepine-induced syndrome of inappropriate antidiuretic hormone secretion. The patient's mental state gradually improved once the hyponatremia was corrected using 3% normal saline and supportive therapy. The patient presented to the outpatient clinic with confusion and altered sensorium. Brain computed tomography showed diffuse cerebral atrophy and periventricular ischemia demyelination alterations, and magnetic resonance imaging showed an enhanced section in the brainstem that included the pons, suggesting osmotic demyelination alterations. Ventilatory support and supportive therapy were initiated, and hyponatremia was rectified. Although the patient did well with the treatment, his prognosis was still dismal, so he was sent home with instructions to follow up.
ABSTRACT
The second most frequent primary carcinoma of the liver to emerge is intrahepatic cholangiocarcinoma (ICC), which is thought to be an incurable, rapidly proliferating tumor with a dismal prognosis. ICC is typically found at an advanced stage and is physiologically hostile. Regional lymph nodes and liver metastases are frequent tumor metastatic sites for ICC and serve as indicators of tumor recurrence. ICC metastasizing to the male urogenital tract has only seldom been documented. Typically, lymph vessels serve as the primary pathway for disseminating tumor cells. The high fatality rate associated with ICC and the rapid spread of the disease may be caused by this lymphatic route. The only curative therapeutic approach for treating these tumors is surgical removal. We report a case of prostatic metastasis from ICC.
