Metástasis cerebral de cáncer de endometrio en paciente joven / Brain metastases of endometrial carcinoma in a young woman

Se presenta un caso de metástasis cerebral de cáncer de endometrio precediendo al diagnóstico del tumor primario en una paciente de 43 años, sin factores de riesgo para cáncer de endometrio. Los estudios anatomopatológicos diagnosticaron un adenocarcinoma endometrial pobremente diferenciado, con importantes áreas vasculares demostradas mediante positividad para el factor VIII. Aunque se han descrito metástasis intracraneales en casos de estadios tempranos de la enfermedad o en mujeres sin sospecha de cáncer endometrial, su presentación es excepcional. Cuando encontramos sangrados irregulares a esa edad, no solemos sospechar la existencia de cáncer y es habitual que se intente regularlos con terapia hormonal, lo que puede retrasar el diagnóstico

We report a case of brain metastases preceding diagnosis of the primary tumor in a 43-year-old woman without risk factors for endometrial carcinoma. Histological examination and immunohistochemical studies revealed a poorly differentiated endometrial adenocarcinoma with highly vascular areas identified by factor VIII-positive cells. Although brain metastases have been described early in the course of the disease and in patients without suspected endometrial cancer, such cases are uncommon. In women of this age with bleeding disturbances, endometrial carcinoma is not usually suspected as the primary cause. The disturbance is normally treated with hormone therapy, which can delay diagnosis

[Castleman's disease in the retroperitoneal region]. / Enfermedad de Castleman de localización retroperitoneal.

OBJECTIVE: To describe a case of Castleman's disease presenting as a retroperitoneal mass, with special reference to the differential diagnosis from other retroperitoneal lesions. The histological features, variants, clinical manifestations, etiopathogenesis and treatment of Castleman's disease are reviewed. METHODS: A 64-year-old male presented with voiding symptoms and hypogastric pain. An ultrasound scan showed a 5 x 6 cm mass located behind the bladder and above the prostate, which was confirmed by an abdomino-pelvic CT scan. RESULTS: Retroperitoneal sarcoma was suspected and the mass was resected. The histopathological analysis showed giant lymphoid hyperplasia (vascular hyaline variant of Castleman's disease). CONCLUSIONS: Retroperitoneal Castleman's disease is a lymphoproliferative disorder with two well-defined histological types and a mixed variant. Although this lesion is frequently localized to the mediastinum (71%), extrathoracic lesions have been described. Definitive diagnosis is based on the postoperative pathological findings.