Metástasis palpebral como primera manifestación de un tumor renal / Eyelid metastasis as first presentation of renal cell carcinoma

Caso clínico: Un varón de 87 años desarrolló en el párpado superior un nódulo de crecimiento lento, no doloroso y bien definido. El tumor de 1 cm de diámetro estaba pigmentado y adherido a planos profundos. El estudio anatomopatológico fue compatible con un carcinoma de células renales. El estudio de extensión mostró una masa tumoral en cada riñón y múltiples metástasis pulmonares. Conclusión: El oftalmólogo puede jugar un papel importante en el diagnóstico del cáncer metastásico, cuando la enfermedad ocular está presente. Por tanto, cabe destacar la relevancia de realizar una biopsia en aquellas lesiones sospechosas y/o recurrentes del párpado (AU)

Case report: An 87-year-old male presented with a slow-growing, painless and well defined nodule in the upper eyelid. The tumour measured 1cm, and was pigmented and adhered to deep planes. The histopathology analysis was compatible with renal cell carcinoma. The extension study showed a tumour mass in each kidney, as well as multiple pulmonary metastases. Discussion: The ophthalmologist can play an important role in the diagnosis of metastatic cancer when eye disease is present. Therefore, the importance of a biopsy should be noted in those suspicious and/or recurrent lesions of the eyelid (AU)

Eyelid metastasis as first presentation of renal cell carcinoma. / Metástasis palpebral como primera manifestación de un tumor renal.

CASE REPORT: An 87-year-old male presented with a slow-growing, painless and well defined nodule in the upper eyelid. The tumour measured 1cm, and was pigmented and adhered to deep planes. The histopathology analysis was compatible with renal cell carcinoma. The extension study showed a tumour mass in each kidney, as well as multiple pulmonary metastases. DISCUSSION: The ophthalmologist can play an important role in the diagnosis of metastatic cancer when eye disease is present. Therefore, the importance of a biopsy should be noted in those suspicious and/or recurrent lesions of the eyelid.

[Gastric duplication in an adult]. / Duplicación gástrica en el adulto.

A gastric cystic duplication was found in a 83 year old patient; the cyst was located on the posterior wall of the stomach and required a total gastrectomy. Gastric duplications are usually discovered during the first year of life. They are located in the greater curvature. It's common the cystic form without communication with the gastric lumen. Due to its rarity, in most cases the diagnosis is made at laparotomy.

[Synchronous pancreatic metastasis of renal carcinoma]. / Metástasis pancreática síncrona de un carcinoma renal.

A case of a large synchronous metastasis on the pancreas from a clear cell renal carcinoma is presented. The patient presented with melena from duodenal ulcer and a palpable mass in the mesogastrium. A radical right nephrectomy and cephalic duodenopancreatectomy were performed. Six years later bone and retroperitoneal metastasis developed and she died one year later. Renal clear cell carcinoma give pancreatic metastasis in only 1-3% of cases. Only 1-2% of the pancreatic malignancies are secondary to renal carcinoma. Clinical and radiological findings are similar to those of primary pancreatic tumors, and hemorrhage is the principal symptom. When the metastasis is single, as in this case, duodeno-pancreatectomy is the treatment of choice.

[Gastric syphilis: infrequent presentation of a common disease]. / Sífilis gástrica: presentación infrecuente de una enfermedad común.

A stenosing antral lesion was diagnosed in a patient with previous ulcer dyspepsia. Radiology, gastroscopy and serology made the diagnosis of gastric syphilis. The lesion disappeared with specific therapy. We present this case because of its rare gastric onset (0.3%) among visceral syphilis, though sexual transmission diseases are increasing nowadays.