Cutaneous metastasis of bladder sarcoma: when should we consider this hypothesis? A review of the literature.

The incidence of cutaneous metastases is approximately 0.7 to 10%, while in metastases of urothelial origin the incidence is less than 1%. Transitional cell carcinoma is the most common of the genitourinary tract tumors. Sarcoma of the bladder is rare (0.3%). It can involve multiple clinical presentations, with a nodule being the most common. Diagnosis is made by a combination of medical history, clinical examination and histopathology. The treatment is surgical. The prognosis is very uncertain and depends on a multidisciplinary approach.

Metástase cutânea de sarcoma de bexiga: quando devemos considerar essa hipótese? uma revisão bibliográfica / Cutaneous metastasis of bladder sarcoma: when should we consider this hypothesis? a review of the literature

A incidência de metástases cutâneas é de, aproximadamente, 0,7 a 10 por cento. As de origem urotelial correspondem a menos de 1 por cento. Dos tumores do trato genitourinário, o carcinoma de células transicionais é mais comum. O sarcoma de bexiga é raro, correspondendo a 0,3 por cento. Podem ter múltiplas apresentações clínicas, sendo o nódulo mais comum. O diagnóstico é realizado pela anamnese, quadro clínico e histopatologia. O tratamento é cirúrgico. O prognóstico é muito reservado e depende de um acompanhamento multidisciplinar.

The incidence of cutaneous metastases is approximately 0.7 to 10 percent, while in metastases of urothelial origin the incidence is less than 1 percent. Transitional cell carcinoma is the most common of the genitourinary tract tumors. Sarcoma of the bladder is rare (0.3 percent). It can involve multiple clinical presentations, with a nodule being the most common. Diagnosis is made by a combination of medical history, clinical examination and histopathology. The treatment is surgical. The prognosis is very uncertain and depends on a multidisciplinary approach.

Alterações oftalmológicas em paciente com hanseníase e neurocisticercose: relato de caso / Ocular changes in patient with leprosy and neurocysticercosis: case report

JUSTIFICATIVA E OBJETIVOS: A hanseníase e a neurocisticercose são doenças tropicais, infecciosas, que têm importante repercussão na saúde pública e podem ter uma forma ocular, gerando dúvida etiológica desta oftalmopatia ao ocorrem concomitantemente. O objetivo deste estudo foi relatar a presença de alterações oculares na hanseníase, além da importância da sua prevenção e diferenciação de outra comorbidade. RELATO DO CASO: Paciente do sexo feminino, 63 anos, procedente de Nova Iguaçu-Rio de Janeiro, queixando-se de manchas pelo corpo, parestesia e edema nos membros inferiores. Foi diagnosticada e tratada hanseníase indeterminada e reação reversa. Posteriormente, apresentou a forma virchowiana e evoluiu com paralisia do olhar conjugado para cima, estrabismo divergente e ptose palpebral à direita. Durante a investigação da oftalmoplegia foi diagnosticado neurocisticercose. As lesões calcificadas da neurocisticercose estavam fora do trajeto da via óptica, sendo o quadro ocular secundário à hanseníase. CONCLUSÃO: Apesar do tratamento e acompanhamento adequados da hanseníase, a paciente apresentou sequela ocular. Nota-se a importância de, em todos pacientes com hanseníase, realizar diagnóstico e terapia precoces, medidas anti-reacionais, supervisão pós-cura, cuidado multidisciplinar e exame oftalmológico de rotina, para evitar as complicações hansênicas.

BACKGROUND AND OBJECTIVES: Leprosy and neurocysticercosis are tropical and infectious diseases, which have important impacts on public health. They may have an ocular form, creating doubts in the etiology of ophthalmopathy, if developed concurrently. The aim of this study was to report the presence of ocular changes in leprosy and the importance of prevention and differential diagnosis. CASE REPORT: Female patient, 63 years, from Nova Iguaçu-Rio de Janeiro, complaining of spots throughout the body, paresthesia and edema in lower limbs. She was diagnosed and treated as indeterminate leprosy and reverse reaction. Subsequently, she developed the lepromatous form, with paralysis of conjugate gaze upward, divergent strabismus and blepharoptosis in the right eye and during the investigation of ophthalmoplegia was diagnosed neurocysticercosis. Calcified lesions of neurocysticercosis were outside of the visual pathway, and the ocular manifestations were considered secondary to leprosy. CONCLUSION: Despite adequate treatment and monitoring of leprosy, the patient developed ocular sequel. Note the importance of, in all leprosy patients, make early diagnosis and therapy, prevent leprosy reactions, and realize aftercare supervision, multidisciplinary care and routine eye examination, to avoid the leprosy complications.