ABSTRACT
We present the case of a 37-year-old female with abdominal pain in the epigastrium radiating to the right flank of a month of evolution. On physical examination, the epigastric mass was palpated, firm and painless. Computed tomography (CT) showed a cystic tumor in the body and tail of the pancreas with solid areas and defined borders (12 x 10 cm), which displaced structures. Endoscopic ultrasound (EUS)-guided fine needle biopsy was performed, with a cytology consistent with solid pseudopapillary tumor (SPT). Subsequently, a distal pancreatectomy with tumor resection and nodal dissection were performed. Cytology reported discohesive cells, some arranged around capillaries, with small nuclei with clefts, CK7 negative and ß-catenin positive. After four years of follow-up, there is no evidence of recurrence.
Subject(s)
Pancreatic Neoplasms , Abdominal Pain/surgery , Adult , Biopsy, Fine-Needle/methods , Endosonography/methods , Female , Humans , Pancreas/diagnostic imaging , Pancreatectomy , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/surgeryABSTRACT
(1) Background: Latin America has been harshly hit by SARS-CoV-2, but reporting from this region is still incomplete. This study aimed at identifying and comparing clinical characteristics of patients with COVID-19 at different stages of disease severity. (2) Methods: Cross-sectional multicentric study. Individuals with nasopharyngeal PCR were categorized into four groups: (1) negative, (2) positive, not hospitalized, (3) positive, hospitalized with/without supplementary oxygen, and (4) positive, intubated. Clinical and laboratory data were compared, using group 1 as the reference. Multivariate multinomial logistic regression was used to compare adjusted odds ratios. (3) Results: Nine variables remained in the model, explaining 76% of the variability. Men had increased odds, from 1.90 (95%CI 0.87-4.15) in the comparison of 2 vs. 1, to 3.66 (1.12-11.9) in 4 vs. 1. Diabetes and obesity were strong predictors. For diabetes, the odds for groups 2, 3, and 4 were 1.56 (0.29-8.16), 12.8 (2.50-65.8), and 16.1 (2.87-90.2); for obesity, these were 0.79 (0.31-2.05), 3.38 (1.04-10.9), and 4.10 (1.16-14.4), respectively. Fever, myalgia/arthralgia, cough, dyspnea, and neutrophilia were associated with the more severe COVID-19 group. Anosmia/dysgeusia were more likely to occur in group 2 (25.5; 2.51-259). (4) Conclusion: The results point to relevant differences in clinical and laboratory features of COVID-19 by level of severity that can be used in medical practice.
