Tumor del vértice pulmonar derecho que produce un síndrome de Pancoast. Descripción de un caso clínico / Tumour of the right lung vertex that produced a Pancoast syndrome: description of a case

Se describe el caso clínico de una paciente, mujer de 80 años de edad, con antecedentes de enfermedad de Alzheimer, que acudió por presentar dolor en hombro derecho, parestesias y disminución de la fuerza en miembro superior derecho, ptosis palpebral en el ojo derecho, tos y disfagia. Tras la realización de exploración y pruebas complementarias se objetivó una gran masa en el lóbulo superior y vértice del pulmón derecho y adenopatías metastásicas supraclaviculares. La histología de la punción aspiración de la masa mostró un carcinoma poco diferenciado de células no pequeñas. Se remitió a Oncología que indicó tratamiento quimioterapéutico (AU)

We describe a clinical case of an 80 year-old woman, with a history of Alzheimer's disease, who presented with right shoulder pain, numbness and decreased strength in the right arm, with right eye ptosis, cough and dysphagia. The chest X-Ray and thoracic-abdominal computed tomography scan showed a large mass in the upper lobe and apex of the right lung, supraclavicular metastatic lymph nodes. In the fine needle aspiration biopsy: poorly differentiated non-small cell carcinoma. She was referred to Oncology to start chemotherapy treatment (AU)

Carcinoma epidermoide de esófago, estenosante, estadio IV, en mujer de 41 años. Descripción de un caso clínico / Stage IV stenosing sqamous cell carcinoma of the oesopahgus in a 41 year-old woman. A case presentation

Objetivos. Presentar un caso clínico de una mujer de 41 años con un carcinoma epidermoide de esófago en estadio IV. Método y pacientes. Mujer de 41 años. No hábitos tóxicos, DMNID, hiperferritinemia, resección de placa hemosiderina lingual, LOE hepática estudiada con ecografía y RMN con aumento del tamaño, sin lograr diferenciar entre hemangioma y hepatocarcinoma. Comienza con disfagia, progresiva, pérdida de peso. Esofagogastroscopía (FGC) con toma de biopsia: neoformación estenosante a 20cm. Estudio AP: carcinoma epidermoide. TAC toracoabdominal: lesiones esofágicas compatibles con proceso neoformativo. Metástasis pulmonares y adrenal izquierda, lesión hepática compatible con proceso neoformativo. Laboratorio: eritrosedimentación: 55mm. Se remite a Cirugía para realización de gastrostomía para alimentación enteral por sonda y a Oncología que indica tratamiento con quimioterapia paliativa. Conclusiones. El carcinoma epidermoide esofágico es el más frecuente. Los dos factores de riesgo más importantes son: el tabaco y el alcohol. El síntoma más frecuente es la disfagia (96%). El pronóstico es malo y tiene una elevada mortalidad. La Cirugía es el tratamiento estándar, cuando el tumor está localizado. La quimioterapia y radioterapia son tratamientos paliativos, sin que se haya demostrado claramente su eficacia (AU)

Objective. To present a clinical case of a 41 year-old woman, with a stage IV squamous cell carcinoma of the oesophagus. Methods and patients. We present a clinical case of 41 year-old woman with a history of type 2 diabetes mellitus, and resection of a haemosiderin plaque on the tongue. A space occupying lesion (SOL) was studied using ultrasound and Nuclear Magnetic Resonance (NMR), detecting, but unable to differentiate, a gradually increasing haemangioma or hepatocarcinoma. She was seen at the clinic due to dysphagia and loss of weight. In oesophagogastroscopy with biopsy a squamous cell carcinoma of the oesophagus was diagnosed. The Computed Tomography (CT) of the neck, thorax and abdomen showed a stenosing tumour in the oesophagus with metastasis in the lungs and left adrenal gland, and a SOL in the liver compatible with a neo-formative process. The erythrocyte sedimentation rate was 55mm. She was referred to Surgery and Oncology, who performed a gastrostomy for enteral feeding and started treatment with palliative chemotherapy. Conclusions. Squamous cell carcinoma of the oesophagus is very frequent. The two most important risk factors are alcoholism and nicotine poisoning. The dysphagia is the most common symptom (96% of the patients). The prognosis is a poor, with high mortality. Surgery is the standard treatment when the tumour is located. Chemotherapy and radiotherapy are palliative treatments, but has not shown to be very effective (AU)

[Stage IV stenosing sqamous cell carcinoma of the oesopahgus in a 41 year-old woman. A case presentation]. / Carcinoma epidermoide de esófago, estenosante, estadio IV, en mujer de 41 años. Descripción de un caso clínico.

OBJECTIVE: To present a clinical case of a 41 year-old woman, with a stage IV squamous cell carcinoma of the oesophagus. METHODS AND PATIENTS: We present a clinical case of 41 year-old woman with a history of type 2 diabetes mellitus, and resection of a haemosiderin plaque on the tongue. A space occupying lesion (SOL) was studied using ultrasound and Nuclear Magnetic Resonance (NMR), detecting, but unable to differentiate, a gradually increasing haemangioma or hepatocarcinoma. She was seen at the clinic due to dysphagia and loss of weight. In oesophagogastroscopy with biopsy a squamous cell carcinoma of the oesophagus was diagnosed. The Computed Tomography (CT) of the neck, thorax and abdomen showed a stenosing tumour in the oesophagus with metastasis in the lungs and left adrenal gland, and a SOL in the liver compatible with a neo-formative process. The erythrocyte sedimentation rate was 55 mm. She was referred to Surgery and Oncology, who performed a gastrostomy for enteral feeding and started treatment with palliative chemotherapy. CONCLUSIONS: Squamous cell carcinoma of the oesophagus is very frequent. The two most important risk factors are alcoholism and nicotine poisoning. The dysphagia is the most common symptom (96% of the patients). The prognosis is a poor, with high mortality. Surgery is the standard treatment when the tumour is located. Chemotherapy and radiotherapy are palliative treatments, but has not shown to be very effective.

[Tumour of the right lung vertex that produced a Pancoast syndrome: description of a case]. / Tumor del vértice pulmonar derecho que produce un síndrome de Pancoast. Descripción de un caso clínico.

We describe a clinical case of an 80 year-old woman, with a history of Alzheimer's disease, who presented with right shoulder pain, numbness and decreased strength in the right arm, with right eye ptosis, cough and dysphagia. The chest X-Ray and thoracic-abdominal computed tomography scan showed a large mass in the upper lobe and apex of the right lung, supraclavicular metastatic lymph nodes. In the fine needle aspiration biopsy: poorly differentiated non-small cell carcinoma. She was referred to Oncology to start chemotherapy treatment.