RESUMO
Primary malignant fibrous histiocytoma, now classified as pleomorphic undifferentiated sarcoma, is the most common soft-tissue sarcoma in adult life. Primary splenic pleomorphic undifferentiated sarcoma is extremely rare and aggressive, and is associated with a poor prognosis; only 14 cases of splenic pleomorphic undifferentiated sarcoma have been documented in the English literature. We discuss a case of a 56-year-old woman with iron-deficiency anaemia, early satiety and left upper-quadrant pain, who was preoperatively diagnosed with a large splenic cyst following thorough investigation. This was excised in an elective procedure. Unfortunately, histology confirmed splenic pleomorphic undifferentiated sarcoma. Following a review and summary of the literature, we discuss key differentials between splenic cysts and splenic pleomorphic undifferentiated sarcoma. This case highlights that iron-deficiency anaemia is unusual in splenic cysts and more sinister causes must be considered.
Assuntos
Cistos/diagnóstico , Histiocitoma Fibroso Maligno/diagnóstico , Baço/patologia , Esplenectomia , Neoplasias Esplênicas/diagnóstico , Cistos/patologia , Cistos/cirurgia , Diagnóstico Diferencial , Procedimentos Cirúrgicos Eletivos , Endoscopia do Sistema Digestório , Feminino , Histiocitoma Fibroso Maligno/patologia , Histiocitoma Fibroso Maligno/cirurgia , Humanos , Pessoa de Meia-Idade , Neoplasias Esplênicas/patologiaRESUMO
The use of elastomeric hydrogel (Aquavene, Menlo Care, Menlo Park, Calif.) peripheral catheters in home infusion therapy was prospectively evaluated. Elastomeric hydrogel catheter composition differs from that of conventional peripheral catheters made of Teflon or silicone in that it softens upon insertion and expands two gauge sizes within 30 minutes of insertion. Fifty-four test catheters were successfully placed in 44 home infusion therapy patients, for a total dwell time of 290 days. Average dwell time was 5.37 days, with a range of 1 to 20 days. The extension of dwell time beyond the accepted standard of 72 hours was not associated with an increased incidence of phlebitis when compared to the incidence of phlebitis reported in the scientific literature. The ability to extend peripheral catheter dwell time without increasing the incidence of catheter-related complications may have major clinical and economic advantages for the payors, providers, and consumers of home infusion therapy.
