Assuntos
Antituberculosos/administração & dosagem , Dor Lombar , Vértebras Lombares/diagnóstico por imagem , Abscesso do Psoas , Tomografia Computadorizada por Raios X/métodos , Tuberculose da Coluna Vertebral , Drenagem/métodos , Feminino , Humanos , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Abscesso do Psoas/diagnóstico , Abscesso do Psoas/etiologia , Abscesso do Psoas/cirurgia , Resultado do Tratamento , Tuberculose da Coluna Vertebral/complicações , Tuberculose da Coluna Vertebral/diagnóstico , Tuberculose da Coluna Vertebral/tratamento farmacológico , Tuberculose da Coluna Vertebral/fisiopatologia , Adulto JovemRESUMO
Urothelial cancers of the upper tract are aggressive malignancies with a propensity for distant metastases. Transitional cell carcinoma can also develop de novo in the ovaries and differentiation between these lesions requires immunohistochemistry. We report a case of right lower ureteric urothelial carcinoma with metastases to both ovaries. To our knowledge, this is the first reported case of bilateral ovarian metastases from an upper tract primary, diagnosed with immunohistochemistry.
RESUMO
BACKGROUND: To study the magnitude of radiation cystitis following radiation therapy for carcinoma cervix, and propose an algorithm to decide on early diversion, with or without vesicovaginostomy. METHODS: Women who developed radiation cystitis following radiotherapy for carcinoma cervix from January 1998 to December 2011 were included in this retrospective study. Electronic hospital records were analysed to document the presence of radiation cystitis. All women who developed evidence of radiation-induced cystitis, according to the common toxicity and Radiation Therapy Oncology Group criteria, were included in the study. We looked at transfusion requirements, number of hospital admissions, quality of life and cost involved. Chi-square tests were done where applicable. SPSS version 16 was used for analysis. RESULTS: Of the 902 patients who received radiation for carcinoma cervix in the 13-year period, 62 (6.87%) developed grade 3/4 cystitis. Twenty-eight of them underwent ileal conduit diversion, with 18 undergoing concomitant vesicovaginostomy. When compared with the patients who did not have diversion, the transfusion requirements, number of hospital admissions and quality of life had a statistically significant difference. Cost analysis of early diversion too showed a marginal benefit with early diversion. The limitation of the study was that it was retrospective in nature. CONCLUSION: In radiation cystitis, multiple hospital admissions and consequential increase in cost is the norm. In severe disease, early diversion is a prudent, cost-effective approach with good quality of life and early return to normal activity.
Assuntos
Carcinoma/complicações , Carcinoma/radioterapia , Carcinoma/cirurgia , Colo do Útero/efeitos da radiação , Cistite/cirurgia , Cistostomia/métodos , Lesões por Radiação/cirurgia , Derivação Urinária/métodos , Neoplasias do Colo do Útero/radioterapia , Adulto , Idoso , Colo do Útero/patologia , Colo do Útero/cirurgia , Análise Custo-Benefício , Cistite/etiologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Estudos Retrospectivos , Atenção Terciária à Saúde , Medicina Transfusional/métodos , Neoplasias do Colo do Útero/cirurgia , Vagina/cirurgiaAssuntos
Carcinoma de Células Renais/etiologia , Doenças Renais Císticas/etiologia , Neoplasias Renais/etiologia , Transplante de Rim , Complicações Pós-Operatórias , Carcinoma de Células Renais/diagnóstico , Humanos , Doenças Renais Císticas/diagnóstico , Neoplasias Renais/diagnóstico , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnósticoAssuntos
Anticorpos Monoclonais , Antígenos de Neoplasias/imunologia , Anidrases Carbônicas/imunologia , Carcinoma de Células Renais/diagnóstico por imagem , Radioisótopos de Índio , Neoplasias Renais/diagnóstico por imagem , Compostos Radiofarmacêuticos , Feminino , Humanos , Masculino , CintilografiaRESUMO
Extramedullary haematopoiesis (EMH) is common in the spleen, liver and lymph nodes, or in para osseus sites. EMH in the adrenal is rare, with fewer than 10 cases reported. We report the case of a 40-year-old male who underwent laparoscopic adrenalectomy for an incidentally detected adrenal mass. The histology showed extramedullary hematopoesis. In patients with a known history of haemolytic anaemia, an enlarged adrenal gland in an asymptomatic individual could represent extramedullary haematopoesis. A confirmatory biopsy would be all that is necessary to avoid adrenalectomy.
RESUMO
Retropneumoperitoneum due to duodenal perforation after endoscopic retrograde cholangiopancreatography is rare. Recognizing the presence of free air, which outlines the right kidney, is essential for its early diagnosis and appropriate management.