RESUMO
Fournier's gangrene is a rare and potentially lethal condition. Previously described as an idiopathic process, this necrotising fasciitis is secondary to infection and in 95% of cases the cause arises from ano-rectum (30-50%), uro-genitalia (20-40%) or genital skin (20%). Cancer could lead to a Fournier's gangrene thanks a Romacompromised host immunity condition. In the past the rate of death was high ranging from 20% to 80%, while currently mortality is decreasing to 10%. We report a case of a 76-years-old man with Fournier's Gangrene due to locally advanced prostate cancer. The multimodal therapeutic management included broad-spectrum antibiotic therapy, intravenous fluid resuscitation and surgical debridement that was delayed by the will of the patient. To our knowledge, this is the first case of Fournier's gangrene caused by prostate cancer without common predisposing factors. In order to improve the knowledge about this rare disease, we performed a narrative review of the literature.
Assuntos
Adenocarcinoma/complicações , Gangrena de Fournier/etiologia , Neoplasias da Próstata/complicações , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Idoso , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/etiologia , Infecções Bacterianas/cirurgia , Coinfecção , Terapia Combinada , Desbridamento , Gangrena de Fournier/cirurgia , Gangrena de Fournier/terapia , Humanos , Oxigenoterapia Hiperbárica , Masculino , Invasividade Neoplásica , Orquiectomia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologiaRESUMO
In 1998 Tazawa and Tsutsumi described for the first time a case of Helicobacter pylori (HP)-related gastritis characterized by the presence of a conspicuous plasma cell infiltrate with Russell bodies, and coined the term Russell body gastritis (RBG). A 59-year-old HIV-positive man complaining of recurrent epigastric pain underwent an upper gastrointestinal endoscopy revealing in the stomach only hyperemia in the antral portion. Histology showed a moderate glandular atrophy associated with an expansion of the lamina propria due to an infiltration of monomorphous cells with eosinophilic cytoplasm inclusions and eccentric nuclei, somewhat resembling plasma cells. A diagnosis of HP-related RBG was made, after excluding, by means of histochemical, immunohistochemical stainings and molecular studies, a neoplastic process. A review of all cases of RBG previously described in the English literature is reported in order to examine the clinical, endoscopic and microscopic features of this histopathological entity and the possible pathogenetic mechanisms.
