Uterine carcinosarcoma with intestinal involvement: A case report and literature review.

Uterine carcinosarcoma (UCS) is a high-grade endometrial cancer characterized by two components: Carcinomatous (epithelial) and sarcomatous (stromal tissue) elements. The present study describes a clinical case of this type of UCS and also provides a brief literature review of this type of tumor. A 72-year-old female visited the emergency department of the authors' hospital with pain in the hypogastric region, intestinal dysrhythmia since 3 months prior, fever and a palpable abdominal mass. Laboratory test results revealed sepsis and mild anemia and an imaging test revealed a large uterine tumor with wide areas of necrosis and adenopathies. As determined by the multidisciplinary committee, surgery was considered the main treatment option and this was performed with no incidences. Carcinosarcoma is a rare tumor, which most frequently occurs in older women. The diagnosis is based on symptoms and imaging tests, such as ecography and scans. The gold standard of treatment is surgery, although it is possible that other types of therapies, such as chemotherapy and radiotherapy may also be effective, depending on the tumor stage. On the whole, the prognosis of patients with this type of tumor is poor, with a low survival rate, even in earlier stages due to its malignant component and the possibility for metastasis. Surgery is the optimal treatment for this type of tumor, if this is possible, always individualizing patients.

Colon adenocarcinoma first presenting as shoulder pain. Case report.

Bone metastases of colorectal cancer (CRC) are uncommon and usually occur in the context of a widespread disease. A 77-year-old woman presented with increasing pain in the right shoulder which had started 5 months earlier. On examination, a hard mass arising from the right scapula was found. There were no other abnormal findings on body Computerized Tomography (CT). A biopsy confirmed a metastatic adenocarcinoma. Further colonoscopy revealed a colonic obstructive tumour. Both solitary metastasis and the primary tumour were treated, and patient maintains a progression-free status. This is an unusual form of presentation for a colon cancer. With this report we aimed to discuss the unique clinical and pathological features of this colonic cancer and call attention of the physicians' community for this atypical presentation. Isolated bone metastasis in CRC is a rare entity and there are only a few similar cases reported in the literature.

Septic thrombosis of internal jugular vein: a rare cause of uncontrollable hiccups.

Septic thrombosis of the internal jugular vein is a possible complication related to central venous catheters. The enlargement of the diameter of the jugular vein can stimulate phrenic nerve causing hiccups and, septic thrombus can metastasize to different organs threating patient's life. Diagnosis of septic thrombosis of internal jugular vein should be confirmed with a cervicothoracic CT-scan. Its management consists of catheter's removal, antibiotic treatment and anticoagulation in high-risk patients. Surgical intervention might be considered if conservative treatment fails.