RESUMO
INTRODUCTION: Pancreas angiosarcoma is a very aggressive malignant neoplasm. The symptoms are nonspecific and it is usually diagnosed at an advanced stage, which confers a poor prognosis. PRESENTATION OF CASE: We present a 56-year-old woman with abdominal epigastric pain and nausea. The abdominal CT-scan showed a 7â¯cm mass within the head of the pancreas and the pathology and immunochemistry analysis were positive for pancreas angiosarcoma. Intra-operatively the tumor was irresectable. DISCUSSION: Pancreas angiosarcoma is an extremely rare neoplasm with non-specific diagnosis. The histology has a wide range of presentations and immunohistochemistry is required. The surgery appears to be the only effective treatment. CONCLUSION: We report the seventh case of pancreas angiosarcoma in the English literature. Despite it's irresectability, the patient was asymptomatic two months after surgery, initiating chemotherapy with paclitaxel, with good tolerance.
RESUMO
Paragangliomas and pheocromocytomas are rare neuroendocrine tumors with different clinical presentation, being responsible for secondary arterial hypertension with target-organ lesions. Surgery is a curative therapy in these tumors and demands a multidisciplinary approach. These tumors are more frequent between the 4th and 5th decades of life and their clinical manifestations are related to catecholamines production: headache, palpitations, variable blood pressure. This article presents 13 clinical cases of patients with neuroendocrine tumors, with an median-age of 56,7 years, submitted to surgery between 2014 and 2017. The diagnosis was made based on clinical suspicion, serum and urinary catecholamines and metanephrins, imagiologic evaluation with CT or abdominal and pelvic MRI and MIBG scintigraphy. After surgery, the majority of patients remained with normal blood pressure, without anti-hypertensive therapy and follow-up was maintained in Outpatient Clinic, with periodic blood tests and imaging reevaluation.
