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Patient aged 71 with a history of type 2 diabetes mellitus. He came to the emergency department for abdominal pain and vomiting. Laboratory tests showed an increase in acute phase reactants. Abdominal CT scan showed dilated jejunal loops, compatible with intestinal occlusion. Urgent intervention was performed, resecting the affected segment. The pathology report showed a prominent transmural inflammatory infiltrate and interstitial oedema, with moderate villous atrophy, identifying parasitic structures compatible with anisakis larvae (family Anisakidae). Given the mechanism of tissue invasion, the larvae are surrounded by a predominantly eosinophilic inflammatory infiltrate, organised as granulomas or abscesses.
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BACKGROUND: Angiomyolipoma is a benign mesenchymal neoplasm of a wide histological heterogeneity belonging to the PEComa "family." The liver, after the kidney, is their second most frequent location. However, inflammatory hepatic AMLs constitute a rare entity, with only fourteen documented cases until 2020. These neoplasms can overlap morphological features of IgG4-related diseases, being of great diagnostic relevance to demonstrating myomelanocytic-lineage differentiation of the neoplastic cells. CASE PRESENTATION: we present a new case of an inflammatory hepatic AML resembling an IgG4-related disease in a 35-year-old woman with a subcapsular 5 cm mass confined to segment VII of the right hepatic lobe. Although having reduced its size along the tumor's natural evolution, complete tumor resection was decided due to its hypermetabolic behavior (max. SUV = 12,6) assessed by PET-CT scan. Finally, the patient underwent a right hepatectomy due to spontaneous rupture and bleeding of the lesion during the intervention. All the diagnostic and therapeutic procedures occurred in the last months of the COVID-19 pandemic. CONCLUSIONS: This review aims to describe inflammatory hepatic AML histological and immunohistochemical features. We further sought to establish a clinicopathological contextualization of this tumoral subtype.
Assuntos
Angiomiolipoma , COVID-19 , Neoplasias Gastrointestinais , Neoplasias Hepáticas , Feminino , Humanos , Adulto , Angiomiolipoma/diagnóstico , Angiomiolipoma/cirurgia , Angiomiolipoma/patologia , Neoplasias Hepáticas/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Pandemias , Teste para COVID-19RESUMO
A 39-year-old patient consulted for an incidental finding of a mesenteric-epiploic mass measuring 11x6x9.5 cm. Laparoscopic excision of the lesion and cholecystectomy were indicated, revealing a myolipomatous mesenchymal neoplasm in the hepatic round ligament.
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Leiomioma , Lipoma , Ligamento Redondo do Útero , Adulto , Colecistectomia , Feminino , Humanos , Leiomioma/cirurgia , Lipoma/cirurgia , Fígado/diagnóstico por imagem , Fígado/cirurgia , Ligamento Redondo do Útero/patologia , Ligamento Redondo do Útero/cirurgiaRESUMO
A 67-year-old female, with no alterations in glucose metabolism or other relevant history, presented to the Emergency Department due to abdominal pain and vomiting after a syncopal episode. Physical examination revealed a poor general condition, mild stupor and a distended abdomen, painful on palpation in the right hypochondrium, with localized rigidity. On arrival at the Emergency Department, the patient's blood pressure (BP) was 150/66 mmHg, heart rate (HR) was 110 beats/minute and temperature 35 °C.
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Enfisema , Hepatite , Dor Abdominal , Idoso , Feminino , Humanos , Prognóstico , VômitoRESUMO
INTRODUCCIÓN: La evidencia clínica tiene más peso en las especialidades médicas que en las quirúrgicas. El cáncer de recto (CR) no es una excepción. En este artículo, nos hemos planteado explorar de forma cuantitativa y cualitativa, qué cuestiones y materias relacionadas con el CR están siendo investigadas en el momento actual y, posteriormente, analizar esta información para conocer qué respuestas podrá darnos la investigación clínica en el futuro. MÉTODOS: La obtención de datos se realizó en abril de 2014 y se basó en 3 fuentes: 2 registros institucionales de ensayos clínicos, -el registro americano (clinicaltrials.gov) y el registro europeo (EU Clinical Trials Register) - y una encuesta realizada a través de la Asociación Española de Coloproctología (AECP). Los estudios obtenidos fueron exportados a una base de datos diseñada especialmente para esta revisión, en la que se incluyeron además una serie de elementos descriptivos que permitieran la catalogación de los estudios. Los resultados de la encuesta AECP fueron analizados de forma separada. RESULTADOS: Hay actualmente en marcha 216 estudios referidos al CR. Dos tercios son fundamentalmente oncológicos. Casi un tercio son quirúrgicos. Las líneas de investigación se centran en la mejora del tratamiento preoperatorio: nuevos fármacos, nuevos esquemas de quimiorradioterapia (generalmente de inducción o consolidación) u optimización de la radioterapia y sus efectos. Los ensayos clínicos quirúrgicos estudian aspectos relacionados con robótica, laparoscopia, estomas, anastomosis bajas, CR distal y tratamiento local. CONCLUSIONES: La mayoría de los estudios actuales sobre CR analizan aspectos relacionados con la quimiorradioterapia y sus efectos. Un tercio se centran en temas especialmente quirúrgicos
INTRODUCTION: Clinical evidence has a more significant role in medical specialties than in surgery. Rectal cancer (CR) is no exception. This paper explores what CR-related subjects are being investigated at the present time in a quantitative and qualitative way and analyzes this information to know what possible answers clinical research could give us in the future. METHODS: The data collection was carried out in April 2014 and was based on 3 sources: 2 institutional clinical trials registries -American (clinicaltrials.gov) and European (EU Clinical Trials Register)- and a survey given to members of the Asociación Española de Coloproctología (AECP). The obtained studies were exported to a database designed especially for this review, which included a number of descriptive elements that would allow the cataloging of the different studies. The AECP survey results were analyzed separately. RESULTS: There are currently 216 clinical trials ongoing related to CR. Two-thirds are primarily conducted by oncologists. Nearly a third are surgical. The research focuses on improving preoperative treatment: new drugs, new schemes of chemo-radiotherapy (usually induction or consolidation schemes) or optimization of radiotherapy and its effects. Surgical clinical trials are related to robotics, laparoscopy, stoma, low colorectal anastomosis, distal CR and local treatment. CONCLUSION: Most of the current clinical trials ongoing on CR are analyzing aspects of chemo-radiotherapy and its effects. A third focus on purely surgical issues
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Humanos , Neoplasias Retais/cirurgia , Quimiorradioterapia , Prática Clínica Baseada em Evidências , Estomas Cirúrgicos , Anastomose Cirúrgica , LaparoscopiaRESUMO
No disponible
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Humanos , Masculino , Adulto Jovem , Embolização Terapêutica , Hemotórax/cirurgia , Doença Iatrogênica , Complicações Pós-OperatóriasRESUMO
INTRODUCTION: Clinical evidence has a more significant role in medical specialties than in surgery. Rectal cancer (CR) is no exception. This paper explores what CR-related subjects are being investigated at the present time in a quantitative and qualitative way and analyzes this information to know what possible answers clinical research could give us in the future. METHODS: The data collection was carried out in April 2014 and was based on 3 sources: 2 institutional clinical trials registries -American (clinicaltrials.gov) and European (EU Clinical Trials Register)- and a survey given to members of the Asociación Española de Coloproctología (AECP). The obtained studies were exported to a database designed especially for this review, which included a number of descriptive elements that would allow the cataloging of the different studies. The AECP survey results were analyzed separately. RESULTS: There are currently 216 clinical trials ongoing related to CR. Two-thirds are primarily conducted by oncologists. Nearly a third are surgical. The research focuses on improving preoperative treatment: new drugs, new schemes of chemo-radiotherapy (usually induction or consolidation schemes) or optimization of radiotherapy and its effects. Surgical clinical trials are related to robotics, laparoscopy, stoma, low colorectal anastomosis, distal CR and local treatment. CONCLUSION: Most of the current clinical trials ongoing on CR are analyzing aspects of chemo-radiotherapy and its effects. A third focus on purely surgical issues.