RESUMO
A 76-year-old woman presented with a 1-year history of back pain and sudden onset of plantar keratoderma. Her serum carbohydrate antigen (CA 19.9) levels were elevated. Endoscopic radial sonographic examination led to the diagnosis of pancreatic adenocarcinoma, in a stage not detectable with helical CT yet amenable to surgical therapy. Cutaneous lesions disappeared after distal pancreatectomy.
Assuntos
Adenocarcinoma/complicações , Endossonografia/métodos , Ceratodermia Palmar e Plantar/etiologia , Neoplasias Pancreáticas/complicações , Síndromes Paraneoplásicas , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Diagnóstico Diferencial , Progressão da Doença , Feminino , Humanos , Ceratodermia Palmar e Plantar/diagnóstico , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgiaRESUMO
A minor proportion of patients with achalasia eventually have a neoplasm and, as a consequence, pseudoachalasia is diagnosed. A neoplasm may either involve gastrointestinal junction or present a paraneoplastic effect. Over the global diagnoses of achalasia issued in 5 years of experience in our motility unit, we have found 13% (3/23 cases) of pseudoachalasia (2-4% in previous series, probably due to the fact that the population assisted was mainly composed of elderly patients). The origin of the neoplasm was bladder, prostate and metastases from epidermoid carcinoma of vocal chord. Treatment of primary neoplasm, besides classical approach (with dilatation of botulinum injection) may help in the resolution of this clinical disorder.
