RESUMO
We report a case of a young female patient presenting with a high serum beta-HCG levels, amenorrhea, nausea and anemia which mimicked pregnancy followed by upper gastrointestinal bleeding. A gastric tumor was shown on endoscopy. Histopathologic evaluation revealed Primary Gastric Choriocarcinoma (PGC). The patient was treated with three cycles of standard nongestational choriocarcinoma chemotherapy. Tumor persistence was evidenced by CT Scans and high serum beta-HCG levels. The patient died approximately six months after diagnosis. Our case report suggest that PGC is a highly aggressive tumor that is often associated with liver and lungs metastasis without evidence of pelvic organ abnormality and is associated with some hormonal effects, such as amenorrhea, anemia, nausea and vomiting mimicking pregnancy in young adult female
Assuntos
Coriocarcinoma não Gestacional/diagnóstico , Erros de Diagnóstico , Neoplasias Gástricas/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/sangue , Bleomicina/administração & dosagem , Coriocarcinoma não Gestacional/tratamento farmacológico , Coriocarcinoma não Gestacional/secundário , Gonadotropina Coriônica Humana Subunidade beta/sangue , Cisplatino/administração & dosagem , Etoposídeo/administração & dosagem , Evolução Fatal , Feminino , Humanos , Ifosfamida/administração & dosagem , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/secundário , Metotrexato/administração & dosagem , Paclitaxel/administração & dosagem , Gravidez , Gravidez Ectópica/diagnóstico , Terapia de Salvação , Neoplasias Gástricas/tratamento farmacológico , Adulto JovemRESUMO
This is the case of a 32 year-old-male with chronic kidney disease in hemodialysis who presented with uncontrolled blood pressure after admission to the hospital further complicated with seizures. Head CT-Scan revealed hypodensives areas in sub-cortical white matter and parietal-occipital lobes. Posterior reversible leukoencephalopathy syndrome (PRES) was diagnosed by radiologic findings. The underlying cause of PRES was treated with good resolution of hypodensives areas. Good prognostic outcome of PRES depends on prompt recognition and treatment to avoid excessive morbidity and/or mortality.
Assuntos
Hipertensão/complicações , Síndrome da Leucoencefalopatia Posterior/etiologia , Convulsões/etiologia , Uremia/complicações , Adulto , Edema Encefálico/etiologia , Emergências , Infecções por HIV/complicações , Hemianopsia/etiologia , Hepatite Viral Humana/complicações , Humanos , Angiografia por Ressonância Magnética , Masculino , Síndrome da Leucoencefalopatia Posterior/diagnóstico , Síndrome da Leucoencefalopatia Posterior/patologia , Diálise Renal , Abuso de Substâncias por Via Intravenosa/complicações , Uremia/terapiaRESUMO
This is a case of 49 year-old-female with left lower quadrant pain. Initial diagnosis of acute diverticulitis entertained and treated accordingly. Diagnosis of epiploic appendagitis was done by abdominal CT-Scan. Epiploic appendagitis is commonly misdiagnosed as diverticulitis and appendicitis. Non-invasive studies may lead to early diagnosis avoiding unnecessary hospitalizations, antibiotic therapy and surgical intervention.
