RESUMO
An oral cavity metastasis from a poorly differentiated carcinoma, presumed to have originated in the pancreas, mimicked a dental abscess. An additional metastasis to the lung caused a postobstructive lobar pneumonia that masked the lesion, thereby delaying the diagnosis of malignancy. This case report illustrates how the clinical manifestations of a widely disseminated neoplasm led to initial medical confusion and subsequent dental misdiagnosis, and serves to caution of a possible pitfall in the dental evaluation of endodontic lesions.
Assuntos
Carcinoma/diagnóstico , Carcinoma/secundário , Assistência Odontológica para Doentes Crônicos , Neoplasias Mandibulares/diagnóstico , Neoplasias Mandibulares/secundário , Necrose da Polpa Dentária/diagnóstico , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Dente Molar , Neoplasias Pancreáticas/patologia , Abscesso Periapical/complicações , Abscesso Periapical/diagnóstico , Odontalgia/etiologiaRESUMO
An 80-year-old woman developed vaginal bleeding caused by a large tumor of the cervix. Histologically, the tumor proved to be composed predominantly of adenoid cystic carcinoma focally associated with squamous cell carcinoma. Of special interest was the stroma, which displayed pleomorphism, multinucleated tumor giant cells, and numerous mitoses, justifying the designation of carcinosarcoma. A single similar reported case also regarded as a carcinosarcoma described a primary cervical neoplasm in a postmenopausal woman containing an admixture of heterologous sarcoma and conventional cervical adenocarcinoma, which focally demonstrated areas of adenoid cystic carcinoma.
Assuntos
Carcinoma Adenoide Cístico/patologia , Carcinossarcoma/patologia , Neoplasias do Colo do Útero/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Adenoide Cístico/química , Carcinossarcoma/química , Feminino , Humanos , Imuno-Histoquímica , Neoplasias do Colo do Útero/químicaRESUMO
A primary intracranial atypical teratoid/rhabdoid tumor was encountered in a child (age 4 years and 9 months) with Canavan disease. The tumor contained a large spindled cell component as well as classical rhabdoid morphology and focal areas resembling a primitive neuroectodermal tumor. The rhabdoid areas of the neoplasm were immunoreactive with antibodies against epithelial membrane antigen and vimentin, in the classically described pattern. Ultrastructurally these portions of the tumor displayed the characteristic perinuclear whorls of intermediate filaments reported in rhabdoid tumors of all body sites. Thought to be purely coincidental, this is also the first description of any intracranial neoplasm associated with Canavan disease.
Assuntos
Neoplasias Encefálicas/cirurgia , Doença de Canavan/cirurgia , Tumor Rabdoide/cirurgia , Teratoma/cirurgia , Biomarcadores Tumorais/análise , Neoplasias Encefálicas/patologia , Doença de Canavan/patologia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Filamentos Intermediários/patologia , Bulbo/patologia , Bulbo/cirurgia , Glicoproteínas de Membrana/análise , Microscopia Eletrônica , Mucina-1 , Mucinas/análise , Tumor Rabdoide/patologia , Teratoma/patologia , Vimentina/análiseRESUMO
From March 1988 through March 1990, at the Philadelphia Medical Examiner's Office toxicology laboratory, samples from 77 decomposed human bodies were tested for the presence of cocaine, employing gas chromatography/mass spectrometry (GC-MS). The material analyzed included decomposed soft tissue, bloody decomposition fluid, mummified tissue, maggots, and beetle feces. Twenty-two cases (28.6%) were positive for cocaine, many of these cases in states of advanced decomposition. These findings indicate the usefulness of testing decomposed tissue for cocaine in all cases where its presence is suspected. This is contrary to what might be expected, since cocaine is generally labile and rapidly broken down by both enzymatic and nonenzymatic mechanisms.
