Hamartoma de glándulas de Brunner y anisakiasis: ¿una asociación etiológica? / Brunner's gland hamartoma and anisakiasis: an ethiologic association?

El hamartoma de glándulas de Brunner es un raro tumor duodenal localizado con mayor frecuencia a nivel de la primera porción, que si bien puede ser asintomático no es raro que produzca cuadros de hemorragia digestiva u obstrucción intestinal. Su diagnóstico se realiza por gastroscopia o estudio digestivo baritado y su tratamiento consiste en la resección endoscópica o quirúrgica, con muy buen pronóstico. Presentamos el caso de una mujer de 59 años que acude al hospital con un cuadro clínico de hemorragia digestiva alta presentando en la endoscopia realizada una úlcera sobre un pólipo en bulbo duodenal. Se realizó polipectomía correspondiendo en el estudio histológico a un hamartoma de glándulas de Brunner en cuyo interior aparecía un granuloma parasitario. La determinación de IgE para Anisakis así como los test cutáneos fueron positivos. La asociación de hamartoma de glándulas de Brunner y granuloma parasitario por Anisakis no se había descrito nunca (AU)

Brunner´s gland hamartoma is a rare duodenal tumor generally localized in the duodenal bulb. Normally assymptomatic, it might cause upper gastrointestinal bleeding or intestinal obstruction. The diagnosis is based on upper gastrointestinal endoscopic or barium examination findings, and its treatment includes surgical or endoscopic ressection, with an optimum prognosis. We present the case of a 59-year-old woman who was admitted to the hospital with an upper gastrointestinal bleeding picture. Endoscopic examination showed an ulcerated polyp in duodenal bulb which was cut with polipectomy wire. Histological slides showed a parasitic granuloma within a Brunner´s gland hamartoma. Skin prick test and specific IgE determination were positive for Anisakis. Up to our knowledge, this association has never been described before (AU)

[Brunner gland hamartoma and anisakiasis: etiologic association?]. / Hamartoma de glándulas de Brunner y anisakiasis: una asociación etiológica?

Brunner's gland hamartoma is a rare duodenal tumor generally localized in the duodenal bulb. Normally assymptomatic, it might cause upper gastrointestinal bleeding or intestinal obstruction. The diagnosis is based on upper gastrointestinal endoscopic or barium examination findings, and its treatment includes surgical or endoscopic resection, with an optimum prognosis. We present the case of a 59-year-old woman who was admitted to the hospital with an upper gastrointestinal bleeding picture. Endoscopic examination showed an ulcerated polyp in duodenal bulb which was cut with polipectomy wire. Histological slides showed a parasitic granuloma within a Brunner's gland hamartoma. Skin prick test and specific IgE determination were positive for Anisakis. Up to our knowledge, this association has never been described before.

[Refractory epilepsy status in Reye's syndrome in an adult. A case report]. / Estado epiléptico refractario en un síndrome de Reye en el adulto. A propósito de un caso.

INTRODUCTION: Reye s syndrome (RS) is a potentially fatal disease described in 1963 by Reye, Morgan and Baral as an acute encephalopathy associated with a lipid degeneration of the liver. It affects children of all ages, with a peak incidence between 5 and 15 years old, but on rare occasions it can also affect adults. Its aetiology is not known, but is has been linked with viral infections and with the ingestion of salicylates. Its occurrence in adults is not at all frequent and only 27 cases have been recorded in the literature. CASE REPORT: We report the case of a 33 year old primiparous patient who, during lactation, began suffering from epilepsy and a lowered level consciousness in the course of an infection of the pharynx and tonsils, and died on the 12th day after admission to the ICU. Anamnesis revealed she had taken ASA for the first time in her life, which guided diagnosis, and this was confirmed post mortem in the anatomopathological examination. CONCLUSION: RS in adults occurs only rarely but should be a part of the differentiating diagnosis of any encephalopathy of unknown origin and especially of the epileptic status of an adult, above all if there is a history of ingestion of salicylates, previous viral infection and vomiting.

Estado epiléptico refractario en un síndrome de Reye en el adulto.A propósito de un caso / Refractory epilepsy status in reye's syndrome in an adult. A case report

Introducción. El síndrome de Reye (SR) es una enfermedad potencialmente letal, descrita en 1963 por Reye, Morgan y Baral como una encefalopatía aguda asociada a una degeneración grasa del hígado. Afecta a niños de todas las edades, con un pico de incidencia entre los 5 y los 15 años, pero en raras ocasiones también puede ocurrir en adultos. Su etiología es desconocida, pero se ha relacionado con infecciones víricas y con la ingesta de salicilatos. La presentación en adultos es rara y sólo hay 27 casos recogidos en la literatura. Caso clínico. Presentamos el caso de una paciente de 33 años de edad, primípara, que en el período de lactancia se inició con un status epiléptico y una disminución del nivel de conciencia en el seno de una infección faringoamidgalar, y falleció al 12.º día de su ingreso en la UCI. En la anamnesis se recoge una ingesta de AAS por primera vez en su vida, lo que orientó el diagnóstico, que se confirmó postmortem en el examen anatomopatológico. Conclusión. El SR del adulto es una entidad rara y poco frecuente, pero debería formar parte del diagnóstico diferencial de cualquier encefalopatía de causa desconocida y en particular del status epiléptico en un adulto, sobre todo si hay antecedentes de ingesta de salicilatos, infección vírica previa y vómitos (AU)

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[Spermatic cord liposarcoma: differential diagnostic criteria and treatment]. / Liposarcoma de cordón espermático: criterios de diagnóstico diferencial y tratamiento.

OBJECTIVE: To report a case of liposarcoma of the spermatic cord in a young male, with special reference to the difficulties encountered in making the clinical and histopathological differential diagnosis. METHODS/RESULTS: A 43-year-old patient underwent surgery for a tumor (8 x 7 cms) in the left spermatic cord. Pathological analysis demonstrated a well-differentiated liposarcoma with myxoid areas. Radical orchidectomy was performed. The patient is well, with no tumor recurrence or metastasis. RESULTS/CONCLUSIONS: Paratesticular liposarcoma is rare. It is therefore difficult to establish the guidelines for treatment, prognosis and differential diagnosis. Similarly, difficulty is encountered when making the preoperative diagnosis, although US and CT can be useful. As in liposarcomas localized to other sites, the histological type and grade of the lesion are useful for the prognosis. Radical inguinal orchidectomy is the treatment of choice.