RESUMO
The paraneoplastic syndromes are an a group of clinical manifestations of uncommon frequency that they are associated with tumors and they often are precursors of these. The Sweet's syndrome is a dermatosis characterized by fever, erythematous plaques and infiltrate consisting of mature neutrophils. It occurs occasionally in association with hematologic malignancies and is very rare with solid tumors. The isolated motor neuron disease is rare like paraneoplastic syndrome. We report the case of a patient with epidermoid carcinoma of esophagus that it was diagnosed after beginning clinically with two paraneoplastic syndromes: Sweet's syndrome and motor neuron disease.
Assuntos
Carcinoma de Células Escamosas/complicações , Neoplasias Esofágicas/complicações , Doença dos Neurônios Motores/etiologia , Síndromes Paraneoplásicas , Síndrome de Sweet/etiologia , Biópsia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Esôfago/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença dos Neurônios Motores/diagnóstico , Síndrome de Sweet/diagnósticoRESUMO
Twenty-two cases of community-acquired epidemic listeriosis were recorded from December 31st, 1991, to May 15th, 1993, at the Nuestra Señora del Pino Hospital, Las Palmas. The incidence during this outbreak was 31 times higher than the corresponding incidence in the last few years. Twelve cases occurred in pregnant women and/or neonates and ten in non-pregnant adult individuals. Our aim was to study the clinical, biological, radiological, and evolutive issues in non-pregnant adult patients. Six patients had some immunosuppressive condition: cancer, chemotherapy, AIDS, diabetes, and alcoholism. Eight patients had documented involvement of central nervous system: 6 cases of meningitis and 3 of cerebritis (one case had both meningitis and cerebritis); in the remaining two patients associated with seizures and acute confusional states, respectively. A neurological involvement was not documented because of the fulminant clinical course. CSF examination revealed mononuclear predominance in half of meningitis cases and was normal in two of the three cerebritis cases. The mean time from admission to diagnosis was 3.5 days. All patients but the two who died in the first hours of the disease received ampicillin and an aminoglycoside. The response to therapy was excellent with exception of one patient with meningitis who died in the fourth day of therapy. The clustering of listeriosis cases should alert physicians about the possibility of an epidemic outbreak. Listeria infection in non-pregnant adult individuals in this outbreak showed a high rate of neurological involvement, with focal cerebritis and pleocytosis with a mononuclear predominance in meningitis.