RESUMO
La osteomalacia inducida por tumor es una rara enfermedad del metabolismo óseo caracterizada por el aumento en la excreción de fosfato a nivel renal seguido de hipofosfatemia. Es causada por agentes fosfatúricos producidos por determinados tumores. La resección total del tumor resulta en la completa reversión de las anormalidades bioquímicas, la desaparición de las manifestaciones clínicas y los hallazgos en los estudios por imágenes. Presentamos el caso de un varón de 61 años con cuadro clínico y laboratorio compatibles con osteomalacia oncogénica inducida por tumor mesenquimático de localización rinosinusal. En nuestro caso el diagnóstico histológico correspondió a una neoplasia de tipo vascular: hemangiopericitoma.
Tumor-induced osteomalacia is a rare disease of bone metabolism. The characteristic of this disease is an increase in phosphate excretion followed by hypophosphatemia, due to phosphaturic agents produced by different types of tumors. Tumor resection results in complete resolution of clinical, biochemical and radiological abnormalities. We present the case of a 61 year old man with signs, symptoms and laboratory findings consistent with oncogenic osteomalacia due to a rhino-sinusal mesenchymal tumor. The histological diagnosis showed a vascular neoplasm: hemangiopericytoma.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hemangiopericitoma/complicações , Neoplasias de Tecido Conjuntivo/etiologia , Neoplasias dos Seios Paranasais/complicações , Evolução Fatal , Hemangiopericitoma , Imagem Multimodal , Neoplasias de Tecido Conjuntivo , Neoplasias dos Seios ParanasaisRESUMO
La osteomalacia inducida por tumor es una rara enfermedad del metabolismo óseo caracterizada por el aumento en la excreción de fosfato a nivel renal seguido de hipofosfatemia. Es causada por agentes fosfatúricos producidos por determinados tumores. La resección total del tumor resulta en la completa reversión de las anormalidades bioquímicas, la desaparición de las manifestaciones clínicas y los hallazgos en los estudios por imágenes. Presentamos el caso de un varón de 61 años con cuadro clínico y laboratorio compatibles con osteomalacia oncogénica inducida por tumor mesenquimático de localización rinosinusal. En nuestro caso el diagnóstico histológico correspondió a una neoplasia de tipo vascular: hemangiopericitoma.(AU)
Tumor-induced osteomalacia is a rare disease of bone metabolism. The characteristic of this disease is an increase in phosphate excretion followed by hypophosphatemia, due to phosphaturic agents produced by different types of tumors. Tumor resection results in complete resolution of clinical, biochemical and radiological abnormalities. We present the case of a 61 year old man with signs, symptoms and laboratory findings consistent with oncogenic osteomalacia due to a rhino-sinusal mesenchymal tumor. The histological diagnosis showed a vascular neoplasm: hemangiopericytoma.(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hemangiopericitoma/complicações , Neoplasias de Tecido Conjuntivo/etiologia , Neoplasias dos Seios Paranasais/complicações , Evolução Fatal , Hemangiopericitoma/diagnóstico por imagem , Imagem Multimodal , Neoplasias de Tecido Conjuntivo/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagemRESUMO
Tumor-induced osteomalacia is a rare disease of bone metabolism. The characteristic of this disease is an increase in phosphate excretion followed by hypophosphatemia, due to phosphaturic agents produced by different types of tumors. Tumor resection results in complete resolution of clinical, biochemical and radiological abnormalities. We present the case of a 61 year old man with signs, symptoms and laboratory findings consistent with oncogenic osteomalacia due to a rhino-sinusal mesenchymal tumor. The histological diagnosis showed a vascular neoplasm: hemangiopericytoma.
Assuntos
Hemangiopericitoma/complicações , Neoplasias de Tecido Conjuntivo/etiologia , Neoplasias dos Seios Paranasais/complicações , Evolução Fatal , Hemangiopericitoma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Neoplasias de Tecido Conjuntivo/diagnóstico por imagem , Osteomalacia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Síndromes Paraneoplásicas , CintilografiaRESUMO
Tumor-induced osteomalacia is a rare disease of bone metabolism. The characteristic of this disease is an increase in phosphate excretion followed by hypophosphatemia, due to phosphaturic agents produced by different types of tumors. Tumor resection results in complete resolution of clinical, biochemical and radiological abnormalities. We present the case of a 61 year old man with signs, symptoms and laboratory findings consistent with oncogenic osteomalacia due to a rhino-sinusal mesenchymal tumor. The histological diagnosis showed a vascular neoplasm: hemangiopericytoma.
Assuntos
Hemangiopericitoma/complicações , Neoplasias de Tecido Conjuntivo/etiologia , Neoplasias dos Seios Paranasais/complicações , Evolução Fatal , Hemangiopericitoma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Neoplasias de Tecido Conjuntivo/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagemRESUMO
The pulmonary cryptococcosis in immunocompetent patients is unusual, and its presentation as large masses with involvement of the chest wall and the neighboring soft tissues has not been found in our bibliographic research. The variety gattii (serotype B/C) is limited geographically to tropical and subtropical regions and appears to affect particularly immunocompetent individuals. We describe the case of a 51-year-old man from the Northeast of Argentina, with a history of smoking 10 pack/year. He presented an increased volume of the left shoulder and reported that for the last six months he had been unable to move it due to the pain. A percutaneous biopsy of the mass provided a diagnosis of Cryptococcus neoformans, variety gattii. The patient was treated with antifungal therapy showing a favourable outcome with a progressive decrease of the mass.
Assuntos
Criptococose/diagnóstico , Cryptococcus neoformans/isolamento & purificação , Imunocompetência , Pneumopatias Fúngicas/diagnóstico , Criptococose/microbiologia , Humanos , Pneumopatias Fúngicas/microbiologia , Masculino , Pessoa de Meia-Idade , OmbroRESUMO
La criptococosis pulmonar en pacientes inmunocompetentes es una entidad poco habitual y su presentación como masas de gran tamaño, con compromiso de la pared torácica y de los tejidos blandos vecinos, no la encontramos descriptas en nuestra revisión bibliográfica. La variedad gattii (serotipoB/C) está acotada geográficamente a regiones tropicales y subtropicales y parece afectar preferentemente a individuos inmunocompetentes. Presentamos el caso de un hombre de 51 años proveniente del noreste de la Argentina, fumador de 10 atados/año que consulta por aumento del volumen del hombro izquierdo e impotencia funcional por intenso dolor de seis meses de evolución. Mediante una biopsia percutánea de la masa, se diagnostica Cryptococcus neoformans, variedad gattii. El paciente recibe terapéutica antifúngica, mostrando una evolución favorable con disminución progresiva de la masa.
The pulmonary cryptococcosis in immunocompetent patients is unusual, and its presentation as large masses with involvement of the chest wall and the neighboring soft tissues has not been found in our bibliographic research. The variety gattii (serotype B/C) is limited geographically to tropical and subtropical regions and appears to affect particularly immunocompetent individuals. We describe the case of a 51-year-old man from the Northeast of Argentina, with a history of smoking 10 pack/year. He presented an increased volume of the left shoulder and reported that for the last six months he had been unable to move it due to the pain. A percutaneous biopsy of the mass provided a diagnosis of Cryptococcus neoformans, variety gattii. The patient was treated with antifungal therapy showing a favourable outcome with a progressive decrease of the mass.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Criptococose/diagnóstico , Cryptococcus neoformans/isolamento & purificação , Imunocompetência , Pneumopatias Fúngicas/diagnóstico , Criptococose/microbiologia , Pneumopatias Fúngicas/microbiologia , OmbroRESUMO
Brown tumor is a localized form of osteitis fibrosa cystica, being part of the hyperparathyroid bone disease. It rarely is the first manifestation of hyperparathyroidism, since nowadays, the diagnosis is made at an asymptomatic or minimally symptomatic stage. We present a case of a left superior maxillar brown tumor as the first manifestation of primary hyperparathyroidism due to a parathyroid adenoma. A parathyroidectomy was performed, and there was a regression of the bone lesion, without the need of performing other local surgical procedures.
Assuntos
Adenoma/etiologia , Hiperparatireoidismo Primário/complicações , Osteíte Fibrosa Cística/etiologia , Neoplasias das Paratireoides/etiologia , Adenoma/patologia , Adulto , Feminino , Humanos , Hiperparatireoidismo Primário/patologia , Osteíte Fibrosa Cística/patologia , Neoplasias das Paratireoides/patologiaRESUMO
El tumor pardo es una forma localizada de osteítis fibrosa quística, parte del compromiso óseo por hiperparatiroidismo. Como primera expresión de hiperparatiroidismo es infrecuente, debido a que actualmente éste se diagnostica en estadios asintomáticos o mínimamente sintomáticos. Presentamos el caso de una paciente con un tumor pardo localizado en el maxilar superior izquierdo, como primera manifestación de hiperparatiroidismo primario causado por un adenoma paratiroideo. Posterior a la realización de una paratiroidectomía el tumor evolucionó con franca regresión, sin necesidad de ningún otro procedimiento quirúrgico local.
Brown tumor is a localized form of osteitis fibrosa cystica, being part of the hyperparathyroid bone disease. It rarely is the first manifestation of hyperparathyroidism, since nowadays, the diagnosis is made at an asymptomatic or minimally symptomatic stage. We present a case of a left superior maxillar brown tumor as the first manifestation of primary hyperparathyroidism due to a parathyroid adenoma. A parathyroidectomy was performed, and there was a regression of the bone lesion, without the need of performing other local surgical procedures.