RESUMO
This article describes the first reported case of a primary transitional cell carcinoma of the renal pelvis metastatic to the ovary. The clinical presentation in our patient was similar to that of a primary ovarian carcinoma. The differential diagnosis of a primary or metastatic transitional cell carcinoma in the ovary is important and has therapeutic as well as prognostic implications.
Assuntos
Carcinoma de Células de Transição/secundário , Neoplasias Renais , Pelve Renal , Neoplasias Ovarianas/secundário , Carcinoma de Células de Transição/diagnóstico por imagem , Carcinoma de Células de Transição/patologia , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Pessoa de Meia-Idade , Nefrectomia , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Ovariectomia , Tomografia Computadorizada por Raios XRESUMO
Intravesical administration of bacillus Calmette-Guerin has been shown to be highly effective treatment of superficial bladder cancer. Complications from bacillus Calmette-Guerin therapy are usually minor but serious and even fatal reactions can occur. Five recent cases illustrate the gravity of bacillus Calmette-Guerin sepsis. One man with severe debility and the organic brain syndrome died acutely with a fever of 40 C. Two men had frank sepsis that progressed to multiorgan failure and death. Sepsis progressed despite the use of isoniazid, rifampin and streptomycin. Two men who had equally progressive sepsis with intravesical bacillus Calmette-Guerin survived with the use of cycloserine for the first 72 hours of treatment. Triple antituberculous antibiotics, including cycloserine, may be lifesaving. Sepsis resulted from intravenous absorption through inflamed or disrupted urothelium. Bacillus Calmette-Guerin treatment should not be administered in the presence of severe cystitis or after grossly traumatic catheterization.
