RESUMO
Metaplastic breast carcinoma, a rare entity, accounts for only about 0.02% of all breast carcinomas. It involves the transformation of mammary neoplasms into osteoid and chondroid substances. Because of the relatively small patient population and the limited number of controlled studies, there is confusion regarding its classification and staging. Its histogenesis is unknown. The authors describe a 65-year-old woman with findings consistent with metaplastic breast carcinoma. Theories as to etiology and prognosis as well as treatment are discussed.
Assuntos
Neoplasias da Mama/patologia , Carcinoma Adenoescamoso/patologia , Carcinoma/patologia , Neoplasias de Tecido Ósseo/patologia , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/cirurgia , Carcinoma/cirurgia , Carcinoma Adenoescamoso/cirurgia , Feminino , Humanos , Mamografia , Mastectomia Radical , Metaplasia/patologia , Neoplasias de Tecido Ósseo/cirurgia , PrognósticoRESUMO
Axillary disruption of axillobifemoral grafts has not previously been reported after appropriate placement of the graft medially on the axillary artery and proper subpectoral tunneling. Six weeks after undergoing such surgery followed by a relatively uncomplicated postoperative course, the patient--an 81-year-old man--was found unconscious at home. He was resuscitated, and taken to an emergency room where he had a respiratory arrest. At surgery, it was found that the polytetrafluoroethylene graft had separated from the axillary artery. Inspection of the axillary artery showed a completely intact suture line on the artery itself. Graft cultures tested negative. The authors believe the anastomotic disruption was the result of trauma to the anastomosis during cardiopulmonary resuscitation and external cardiac massage.
Assuntos
Artéria Axilar/cirurgia , Prótese Vascular , Reanimação Cardiopulmonar/efeitos adversos , Artéria Femoral/cirurgia , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Humanos , Claudicação Intermitente/cirurgia , Masculino , Falha de PróteseRESUMO
Acute diverticulitis of the colon should be considered in the differential diagnosis in young adult (younger than 40 years) patients with pain and tenderness in the lower abdomen. Among young adults, men are afflicted more commonly than women and the disease runs a more virulent course. Complications are commonly encountered, and the key to diagnosis is a high index of suspicion. Barium enema examination without bowel preparation is useful and safe in this age group. In patients with acute diverticulitis with perforation and abscess, the most appropriate therapy is surgical, as demonstrated in the three cases reported here.
