Case 304: Porphyria Cutanea Tarda.

HISTORY: In 2017, a 72-year-old woman was seen in the gastroenterology department with a 2-month history of mild and intermittent abdominal pain without other accompanying symptoms. Her medical history was unremarkable, except for a previous visit due to facial photodermatitis 3 years earlier. Diazepam for a sleeping disorder was the only chronic medication recorded. Results of physical examination, blood count, and basic metabolic panels including assessment of renal and liver function were normal; only the ferritin level was slightly elevated (265 ng/mL [595 pmol/L]; normal range, 10-120 ng/mL [22-269 pmol/L]). Abdominal US was performed, followed by multiphasic contrast-enhanced CT and liver MRI due to the findings of the first study. A diagnosis was not established in that moment, and acetaminophen was prescribed for pain relief. As the symptoms continued, laboratory tests and imaging studies were repeated 2 years later, with similar findings and no notable changes.

Case 304.

History In 2017, a 72-year-old woman was seen in the gastroenterology department with a 2-month history of mild and intermittent abdominal pain without other accompanying symptoms. Her medical history was unremarkable, except for a previous visit due to facial photodermatitis 3 years earlier. Diazepam for a sleeping disorder was the only chronic medication recorded. Results of physical examination, blood count, and basic metabolic panels including assessment of renal and liver function were normal; only the ferritin level was slightly elevated (265 ng/mL [595 pmol/L]; normal range, 10-120 ng/mL [22-269 pmol/L]). Abdominal US was performed, followed by multiphasic contrast-enhanced CT and liver MRI due to the findings of the first study. A diagnosis was not established in that moment, and acetaminophen was prescribed for pain relief. As the symptoms continued, laboratory tests and imaging studies were repeated 2 years later, with similar findings and no notable changes (Figs 1-5).

Mielolipoma suprarrenal: una visión radiológica / Adrenal myelolipoma: ultrasound and CT findings

OBJETIVO: Presentamos el caso de un mielolipoma suprarrenal en una paciente con antecedentes de HTA y elevación de la aldosterona plasmática. MÉTODO: Además de técnicas de imagen (ecografía y TC), se realizó estudio anatomopatológico. RESULTADOS: Se visualizó una masa adrenal izquierda mediante técnicas de imagen (ecografía y TC abdominal), con grasa en su seno, siendo tipificada tras extirpación quirúrgica y estudio anatomopatológico de mielolipoma suprarrenal, observándose una tumoración benigna compuesta por tejido adiposo y elementos hematopoyéticos en distintas proporciones. CONCLUSIÓN: Ante una masa suprarrenal que presenta en su interior áreas grasas detectables por los métodos de imagen (ecografía, TC o RM) uno de los diagnósticos de sospecha debe ser un mielolipoma (AU)