RESUMO
CASE REPORT: We describe a 44-year-old woman with a primary retroperitoneal serous cystadenocarcinoma as the fourth report in the world literature. A contrast-enhanced computed tomographic scan of the abdomen demonstrated a mass with enhanced solid mural nodules and septa in the left retroperitoneum. Serum CA19-9 was elevated at 181 U/ml. The patient underwent a complete resection of the retroperitoneal tumor with a partial resection of the psoas major muscle and its fascia. Pathological examination showed a well-differentiated papillary serous cystadenocarcinoma of ovarian type and locoregional lymph node metastases. Seven months after surgery, the patient developed a pelvic recurrence, and underwent a total hysterectomy, a left salpingo-oophorectomy and a resection of the metastatic mesenteric mass. Two months after the second surgery, serum CA19-9 and CA125 increased to 1,114 U/ml and 218 U/ml, respectively. A solitary liver metastasis was confirmed on a computed tomographic scan. The patient is now being treated with weekly docetaxel and carboplatin. CONCLUSION: The present case illustrates the clinically aggressive nature of a primary retroperitoneal serous cystadenocarcinoma.
Assuntos
Cistadenocarcinoma Seroso/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Adulto , Antineoplásicos/uso terapêutico , Antineoplásicos Fitogênicos/uso terapêutico , Antígeno Ca-125/sangue , Antígeno CA-19-9/sangue , Carboplatina/uso terapêutico , Cistadenocarcinoma Seroso/patologia , Cistadenocarcinoma Seroso/secundário , Cistadenocarcinoma Seroso/cirurgia , Docetaxel , Feminino , Humanos , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Imageamento por Ressonância Magnética , Mesentério , Recidiva Local de Neoplasia/cirurgia , Neoplasias Pélvicas/secundário , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Taxoides/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
This report concerns percutaneous endoscopic gastrostomy (PEG) administered in the neurosurgical care unit to a patient with dysphasia. This reliable nutrition route has the major advantage of minimal surgical invasion and can be expected to become a standard nutritional method. Since patients with neurological disorders account for the majority of those who need PEG, neurosurgeons need to be aware of the importance of PEG.
Assuntos
Transtornos de Deglutição/cirurgia , Nutrição Enteral , Gastroscopia , Gastrostomia/métodos , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/complicações , Hemorragia Cerebral/complicações , Infarto Cerebral/complicações , Transtornos de Deglutição/etiologia , Feminino , Gastrostomia/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Nutricional , Nutrição ParenteralRESUMO
The biological characteristics of right-sided colon cancer were examined in 74 colon cancers with regard to clinicopathological parameters, proliferative activity and p53 expression. Significant differences between right-sided and left-sided colon cancer were found in age, tumor size, histological type and lymphatic vessel invasion. The proliferating cell nuclear antigen labeling index did not significantly differ between the two cancers. The frequency of p53 overexpression was lower in the former than in the latter. The results suggested that right-sided colon cancer did not differ from left-sided colon cancer in proliferative activity except for its tendency to be locally advanced and to differ in carcinogenesis.
Assuntos
Neoplasias do Colo/patologia , Idoso , Antígeno Carcinoembrionário/sangue , Divisão Celular/fisiologia , Neoplasias do Colo/classificação , Neoplasias do Colo/metabolismo , Feminino , Expressão Gênica , Genes p53/genética , Humanos , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Antígeno Nuclear de Célula em Proliferação/metabolismo , Proteína Supressora de Tumor p53/biossíntese , Proteína Supressora de Tumor p53/genéticaRESUMO
A 46-year-old woman with antiphospholipid syndrome (APS) underwent an emergent laparotomy. The symptoms and signs of APS are reported to be thrombosis, habitual abortion, thrombocytopenia and biological false positive (BFP) for syphilis' tests. Clinical symptoms are based on hypercoagulation of blood, while prothrombin time (PT) activity and activated partial thromboplastin time (APTT) are prolonged. Although we have selected general endotracheal anesthesia without epidural catheterization, we recommend that the regional analgesia is suitable for those APS patients with abnormality of coagulation. If PT and APTT differ from clinical symptoms, we have to think about APS and manage the patients carefully as APS.
Assuntos
Anestesia Geral , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/sangue , Emergências , Feminino , Humanos , Perfuração Intestinal/complicações , Perfuração Intestinal/cirurgia , Laparotomia , Pessoa de Meia-Idade , Tempo de Tromboplastina Parcial , Contagem de Plaquetas , Tempo de ProtrombinaRESUMO
Using oxyntic and duodenal rat tissues, we investigated the effects of cimetidine, an antisecretagogue and a H2-receptor antagonist, on deoxyribonucleic acid (DNA) biosynthesis, determined according to the 3H-thymidine incorporation into DNA fraction. Serum gastrin concentration and DNA biosynthesis in the tissues increased significantly in the fed rats, and administration of cimetidine significantly increased both serum gastrin concentration and the DNA biosynthesis in the oxyntic tissues. There was a significant correlation between the oxyntic DNA biosynthesis and the serum gastrin concentration. Cimetidine in concentrations of 0.01 to 1.0 mM, added to the incubation mixture, had no stimulatory effect on the DNA biosynthesis in the oxyntic tissues. These results support the hypothesis that DNA biosynthesis in oxyntic mucosa of rats may be regulated by the circulating gastrin.
