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1.
J Obstet Gynaecol Res ; 48(12): 3319-3324, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36122688

RESUMO

We report an extremely challenging case of fetal goitrous hypothyroidism involving all three fetuses of a triplet pregnancy in which successful fetal treatment led to a favorable pregnancy outcome. The patient had a trichorionic, triamniotic triplet pregnancy and was referred to us at 24 weeks gestation after goiters affecting all three fetuses and polyhydramnios involving two fetuses were noted. Immediately before the conception, she underwent hysterosalpingography with an oil-soluble iodinated contrast medium. After the diagnosis of fetal hypothyroidism was made, intra-amniotic injection of levothyroxine was performed for two fetuses with polyhydramnios 3 times between 28 and 31 weeks gestation. The goiters shrunk and the polyhydramnios improved in response to the in utero treatment. No complications occurred. Cesarean section was performed at 33 weeks gestation. None of the three neonates developed respiratory insufficiency. Our experience suggested that successful intrauterine treatment is possible for fetal goitrous hypothyroidism, even in a triplet pregnancy. The indication, treatment timing, and diagnostic and assessment strategies should be carefully discussed to minimize puncture-related complications.


Assuntos
Doenças Fetais , Bócio , Hipotireoidismo , Poli-Hidrâmnios , Gravidez de Trigêmeos , Recém-Nascido , Gravidez , Humanos , Feminino , Tiroxina/uso terapêutico , Cesárea , Doenças Fetais/tratamento farmacológico , Doenças Fetais/diagnóstico , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/complicações , Bócio/complicações , Líquido Amniótico
2.
Gan To Kagaku Ryoho ; 48(7): 979-982, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34267041

RESUMO

A 75-year-old woman was treated with TC plus Bev for cancer of unknown primary. During treatment, she presented to the clinic with chief complaints of general malaise and anorexia. On presentation, abdominal distention and upper abdominal tenderness were noted, and sepsis was suspected. A thoracoabdominal CT scan revealed prominent intramural emphysema and mesenteric gas in the ascending colon. An emergency laparotomy was performed for suspected pneumatosis intestinalis non-obstructive intestinal ischemia. However, no intra-abdominal contamination or ischemic changes were observed intraoperatively. Histological examination revealed a small adenocarcinoma on the serous surface of the ascending colon, and immunochemical staining confirmed the diagnosis of serous adenocarcinoma as the patient's primary cancer. This report describes a case in which the patient achieved long-term survival after diagnosis. It also emphasizes the importance of identifying the subset of patients with cancer of unknown primary who have a good prognosis in order to provide appropriate treatment.


Assuntos
Adenocarcinoma , Neoplasias Primárias Desconhecidas , Pneumatose Cistoide Intestinal , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/cirurgia , Idoso , Bevacizumab , Feminino , Humanos , Laparotomia , Neoplasias Primárias Desconhecidas/tratamento farmacológico , Pneumatose Cistoide Intestinal/induzido quimicamente , Pneumatose Cistoide Intestinal/diagnóstico por imagem
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