RESUMO
Malignant epithelioid hemangioendothelioma (MEH), also known as high-risk epithelioid hemangioendothelioma, is a low- to intermediate-grade vascular malignancy originally described as a vascular neoplasm of endothelial origin. This very rare vascular neoplasm has been described mainly in soft tissue, but also in various organs and locations, including the liver, lung, brain, colon, lymph nodes, peritoneum, spleen, bone, skin, heart, soft tissues, and vascular system. Several cases have been described in the head and neck, including the submandibular gland, parotid gland, nasal cavity, parapharyngeal space, maxilla, maxillary sinus, occipital bone, oral cavity, thyroid gland, neck, scalp, larynx, and mandible. This case report is the first description of MEH presenting as an exophytic lower-lip lesion.
Assuntos
Hemangioendotelioma Epitelioide/diagnóstico , Neoplasias Labiais/diagnóstico , Biópsia , Núcleo Celular/ultraestrutura , Citoplasma/ultraestrutura , Diagnóstico Diferencial , Epitélio/patologia , Feminino , Seguimentos , Humanos , Lábio/cirurgia , Pessoa de Meia-Idade , Gradação de Tumores , Úlceras Orais/diagnósticoRESUMO
A case of amphotericin B lipid complex induced fatal fat embolism is described. A 41-year-old Caucasian man with AIDS was undergoing treatment for cryptococcal meningitis with amphotericin B. His course was complicated by renal failure necessitating a change in therapy to amphotericin B lipid complex (Abelcet). At approximately 48 h, the patient developed tachycardia, tachypnea, respiratory failure, decline in hematocrit, thrombocytopenia, and alteration in mental status. Autopsy findings included fat emboli involving heart, lungs, kidney, and brain. To our knowledge, this is the first case report of a fatal fat embolism caused by intravenous liposome drug delivery.
Assuntos
Anfotericina B/efeitos adversos , Antifúngicos/efeitos adversos , Embolia Gordurosa/induzido quimicamente , Emulsões Gordurosas Intravenosas/efeitos adversos , Fosfatidilcolinas/efeitos adversos , Fosfatidilgliceróis/efeitos adversos , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Encéfalo/microbiologia , Encéfalo/patologia , Cryptococcus neoformans/isolamento & purificação , Combinação de Medicamentos , Sistemas de Liberação de Medicamentos , Quimioterapia Combinada , Embolia Gordurosa/patologia , Evolução Fatal , Humanos , Injeções Intravenosas , Masculino , Meninges/microbiologia , Meninges/patologia , Meningite Criptocócica/tratamento farmacológico , Fosfatidilcolinas/administração & dosagem , Fosfatidilgliceróis/administração & dosagemRESUMO
A rare case of symptomatic islet cell tumor arising from heterotopic pancreas in the duodenum with ulceration is described. Gastrointestinal bleeding was the only sign observed in this patient. Tagged red blood cell scan, upper endoscopy, and computed tomography scan showed active bleeding ulcer from a periampullary mass. Removal of the submucosal tumor was done to prevent future re-bleeding. Histologic and immunohistochemical characterization of the tumor showed an endocrine tumor that expressed a variety of endocrine peptides.
