Spontaneous Hemothorax in a Patient With von Recklinghausen's Disease.

Type I neurofibromatosis (NF-1) is a rare autosomal dominant disease. It can affect any organ system including vascular tissues. A 53 years old man, with a past medical history of NF-1, retinitis pigmentosa and hypertension attended to the emergency department for chest pain and palpitations and was discharged 2 days after acute coronary syndrome was ruled out. During this admission an echocardiogram was performed which showed a left ventricular hypertrophy with normal ejection fraction and a chest X-ray which revealed no pathologic images. No invasive procedures were preformed. Three days after discharge, he returned to our hospital for sudden onset of oppressive chest pain in the right arm, irradiated to the ipsilateral shoulder, chest and back. After several tests, a diagnosis of hemothorax was made. Hemoglobin levels declined during the first 2 days of admission from 12.1 to 9.6 g/dL, although the patient remained hemodynamic stable. An arteriography was performed, which showed the presence of bleeding from a branch of the right subclavian artery, which was selectively catheterized and embolized with coils. Afterwards, a video-assisted thoracoscopy was made, in order to drain the hemothorax and to carry out a visual review of the pleural cavity. The patient had a good clinical and radiologic progression and was discharged after few days. After a year of follow-up, the patient has remained clinically asymptomatic with no further episodes of active bleeding.

Pulmonary metastases in a bilateral carotid body paraganglioma.

We report the case of a bilateral carotid body paraganglioma which gave metastases to the lung parenchyma; the rarity of diffuse visceral spread is emphasised in this article. The patient was a 69-year-old woman operated for a right carotid body paraganglioma in 1997. In August 2002, a recurrent left carotid body paraganglioma was resected. Three months later she started presenting minimum hemoptysis and pulmonary tumours were detected during a routine chest roentgenographic examination. A right upper lobectomy and a wedge resection in the lower lobe were performed to remove them. Grossly, the greatest tumour measured 3.3x2.5x2.3cm and was well circumscribed and subpleural. It was histologically confirmed that these pulmonary tumours were metastases from the primary paraganglioma.

Adenoma paratiroideo intratiroideo: presentación de un caso como nódulo frío en la gammagrafía tiroidea / Intrathyroid parathyroid adenoma: report of a case with a cold nodule in the thyroid gammagraphy

Se presenta un caso de adenoma paratiroideo de localización intratiroidea, situado en hemitiroides izquierda, el cual hizo su presentación en la clínica como un nódulo frío en la gammagrafía tiroidea. Los autores resaltan la rareza del caso presentado dentro de la literatura universal, de los cuales hay descritos previamente 7 casos. Por ello, se deberá tener en cuenta esta posibilidad en la clínica, especialmente si van asociados a sintomatología hiperparatiroidea (AU)

Adenoma paratiroideo intratiroideo: presentación de un caso como nódulo frío en la gammagrafía tiroidea / Intrathyroid parathyroid adenoma: report of a case with a cold nodule in the thyroid gammagraphy

Se presenta un caso de adenoma paratiroideo de localización intratiroidea, situado en hemitiroides izquierda, el cual hizo su presentación en la clínica como un nódulo frío en la gammagrafía tiroidea. Los autores resaltan la rareza del caso presentado dentro de la literatura universal, de los cuales hay descritos previamente 7 casos. Por ello, se deberá tener en cuenta esta posibilidad en la clínica, especialmente si van asociados a sintomatología hiperparatiroidea