Assuntos
Infecções por Flavobacteriaceae/diagnóstico , Flavobacteriaceae/isolamento & purificação , Sarcoma de Ewing/diagnóstico , Adolescente , Antineoplásicos/uso terapêutico , Flavobacteriaceae/genética , Infecções por Flavobacteriaceae/complicações , Infecções por Flavobacteriaceae/microbiologia , Humanos , Masculino , RNA Ribossômico 16S/química , RNA Ribossômico 16S/genética , RNA Ribossômico 16S/metabolismo , Sarcoma de Ewing/complicações , Sarcoma de Ewing/tratamento farmacológico , Sarcoma de Ewing/microbiologia , Análise de Sequência de DNAAssuntos
Antifúngicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Hifas/efeitos dos fármacos , Hospedeiro Imunocomprometido , Pitiose/microbiologia , Pythium/efeitos dos fármacos , Coxa da Perna/microbiologia , Antifúngicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/imunologia , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/imunologia , Neoplasias Ósseas/microbiologia , Neoplasias Ósseas/patologia , Criança , Humanos , Hifas/fisiologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/microbiologia , Neoplasias Pulmonares/secundário , Masculino , Pirimidinas/administração & dosagem , Pirimidinas/uso terapêutico , Pitiose/diagnóstico , Pitiose/tratamento farmacológico , Pitiose/imunologia , Pythium/fisiologia , Sarcoma de Ewing/tratamento farmacológico , Sarcoma de Ewing/imunologia , Sarcoma de Ewing/microbiologia , Sarcoma de Ewing/patologia , Coxa da Perna/patologia , Triazóis/administração & dosagem , Triazóis/uso terapêutico , VoriconazolRESUMO
INTRODUCTION: Ewing's sarcoma is a relatively rare osseous malignant tumour. The age of onset is generally in the youth. Epidural localisation of the malignant osseous tumour Ewing's sarcoma is exceptional. Only 29 cases were reported in surgical literature including only one infected case. OBSERVATION: We report a case of a 24 years old patient who displayed a complete flaccid tétraplégia with T1 sensitive level. Spinal cord MRI documented a cervical posterior epidural process with peripheric gadolinium enhancement. Patient was operated in emergency. A C6 and C7 laminectomy allowed complete tumour resection with its purulent intratumoural collection revealed during the operation. A total tumour removal was performed. The immediate postsurgical evolution was remarkable, with a quasi complete recovery in the upper limbs. DISCUSSION: Firstly described by James Ewing in 1921, the spinal epidural locations of the Ewing's sarcoma are rare without specific clinical signs generally presenting as a radiculo-medullary compression. Our case is the second infected epidural Ewing sarcoma reported in the literature. However the cause remains unexplained. For this spinal epidural extraosseous tumour, X-ray radiography failed to show any osseous lesions. On MRI, the usually found aspect is a T1 and T2 isosignal with gadolinium enhancement. CONCLUSION: Through our observation, we underlined the scarcity of this pathology in the cervical epidural localization and the association with infection. We also emphasized on the complete removal, in order to give the best functional and vital outcome.
Assuntos
Neoplasias Epidurais/diagnóstico , Imageamento por Ressonância Magnética , Sarcoma de Ewing/diagnóstico , Adulto , Vértebras Cervicais , Meios de Contraste , Diagnóstico Diferencial , Neoplasias Epidurais/microbiologia , Neoplasias Epidurais/cirurgia , Gadolínio DTPA , Humanos , Sarcoma de Ewing/microbiologia , Sarcoma de Ewing/cirurgiaRESUMO
Rhodotorula sp. are commensal yeasts that may cause opportunistic infections. There have been only a few case reports of Rhodotorula fungemia in children with cancer, and in all of them the patients had a central venous catheter inserted. The authors report three nonfatal cases of fungemia by Rhodotorula in patients with post-chemotherapy neutropenia. Two of three patients required catheter removal, and a response was achieved with systemic antifungal therapy. Aggressive therapy may be required for selected high-risk patients.
Assuntos
Antifúngicos/uso terapêutico , Fungemia/etiologia , Rhodotorula/isolamento & purificação , Adolescente , Antineoplásicos/uso terapêutico , Cateterismo Venoso Central/efeitos adversos , Cateteres de Demora/microbiologia , Criança , Feminino , Fungemia/tratamento farmacológico , Humanos , Leucemia Promielocítica Aguda/complicações , Leucemia Promielocítica Aguda/tratamento farmacológico , Leucemia Promielocítica Aguda/microbiologia , Linfoma de Células T/complicações , Linfoma de Células T/tratamento farmacológico , Linfoma de Células T/microbiologia , Sarcoma de Ewing/complicações , Sarcoma de Ewing/tratamento farmacológico , Sarcoma de Ewing/microbiologiaRESUMO
An unusual case of extradural, intraspinal Ewing's sarcoma with significant extraspinal extension is reported. In view of associated constitutional symptoms, suggestive signs, leucocytosis, elevated ESR and operative findings, the initial diagnosis of Pott's spine was entertained. The lesion however turned out to be infected Ewing's sarcoma on histopathology and bacteriological examination.