RESUMEN
Breast cancer is known to metastasise to different organs in the body, but an initial presentation of breast cancer with loin pain secondary to a metastatic renal mass is extremely rare. We report a 58-year-old woman who presented with recurrent left loin pain due to a metastatic deposit of invasive lobular carcinoma of the breast. The detection of a renal mass on computed tomography led to the assumption of a renal pelvic malignancy. The diagnostic dilemma posed by the detection of a breast mass during staging and the usefulness of immunohistochemistry in the confirmation of diagnosis are discussed.
RESUMEN
A total of 39 patients were diagnosed to have Kawasaki disease by the standard diagnostic criteria, at The Royal Hospital, Muscat, Oman, during the period January 1995 to August 2002. A retrospective analysis of the case records of the patients with the diagnosis of Kawasaki disease was done. The results of the clinical features and the laboratory manifestations of the patients, who are from the Middle East region, are presented. The peak age at presentation was 6-30 months, mean 29 months. Peak months of the occurrence of the disease were March and October. Oral lesions were found in all cases. The mean duration of hospital stay for these patients was 8.5 days, range 2-21 days. The total duration of fever ranged from 6 to 21 days, with a mean value of 9.4 days. An elevated erythrocytic sedimentation rate (ESR; 91.7 per cent) and a raised C-reactive protein (C-RP; 92.3 per cent) were the most significant laboratory findings. Echocardiographic abnormalities were found in 25 per cent of cases, the incidence of coronary artery involvement (dilatation with or without stenosis) being 12.5 per cent. High dose intravenous immunoglobulin (2 g/kg over a 12-h period) plus aspirin therapy was found to be safe and effective in patients with Kawasaki disease.
