RESUMEN
BACKGROUND: Most of malignant melanomas originate from skin and often metastasize to the lungs, rarely metastasizes to the liver and bone. However, imageology characters of lung metastasis tumor are commonly similar to those of fungal infections. CASE PRESENTATION: A patient was admitted with unhealed plantar puncture wound for 3 years, and cough and expectoration for 2 years. The chest computed tomography (CT) revealed multiple nodules with cavities, and the patient was diagnosed of pulmonary fungal infection in another hospital and received antifungal therapy for more than 8 months, but the clinical symptoms and chest imaging findings continue to progress. After admission, the pathological results of both lung biopsy and biopsy of the plantar wound 3 years ago indicated malignant melanoma. CONCLUSIONS: The diagnosis of lung lesions cannot rely solely on imaging diagnosis, lung biopsy should be performed if necessary.
Asunto(s)
Enfermedades Pulmonares Fúngicas , Neoplasias Pulmonares , Melanoma , Neoplasias Cutáneas , Humanos , Enfermedades Pulmonares Fúngicas/diagnóstico , Neoplasias Pulmonares/patología , Melanoma/diagnóstico , Melanoma/patología , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/diagnóstico , Tomografía Computarizada por Rayos X/métodosRESUMEN
Progressive encephalomyelopathy is a rare neurological complication of chronic liver disease, even manifesting progressive spastic paraparesis. Few reports detailing the clinical and diagnostic aspects of this uncommon cause of neurological deterioration in patients with hepatic insufficiency have been published. Early recognition of this disorder will become more important in the future as patients with liver disease survive longer due to medical advances, including liver transplantation. The case of a patient with hepatic encephalomyelopathy associated with Budd-Chiari syndrome and HBV-related cirrhosis is presented.
