RESUMO
Skeletal muscle metastases from non-small-cell lung cancer are uncommon. We report a case of lung adenocarcinoma disclosed by metastatic dissemination to a forearm muscle. A 46-year-old man consulted for a painful mass of the right forearm. Ultrasonography and computed tomography revealed a heterogeneous collection in the forearm invading the cortex of the humerus. An excisional biopsy of the right forearm showed an infiltration of the muscle with metastatic adenocarcinoma. Immunohistochemical patterns suggested the pulmonary origin. Chest x-ray was normal. Bronchoscopy revealed an endobronchial mass that was confirmed by biopsy to be an adenocarcinoma. The lung tumor was staged T2N0M1. The patient has received local radiation therapy and chemotherapy. After eighteen months, the disease progressed but without local muscular recurrence. Skeletal muscle metastases from lung cancer are rare and although their prognosis is poor, local treatment may be worthwhile.
Assuntos
Adenocarcinoma/diagnóstico , Adenocarcinoma/secundário , Neoplasias Brônquicas/diagnóstico , Neoplasias Brônquicas/patologia , Neoplasias de Tecidos Moles/secundário , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Vermian epidermoid cyst developing in the fourth ventricle is very rare. We report a case observed in a 24-year-old man, who presented severe headache, dizziness and a blurred vision following head injury. Examination revealed a discrete gait disturbance. Cerebral CT-scan showed a large hypodense lesion of the posterior fossa without contrast enhancement. MRI demonstrated the vermian location of this lesion which displaced the roof of the fourth ventricle upward and the brainstem forward. A suboccipital approach allowed total removal of a well-encapsulated epidermoid cyst, non adherent to the floor of the fourth ventricle. The postoperative course was uneventful.
Assuntos
Doenças Cerebelares/diagnóstico , Doenças Cerebelares/cirurgia , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/cirurgia , Quarto Ventrículo/patologia , Quarto Ventrículo/cirurgia , Traumatismos Cranianos Fechados/diagnóstico , Achados Incidentais , Adulto , Doenças Cerebelares/patologia , Diagnóstico Diferencial , Cisto Epidérmico/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
Synovial chondromatosis is a rare metaplasia of the synovium of unknown etiology that may involve occasionally the subacromial bursa. We report a new case diagnosed by ultrasound in a 30-year-old man and we present pathogenetic, diagnostic and therapeutic features of this disease with a literature review.
Assuntos
Articulação Acromioclavicular/patologia , Bolsa Sinovial/patologia , Condromatose Sinovial/diagnóstico , Articulação Acromioclavicular/diagnóstico por imagem , Adulto , Bolsa Sinovial/diagnóstico por imagem , Condromatose Sinovial/diagnóstico por imagem , Humanos , Corpos Livres Articulares/patologia , Masculino , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
INTRODUCTION: Intradiscal injection of triamcinolone hexacetonide, used to treat sciatica caused by herniated discs was discontinued after discovery that it was followed in some cases by epidural calcification. OBSERVATION: Ten years after an intradiscal injection at L4-L5, a 40 year-old man developed voluminous perivertebral, bilateral foraminal and intraductal calcifications that compressed the dural sheath. After preliminary excision, these calcifications recurred and required further excision, followed by posterior lateral grafting and osteosynthesis. DISCUSSION: Calcifications following intradiscal injections are symptomatic in 14 to 68% of cases. They require radical surgical treatment to avoid recurrence.
Assuntos
Anti-Inflamatórios/efeitos adversos , Calcinose/induzido quimicamente , Doenças da Medula Espinal/induzido quimicamente , Triancinolona Acetonida/análogos & derivados , Adulto , Anti-Inflamatórios/administração & dosagem , Humanos , Injeções Intralesionais , Deslocamento do Disco Intervertebral/tratamento farmacológico , Masculino , Triancinolona Acetonida/administração & dosagem , Triancinolona Acetonida/efeitos adversosRESUMO
Pulmonary angiosarcoma is an uncommon vascular and usually secondary tumor. Only a few primary cases of pulmonary angiosarcoma have been described. We report a case of primary pulmonary angiosarcoma in an adult man who presented with hemoptysis. Chest x-ray film and chest CT showed a right para-cardiac opacity associated with diffuse alveolar consolidation of the right basal lobe. Right inferior lobectomy has been performed. Pulmonary angiosarcoma was diagnosed on histological and immuno-histochemical studies of the operative specimen. The primitive character was retained after ruling out all other tumor localizations. The clinical outcome was rapidly fatal. This observation is added to the other rare cases published of primitive pulmonary angiosarcoma. It confirms the poor prognosis and the extremely hemorrhagic nature of this tumor. Isolated necrotic parenchymatous mass was an original radiological pattern observed in this patient.
Assuntos
Hemangiossarcoma/diagnóstico , Neoplasias Pulmonares/diagnóstico , Evolução Fatal , Hemangiossarcoma/complicações , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/cirurgia , Hemoptise/etiologia , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XAssuntos
Aspergilose/etiologia , Pneumopatias Fúngicas/etiologia , Sarcoidose Pulmonar/complicações , Aspergilose/patologia , Feminino , Humanos , Pneumopatias Fúngicas/patologia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Sarcoidose Pulmonar/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
The carpal scaphoid is an uncommon localization for chondroma. Ten cases have been reported in the literature. We report a new case of right carpal scaphoid chondroma complicated by fracture in a 30 year-old man. The diagnosis was strongly suggested by the computed tomography scan and confirmed at pathology examination of the operative specimen. Treatment consisted in tumor enucleation and a cortico-cancellous graft to fill the gap followed by plaster case immobilization. Clinical and radiological outcome was favorable.
Assuntos
Neoplasias Ósseas/complicações , Condroma/complicações , Fraturas Espontâneas/etiologia , Osso Escafoide/lesões , Adulto , Humanos , MasculinoRESUMO
The authors report a case of a gastro-epiploic lymphangioma in a 29-year-old male patient presenting with epigastric cramps. Physical examination was normal. Ultrasound and abdominal CT-scan showed a cystic mass under the left lobe of the liver containing fine septations and extending to the lesser sac. At surgery, a large cystic mass was found, situated around the celiac trunk. It was adherent to the lesser curvature of the stomach and posterior surface of the antrum and extended to the lesser sac. Excision of the mass and antrectomy were performed. Histologic examination was consistent with a diagnosis of cystic lymphangioma.
Assuntos
Neoplasias do Colo/diagnóstico , Linfangioma Cístico/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Gástricas/diagnóstico , Adulto , Humanos , MasculinoRESUMO
Choroid plexus cyst is generally small and a relatively common finding at autopsy. Huge and symptomatic cysts are rare. Few cases are reported in the literature. We report one case of symptomatic choroid plexus cyst of the right lateral ventricle in a six month baby who presented with epilepsy. Cerebral CT scan and MRI showed a large cyst in the right lateral ventricle compressing the adjacent structures. Total removal of the cyst has been performed by a parieto-temporal approach. The course was uneventful.
Assuntos
Ventrículos Cerebrais/cirurgia , Doenças da Coroide/cirurgia , Plexo Corióideo/cirurgia , Cistos/cirurgia , Ventrículos Cerebrais/patologia , Doenças da Coroide/patologia , Plexo Corióideo/patologia , Cistos/patologia , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
The authors describe a case of congenital lobar emphysema of the upper right pulmonary lobe discovered at birth with an opaque hemithorax and a shift of mediastinum. The diagnosis was confirmed by a CT-scan. A lobectomy was performed at 6 weeks of age. The different diagnosis and physiopathological mechanisms are discussed.
Assuntos
Enfisema Pulmonar/congênito , Enfisema Pulmonar/diagnóstico por imagem , Humanos , Recém-Nascido , Masculino , Atelectasia Pulmonar/diagnóstico por imagem , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
We report a case of double primary amoebic brain abscess in a 22 year old man, with signs of intracranial hypertension and deficit. Computed tomography found two hypodense lesions, not suggestive of pyogenic abscesses. Aspiration of one of the two abscesses, revealed the organism, and the two abscesses regressed in response to medical treatment. The authors insist on the rarity of these abscesses, their gravity, and the difficulty of the diagnosis.
Assuntos
Abscesso Encefálico/microbiologia , Entamoeba histolytica/isolamento & purificação , Entamebíase/microbiologia , Adulto , Animais , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/tratamento farmacológico , Abscesso Encefálico/cirurgia , Terapia Combinada , Entamebíase/diagnóstico por imagem , Entamebíase/tratamento farmacológico , Entamebíase/cirurgia , Humanos , Masculino , Metronidazol/uso terapêutico , Fenobarbital/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodeficiency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature.