RESUMO
Juvenile myelomonocytic leukemia (JMML) is a distinct myeloproliferative malignancy of early childhood with a varied clinical presentation that may include failure to thrive, malaise, fever, bleeding, pallor, lymphadenopathy, and hepatosplenomegaly. Skin, pulmonary, and gastrointestinal involvement have also been reported. There are no reports of central nervous system (CNS) involvement at diagnosis of this disease. This is a report of a 21-month old boy who had a right facial paresis at presentation. A brain mass was demonstrated on magnetic resonance imaging and cerebrospinal fluid analysis confirmed CNS leukemic infiltration. We report the presence of CNS infiltration as a part of the natural course of JMML and provide a review of the literature.
Assuntos
Paralisia Facial/diagnóstico , Leucemia Mielomonocítica Juvenil/diagnóstico , Encéfalo/patologia , Paralisia Facial/líquido cefalorraquidiano , Paralisia Facial/etiologia , Humanos , Lactente , Leucemia Mielomonocítica Juvenil/líquido cefalorraquidiano , Leucemia Mielomonocítica Juvenil/complicações , Infiltração Leucêmica/patologia , Imageamento por Ressonância Magnética , MasculinoRESUMO
A 75 year-old woman presented to the authors' institution with abdominal pain and early satiety. An adrenal mass was found on CT scanning. Laparoscopic adrenalectomy was performed, and the patient was found to have a retroperitoneal bronchogenic cyst adherent to the adrenal gland. The workup of an adrenal mass is discussed as well as the pathophysiology of bronchogenic cysts.
Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Cisto Broncogênico/diagnóstico , Adrenalectomia , Idoso , Cisto Broncogênico/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Laparoscopia , Imageamento por Ressonância Magnética , Espaço Retroperitoneal , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: We present a case of recurrent colon cancer detected by routine, annual Papanicolaou screening. CASE: A 59-year-old African American woman who had been treated for T2N0M0 (stage II, Dukes A) colon cancer 2 years before to presentation had a Pap smear showing a high-grade squamous intraepithelial lesion with a normal cervical biopsy result. Because of this discrepancy, a loop electrosurgical excision procedure and endocervical curettage were performed and showed atypical glandular cells suspicious for adenocarcinoma. Subsequent colonoscopy showed recurrent adenocarcinoma of the colon. The patient underwent an en-block total abdominal hysterectomy and anterior-perineal resection showing invasion of recurrent colon cancer into the uterus and cervix. CONCLUSION: In patients with a history of extrauterine adenocarcinoma, abnormal Pap screening may indicate recurrent or metastatic carcinoma.