RESUMO
CASE PRESENTATION: A 49-year-old woman presented to the ED with sudden onset abdominal pain, nausea, and vomiting. Her medical history included an uncomplicated gastric lap band surgery 9 years ago and subsequent removal of lap band after 6 years. She had a Roux-en-Y gastric bypass and cholecystectomy 5 months prior to the current presentation. The patient had been diagnosed with asthma and was prescribed an inhaled corticosteroid that she used only as needed. The patient denied smoking and heavy alcohol consumption. She was currently employed as a scrub technician in a local surgical center.
Assuntos
Quilotórax , Linfedema , Linfografia/métodos , Derrame Pleural , Pleurodese/métodos , Toracentese/métodos , Cirurgia Torácica Vídeoassistida , Síndrome das Unhas Amareladas , Cateteres de Demora , Quilotórax/diagnóstico , Quilotórax/etiologia , Quilotórax/fisiopatologia , Quilotórax/terapia , Diagnóstico Diferencial , Dispneia/diagnóstico , Feminino , Humanos , Linfedema/diagnóstico , Linfedema/etiologia , Pessoa de Meia-Idade , Exame Físico/métodos , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Derrame Pleural/fisiopatologia , Derrame Pleural/terapia , Radiografia Torácica/métodos , Recidiva , Cirurgia Torácica Vídeoassistida/instrumentação , Cirurgia Torácica Vídeoassistida/métodos , Resultado do Tratamento , Síndrome das Unhas Amareladas/complicações , Síndrome das Unhas Amareladas/diagnósticoRESUMO
BACKGROUND: Solitary fibrous tumors are rare tumors of mesenchymal origins, most commonly seen arising from the pleural lining of the lungs. These are generally benign tumors, which in rare cases have been identified to be associated with multiple para-neoplastic syndromes. CASE REPORT: This is a case of a solitary fibrous tumor of the pleura in a 49 year old female which was found to be associated with elevated levels of serum beta human chorionic gonadotropin ß-hCG). Due to the lack of plausible causes for elevated ß-hCG in the patient, immune-histochemical staining of the tumor specimen for ß-hCG was obtained. This confirmed the patient's solitary fibrous tumor as the source of the ß-hCG. The patient was also found to have a possible paraneoplastic syndrome with irregular menstruation and hot flushes from the secreted ß-hCG. CONCLUSIONS: This is the first reported case of solitary fibrous tumors of the pleura producing {b-hCG. Multiple types of lung tumors have been associated with production of ß-subunit of human chorionic gonadotropin. Production of ß-hCG by these tumors has been associated with a poor prognosis. In this case, we find an aggressive form of solitary fibrous tumor associated with production of ß-hCG and associated paraneoplastic syndrome secondary to the ß-hCG. Further study is required to identify the frequency of this phenomenon and the implications of ß-hCG production in the prognosis of the solitary fibrous tumors.