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OBJECTIVE: Mitral regurgitation (MR) represents an important feature in patients with hypertrophic cardiomyopathy (HCM) due to left ventricular outflow tract (LVOT) obstruction and mitral valve systolic anterior motion (SAM). Mitral valve anatomical variants associated with HCM also contribute to the severity of MR. The aim of this study is to evaluate MR severity and its correlation with different parameters in patients with HCM using cardiac magnetic resonance imaging (cMRI). PATIENTS AND METHODS: 130 patients with HCM underwent cMRI. Parameters assessed for the quantification of MR severity were mitral regurgitation volume (MRV) and mitral regurgitation fraction (MRF). cMRI was also used to characterize LV function, left atrium volume (LAV) index, filling pressures and structural abnormalities associated with HCM, all in correlation to MR. RESULTS: Patients with HCM had mild (26.9%), moderate (52.3%) or severe (20.7%) MR. Most relevant parameters related to MR severity were MRV and MRF; other parameters with strong correlation with MR were LAV index and E/E' ratio, both increasing with its severity. Patients with LVOT obstruction had more severe MR (70.3%), 79% of them due to SAM. LV ejection fraction (LVEF) increased proportionally with the severity of MR, while LV strain (LAS) was inversely correlated with it. Independent predictors for quantifying the severity of MR, after the adjustment for covariates, were MRV, MRF, SAM, LAV index and E/E'. CONCLUSIONS: cMRI can accurately assess MR in patients with HCM, especially by using novel indicators, MRV and MRF respectively, along with LAV index and E/E' ratio. Severe MR, due to SAM, is more frequent in the obstructive form of HCM (HOCM). Also, the severity of MR is significantly associated with significantly associated with MRV, MRF, LAV index and E/E' ratio.
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Cardiomiopatia Hipertrófica , Insuficiência da Valva Mitral , Obstrução do Fluxo Ventricular Externo , Humanos , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/complicações , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Valva Mitral , Átrios do Coração , Imageamento por Ressonância Magnética , Obstrução do Fluxo Ventricular Externo/diagnóstico por imagem , Obstrução do Fluxo Ventricular Externo/complicaçõesRESUMO
We have designed and constructed a high-energy γ-ray source for detector characterisation and calibration. The source is a composite type based on a plutonium-beryllium neutron emitter embedded in a paraffin moderator, which is homogeneously mixed with nickel powder. The 9 MeV γ-ray source produces approximately 450 photons per second in 4π when 2.2×105 neutrons per second are emitted, corresponding to a surface flux of 9 MeV γ-rays of approximately 2.5×10-6 cm-2 per emitted neutron. Here we discuss the properties and design of this source, including the characterisation of homogeneity and high-energy γ-ray emission spectra.
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The external carotid artery divides terminally into the superficial temporal and maxillary arteries (MA), deep to the base of the neck of the mandible. Arterial fenestrations are commonly found in the vertebrobasilar and internal carotid systems but are rarely encountered, or reported, in the external carotid artery system. The archived computed tomography angiograms of a 70-year-old male patient were observed anatomically. Inferior to the posterior end of the lateral pterygoid muscle was found a fenestrated segment of the MA, oriented mediolaterally. The middle meningeal artery left the superior arm of that fenestration. The inferior arm of the fenestration gave off a temporoalveolar trunk, further divided into posterior deep temporal and inferior alveolar arteries. The MA fenestration and the temporoalveolar trunk are rare variations of the MA at the entrance in the infratemporal fossa. These make the MA prone to iatrogenic lesions during different surgical procedures addressed to this region.
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Artéria Maxilar , Músculos Pterigoides , Masculino , Humanos , Idoso , Artéria Maxilar/diagnóstico por imagem , Artéria Carótida Externa/diagnóstico por imagem , Artérias , AngiografiaRESUMO
There is a developing enthusiasm for discovering new methods, cryoprotectants, systems and devices for cells, tissues, and organ preservation in medicine, in sub-zero temperature conditions and a growing interest in developing more efficient and economical methods for long-term preservation of food in a frozen state. Most of the preservation protocols currently used in medicine and food preservation involve the use of atmospheric pressure, and temperatures lower than normal body temperature in medicine, or lower than room temperature in the food industry. In this state of the art review, we analyzed the results of a new preservation method that uses an isochoric system. We aimed to offer a clear overview of the potential of this new technology. Firstly, to study the origins of isochoric preservation, we searched using the WoS Database. A search with the world "isochoric" returned 488 results. A more specific search of the term isochoric freezing returned 94 results. From these searches, we selected the 12 most relevant articles and discuss them here in detail. We present an overall characterization and criticism of the current use and potential of this new preservation method that can be used in the medicine and food industry. The main findings indicate encouraging results for the tested biological matter, including for the preservation of food products (e.g. cherries, spinach, potatoes), biological organisms (e.g. Caenorhabditis elegans, Escherichia coli, Listeria, Salmonella typhimurium), organs (e.g. rat hearts), tissues (e.g., tilapia fish filets) or cells (e.g., mammalian cells, pancreatic cells). Accordingly, we conclude that the isochoric system holds huge potential as a new technique in the field of preservation. doi.org/10.54680/fr22410110112.
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Criopreservação , Isocoros , Ratos , Animais , Criopreservação/métodos , Congelamento , Crioprotetores/farmacologia , Temperatura , MamíferosRESUMO
PURPOSE: Dynamic testing represents the mainstay in the differential diagnosis of ACTH-dependent Cushing's syndrome. However, in case of undetectable or detectable lesion < 6 mm on MRI, bilateral inferior petrosal sinus sampling (BIPSS) is suggested by current guidelines. Aim of this study was to analyze the performance of CRH, desmopressin and high-dose dexamethasone suppression test (HDDST) in the differential diagnosis of ACTH-dependent Cushing's syndrome as well as the impact of invasive and noninvasive tests on surgical outcome in patients affected by Cushing's disease (CD). METHODS: Retrospective analysis on 148 patients with CD and 26 patients with ectopic ACTH syndrome. RESULTS: Among CD patients, negative MRI/lesion < 6 mm was detected in 97 patients (Group A); 29 had a 6-10 mm lesion (Group B) and 22 a macroadenoma (Group C). A positive response to CRH test, HDSST and desmopressin test was recorded in 89.4%, 91·4% and 70.1% of cases, respectively. Concordant positive response to both CRH/HDDST and CRH/desmopressin tests showed a positive predictive value of 100% for the diagnosis of CD. Among Group A patients with concordant CRH test and HDDST, no difference in surgical outcome was found between patients who performed BIPSS and those who did not (66.6% vs 70.4%, p = 0.78). CONCLUSIONS: CRH, desmopressin test and HDDST have high accuracy in the differential diagnosis of ACTH-dependent CS. In patients with microadenoma < 6 mm or non-visible lesion, a concordant positive response to noninvasive tests seems sufficient to diagnose CD, irrespective of MRI finding. In these patients, BIPSS should be reserved to discordant tests.
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Hormônio Adrenocorticotrópico/sangue , Síndrome de Cushing/diagnóstico , Imageamento por Ressonância Magnética/métodos , Amostragem do Seio Petroso/métodos , Hipersecreção Hipofisária de ACTH , Testes de Função Hipofisária/métodos , Neoplasias Hipofisárias , Adulto , Síndrome de Cushing/epidemiologia , Diagnóstico Diferencial , Técnicas de Diagnóstico Endócrino , Feminino , Humanos , Hipofisectomia/métodos , Hipofisectomia/estatística & dados numéricos , Itália/epidemiologia , Masculino , Hipersecreção Hipofisária de ACTH/sangue , Hipersecreção Hipofisária de ACTH/diagnóstico , Hipersecreção Hipofisária de ACTH/epidemiologia , Hipersecreção Hipofisária de ACTH/cirurgia , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/cirurgia , Estudos RetrospectivosRESUMO
OBJECTIVE: Patients with Cushing's syndrome (CS) are at high risk of venous thromboembolism related to a hypercoagulability due to procoagulant imbalance. However, whether these alterations are reversible after disease remission is still unclear. The endogenous thrombin potential (ETP) measured with and without the addition of thrombomodulin provides a global representation of coagulation and previous data confirmed hypercoagulable profile in patients with active hypercortisolism. Aim of this study was to assess the short- and long-term modification of ETP in patients with CS after disease remission. DESIGN AND METHODS: Nineteen patients with CS for whom surgical remission was achieved, were prospectively evaluated for clinical characteristics, cortisol secretion profile and ETP at different time points: (i) before surgical intervention; (ii) after 6 months and (iii) 5 years from the time of persistent remission. Nineteen healthy subjects matched for age and gender were also evaluated as control group. RESULTS: Before surgery, patients showed higher ETP-ratio (with/without thrombomodulin) than controls (0.62 ± 0.09-vs-0.56 ± 0.09, p = 0.034). No significant correlation between ETP-ratio and cortisol secretion was found. 6 months after remission, ETP-ratio was still significantly increased compared to controls (0.64 ± 0.09-vs-0.56 ± 0.09, p = 0.01), but was similar to baseline (0.64 ± 0.09-vs-0.62 ± 0.09, p = 0.87). At 5 years, ETP-ratio showed a significant decrease (0.55 ± 0.14-vs-0.62 ± 0.09, p = 0.02) and was comparable to controls (0.55 ± 0.14-vs-0.56 ± 0.09, p = 0.7). CONCLUSIONS: Plasma hypercoagulability detected in patients with active hypercortisolism persists at short-term evaluation and seems to be completely reversible after long-term remission of disease. These data, as part of a whole evaluation of thrombotic risk, can contribute to make appropriate therapeutic choice in these patients.
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Testes de Coagulação Sanguínea/métodos , Síndrome de Cushing , Hidrocortisona/sangue , Trombina/análise , Trombofilia , Tromboembolia Venosa , Adrenalectomia/métodos , Adulto , Coagulação Sanguínea , Síndrome de Cushing/sangue , Síndrome de Cushing/complicações , Síndrome de Cushing/cirurgia , Feminino , Humanos , Hipofisectomia/métodos , Masculino , Período Pós-Operatório , Indução de Remissão , Medição de Risco/métodos , Trombofilia/sangue , Trombofilia/etiologia , Tempo , Tromboembolia Venosa/sangue , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controleRESUMO
World Health Organization estimates that 30-50% of cancers are preventable by healthy lifestyle choices, early detection and adequate therapy. When the conventional therapeutic strategies are still regulated by the lack of selectivity, multidrug resistance and severe toxic side effects, nanotechnology grants a new frontier for cancer management since it targets cancer cells and spares healthy tissues. This review highlights recent studies using biotin molecule combined with functional nanomaterials used in biomedical applications, with a particular attention on biotinylated chitosan-based nanosystems. Succinctly, this review focuses on five areas of recent advances in biotin engineering: (a) biotin features, (b) biotinylation approaches, (c) biotin functionalized chitosan based nanosystems for drug and gene delivery functions, (d) diagnostic and theranostic perspectives, and (e) author's inputs to the biotin-chitosan based tumour-targeting drug delivery structures. Precisely engineered biotinylated-chitosan macromolecules shaped into nanosystems are anticipated to emerge as next-generation platforms for treatment and molecular imaging modalities applications.
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Quitosana/química , Substâncias Macromoleculares/química , Nanoestruturas/química , Neoplasias/tratamento farmacológico , Biotina/química , Biotinilação , Quitosana/uso terapêutico , Sistemas de Liberação de Medicamentos , Humanos , Substâncias Macromoleculares/uso terapêutico , Imagem Molecular , Nanoestruturas/uso terapêutico , Nanotecnologia/tendênciasRESUMO
PURPOSE: A long-lasting remission of acromegaly after somatostatin analogues (SAs) withdrawal has been described in some series. Our aim was to update the disease evolution after SAs withdrawal in a cohort of acromegalic patients. METHODS: We retrospectively evaluated 21 acromegalic patients previously included in a multicentre study (Ronchi et al. 2008), updating data at the last follow-up. We added further 8 patients selected for SAs withdrawal between 2008-2018. Pituitary irradiation represented an exclusion criterion. The withdrawal was suggested after at least 9 months of clinical and hormonal disease control. Clinical and biochemical data prior and after SAs withdrawal were analysed. RESULTS: In the whole cohort (29 patients) mean age was 50 ± 14.9 years and 72.4% were females. In 69% pituitary surgery was previously performed. Overall, the median time of treatment before SAs withdrawal was 53 months (IQR = 24-84). At the last follow up in 2019, 23/29 patients (79.3%) had a disease relapse after a median time of 6 months (interquartile range or IQR = 3-12) from the drug suspension, while 6/29 (20.7%) were still on remission after 120 months (IQR = 66-150). IGF-1 levels were significantly lower before withdrawal in patients with persistent remission compared to relapsing ones (IGF-1 SDS: -1.5 ± 0.6 vs -0.11 ± 1, p = 0.01). We did not observe any other difference between patients with and without relapse, including SAs formulation, dosage and treatment duration. CONCLUSION: A successful withdrawal of SAs is possible in a subset of well-controlled acromegalic patients and it challenges the concept that medical therapy is a lifelong requirement.
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Acromegalia , Fator de Crescimento Insulin-Like I/análise , Prevenção Secundária , Somatostatina , Suspensão de Tratamento/estatística & dados numéricos , Acromegalia/sangue , Acromegalia/diagnóstico , Acromegalia/tratamento farmacológico , Duração da Terapia , Feminino , Hormônios/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Indução de Remissão/métodos , Prevenção Secundária/métodos , Prevenção Secundária/estatística & dados numéricos , Somatostatina/análogos & derivados , Somatostatina/farmacologia , Tempo , Resultado do TratamentoAssuntos
Biomarcadores/metabolismo , Diabetes Insípido/diagnóstico , Glicopeptídeos/metabolismo , Procedimentos Neurocirúrgicos/efeitos adversos , Doenças da Hipófise/cirurgia , Complicações Pós-Operatórias/diagnóstico , Diabetes Insípido/etiologia , Diabetes Insípido/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Hipófise/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/metabolismo , Prognóstico , Estudos ProspectivosRESUMO
Adrenocortical carcinomas (ACCs) overexpress insulin-like growth factor 2 (IGF2), that drives a proliferative autocrine loop by binding to IGF1R and IR, but IGF1R/IR-targeted therapies failed in ACC patients. The cytoskeleton actin-binding protein filamin A (FLNA) impairs IR signalling in melanoma cells. Aims of this study were to test FLNA involvement in regulating IGF1R and IR responsiveness to both IGF2 and inhibitors in ACC. In ACC cells H295R and SW13 and primary cultures (1ACC, 4 adenomas) we found that IGF1R and IR interacted with FLNA, and FLNA silencing increased IGF1R and reduced IR expression, with a downstream effect of increased cell proliferation and ERK phosphorylation. In addition, FLNA knockdown potentiated antiproliferative effects of IGF1R/IR inhibitor Linsitinib and IGF1R inhibitor NVP-ADW742 in H295R. Finally, Western blot showed lower FLNA expression in ACCs (n = 10) than in ACAs (n = 10) and an inverse correlation of FLNA/IGF1R ratio with ERK phosphorylation in ACCs only. In conclusion, we demonstrated that low FLNA levels enhance both IGF2 proliferative effects and IGF1R/IR inhibitors efficacy in ACC cells, suggesting FLNA as a new factor influencing tumor clinical behavior and the response to the therapy with IGF1R/IR-targeted drugs.
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Neoplasias do Córtex Suprarrenal/patologia , Carcinoma Adrenocortical/patologia , Biomarcadores Tumorais/metabolismo , Filaminas/metabolismo , Fator de Crescimento Insulin-Like II/metabolismo , Receptor IGF Tipo 1/antagonistas & inibidores , Receptor de Insulina/antagonistas & inibidores , Citoesqueleto de Actina/metabolismo , Neoplasias do Córtex Suprarrenal/tratamento farmacológico , Neoplasias do Córtex Suprarrenal/metabolismo , Carcinoma Adrenocortical/tratamento farmacológico , Carcinoma Adrenocortical/metabolismo , Apoptose , Biomarcadores Tumorais/genética , Proliferação de Células , Filaminas/genética , Regulação Neoplásica da Expressão Gênica , Humanos , Imidazóis/farmacologia , Fator de Crescimento Insulin-Like II/genética , Mitógenos/farmacologia , Pirazinas/farmacologia , Pirimidinas/farmacologia , Pirróis/farmacologia , Transdução de Sinais , Células Tumorais CultivadasAssuntos
COVID-19/diagnóstico , COVID-19/epidemiologia , Hipersecreção Hipofisária de ACTH/diagnóstico , Hipersecreção Hipofisária de ACTH/epidemiologia , Centros de Atenção Terciária/tendências , Adulto , Idoso , COVID-19/terapia , Estudos de Coortes , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Hipersecreção Hipofisária de ACTH/terapiaAssuntos
Lesão Pulmonar/induzido quimicamente , Lesão Pulmonar/complicações , Proteinose Alveolar Pulmonar/induzido quimicamente , Proteinose Alveolar Pulmonar/diagnóstico , Proteinose Alveolar Pulmonar/tratamento farmacológico , Esteroides/uso terapêutico , Vaping/efeitos adversos , Adulto , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: First-line therapy of Cushing disease (CD) is transsphenoidal surgery (TSS) aimed to obtain a complete removal of the pituitary adenoma and remission of disease. PURPOSE: To analyse the surgical outcome of patients with CD who underwent TSS in our Centre. METHODS: Retrospective analysis on patients with CD who underwent TSS between 1990 and 2016. RESULTS: We analysed 102 TSS that included: 84 first TSS and 18 second and third TSS. The overall remission rate after surgery was 76.5%, with a significant higher percentage of remitted patients after the first TSS compared to the subsequent TSS (82% vs 50%, p = 0.014). The remission after the first TSS was significantly higher when performed by a dedicated surgical team (DST) (89.8% vs 71% p = 0.04) and when the immunohistochemical examination confirmed the adrenocorticotropic adenoma (87% vs 55%, p = 0.04). Neuroradiological findings influenced the surgical outcome in a non-significant manner. Post-TSS complications were reported in 32 patients, with no significant variation when TSS was performed by DST. In case of reintervention, remission of disease was obtained in 72.7% of microadenoma, while no remitted patients were observed in case of macroadenomas. The DST did not significantly improve the outcome. CONCLUSION: Cushing disease is characterized by a broad spectrum of neuroradiological presentation. Despite the availability of a DST make the TSS a safe and effective first-line treatment among all these patients, a precise pre-treatment evaluation is needed in order to define the aim of neurosurgery and to schedule the management of recurrent disease.
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Adenoma/cirurgia , Procedimentos Neurocirúrgicos/métodos , Hipersecreção Hipofisária de ACTH/cirurgia , Neoplasias Hipofisárias/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
A search for shape isomers in the ^{66}Ni nucleus was performed, following old suggestions of various mean-field models and recent ones, based on state-of-the-art Monte Carlo shell model (MCSM), all considering ^{66}Ni as the lightest nuclear system with shape isomerism. By employing the two-neutron transfer reaction induced by an ^{18}O beam on a ^{64}Ni target, at the sub-Coulomb barrier energy of 39 MeV, all three lowest-excited 0^{+} states in ^{66}Ni were populated and their γ decay was observed by γ-coincidence technique. The 0^{+} states lifetimes were assessed with the plunger method, yielding for the 0_{2}^{+}, 0_{3}^{+}, and 0_{4}^{+} decay to the 2_{1}^{+} state the B(E2) values of 4.3, 0.1, and 0.2 Weisskopf units (W.u.), respectively. MCSM calculations correctly predict the existence of all three excited 0^{+} states, pointing to the oblate, spherical, and prolate nature of the consecutive excitations. In addition, they account for the hindrance of the E2 decay from the prolate 0_{4}^{+} to the spherical 2_{1}^{+} state, although overestimating its value. This result makes ^{66}Ni a unique nuclear system, apart from ^{236,238}U, in which a retarded γ transition from a 0^{+} deformed state to a spherical configuration is observed, resembling a shape-isomerlike behavior.
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The role of progenitor/stem cells in pituitary tumorigenesis, resistance to pharmacological treatments and tumor recurrence is still unclear. This study investigated the presence of progenitor/stem cells in non-functioning pituitary tumors (NFPTs) and tested the efficacy of dopamine receptor type 2 (DRD2) and somatostatin receptor type 2 (SSTR2) agonists to inhibit in vitro proliferation. They found that 70% of 46 NFPTs formed spheres co-expressing stem cell markers, transcription factors (DAX1, SF1, ERG1) and gonadotropins. Analysis of tumor behavior showed that spheres formation was associated with tumor invasiveness (OR = 3,96; IC: 1.05-14.88, p = 0.036). The in vitro reduction of cell proliferation by DRD2 and SSTR2 agonists (31 ± 17% and 35 ± 13% inhibition, respectively, p < 0.01 vs. basal) occurring in about a half of NFPTs cells was conserved in the corresponding spheres. Accordingly, these drugs increased cyclin-dependent kinase inhibitor p27 and decreased cyclin D3 expression in spheres. In conclusion, they provided further evidence for the existence of cells with a progenitor/stem cells-like phenotype in the majority of NFPTs, particularly in those with invasive behavior, and demonstrated that the antiproliferative effects of dopaminergic and somatostatinergic drugs were maintained in progenitor/stem-like cells.
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Carcinogênese/genética , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Hipofisárias/tratamento farmacológico , Receptores de Dopamina D2/genética , Receptores de Somatostatina/genética , Adulto , Carcinogênese/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Ciclina D3/biossíntese , Inibidor de Quinase Dependente de Ciclina p27/biossíntese , Receptor Nuclear Órfão DAX-1/biossíntese , Dopaminérgicos/administração & dosagem , Resistencia a Medicamentos Antineoplásicos/genética , Canal de Potássio ERG1/biossíntese , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Gonadotropinas/biossíntese , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Células-Tronco Neoplásicas/efeitos dos fármacos , Neoplasias Hipofisárias/genética , Neoplasias Hipofisárias/patologia , Fatores de Processamento de RNA/biossíntese , Receptores de Dopamina D2/agonistas , Receptores de Somatostatina/agonistas , Esferoides Celulares/efeitos dos fármacos , Esferoides Celulares/patologiaRESUMO
Optical and structural properties are presented for GaN nanorods (NRs) grown in the [0001] direction on Si(111) substrates by direct-current reactive magnetron sputter epitaxy. Transmission electron microscopy (TEM) reveals clusters of dense stacking faults (SFs) regularly distributed along the c-axis. A strong emission line at â¼3.42 eV associated with the basal-plane SFs has been observed in luminescence spectra. The optical signature of SFs is stable up to room temperatures with the activation energy of â¼20 meV. Temperature-dependent time-resolved photoluminescence properties suggest that the recombination mechanism of the 3.42 eV emission can be understood in terms of multiple quantum wells self-organized along the growth axis of NRs.
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Oxigenação por Membrana Extracorpórea/métodos , Insuficiência Cardíaca/terapia , Transplante de Coração/efeitos adversos , Coração Auxiliar , Edema Pulmonar/etiologia , Edema Pulmonar/terapia , Terapia Combinada , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Transplante de Coração/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Prognóstico , Edema Pulmonar/patologia , Respiração Artificial/métodos , Medição de Risco , Tetralogia de Fallot/diagnóstico , Tetralogia de Fallot/cirurgia , Traqueostomia/métodosRESUMO
Fetal tumors are rare and can be difficult to diagnose in utero. In this presentation, we report an infantile hemangiopericytoma of the tongue, and also review the clinical characteristics, imaging appearances, perinatal differential diagnosis, and potential treatments of this tumors. Prenatal diagnosis of lingual fetal tumors with two-dimensional (2D) ultrasound presents a challenge to sonographers and perinatologists because these lesions are rare, usually develop in the third trimester of pregnancy and need a multidisciplinary approach. We describe an lingual tumor and moderate polyhydramnios which were prenatally detected at 31 weeks of gestation with two- dimensional ultrasound. The application of the surface mode of three-dimensional ultrasound improved the visualization of this tumor. Fetal Magnetic resonance imaging was performed to help in prenatal differential diagnostic. The option of prenatal cytology gained by amniocentesis should also be considered. To our knowledge there are no prenatal reports of similar cases. However, in our experience every information provided during the pregnancy, a correct and early diagnose of fetal condition helps to cope with the demands of perinatal management and to explain to the parents and neonatologists the findings of the case.