ACTH-secreting parotid acinic cell carcinoma unusually reported as a paraneoplastic syndrome.

Paraneoplastic syndromes, induced by an immunological cross-reaction or hormone/peptide secretion, are an atypical presentation of tumors. Some tumors, such as small cell lung cancer and bronchial carcinoid, can be adrenocorticotropic hormone (ACTH) secreting tumors. Less commonly, parotid acinic cell carcinoma can be ACTH-secreting tumor leading to Cushing's syndrome. Few literature cases have described ACTH related paraneoplastic syndrome of parotid adenocarcinoma. Because of the rarity of the condition, little is known about the management and prognosis of this phenomenon. In this report, we highlighted the case of a 59-year-old male with a past medical history of parotid adenocarcinoma treated with surgery, chemotherapy, and radiation therapy presented with clinical and biochemical signs of hyperaldosteronism. Abdominal ultra-sound, computed tomography, and magnetic resonance imaging showed hepatic mass. Liver biopsy with immunohistochemistry confirmed the presence of parotid adenocarcinoma secreting ACTH. He is on paclitaxel and carboplatin medication with good clinical response.

Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease.

BACKGROUND AND PURPOSE: Radiotherapy has been associated with late dose-dependent cardiovascular toxicity. In this cross-sectional pilot study, radiation dose distributions were correlated with areas of localized and diffuse myocardial fibrosis as measured by novel cardiac MRI (CMR) sequences including late gadolinium enhancement (LGE) and T1 mapping with the goal to identify early markers of myocardial damage. MATERIALS AND METHODS: Twenty-eight patients with chest tumors including lung, breast, esophagus, and lymphoma underwent CMR per study protocol on average 46.4 months (range 1.7-344.5) after radiotherapy. Patients without pretreatment cardiac history were included if the volume of heart receiving 5 Gy or more was at least 10% (V5Gy ≥ 10%). The association of LGE with cardiac dosimetric factors, clinical factors (e.g., tumor type, smoking history, BMI), and T1 values was analyzed. RESULTS: Cardiac maximum (Dmax) and mean dose (Dmean) equivalent to doses delivered in 2 Gy fractions (EQD2) were on average 50.9 Gy (range 6.2-108.0) and 8.2 Gy (range 1.0-35.7), respectively, compared to 60.8 Gy (40.8-108.0) and 6.8 Gy (1.8-21.8) among the 9 patients with LGE. Doses were not different between patients with and without LGE (p = 0.16 and 0.56, respectively). The average T1 value of the left ventricle myocardium was 1009 ms (range 933-1117). No significant correlation was seen for heart Dmax and Dmean and T1 values (p = 0.14 and 0.58, respectively). In addition, no significant association between clinical factors and the development of LGE was identified. CONCLUSIONS: No relation between cardiac doses, the presence of LGE or T1 values was observed. Further study is needed to determine the benefit of CMR for detecting radiotherapy-related myocardial fibrosis.

Tumor glómico. A propósito de un caso, revisión de la literatura / Glomus tumor a case report: review of literature

A propósito de la presentación de un caso de tumor glómico se revisa la literatura, se precisa su particular sintomatología dolorosa, su localización y la efectividad del tratamiento quirúrgico, debiendo tenerse en cuenta que debe realizarse una escisión completa de la lesión, ya que pueden presentarse recidivas por no haber advertido en el momento del acto quirúrgico la presencia de otros tumores por hipertrofia de otros glomus

Diagnóstico citogenético prenatal en madre portadora de translocación cromosómica 4;9: seguimiento del recién nacido / Prenatal cytogenetic diagnosis in a mother with 4;9 chromosomal translocation

El diagnóstico citogenético prenatal constituye una práctica de rutina en muchos países. La indicación más común es edad materna avanzada; sin embargo, algunos casos se deben a que uno de los padres es portador de una translocación cromosómica. En el presente trabajo se describe un caso de diagnóstico citogenético prenatal en una madre portadora de una translocación cromosómica 4;9, con antecedentes de dos abortos y dos muertes perinatales, uno de los productos con labio y paladar hencido. Se describe el manejo de la paciente embarazada, el diagnóstico citogenético prenatal con la obtención de un carioptipo fetal normal y el seguimiento del embarazo y del recién nacido