RESUMO
Malignant degeneration of colon endometriosis is a very rare event. We report here on three cases. A 48-year-old woman with a 10-year history of endometriosis was treated for a rectal adenocarcinoma, a 61-year-old G1P1, who was operated at the age of 40 years for ovarian endometriosis and again at the age of 53 years for an endometriosis-associated endometroid ovarian carcinoma, presented for therapy for a lymph node recurrence of the ovarian cancer and, secondly, due to a malignantly degenerated rectum-sigmoid colon endometriosis; furthermore a 54-year old woman with a 21-year history of endometriosis was operated for malignant colon endometriosis. The tumour occurred during an adjuvant anti-oestrogen treatment with an aromatase inhibitor following surgical and radiotherapy for breast cancer. In all cases a radical cancer operation was followed by adjuvant chemotherapy and in one case with an additional radiotherapy. In the follow-up periods of 18 months, 2 and 5 years, respectively, all women remained free of recurrences. Although this is not a randomised controlled study due to the rare occurrence of such cases, a radical operation followed by individualised adjuvant therapy appears to be the treatment of choice.
RESUMO
Penile metastases are very uncommon. Prostate cancer as the most frequent malignoma of the male is the main primary lesion. Metastases in the penis only occur at an advanced state of the tumour and with a high dedifferentiation, e. g., ductal adenocarcinoma. Changes in the morphology of the prostate carcinoma are specially known for the occurrence of small-cell neuroendocrine and undifferentiated carcinomas. Often prior to the transformation an anti-androgen therapy has been undertaken. At this state of the disease, there is only the possibility of a palliative therapy with a poor prognosis. The increasing histological dedifferentiation of the tumour tissue can make it difficult or even impossible to identify the primary lesion.
Assuntos
Adenocarcinoma/secundário , Antagonistas de Androgênios/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Carcinoma Basocelular/secundário , Carcinoma de Células de Transição/secundário , Transformação Celular Neoplásica/patologia , Difosfonatos/uso terapêutico , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Neoplasias Primárias Múltiplas/tratamento farmacológico , Neoplasias Penianas/secundário , Neoplasias da Próstata/tratamento farmacológico , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Antagonistas de Androgênios/efeitos adversos , Antineoplásicos Hormonais/efeitos adversos , Biomarcadores Tumorais/análise , Biópsia , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/secundário , Neoplasias Ósseas/cirurgia , Carcinoma Basocelular/tratamento farmacológico , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células de Transição/tratamento farmacológico , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Transformação Celular Neoplásica/efeitos dos fármacos , Terapia Combinada , Cistectomia , Diagnóstico Diferencial , Progressão da Doença , Humanos , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Penianas/tratamento farmacológico , Neoplasias Penianas/patologia , Neoplasias Penianas/cirurgia , Pênis/patologia , Pênis/cirurgia , Próstata/patologia , Próstata/cirurgia , Prostatectomia , Neoplasias da Próstata/patologiaRESUMO
Actinomycosis is a rare infection mainly of the head and neck region (cervicofacial actinomycosis). The cause of this infection is bacterial invasion of the host's mucosal barrier with consecutive infiltration of the surrounding tissues. The treatment of choice after diagnosis is a prolonged course of high-dose antibiotics. The presence of abdominal actinomycosis is at a maximum of 25%, whereas renal involvement appears only sporadically. Aggravating causes for early diagnosis are the appearance of abscesses, fistulae and a debilitating illness resembling carcinoma and leading to surgery as the treatment of choice. Renal actinomycosis is a diagnostic challenge because it is included in the differential diagnosis of renal masses with coexisting B-symptoms. The suspicion requires surgical treatment--nephrectomy. We report on a patient who was transferred to our department for nephrectomy because of radiologically diagnosed renal and perirenal abscesses. The histological result showed renal actinomycosis.
Assuntos
Abscesso/diagnóstico , Actinomicose/diagnóstico , Pielonefrite/diagnóstico , Doenças Ureterais/diagnóstico , Abscesso/patologia , Abscesso/cirurgia , Actinomicose/patologia , Actinomicose/cirurgia , Idoso , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Rim/patologia , Nefrectomia , Cuidados Pós-Operatórios , Pielonefrite/patologia , Pielonefrite/cirurgia , Doenças Ureterais/patologia , Doenças Ureterais/cirurgiaRESUMO
Secondary malignant testicular tumors are rare, with the exception of infiltrations by lymphomas and leukemias. Metastases are sometimes found in cancers of the lung, gastrointestinal tract, kidney, skin and prostate. Less than about 200 cases of testicular metastasis of prostate cancer have been described in the literature. This is this a very small number in comparison to the high incidence of prostate cancer and the vast number of orchiectomies for operative hormone deprivation in advanced cases. The testicle metastases described are mostly unilateral and are often found as ductal carcinoma of the prostate. In our case, the testicular metastasis from a small cell prostate carcinoma appeared 2.5 years after androgen deprivation of an adenocarcinoma of the prostate.