Urothelial bladder cancer with cardiac metastasis: Literature review and case report.

INTRODUCTION AND IMPORTANCE: Urothelial bladder cancer can infrequently result in cardiac metastasis, and be usually diagnosed in severe clinical conditions. We report a urothelial bladder cancer with cardiac metastasis and perform a literature review of published cases of transitional cell carcinoma (TCC) of the bladder with cardiac metastasis from 1934 to 2023 published in Pubmed. CASE PRESENTATION: 42-year-old woman with urinnary bladder TCC, underwent radical cystectomy, developing cardiac metastasis after 25 months, cardiac surgery for partial removal of the lesion and using pembrolizumab with the highest reported survival to date. CLINICAL DISCUSSION: After analysis of 20 case reports in the world among our case, men are more affected, tobacco exposure was the most prevalent risk factor, baseline T3 staging was the most common, and right ventricular and myocardium metastases are more prevalent. The most common symptoms were respiratory failure, changes in cardiac auscultation, and loss of weight. Six patients had cardiac tamponade, and the mean of drained fluid was 1040 ml. Immunohistochemical markers, such as CK7 and Calretinin, were decisive in elucidating the diagnosis. The average time between diagnosis of TCC and cardiac metastasis was 48.69 months, and the survival time after diagnosis of cardiac metastasis was 60.69 days. CONCLUSION: Bladder TCC with cardiac metastasis is rare and with a low survival rate after the diagnosis. Patients with more advanced stages of TCC deserve diagnostic suspicion of cardiac metastasis if they progress with previously unreported respiratory and cardiac symptoms.

Adult Wilms tumor during gestational period.

We present a case of a 17-year-old pregnant girl, with hematuria. Magnetic resonance imaging showed a solid left renal mass. The patient had a radical nephrectomy during the 20th week gestation and the diagnosis was nephroblastoma. She gave birth to a healthy child at term and refused adjuvant treatment. She is disease-free after 24 months of follow-up. Based on the excellent results achieved while treating children with Wilms' tumor using surgery, chemotherapy and radiotherapy, adults with the same disease should be treated similarly. This treatment must be instituted early, even in pregnant women.

Revisão sobre infecção de sítio cirúrgico e recomendações de antibioticoprofilaxia em clínicas cirúrgicas / Review on Surgical Site Infection and Prophylactic Recommendations in Surgical Clinics

Este trabalho trata de revisão da literatura abordando os fatores de risco pré e intra-operatório, os microorganismos mais prevalentes e as medidas para diminuir a ocorrência de infecções de sítio cirúrgico. Enfoca o uso correto da antibioticoprofilaxia e sua relação com o problema da resistência bacteriana para as principais cirurgias de diversas especialidades.