RESUMO
Multiple endocrine neoplasia type 1 (MEN1) syndrome is a relatively rare disease, characterized by the occurrence of multiple endocrine tumors in the parathyroid and pituitary glands as well as the pancreas. Here, we report a case of MEN1 with neuroendocrine tumors (NETs) in the stomach, duodenum, and pancreas. A 53-year-old man visited our hospital to manage gastric NET. Five years prior to his visit, he had undergone surgery for incidental meningioma. His brother had pancreatic nodules and a history of surgery for adrenal adenoma. His brother's daughter also had pancreatic nodules, but had not undergone surgery. The lesion was treated by endoscopic submucosal dissection and diagnosed as a grade 1 NET. Another small NET was detected in the second duodenal portion, resected by endoscopic submucosal dissection, which was also diagnosed as a grade 1 NET. During evaluation, three nodules were detected in the pancreas, and no evidence of pituitary, parathyroid tumors, or metastasis was observed. After surgery, the pancreatic lesions were diagnosed as NETs, with the same immunohistochemical patterns as those of the stomach and duodenum. Genetic testing was performed, and a heterozygous mutation was detected in the MEN1 gene, which is located on 11q13.
Assuntos
Duodeno/patologia , Neoplasia Endócrina Múltipla Tipo 1/diagnóstico , Pâncreas/patologia , Proteínas Proto-Oncogênicas/genética , Estômago/patologia , Análise Mutacional de DNA , Duodeno/diagnóstico por imagem , Duodeno/metabolismo , Mucosa Gástrica/metabolismo , Mutação em Linhagem Germinativa , Humanos , Mutação INDEL , Masculino , Pessoa de Meia-Idade , Neoplasia Endócrina Múltipla Tipo 1/genética , Pâncreas/diagnóstico por imagem , Pâncreas/metabolismo , Estômago/diagnóstico por imagem , Tomografia Computadorizada por Raios XAssuntos
Glomerulonefrite/complicações , Poliangiite Microscópica/complicações , Pancreatite/etiologia , Doença Aguda , Biópsia , Evolução Fatal , Feminino , Imunofluorescência , Glomerulonefrite/diagnóstico , Glomerulonefrite/tratamento farmacológico , Glomerulonefrite/imunologia , Humanos , Imunossupressores/uso terapêutico , Poliangiite Microscópica/diagnóstico , Poliangiite Microscópica/tratamento farmacológico , Poliangiite Microscópica/imunologia , Pessoa de Meia-Idade , Pancreatite/diagnóstico , Pancreatite/tratamento farmacológico , Pancreatite/imunologia , Resultado do TratamentoRESUMO
Rothia muciliaginosa (R. mucilaginosa) is a facultative, Gram-positive coccus that is considered to be part of the normal flora of the mouth and respiratory tract. There are sporadic reports of the organism causing endocarditis in patients with heart valve abnormalities, as well as meningitis, septicemia, and pneumonia associated with intravenous drug abuse. However, it is an unusual pathogen in cases of peritoneal dialysis (PD)-associated peritonitis. Although R. mucilaginosa is generally susceptible to penicillin, ampicillin, cefotaxime, imipenem, rifampicin, and glycopeptides, there are no guidelines for the treatment of PD-associated peritonitis. Herein, we report a case of PD-associated peritonitis due to R. mucilaginosa that was resolved with intraperitoneal antibiotic treatment.