RESUMO
BACKGROUND: Extraskeletal osteosarcoma is an extremely rare malignancy that accounts for 1% of soft tissue sarcoma and 4.3% of all osteosarcoma. Extraskeletal osteosarcoma can develop in a patient between the ages of 48 and 60 years. The incidence of extraskeletal osteosarcoma is slightly higher in male patients than in females. CASE PRESENTATION: A 50-year-old Caucasian male patient presented with a 6-month history of intermittent lower-left back pain that limits his activity. Prior ultrasonography and abdominal computed tomography scan showed a diagnosis of kidney stone and tumor in the lower-left abdomen. The computed tomography urography with contrast revealed a mass suspected as a left retroperitoneal malignant tumor. Hence, the tumor was resected through laparotomy and the patient continued with histopathological and immunohistochemistry examination with the result of extraskeletal osteosarcoma. CONCLUSION: Extraskeletal osteosarcoma presents diagnostic challenges requiring multimodal examination, including histological and immunohistochemistry analyses. This case underscores the aggressive nature and poor prognosis despite undergoing the current suggested treatment.
Assuntos
Osteossarcoma , Tomografia Computadorizada por Raios X , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/patologia , Osteossarcoma/diagnóstico , Osteossarcoma/diagnóstico por imagem , Neoplasias Renais/patologia , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Neoplasias Renais/diagnóstico , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/cirurgiaRESUMO
Dogs that had splenectomy are predisposed to fatal thrombotic conditions, and thrombocytosis is a risk factor for post-splenectomy hypercoagulability. However, in veterinary medicine, there are no specific therapeutic approaches for managing this hypercoagulability. This study aimed to determine the preventive effect of clopidogrel on post-operative hypercoagulability during the first 2 weeks post-splenectomy in dogs with splenic masses. This study included 12 dogs that had splenectomy. Seven dogs received no treatment (group A), and five were treated with clopidogrel (group B). Clopidogrel was loaded at 10 mg/kg on day 2 and continued at 2 mg/kg until day 14. Blood samples were collected on the day of surgery and 2, 7, and 14 days after splenectomy in both groups. In group B, thromboelastography (TEG) was performed on the same days. In group A, there was significant elevation of platelet counts on days 7 (p = 0.007) and 14 (p = 0.001) compared to day 0. In group B, the platelet counts were significantly elevated on day 7 (p = 0.032) but no significant difference was found on day 14 compared to day 0. Platelet counts on day 14 were significantly higher in group A than in group B (p = 0.03). The lower platelet counts were correlated with alterations in TEG parameters, and no significant differences were found in the K and α-angle values at all postoperative assessment points compared to day 0. Our study suggests that clopidogrel may reduce post-operative thrombocytosis and hypercoagulability in dogs that undergo splenectomy for splenic masses.
Assuntos
Clopidogrel , Doenças do Cão , Inibidores da Agregação Plaquetária , Esplenectomia , Tromboelastografia , Trombofilia , Animais , Cães , Esplenectomia/veterinária , Esplenectomia/efeitos adversos , Clopidogrel/uso terapêutico , Doenças do Cão/sangue , Doenças do Cão/cirurgia , Doenças do Cão/tratamento farmacológico , Contagem de Plaquetas/veterinária , Feminino , Masculino , Trombofilia/veterinária , Trombofilia/tratamento farmacológico , Inibidores da Agregação Plaquetária/uso terapêutico , Inibidores da Agregação Plaquetária/farmacologia , Tromboelastografia/veterinária , Complicações Pós-Operatórias/veterinária , Complicações Pós-Operatórias/prevenção & controle , Neoplasias Esplênicas/veterinária , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/sangue , Esplenopatias/veterinária , Esplenopatias/cirurgia , Esplenopatias/sangue , Trombocitose/veterináriaRESUMO
BACKGROUND: Dogs with retroperitoneal hemangiosarcoma (HSA) exhibit variable postoperative median survival times (MST). OBJECTIVE: To retrospectively evaluate the prognostic value of selected tumour-related factors, such as tumour size, rupture, invasion into adjacent tissue, involvement of lymph node and distant metastasis, they were analysed in dogs with retroperitoneal HSA. METHODS: Ten dogs with retroperitoneal HSA managed solely with surgical excision were reviewed and compared with spleen (71) and liver (9) HSA. The Kaplan-Meier method and log-rank analysis were used compare MSTs between factors. Multivariable Cox proportional-hazard analysis was used to compare differences between arising sites. RESULTS: Retroperitoneal HSA showed comparatively longer postoperative MST compared with that of spleen and liver HSA and demonstrated significantly longer MST (p = 0.003) for tumours ≥5 cm (195 days) than <5 cm (70 days). Spleen HSA revealed significantly shorter MSTs in involvement of distant lymph nodes (23 days) and distant metastasis (39 days) than those in negative (83 days, p = 0.002 and 110 days, p < 0.001, respectively). Liver HSA also revealed significantly shorter MST (16.5 days compared with 98 days, p = 0.003) for distant metastasis. Additionally, hazard ratios (HRs) and their forest plot for overall HSA revealed as poor prognostic factors, arising sites (spleen; HR 2.78, p = 0.016 and liver; HR 3.62, p = 0.019), involvement of distant lymph nodes (HR 2.43, p = 0.014), and distant metastasis (HR 2.86, p < 0.001), and as better prognostic factor of tumour size ≥5 cm (HR 0.53, p = 0.037). CONCLUSION: In combination with overall HSA, retroperitoneal HSA shows comparatively longer postoperative MST compared to spleen and liver HSA, associated with tumour size ≥5 cm suggesting better prognostic factor.
Assuntos
Doenças do Cão , Hemangiossarcoma , Neoplasias Retroperitoneais , Animais , Cães , Hemangiossarcoma/veterinária , Hemangiossarcoma/patologia , Hemangiossarcoma/cirurgia , Hemangiossarcoma/mortalidade , Estudos Retrospectivos , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Doenças do Cão/mortalidade , Masculino , Feminino , Neoplasias Retroperitoneais/veterinária , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Neoplasias Retroperitoneais/mortalidade , Prognóstico , Neoplasias Esplênicas/veterinária , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/mortalidade , Neoplasias Hepáticas/veterinária , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/patologiaRESUMO
RATIONALE: Sclerosing angiomatoid nodular transformation (SANT) of the spleen is an uncommon benign vascular lesion with an obscure etiology. It predominantly affects middle-aged women and presents with nonspecific clinical signs, making preoperative diagnosis challenging. The definitive diagnosis of SANT relies on pathological examination following splenectomy. This study aims to contribute to the understanding of SANT by presenting a case series and reviewing the literature to highlight the clinical presentation, diagnostic challenges, and treatment outcomes. PATIENT CONCERNS: In this retrospective study, we analyzed the clinical data of 3 patients with confirmed SANT admitted from November 2013 to October 2023. The cases include a 25-year-old male, a 15-year-old female, and a 39-year-old male, each with a splenic mass. DIAGNOSES AND INTERVENTIONS: All of the three cases were treated by laparoscopic splenectomy (LS). Pathological examination confirmed SANT in all cases. OUTCOMES: No recurrence or metastasis was observed during a 10-year follow-up for the first 2 cases, and the third case showed no abnormalities at 2 months postoperatively. Despite its rarity, SANT is a significant condition due to its potential for misdiagnosis and the importance of distinguishing it from malignant lesions. The study underscores the utility of LS as a safe and effective treatment option. LESSONS: SANT is a rare benign tumor of the spleen, and the preoperative diagnosis of whom is challenging. LS is a safe and effective treatment for SANT, with satisfactory surgical outcomes and favorable long-term prognosis on follow-up. The study contributes to the limited body of research on this rare condition and calls for larger studies to validate these findings and improve clinical management.
Assuntos
Esplenectomia , Neoplasias Esplênicas , Humanos , Masculino , Adulto , Feminino , Esplenectomia/métodos , Adolescente , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/diagnóstico , Baço/patologia , Histiocitoma Fibroso Benigno/patologia , Histiocitoma Fibroso Benigno/cirurgia , Histiocitoma Fibroso Benigno/diagnóstico , Estudos Retrospectivos , Laparoscopia/métodos , Diagnóstico Diferencial , Esplenopatias/cirurgia , Esplenopatias/patologia , Esplenopatias/diagnósticoRESUMO
While the importance of conversion surgery has increased with the development of systemic chemotherapy for gastric cancer (GC), reports of conversion surgery for patients with GC with distant metastasis and tumor thrombus are extremely scarce, and a definitive surgical strategy has yet to be established. Herein, we report a 67-year-old man with left abdominal pain referred to our hospital following a diagnosis of unresectable GC. Esophagogastroduodenoscopy and contrast-enhanced abdominal computed tomography (CT) revealed advanced GC with splenic metastasis. A splenic vein tumor thrombus (SVTT) and a continuous thrombus to the main trunk of the portal vein were detected. The patient was treated with anticoagulation therapy and systemic chemotherapy comprising S-1 and oxaliplatin. One year following chemotherapy initiation, a CT scan revealed progressive disease (PD); therefore, the chemotherapy regimen was switched to ramucirumab with paclitaxel. After 10 courses of chemotherapy resulting in primary tumor and SVTT shrinkage, the patient underwent laparoscopic total gastrectomy (LTG) and distal pancreaticosplenectomy (DPS). He was discharged without complications and remained alive 6 months postoperatively without recurrence. In summary, the wait-and-see approach was effective in a patient with GC with splenic metastasis and SVTT, ultimately leading to an R0 resection performed via LTG and DPS.
Assuntos
Neoplasias Esplênicas , Veia Esplênica , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/complicações , Masculino , Idoso , Veia Esplênica/cirurgia , Neoplasias Esplênicas/secundário , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/tratamento farmacológico , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Trombose Venosa/cirurgia , Trombose Venosa/tratamento farmacológico , Gastrectomia/métodosAssuntos
Hemangiossarcoma , Neoplasias Hepáticas , Neoplasias Esplênicas , Humanos , Hemangiossarcoma/cirurgia , Hemangiossarcoma/patologia , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/patologia , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/patologia , Procedimentos Cirúrgicos Robóticos/métodos , Hepatectomia/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Resultado do Tratamento , Esplenectomia/métodosRESUMO
BACKGROUND: Current study aimed to investigate the clinical characterization, differential diagnosis, and treatment of splenic littoral cell angioma (LCA). METHODS: A retrospective analysis was performed for 10 LCA cases admitted to Huzhou Central Hospital from 2007 to 2023, for clinical manifestations, hematological tests, imaging features, pathological features, treatment methods, and prognosis along with the relevant literature was also reviewed. RESULTS: During examinations, no specific clinical manifestations and hematological abnormalities were seen in all 10 cases of LCA. Imaging observations depicted single or even multiple spherical lesions in the spleen. Plains shown by computed tomography (CT) were found somewhat equal or slightly lower in density. On the other hand, magnetic resonance imaging (MRI) plain scans viz. T1 weighted image showed equal low and mixed signals while T2-weighted showed high and low mixed signals. Moreover, punctate low signals could be seen in high signals named "freckle sign" in MRI scans. On contrast-enhanced CT scans, the enhancement of the lesions was not obvious in the arterial phase, and some of the lesions showed edged ring-like enhancements and "filling lake" progressive enhancement during the venous phase and delayed phase. In multiple lesions, the number of enhanced scan lesions showed a variable changing pattern "less-more-less." MRI-enhanced scan showed the characteristics of "fast in and slow out." Microscopic examinations identified tumor tissue actually composed of sinus-like lacunae that anastomosed with each other in the form of a network. Furthermore, cystic expansion and pseudopapillary protrusions were also seen in the dilated sinus cavity which was lined with single-layer endothelial cells having conspicuous cytoplasmic hemosiderin. High immunophenotypic expressions of vascular endothelial cell phenotype (CD31, CD34, FVIII) and tissue cell phenotype (CD68) were also seen. Total and partial splenectomy were performed in 8 and 2 patients, respectively, and follow-up examinations showed survival in all patients with no recurrence. CONCLUSION: LCA is a rare splenic benign lesion with atypical clinical manifestations. CT and MRI imaging are important tools in preoperative diagnosis based on pathomorphological and immunohistochemical examinations. Splenectomy is a superior therapeutic choice with significant impacts and prognosis.
Assuntos
Células Endoteliais , Hemangioma , Neoplasias Esplênicas , Humanos , Células Endoteliais/patologia , Estudos Retrospectivos , Neoplasias Esplênicas/diagnóstico por imagem , Neoplasias Esplênicas/cirurgiaRESUMO
Littoral cell angioma is an extremely rare splenic vascular tumor originating from the cells lining the splenic red pulp sinuses. Approximately 150 cases of littoral cell angioma have been reported since 1991. Its clinical manifestation is usually asymptomatic and is mostly diagnosed as an incidental finding through abdominal imaging. Herein, we present a case of littoral cell angioma in a 41-year-old woman with no previous comorbidities, which initially presented as a nonspecific splenic lesion diagnosed on imaging in the emergency room. The patient was treated through laparoscopic intervention.
Assuntos
Hemangioma , Neoplasias Esplênicas , Humanos , Feminino , Adulto , Neoplasias Esplênicas/diagnóstico por imagem , Neoplasias Esplênicas/cirurgia , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Tomografia Computadorizada por Raios X/métodosRESUMO
Spontaneous rupture of a primary hepatocellular carcinoma (HCC) is a frequently observed and fatal complication. However, the rupture of lymph node (LN) metastases from HCC is rare. A 79 year-old male with hepatitis B underwent three liver resections for HCC. Two years and 6 months after the last liver resection, enhanced computed tomography (CT) revealed a nodule with a diameter of 3 cm in the lower pole of the spleen. Splenic metastasis of HCC was suspected, and splenectomy was scheduled. During our hospital stay for a urinary tract infection before the scheduled operation, he complained of acute left-sided abdominal pain, and CT showed intra-abdominal hemorrhage due to rupture of the splenic tumor. Emergency splenectomy was performed, and the postoperative course was uneventful. Histopathological examination revealed a poorly differentiated HCC in the lower splenic pole lesion, which contained LN structures. The ruptured lesion was diagnosed as splenic hilar LN metastasis of HCC. Although laparoscopic partial liver resection was performed for intrahepatic recurrence, and atezolizumab plus bevacizumab therapy was administered for peritoneal metastases, the patient was alive 25 months after the splenectomy. Our case suggests that emergency surgery for LN metastatic rupture can achieve hemostasis and lead to improved survival outcomes.
Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Metástase Linfática , Esplenectomia , Humanos , Masculino , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Carcinoma Hepatocelular/secundário , Carcinoma Hepatocelular/cirurgia , Carcinoma Hepatocelular/patologia , Ruptura Espontânea , Idoso , Neoplasias Esplênicas/secundário , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/patologia , Tomografia Computadorizada por Raios X , HepatectomiaRESUMO
Background: Splenic sclerosing angiomatoid nodular transformation (SANT) is a rare benign nodular lesion in the red medulla of the spleen. In the past, SANT has not been consistently recognized as the name for this condition and was often misdiagnosed for other conditions. In recent years, SANT has been acknowledged by most scholars as multiple reports have been published. Aim: To assess the clinicopathological features of SANT to identify the histological characteristics of SANT to improve diagnosis and clinical treatment. Materials and Methods: We assessed 25 cases of SANT diagnosed at Zhongshan Hospital affiliated with Fudan University from September 2014 to October 2021, including 14 men and 11 women, aged 24-62 years old. Results: Fourteen cases were complicated with benign tumors of the liver, pancreas, kidney, uterus, and prostate. One case was complicated with renal clear cell carcinoma, and one was complicated with hepatocellular carcinoma. The gross neoplasm is multinodular and well defined. Histologically, angiomatoid nodules are composed of fattened, round, or irregular blood vessels, with or without red blood cells in the lumen, with unequal red blood cell extravasation, and fibrocytes around the nodules. The hemangiomatous nodules were positive for CD31 and CD34, while the vascular wall smooth muscle cells and fibrocytes around the nodules were positive for SMA. Conclusion: The diagnosis of SANT requires a combination of immunohistochemical and histological features, and early splenectomy is crucial for treatment.
Assuntos
Hemangioma , Histiocitoma Fibroso Benigno , Esplenopatias , Neoplasias Esplênicas , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Esplenopatias/diagnóstico , Esplenopatias/cirurgia , Esplenopatias/patologia , Esplenectomia , Hemangioma/diagnóstico , Hemangioma/patologia , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/patologiaRESUMO
ABSTRACT: Sclerosing angiomatoid nodular transformation (SANT) is a reactive non-neoplastic, rare vascular lesion of the spleen. The histology shows multiple angiomatoid nodules surrounded by proliferative stroma. A 31-year-old lady presented with an abdominal mass for 6 months. Contrast-enhanced computed tomography (CECT) abdomen was suggestive of hemangiopericytoma/hemangioendothelioma. An open splenectomy was performed, and the resected specimen was sent for histopathology examination. The gross examination showed a bosselated mass present at the lower pole of the spleen measuring 8 × 8 cm with peripherally located coalescing red-brown nodules embedded in a dense fibrous stroma on the cut surface. On microscopy, multiple circumscribed angiomatoid nodules comprising irregular slit-like vascular channels lined by plump endothelial cells were seen embedded in dense sclerotic stroma. Because of the lack of specific diagnostic features, it is difficult to diagnose SANT clinically and radiologically. However, the typical histopathological findings are a clue in clinching the diagnosis.
Assuntos
Baço , Esplenectomia , Tomografia Computadorizada por Raios X , Humanos , Adulto , Feminino , Baço/patologia , Baço/diagnóstico por imagem , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/diagnóstico por imagem , Histocitoquímica , Microscopia , Histiocitoma Fibroso Benigno/patologia , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/cirurgia , Histiocitoma Fibroso Benigno/diagnóstico por imagem , Radiografia Abdominal , Hemangiopericitoma/patologia , Hemangiopericitoma/diagnóstico , Hemangiopericitoma/diagnóstico por imagem , Hemangiopericitoma/cirurgiaRESUMO
PURPOSE: Robotic surgery is becoming increasingly widely used in the field of pediatric surgery. The present study aimed to evaluate the safety and feasibility of robot-assisted resection of benign pediatric splenic tumors and to discuss the technical points. METHODS: A total of 32 patients who were diagnosed with benign splenic tumors and underwent minimally invasive surgery from January 2017 to September 2023 were included in the study. The clinical data including demographic criteria, operative details, and postoperative outcomes were analyzed retrospectively. RESULTS: Thirteen patients underwent robot-assisted surgery, and 19 patients underwent laparoscopic surgery. The median operation time was 150 min, with an interquartile range (IQR) of 120 to 200 min for the robot-assisted group and 140 min with an IQR of 105 to 180 min in the laparoscopic group (P = 0.318). Despite four cases in the laparoscopic group (21%) being converted to laparotomy because of intraoperative bleeding, compared with none in the robot-assisted group, there was no significant difference between two groups (P = 0.128). The intraoperative volume of blood loss was significantly less (P = 0.041), and the hospitalization expense was significantly higher (P = 0.000) in the robot-assisted group than for the laparoscopic group. There was no significant difference in patients' age, tumor size, postoperative feeding time, and the postoperative hospitalization time between two groups (P > 0.05). CONCLUSION: Robot-assisted benign splenic tumor resection was safe and feasible, and it reduced surgical trauma for the pediatric patient.
Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Robótica , Neoplasias Esplênicas , Humanos , Criança , Neoplasias Esplênicas/cirurgia , Estudos RetrospectivosRESUMO
A 59-year-old woman underwent simple abdominal total hysterectomy with bilateral salpingo-oophorectomy, partial omentectomy, and extirpation of intrapelvic disseminated nodules for right fallopian tube cancer with rectal metastasis and peritoneal dissemination as primary debulking surgery(PDS). The histopathological diagnosis was high grade serous carcinoma( HGSC)of the right fallopian tube. After adjuvant chemotherapy with 4 courses of paclitaxel-carboplatin(TC), low anterior resection of the rectum for rectal metastasis and pelvic and para-aortic lymph node dissection were performed as interval debulking surgery(IDS). Histopathologically, lymph node metastasis was detected only in the right obturator lymph node. After adjuvant chemotherapy with 4 courses of TC, bevacizumab maintenance monotherapy was administered. Three years after PDS, laparoscopic splenectomy for splenic metastasis and extirpation of the solitary peritoneal metastases were performed as secondary debulking surgery(SDS). After adjuvant chemotherapy with 4 courses of TC, olaparib maintenance monotherapy was administered. The patient has remained alive without recurrence for 4 years after SDS and for 7 years after PDS. No case of metachronous splenic metastasis from fallopian tube cancer with synchronous rectal metastasis has been reported; however, long-term prognosis may be expected with PDS, IDS and SDS for platinum-sensitive HGSC.
Assuntos
Neoplasias das Tubas Uterinas , Laparoscopia , Neoplasias Retais , Neoplasias Esplênicas , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias das Tubas Uterinas/tratamento farmacológico , Neoplasias das Tubas Uterinas/cirurgia , Neoplasias das Tubas Uterinas/patologia , Esplenectomia , Neoplasias Esplênicas/tratamento farmacológico , Neoplasias Esplênicas/cirurgia , Linfonodos/patologia , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/cirurgia , Neoplasias Retais/patologiaRESUMO
El angioma de células litorales del bazo es una neoplasia vascular benigna poco frecuente, de presentación clínica, paraclínica e imagenológica inespecífica. Se realizó en nuestro paciente la esplenectomía, el tratamiento indicado y curativo, y se logró el diagnóstico a través de la histología e inmunohistoquímica de la pieza de anatomía patológica.
Littoral cell angioma of the spleen is rather an unusual benign vascular neoplasm with non-specific clinical, paraclinical and imaging presentation. Our patient underwent splenectomy, performed as the appropriate and remedial treatment. Diagnosis was made by means of histology and immunohistochemistry techniques of the pathologic anatomy of the surgical piece.
O angioma de células litoraneas do baço é uma neoplasia vascular benigna rara com apresentação clínica, laboratorial e de imagem inespecíficas. A esplenectomia foi realizada em nosso paciente, sendo esse o tratamento indicado e curativo, obtendo-se o diagnóstico através da histologia e imunohistoquímica da peça anatomopatológica.
Assuntos
Esplenectomia , Neoplasias Esplênicas/cirurgia , HemangiomaRESUMO
Splenic vascular neoplasms are the most common form of spleen tumors. Among them, littoral cell angioma is rare and it is frequently an incidental finding in imaging studies. It has no specific clinical, laboratory or imaging findings. Splenectomy allows definitive diagnosis throughout a histopathological examination. We report a 52-year-old man presenting with asthenia and abdominal distension. Computed tomography with intravenous contrast showed multiple splenic hypodense masses and a prostatic enlargement. Presuming a lymphoma, a laparoscopic splenectomy was performed. Histopathologic examination diagnosed littoral cell angioma. During urological follow-up, a prostate adenocarcinoma was diagnosed.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/diagnóstico por imagem , Hemangioma/cirurgia , Hemangioma/diagnóstico por imagem , EsplenectomiaRESUMO
Los linfomas primarios de bazo afectan al bazo y/o sus ganglios linfáticos inicialmente. Representan <1% de los linfomas e implican un reto diagnóstico, por baja prevalencia y sintomatología inusual. Por lo tanto, el objetivo de este trabajo fue describir el manejo y evolución de un paciente con VIH-SIDA y la presentación de un Linfoma primario de bazo.En este reporte presentamos el caso de un paciente masculino de 52 años con VIH sin apego a tratamiento debuta con dolor abdominal, fiebre y pérdida de peso de 2 meses de evolución. La tomografía computarizada properatoria revela esplenomegalia y lesiones hipodensas sospechosas de neoformación. Es intervenido, realizándose una laparotomía exploratoria, con esplenectomía. El estudio histopatológico reporta linfoma no Hodgkin.El linfoma primario de bazo es poco frecuente. Es necesario su conocimiento para su sospecha diagnóstica y un diagnóstico diferencial en pacientes con esplenomegalia.Primary splenic lymphomas involve the spleen and/or its lymph nodes. They represent <1% of lymphomas and they imply a diagnostic challenge due to its poor symptomatology and low prevalence.There for, the objects this work describe the management and evolution of a patient with HIV-AIDS and presentation of a primary lymphoma of the spleenIn this report we present the case of a 52-year-old male patient with HIV infection without treatment presented with abdominal pain, fever and a 2-month weight loss. The pre-operative computed tomography showed splenomegaly and hypodense lesions suspected to be tumoral. He was operated on, performing an exploratory laparotomy, performing an splenectomy. The histopathological study reported a non-Hodgkin lymphoma.Primary splenic lymphoma is a non frequent entity. It is necessary to be acquainted with it in order to suspect it.
Primary splenic lymphomas involve the spleen and/or its lymph nodes. They represent <1% of lymphomas and they imply a diagnostic challenge due to its poor symptomatology and low prevalence.There for, the objects this work describe the management and evolution of a patient with HIV-AIDS and presentation of a primary lymphoma of the spleenIn this report we present the case of a 52-year-old male patient with HIV infection without treatment presented with abdominal pain, fever and a 2-month weight loss. The pre-operative computed tomography showed splenomegaly and hypodense lesions suspected to be tumoral. He was operated on, performing an exploratory laparotomy, performing an splenectomy. The histopathological study reported a non-Hodgkin lymphoma.Primary splenic lymphoma is a non frequent entity. It is necessary to be acquainted with it in order to suspect it.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/diagnóstico por imagem , Linfoma Relacionado a AIDS , Esplenectomia , Tomografia Computadorizada por Raios X , Síndrome da Imunodeficiência AdquiridaAssuntos
Humanos , Masculino , Neoplasias Esplênicas/patologia , Esplenomegalia/etiologia , Linfoma/patologia , Esplenectomia , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/imunologia , Imuno-Histoquímica , Resultado do Tratamento , Linfoma/cirurgia , Linfoma/imunologia , Pessoa de Meia-IdadeRESUMO
Introducción: Las metástasis únicas en bazo de origen colorrectal son extremadamente infrecuentes. Sin embargo, debido el control postoperatorio más estricto de la patología oncológica con estudios por imágenes modernos, la incidencia ha ido aumentando en los últimos años. Objetivo: Exponer el caso de una paciente con una metástasis esplénica de un tumor colónico primario. Caso clínico: Paciente de sexo femenino, de 85 años con antecedentes de colectomía derecha laparoscópica. La anatomía patológica informó: adenocarcinoma de colon T2 N0, sin requerir tratamiento quimioterápico adyuvante. En el seguimiento postoperatorio, durante el segundo año intercurrió con aumento del antígeno carcinoembrionario (CEA). Se realizó PET-TC que evidenció nódulo hipercaptante único de 3 cm. en bazo. Se programó la esplenectomía laparoscópica, evolucionando satisfactoriamente. La anatomía patológica definitiva informó adenocarcinoma metastásico de origen colónico. Conclusión: La metástasis esplénica de un tumor colónico es extremadamente infrecuente, existiendo solamente casos aislados en la literatura. En pacientes sin otro compromiso sistémico la esplenectomía debe recomendarse. (AU)
Introduction: Isolated splenic metastases are highly uncommon. The incidence has been increasing during the last years due to better medical imaging and long term follow up. Objective: We report a case of a patient who developed isolated splenic metastasis from right colon cancer. Case presentation: Female, 85 years old who underwent a laparoscopic right colectomy. The pathologic investigation confirmed: colon adenocarcinoma staged as T2 N0, without need of oncologic adjuvant therapy. In the postoperative follow up, during the second year, an increased serum carcinoembryonic antigen level was noticed. A PET TC was carried out and demonstrated a 3 cm focus of high radiotracer uptake in the spleen. Laparoscopic splenectomy was performed, postoperative course was uneventful. Pathologic exam demonstrated splenic parenquima invaded with adenocarcinoma originated in colon. Conclusion: Isolated splenic metastases is a very rare clinical entity. Only few case reports can be found in the literature. If they are no other sites of disease, splenectomy should be the optimal approach.
Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias Esplênicas/cirurgia , Neoplasias Esplênicas/secundário , Adenocarcinoma/patologia , Neoplasias do Colo/patologia , Esplenectomia , Assistência ao Convalescente , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Metástase NeoplásicaRESUMO
Se presenta el caso de una paciente de 79 años que desde hace 3 meses presenta marcada sudoración nocturna, dolor abdominal en zona de hipocondrio y flanco izquierdo y ligera pérdida de peso. Al examen físico se observa palidez de piel y mucosas, esplenomegalia que rebasa 7 cm el reborde costal izquierdo, superficie lisa, superficie regular. El resto del examen físico fue normal. Se realizan múltiples investigaciones básicas sin poderse identificar el diagnostico. Por la presencia de gran esplenomegalia y la pancitopenia se decide realizar esplenectomía confirmándose un linfoma no Hogkin folicular primario del bazo(AU)
We present the case of a 79-year-old patient who had marked night sweats, abdominal pain in the hypochondrium area and left flank and slight weight loss for 3 months. Physical examination showed pale skin and mucous membranes, splenomegaly that exceeds the left costal margin by 7 cm, smooth surface, and regular surface. The rest of the physical examination was normal. Multiple basic studies were conducted out but the diagnosis was not identified. Due to the presence of great splenomegaly and pancytopenia, it was decided to perform splenectomy, confirming a follicular non-Hodgkin primary splenic lymphoma(AU)