RESUMO
Although metastasis of carcinoid tumours of the intestine is rare, it has been reported in several organs, mainly in the lungs, the liver and less commonly in the orbits. We report a 50-year-old male patient who presented at Hamad General Hospital, Doha, Qatar, in 2016 with central abdominal pain, distention, nausea and vomiting for the previous four days. The patient had unilateral right-sided exophthalmos for two years prior to presentation. Following an abdominal computed tomography (CT) scan and an ultrasound guided biopsy, the patient was diagnosed with extensive multi-focal metastatic carcinoid tumour of the small bowel and mesentery; histopathology confirmed the diagnosis. Subsequently, the patient underwent a laparotomy and small bowel resection and was administered somatostatin therapy. One week postoperatively, the patient developed an acute increase in his right eye exophthalmos. CT, magnetic resonance imaging and scintigraphy scans revealed an orbital metastatic lesion, which probably originated from the previously diagnosed carcinoid tumour. The orbital metastasis was treated with somatostatin therapy and the patient was lost to follow-up when he left the country.
Assuntos
Tumor Carcinoide/patologia , Exoftalmia/patologia , Neoplasias Gastrointestinais/patologia , Órbita/patologia , Neoplasias Orbitárias/secundário , Somatostatina/análogos & derivados , Dor Abdominal , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/tratamento farmacológico , Exoftalmia/diagnóstico por imagem , Neoplasias Gastrointestinais/diagnóstico por imagem , Neoplasias Gastrointestinais/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Náusea , Órbita/diagnóstico por imagem , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/tratamento farmacológico , Cintilografia , Somatostatina/uso terapêutico , VômitoRESUMO
OBJECTIVE: The study is aimed at determining the prevalence of HER2/neu overexpression in Qatari women with breast cancer and to assess the survival in patients with HER2/neu positive tumors. METHODS: This is a retrospective study of clinical data of 70 Qatari female patients diagnosed with breast cancer during the period 1991 through to 2001, at Hamad Medical Corporation, Doha, Qatar. We also performed a retrospective review of breast tissue sample for those patients using paraffin sections and applying immunohistochemistry staining-[Hercep test (DAKO Inc)] to determine the HER2/neu status. RESULTS: Eighteen patients (26%) were HER2/neu positive (2+ and 3+) with a mean age at diagnosis of 49.3years, and 52 (74%) were negative (0 and 1+) with mean age at diagnosis of 46.6 years. Of the patients with positive HER2/neu, 5 (28%) had a relapse of the disease and 4 (22%) died of the disease during follow up. Of the patients with HER2/neu, negative test 9 (17%) had a relapse of the disease and 10 (19%) died of the disease. The median survival function at mean of covariates for HER2/neu positive patients was 26 months, and for HER2/NEU negative patients was 28 months. CONCLUSION: The prevalence of HER2/neu over expression in Qatari female with breast cancer in this study is 26%, but due to a small sample size it may not reflect really the prevalence. Patient with HER2/neu positive were older at diagnosis than patients with HER2/neu negative, also they had higher relapse rate and mortality. Median survival function was better for HER2/neu negative patients.