RESUMO
Extramammary Paget disease (EMPD) is a very rare form of intraepithelial adenocarcinoma. We report the cases of EMPD diagnosed in a referral hospital over a 5-year period from 2009 to 2013. Ten cases of EMPD were diagnosed in 4 men and 6 women aged between 50 and 79 years. Erroneous clinical diagnoses led to diagnostic delays of 1 to 5 years in all cases. Six patients had in situ lesions and dermal invasion was observed in the other 4 cases. Four patients had a second neoplasm and 2 of the patients with invasive EMPD died. Because EMPD is rare and its clinical presentation is nonspecific, a high degree of clinical suspicion is required to avoid delays in diagnosis and treatment.
Assuntos
Doença de Paget Extramamária , Idoso , Erros de Diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Doença de Paget Extramamária/diagnóstico , Doença de Paget Extramamária/patologiaRESUMO
Scedosporium apiospermum is a filamentous fungus that can cause cutaneous or extracutaneous disease. A large number of cases have been published over the last decades, mainly in patients immunocompromised as a result of their disease or treatment. These kinds of infections can progress rapidly and become disseminated, leading to very serious or even fatal complications. We report two new cases of skin infection by Scedosporium apiospermum from our hospital.
Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/imunologia , Hospedeiro Imunocomprometido , Naftalenos/administração & dosagem , Pirimidinas/administração & dosagem , Scedosporium/isolamento & purificação , Triazóis/administração & dosagem , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Idoso , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Humanos , Masculino , Scedosporium/efeitos dos fármacos , Terbinafina , VoriconazolRESUMO
We present the case of a 4 year old boy with no previous personal or family history of interest, who attended the Paediatric Department of our hospital after a physical examination revealed a painful induration in the left arm which had increased in size; imaging tests were consistent with a calcified mass in soft tissues, without cortical involvement, suspected of being malignant. Two-phase bone scintigraphy was requested in which a soft tissue lesion, not suggestive of malignancy, was detected. The biopsy was negative for malignant cells. However, in view of the progressive increase in size of the lesion, FDG positron emission tomography (FDG-PET) was performed, showing a hypermetabolic mass consistent with malignancy in the left arm, for which the patient underwent surgery for suspected possible parosteal osteosarcoma.
Assuntos
Miosite Ossificante/diagnóstico , Pré-Escolar , Humanos , MasculinoAssuntos
Imunossupressores/efeitos adversos , Leishmaniose/patologia , Nefrite Lúpica/complicações , Ácido Micofenólico/análogos & derivados , Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Feminino , Humanos , Leishmania infantum , Leishmaniose/tratamento farmacológico , Nefrite Lúpica/tratamento farmacológico , Pessoa de Meia-Idade , Ácido Micofenólico/efeitos adversosAssuntos
Lipoma/diagnóstico por imagem , Linfoma Folicular/diagnóstico por imagem , Neoplasias Musculares/diagnóstico por imagem , Segunda Neoplasia Primária/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tecido Adiposo Marrom/metabolismo , Tecido Adiposo Marrom/patologia , Radioisótopos de Flúor/análise , Radioisótopos de Flúor/farmacocinética , Fluordesoxiglucose F18/análise , Fluordesoxiglucose F18/farmacocinética , Humanos , Achados Incidentais , Lipoma/metabolismo , Lipoma/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/metabolismo , Neoplasias Musculares/patologia , Compostos Radiofarmacêuticos/análise , Compostos Radiofarmacêuticos/farmacocinética , UltrassonografiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Lipoma , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons/instrumentação , Tomografia por Emissão de Pósitrons/métodos , Linfoma/patologia , Linfoma , Seguimentos , Linfoma Folicular/patologia , Linfoma Folicular , Medicina Nuclear/métodosRESUMO
La enfermedad de Paget extramamaria (EPEM) es una forma extremadamente rara de adenocarcinoma intraepitelial. Presentamos los casos de EPEM diagnosticados en los últimos 5 anos en un hospital de tercer nivel (2009-2013). Se trata de 10 casos, 4 varones y 6 mujeres, con edades comprendidas entre los 50-79 anos. Todos ellos sufrieron un retraso diagnóstico de uno a 5 anos debido a sospechas diagnósticas erróneas. Seis casos correspondieron a EPEM in situ y en 4 existía invasión dérmica. Se localizó una segunda neoplasia en 4 pacientes y 2 con EPEM invasiva fallecieron. La baja incidencia de esta enfermedad y su clínica inespecífica nos debe alertar sobre la necesidad de establecer una alta sospecha clínica para evitar retrasos diagnósticos y terapéuticos (AU)
Extramammary Paget disease (EMPD) is a very rare form of intraepithelial adenocarcinoma. We report the cases of EMPD diagnosed in a referral hospital over a 5-year period from 2009 to 2013. Ten cases of EMPD were diagnosed in 4 men and 6 women aged between 50 and 79 years. Erroneous clinical diagnoses led to diagnostic delays of 1 to 5 years in all cases. Six patients had in situ lesions and dermal invasion was observed in the other 4 cases. Four patients had a second neoplasm and 2 of the patients with invasive EMPD died. Because EMPD is rare and its clinical presentation is nonspecific, a high degree of clinical suspicion is required to avoid delays in diagnosis and treatment (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença de Paget Extramamária/diagnóstico , Neoplasias Cutâneas/diagnóstico , Diagnóstico Tardio , Adenocarcinoma/diagnósticoRESUMO
Se presenta el caso de un niño de 4 años de edad sin antecedentes personales ni familiares de interés, que acude al Servicio de Pediatría de nuestro hospital por presentar en la exploración física una induración dolorosa en el brazo izquierdo que ha aumentado de tamaño, junto con pruebas de imagen compatibles con masa calcificada en partes blandas, sin afectación cortical sospechosa de malignidad. Se le solicita una gammagrafía ósea en dos fases en la cual se aprecia una lesión de partes blandas no sugerente de malignidad. La biopsia realizada fue negativa para células malignas. Pero ante el progresivo aumento de tamaño de la lesión se le realiza una tomografía por emisión de positrones con fluordesoxiglucosa (PET -FDG), donde se evidencia una masa hipermetabólica compatible con malignidad en el brazo izquierdo, por lo que, ante la sospecha de un posible osteosarcoma parostal, se lleva a cabo una intervención quirúrgica
We present the case of a 4 year old boy with no previous personal or family history of interest, who attended the Paediatric Department of our hospital after a physical examination revealed a painful induration in the left arm which had increased in size; imaging tests were consistent with a calcified mass in soft tissues, without cortical involvement, suspected of being malignant. Two-phase bone scintigraphy was requested in which a soft tissue lesion, not suggestive of malignancy, was detected. The biopsy was negative for malignant cells. However, in view of the progressive increase in size of the lesion, FDG positron emission tomography (FDG-PET) was performed, showing a hypermetabolic mass consistent with malignancy in the left arm, for which the patient underwent surgery for suspected possible parosteal osteosarcoma
Assuntos
Humanos , Masculino , Pré-Escolar , Miosite Ossificante/diagnósticoRESUMO
Propósito: El objetivo del artículo ha sido realizar una revisión de la Histiocitosis de células de Langerhans (HCL) a través de la presentación de un caso en nuestro centro. Material y métodos: A partir del caso clínico presentado en un paciente de 15 años se procedió a la revisión exhaustiva de la bibliografía encontrada de una enfermedad poco frecuente para los oncólogos. Para la realización de esta revisión se solicitó ayuda a la Sociedad Española de Oncología Pediatría. Conclusiones: La HCL es una patología propia de niños y adolescentes con una alta tasa de curabilidad de ahí la importancia en realizar un correcto estadiaje y tratamiento adecuado siguiendo las recomendaciones de la Sociedad Española de Oncología Pediátrica; asimismo se ha de hacer hincapié en el seguimiento de estos pacientes dada la posibilidad de recaída y tratamiento de rescate. (AU)