RESUMO
SUMMARY: Neuroendocrine lung tumours are a group of different tumours that have similar morphological, immunohistochemical and molecular characteristics, and represents 1-2 % of all malignant lung tumours. Tumorlet carcinoids represent the nodular proliferation of hyperplastic neuroendocrine cells that is smaller than 5 mm in size. In this study, we reported the unusual finding of tumour carcinoid and endobronchial hamartoma in the same bronchus. A 49-year-old male patient with symptoms of prolonged severe cough and fever, and was treated for pneumonia. Since he did not adequately respond to antibiotic therapy lung CT scan was performed which showed middle lobe bronchus obstruction. Bronchoscopy revealed a lobulated whitish tumour which was biopsied and histopathological diagnosis was hamartoma. Tumour could not be completely removed during bronchoscopy, it was decided to surgically remove it. On serial section, during gross examination in the same bronchus, an oval yellowish area with a diameter of 3 mm was found along the bronchial wall. According to gross and histomorphological characteristics and immunophenotype of tumour cells, the diagnosis of tumour carcinoid was set. Diagnosis of carcinoids of the tumorlet type is usually an accidental finding and it can be seen on CT in the form of subcentimeter, single or multiple, nodular changes. Considering that the clinical picture is nonspecific, they should always be kept in mind as a possible differential diagnosis.
RESUMEN: Los tumores neuroendocrinos de pulmón son un grupo de tumores de diferentes características morfológicas, inmunohistoquímicas y moleculares similares, y representan el 1- 2 % de todos los tumores malignos de pulmón. Los carcinoides tumorales representan la proliferación nodular de células neuroendocrinas hiperplásicas de tamaño inferior a 5 mm. En este estudio reportamos el hallazgo inusual de tumor carcinoide y hamartoma endobronquial en el mismo bronquio. Un paciente varón de 49 años con síntomas de tos severa prolongada y fiebre fue tratado por neumonía. Al no responder adecuadamente a la terapia con antibióticos, se realizó una tomografía computarizada de pulmón que mostró obstrucción del bronquio del lóbulo medio. La broncoscopia reveló una tumoración blanquecina lobulada de la cual se tomó biopsia y el diagnóstico histopatológico fue hamartoma. No fue posible extirpar el tumor por completo durante la broncoscopia y se decidió extirparlo quirúrgicamente. En la sección seriada, durante el examen macroscópico en el mismo bronquio, se encontró un área amarillenta ovalada de 3 mm de diámetro a lo largo de la pared bronquial. De acuerdo a las características macroscópicas e histomorfológicas y de inmunofenotipo de las células tumorales, se estableció el diagnóstico de tumor carcinoide. El diagnóstico de carcinoides de tipo tumorlet suele ser un hallazgo accidental y se observan en la TC en forma de cambios nodulares subcentimétricos, únicos o múltiples. En consideración de que el cuadro clínico es inespecífico, siempre debe tenerse en cuenta como posible diagnóstico diferencial.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Brônquicas/patologia , Tumor Carcinoide/patologia , Hamartoma/patologia , Neoplasias Brônquicas/diagnóstico , Broncoscopia , Tumor Carcinoide/diagnóstico , Hamartoma/diagnósticoRESUMO
Abstract Skin metastases are rare and may occur in the context of a known metastatic disease or be the first clinical sign of an underlying primary tumor. In the case of carcinoid neoplasms, determining whether the cutaneous tumor is primary or secondary and identifying the tumor origin in metastatic cases is not always an easy task. This is the report of a case of cutaneous metastasis presenting as the first clinical manifestation of a previously unknown pulmonary carcinoid tumor, including the discussion of histopathological and immunohistochemical findings that allowed an adequate diagnosis of the tumor etiology and reinforces the importance for dermatologists and dermatopathologists to be familiar with these findings.
Assuntos
Humanos , Neoplasias Cutâneas , Tumor Carcinoide/diagnóstico , Neoplasias PulmonaresRESUMO
ABSTRACT The authors present a case of rectal carcinoid tumor in an asymptomatic patient who sought a coloproctology service with the purpose of colorectal cancer prevention. During colonoscopy, a polyp lesion was found in the rectum, and it was resected with a polypectomy loop. Anatomopathological examination revealed a rectal carcinoid tumor with compromised margins. The lesion site was resected again and pathological exam no longer showed neoplasia. A systematic review of the issue was performed, discussing diagnosis aspects, difficulties in the choice of therapeutic approaches, and prognosis. The conclusion is that the rarity of the disease brings difficulties in the choice of treatment; although it has a good prognosis in most cases, its malignant potential cannot be underestimated.
RESUMO Apresentamos um caso clínico de um tumor carcinóide de reto em um paciente assintomático que procurou um serviço de colo-proctologia com o objetivo de fazer prevenção ao câncer colorretal. Durante a colonoscopia observou-se uma lesão polipóide no reto, a qual foi ressecada com alça de polipectomia. O exame anatomopatológico evidenciou tumor carcinóide de reto com comprometimento de margem. O local foi novamente ressecado e o resultado patológico não mais evidenciou neoplasia. Neste artigo é feita uma revisão bibliográfica do assunto abordando aspectos diagnósticos, dificuldade na escolha da conduta terapêutica e prognóstica. O trabalho conclui que a raridade do caso implica em dificuldades na escolha da conduta e que apesar de ter bom prognóstico, em uma parcela dos casos o seu potencial maligno não deve ser desprezado.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Retais , Tumor Carcinoide/diagnóstico , Tumores Neuroendócrinos/diagnósticoRESUMO
Los tumores primarios de pulmón son poco frecuentes en el paciente pediátrico. Dentro de ellos, el tumor carcinoide bronquial es el más común. Clínicamente, su manifestación más usual es como infección respiratoria a repetición; sin embargo, su presentación puede ser variada. Reportamos el caso de una paciente de catorce años de edad con clínica de dolor torácico y síntomas respiratorios.
Lung priman- tumors are bizarra in pediátrica. Among them, carcinoid bronchtal tumor is the most common. The claaaical mamíestation is recurrent respiratory tract infectton, but the clinical presentaron can be variable. We report the case of a 14 years-old patient with chest pain and respiratory symptoms.
Assuntos
Pediatria , Tumor Carcinoide/diagnósticoRESUMO
Los tumores carcinoides de testículo son extremadamente raros, representando el 0.23% de los tumores de dicha localización. Se dividen en tres grupos: tumor carcinoide primario de testículo, teratoma de testículo con áreas de carcinoide y tumor carcinoide metastásico de otra localización. Presentamos un paciente de 52 años que consultó por dolor y tumefacción testicular. Se realizó orquiectomía derecha. LDH, alfa feto proteína y beta HCG: normales. Anatomía patológica: tumor blanco amarillento, constituido por células neoplásicas. Inmunohistoquímica: inmunofenotipo correspondiente a tumor neuroendocrino. 5HIAA urinario: normal. Centellografía con (Tc99) octreotide: normal. Se decidió control. Los tumores carcinoides primarios de testículo son infrecuentes, es fundamental descartar localizaciones primarias intestinales para confirmar el diagnóstico. Las herramientas diagnósticas más utilizadas son 5HIAA en orina y centellografía con (TC99) octreotide. El tumor carcinoide primario de testículo presenta un pronóstico favorable luego de la orquiectomía (AU)
Testicular carcinoid tumors are extremely rare. They are divided into three groups: primary testicular carcinoid tumor, testicular teratoma with areas of carcinoid and metastatic carcinoid tumor from another location. We present a 52 years old patient that was admitted with testicular pain and swelling. Right orchiectomy was performed. Serum LDH and alpha, fetoprotein and beta human chorionic gonadotropin were normal. Pathology: white yellowish tumor consisting of neoplastic cells. Immunohistochemistry: immunophenotype corresponding to neuroendocrine tumor. 5HIAA urinary and somatostatin receptor scintigraphy were normal. It was decided to control the patient. Primary testicular carcinoid tumors are uncommon. It is essential to rule out intestinal primary locations to confirm the diagnosis. The diagnostic tools used are 5 HIAA urinary and somatostatin receptor scintigraphy. The primary carcinoid tumor of the testis presents a favorable prognosis after orchiectomy (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Tumor Carcinoide/diagnóstico , Ácido Hidroxi-Indolacético/urina , Neoplasias Testiculares , Cromogranina A , Orquiectomia , Cintilografia , Serotonina/urinaRESUMO
Neuroendocrine tumor (NET) is a cancer-like tumor that occurs mostly in the gastrointestinal system. Within the gastrointestinal tract, NET most commonly occurs in the rectum whereas appendix is very rarely involved. In most cases of appendiceal NET, it is found at a relatively early stage compared to other NETs because appendiceal NET frequently presents with acute appendicitis because appendiceal NET frequently presents with acute appendicitis even when the size is smaller than 1 cm. Therefore, it is very rare for lymph node metastasis to occur in a young adult. Herein, we report a rare case of grade 1 appendiceal NET with lymph node metastasis which developed in a teenage male.
Assuntos
Adolescente , Humanos , Masculino , Neoplasias do Apêndice/diagnóstico , Tumor Carcinoide/diagnóstico , Colectomia , Colonoscopia , Metástase Linfática , Tumores Neuroendócrinos/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Las neoplasias primarias de oído medio son poco frecuentes y más aún lo es el adenoma de oído medio. Se plantea que el tumor se origina de células pluripotenciales endodérmicas indiferenciadas que están presentes en la mucosa. El adenoma carcinoide está compuesto por dos tipos de células: exocrinas y neuroendocrinas, estas últimas son capaces de liberar granulaciones y neuropéptidos que se detectan en la inmunohistoquímica. La mayoría se presentan con síntomas vagos de la esfera otológica, siendo raras las manifestaciones sistémicas de síndrome carcinoide. No existe examen físico característico ni patrón imagenológico. Se debe hacer diagnóstico diferencial con colesteatoma y otros tumores de oído medio. El diagnóstico definitivo es anatomopatológico y el tratamiento de elección es quirúrgico dado el potencial destructivo local. Se presentan en este artículo dos casos de adenoma carcinoide de oído medio.
Primary neoplasms of the middle ear are rare and even more so is the middle ear adenoma. It is stated that the tumor originates from undifferentiated endodermal stem cells that are present in the mucosa. Carcinoid adenoma is compromised of two cell types; exocrine and neuroendocrine cells, the latter are able to release neuropeptides and granulations that can be detected in immunohistochemistry. Most cases present with vague symptoms of the otologic sphere, being less common the systemic manifestations of carcinoid syndrome. There is no physical examination or characteristic imaging pattern. Differential diagnosis must be done with cholesteatoma and other middle ear tumors. The definitive diagnosis is anatomopathological and the treatment of choice is surgery given the local destructive potencial. Two cases of middle ear carcinoid adenoma are presented in this article.
Assuntos
Humanos , Masculino , Feminino , Adulto , Neoplasias da Orelha/diagnóstico , Tumor Carcinoide/diagnóstico , Adenoma/diagnóstico , Orelha Média/patologia , Neoplasias da Orelha/cirurgia , Tumor Carcinoide/cirurgia , Adenoma/cirurgia , Diagnóstico DiferencialRESUMO
The aim of this study was to compare the colorimetric "kit" and enzyme-linked immunosorbent assay (ELISA) methods to quantify urinary 5-hydroxyindoleacetic acid through the Goldenberg's technique, exploring the potential of replacing it. 24-hour urine samples were tested by Goldenberg's assay and compared with kits. The agreement was almost perfect for the comparison of Goldenberg's assay with both colorimetric kit, and with ELISA kit, considering ≤ 7.5 mg/24h normal cutoff value. Therefore, both "kits" would be good alternatives to Goldenberg's technique due to practicality and agreement between values...
O objetivo deste estudo foi comparar métodos por kit colorimétrico e por ensaio imunossorvente ligado à enzima (ELISA) para quantificar o ácido 5-hidroxi-indolacético urinário com a técnica de Goldenberg, explorando o potencial de substituí-la. Amostras de urina de 24 horas foram testadas pela técnica de Goldenberg e com os kits. A concordância foi quase perfeita, tanto para a comparação do ensaio de Goldenberg com o kit colorimétrico quanto para com o kit ELISA, considerando normal o valor de corte de ≤ 7.5 mg/24h. Portanto, ambos os kits seriam boa alternativa para a técnica de Goldenberg devido à praticidade e à concordância entre os valores...
Assuntos
Humanos , Colorimetria/métodos , Ensaio de Imunoadsorção Enzimática/normas , Ácido Hidroxi-Indolacético , Serotonina/urina , Técnicas e Procedimentos Diagnósticos/normas , Tumor Carcinoide/diagnósticoRESUMO
Bronchial carcinoid tumours is a rare group of pulmonary malignant neoplasm that is derived from neuroendocrine system. Bronchial carcinoid usually present with hilar masses, atelactasis, bronchiectasis, or post-obstructive pneumonia. This case describes a very unusual presentation of bronchial carcinoid tumour with multiple lung abscesses involving the whole lung. This report is of an adult lady who presented with multiple lung abscesses involving her whole of the right lung. She was found to have an endo-bronchial lesion in her right main bronchus which eventually turned out to be carcinoid tumour. She responded to resection and antibiotic therapy
Assuntos
Humanos , Feminino , Tumor Carcinoide/diagnóstico , Abscesso Pulmonar , BrônquiosRESUMO
BACKGROUND/AIMS: Rectal carcinoid tumors can be resected with endoscopy, and it is important to assess their prognostic factors. We evaluated the potential of Ki-67 expression as a prognostic factor in rectal carcinoid tumors. METHODS: We retrospectively reviewed the medical records of 37 patients with rectal carcinoid tumors who got endoscopic resection from January 2001 to January 2011 at Inje University Seoul Paik Hospital. We analyzed their endoscopic and histologic findings, Ki-67 expression, clinical outcome, and prognosis. RESULTS: The mean age (+/-SD) of the patients was 56.3+/-10.7 years, and the male : female ratio was 3.6:1. The mean tumor size was 0.5+/-0.4 cm, 33 patients showed grade 1 tumors (89.2%) and the average Ki-67 expression was 0.7+/-1.2%. Thirty five patients underwent endoscopic mucosal resection, and two required endoscopic submucosal dissection. Eight patients had positive margins after resection, but no cases of lymphovascular invasion were identified. The median follow-up duration was 21.4+/-25.4 months, and no recurrences were observed. CONCLUSIONS: In low grade rectal carcinoid tumors which are lack of central depression on colonoscopy, the expression of a molecular marker of malignant potential, Ki-67, was low. Therefore, endoscopic resection seemed to be a safe and effective treatment for these tumors.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Etários , Tumor Carcinoide/diagnóstico , Colonoscopia , Imuno-Histoquímica , Antígeno Ki-67/metabolismo , Prognóstico , Neoplasias Retais/diagnóstico , Estudos Retrospectivos , Fatores SexuaisRESUMO
No abstract available.
Assuntos
Feminino , Humanos , Masculino , Tumor Carcinoide/diagnóstico , Antígeno Ki-67/metabolismo , Neoplasias Retais/diagnósticoRESUMO
Gastric carcinoid corresponds to a rare malignancy, whose frequency increases with time. Several arguments attempt to explain this change. It ́s derived from one type of gastric neuroendocrine cell, the enterochromaffin-like cells. Various classifications have been used, however, the 1993 classification of Rindi remains the most used, which includes 3 types of gastric carcinoid based on its associated conditions, frequency, morphology, pathophysiology and prognosis. Also, a fourth type has been recognized that would represent a more aggressive neoplasm, like an adenocarcinoma. Diagnosis requires an upper gastrointestinal endoscopy, biopsies and ideally levels of chromogranin A as a serum marker. Once the type of gastric carcinoid is established the proper management can range from simple observation, endoscopic resection or surgery. In the case of metastatic disease a number of other treatments that might even eventually include liver transplantation are added. It is still much to learn from this disease, with many controversies in the pathophysiology and management, some of which we will try to clarify in the following article...
Assuntos
Humanos , Neoplasias Gástricas/classificação , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/terapia , Tumor Carcinoide/classificação , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/terapiaRESUMO
El tumor carcinoide de apéndice cecal es el más frecuente de todos los tumores apendiculares y generalmente no presentan manifestaciones clínicas. El objetivo de este trabajo fue dar a conocer un interesante caso de tumor carcinoide en una paciente de 26 años de edad cuyo cuadro clínico se interpretó como una apendicitis subaguda. Se indicó tratamiento con antibióticoterapia y hospitalización. La evolución fue satisfactoria. Se da el alta a los 10 días, con ausencia de la tumoración abdominal tanto clínica como ecográficamente. A los 3 meses se decide la operación y se realiza apendicectomía cecal, y se recibe como resultado de anatomía patológica argentafinoma del tercio distal del apéndice cecal con infiltración de la mucosa. Se interconsultó con oncología y se realizó seguimiento. La paciente se ha mantenido durante 10 años con evolución satisfactoria, libre de enfermedad. Los exámenes de ultrasonido y tomografía axial computarizada anual informan ausencia de adenopatías regionales y de metástasis hepática(AU)
The carcinoid tumors of the cecal appendix are the most frequent of all appendicular tumors, with no clinical manifestations in general. The general objective of this paper was to present an interesting case of carcinoid tumor found in a 26 years-old woman, whose clinical picture was diagnosed as subacute appendicitis. She was hospitalized and treated with antibiotics with good recovery and discharged 10 days later. She had no abdominal tumors confirmed clinically and echographically at that time. Three months later, the patient was operated on and underwent cecal appendicectomy. The pathological anatomy analysis yielded argentaffinoma in the distal third of the cecal appendix with mucosal infiltration. She was referred to the oncology service to be followed up. She has been free from any complication with good recovery for 10 years. The annual ultrasound and the CT scan show that there is neither regional adenopathy nor hepatic metastasis(AU)
Assuntos
Humanos , Feminino , Adulto , Neoplasias do Apêndice/diagnóstico por imagem , Apendicite/cirurgia , Tumor Carcinoide/diagnósticoRESUMO
O comprometimento cardíaco na síndrome carcinoide ocorre em 50% dos pacientes, sendo o ecocardiograma um importante meio diagnóstico da doença. Os achados de exame físico podem passar despercebidos, como o sopro tricúspide e pulmonar, em virtude dabaixa pressão no território pulmonar. Apesar de alguns casos responderem bem aos análogos da somastotina, como o octeotride, a doença cardíaca evolui, inexoravelmente, para insuficiência cardíaca, sendo a indicação cirúrgica uma opção para determinados casos.
Assuntos
Humanos , Feminino , Adulto , Doença Cardíaca Carcinoide/cirurgia , Ecocardiografia/métodos , Ecocardiografia , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico , Radiografia TorácicaRESUMO
Gallbladder carcinoid tumor is a very rare neoplasm, usually lacking specific symptoms. In most instances, gallbladder carcinoid tumors are incidentally found after a cholecystectomy for other gallbladder disorders or on postmortem autopsies. We are presenting a case of a 68 years old male patient with a carcinoid tumor of the gall bladder with liver involvement. Patient presented with signs and symptoms of acute cholecystitis. Conservative treatment was done. Investigations were done for the patient and surgery was performed as elective open cholecystectomy 6 weeks later. Multiple liver nodules were found during surgery, biopsy material was taken from these nodules and send for histopathology in addition to the removed gall bladder. Avery rare condition of Gallbladder carcinoid tumor with liver metastasis
Assuntos
Humanos , Masculino , Tumor Carcinoide/diagnóstico , Colecistite Aguda , Colecistectomia , Fígado/patologia , Imuno-HistoquímicaRESUMO
Los tumores carcinoides son neoplasias que incluyen un grupo de lesiones muy heterogéneas y de lento crecimiento. La mayoría de ellos aparecen en tracto respiratorio y aparato digestivo, en apéndice, intestino delgado y recto en un 90% de los casos. La presentación en recto a menudo es tratable y curable y las metástasis están relacionadas con el tamaño del tumor, siendo los menores a 1 cm lesiones con poca probabilidad de metástasis y los mayores de 1 cm con frecuencia dan metástasis. Los tumores carcinoides a excepción de los de recto, pueden producir una variedad de sustancias endocrinas cuya manifestación clínica es el síndrome carcinoide. El tratamiento de elección es la cirugía y en los casos de lesiones pequeñas, la resección endoscópica suele ser suficiente si no sobrepasan la submucosa y no hay atipias. Presentamos el caso de un paciente masculino de 63 años, con síntomas pépticos y alteraciones del habito intestinal, evaluado con hallazgos de pólipo en recto, cuya histología reporto tumor carcinoide de 0.8 cm por lo que se practico resección mucosal. Un año después en control endoscópico se evidencio nueva lesión carcinoide en recto alto a 5cms por debajo de la lesión previa, la cual fue resecada endoscopicamente con hallazgos de invasión a la submucosa, al USE no se evidenció lesión carcinoide ni adenomegalias. Se refirió a Cirugía para tratamiento quirúrgico, se practicó colectomía izquierda sin evidencias histológicas de tumor en la pieza operatoria.
Carcinoid tumors are neoplasms that include a heterogeneous group of lesions and slow growth. Most of them appear in the respiratory and digestive tract, in appendix, small intestine and rectum in 90% of cases. The right presentation is often treatable and curable and metastases are associated with tumor size, being smaller than 1 cm lesions with low probability of metastasis and greater than 1 cm often give metastases. Carcinoid tumors except the rectum, can produce a variety of endocrine substances whose clinical manifestation is the carcinoid syndrome. The preferred treatment is surgery and in cases of small lesions, endoscopic resection is usually sufficient if not beyond the submucosa and no atypia. We report a male patient of 63 years, peptic symptoms and altered bowel habit, as assessed by rectal polyp findings, the histology reported carcinoid tumor of 0.8 cm so that practical mucosal resection. A year later endoscopic control evidenced rectal carcinoid reinjury high to 5cm below the previous injury, which was resected endoscopically with findings of invasion to the submucosa, there was no evidence to USE carcinoid lesion or lymphadenopathy. He referred to surgery for surgical treatment, left colectomy was performed without histologic evidence of tumor in the surgical specimen.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/cirurgia , Neoplasias Retais/patologia , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico , Gastroenterologia , OncologiaRESUMO
JUSTIFICATIVA E OBJETIVOS: O tumor carcinoide é uma neoplasia rara, com prevalência de apenas 2,47 a 4,48 casos para cada 100.000 habitantes/ano, sendo a síndrome carcinoide ainda mais rara, estando presente em apenas 5% a 7% dessas neoplasias.Na imensa maioria das vezes, só se detecta o tumor quandoo paciente já apresenta sintomas da síndrome, tais como: flushing, diarreia, dor abdominal, telangiectasia, alterações cardíacas, broncoespasmo e pelagra. O objetivo deste estudo foi o de alertar para se incluir a suspeita de síndrome carcinoide como diagnóstico diferencial com outras condições que podem se apresentar com sintomas similares, como climatério, feocromocitoma, anafilaxia, uso de certos medicamentos, ingestão alcoólica e até mesmo a febre. RELATO DO CASO: Paciente do sexo feminino, 42 anos, apresenta há seis anos quadro de flushing na face, pescoço, tronco e membros superiores, evoluindo com eritema telangectásico e há um ano diarreia. Suspeitou-se de síndrome carcinoide, que se confirmou por meio da dosagem do ácido 5-hidroxindolacético na urina de 24h. A investigação prosseguiu com colonoscopia em que se encontrou lesão tumoral em íleo terminal, cuja histopatologia confirmou tumor carcinoide. Foi realizado tratamento com doses mensais de análogos da somatostatina de ação prolongada e programada cirurgia de ressecção tumoral. CONCLUSÃO: A síndrome carcinoide é uma manifestação rara e tardia do tumor, mas é fundamental que o clínico saiba identificá-la, pois apesar do prognóstico já ser desfavorável nessa fase, é possível ainda proporcionar melhor qualidade de vida ao paciente, com bom controle dos sintomas.
BACKGROUND AND OBJECTIVES: Carcinoid tumors are rare with a prevalence of only 2.47 to 4.48 cases per 100.000 inhabitants/year and the carcinoid syndrome is even rarer, present in 5% to 7% of the cases. In most patients, the neoplasm is detectedonly when the syndrome symptoms turn evident - flushing, diarrhea, abdominal pain, telangiectasia, cardiac manifestations, bronchospasm and pellagra. This case report objective was to alert for the importance of including carcinoid syndrome as a differential diagnosis of other conditions that could present similar symptoms like climacterium, pheochromocytoma, anaphylaxis, use of some medications, alcohol ingestion and also fever. CASE REPORT: Female patient, 42 years, has been presentingfor six years flushing episodes on face, neck, trunk and arms.Lately, could be observed telangiectasia and diarrhea. Carcinoid syndrome was suspected and the measurement of 24 hour urine5-hydroxyindoleacetic acid confirmed the diagnosis. The investigation proceeded with a colonoscopy which evidenced a tumoral lesion on the terminal ileum and the histopathology confirmed carcinoid tumor. Treatment was based on mensal doses of longacting somatostatin analogue for posterior tumor resection. CONCLUSION: Carcinoid syndrome is a rare and late tumor manifestation but it is fundamental for the clinician to knowhow to identify the symptoms because although the prognosisis already disfavorable at this stage, it is still possible to providequality of life and good symptoms control.
Assuntos
Humanos , Feminino , Adulto , Síndrome do Carcinoide Maligno/diagnóstico , Tumor Carcinoide/diagnóstico , Diarreia , RuborRESUMO
No abstract available.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Tumor Carcinoide/diagnóstico , Colonoscopia , Cistos/patologia , Neoplasias Retais/diagnóstico , Sinaptofisina/metabolismo , Tomografia Computadorizada por Raios XRESUMO
Relato de caso de paciente masculino, com 62 anos, com quadro de dor epigástrica e perda ponderal. A tomografia abdominal subsequente revelou lesão vegetante de 3,0 x 1,5 cm no antro gástrico. O paciente foi submetido à gastrectomia parcial com reconstrução em Y de Roux. Após análise anatomopatológica da peça cirúrgica, evidenciou-se tumor carcinoide maligno de 2,0 cm associado ao adenocarcinoma gástrico do tipo intestinal de Lauren e à ausência de metástases linfonodais. A imuno-histoquímica confirmou esses achados. Esse caso é de grande importância para a literatura médica, visto que, ao nosso conhecimento, representa o nono relato de um tumor gástrico dotado dessas características.
A case report of a 62-year-old male patient with a history of epigastric pain and weight loss. A subsequent abdominal computed tomography (CT) scan revealed a vegetative lesion of 3.0 x 1.5 cm in the gastric antrum. The patient underwent partial gastrectomy with Roux-en-Y reconstruction. After anatomic pathological analysis of the surgical specimen, a 2-cm malignant carcinoid tumor, associated with a Lauren intestinal-type gastric adenocarcinoma and no lymph node metastasis, was detected. Immunohistochemistry confirmed these findings. This case is of great importance to the medical literature, because this report represents, to our knowledge, the ninth case of a gastric tumor with these characteristics reported in the literature.