Incidental findings of COVID-19 in F18-FDG PET/CT from asymptomatic patients with cancer in two healthcare institutions in Bogotá, Colombia / [Hallazgos incidentales de COVID-19 en tomografías PET/CT 18F-FDG de pacientes asintomáticos con cáncer en dos instituciones de salud de Bogotá, Colombia].

COVID-19 is the viral infection caused by SARS-CoV-2 declared by the World Health Organization (WHO) as a pandemic. Patients with cancer have a higher risk to acquire the infection and worse prognosis as they have to attend more medical visits in healthcare institutions, receive medical and surgical treatments, and be subjected to diagnostic studies such as PET/CT in nuclear medicine services where the infection may be an incidental finding. We present here F18-FDG PET/CT (Positron Emission Tomography and Computed Tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose), images with findings of COVID-19 from patients with different oncological conditions but no respiratory symptoms.

La COVID-19 es la infección viral causada por el SARS-CoV-2 y declarada por la Organización Mundial de la Salud (OMS) como pandemia. Los pacientes con cáncer tienen un mayor riesgo de adquirir la infección y un peor pronóstico, ya que deben asistir a visitas médicas en diferentes centros hospitalarios, reciben tratamientos médicos y quirúrgicos y deben someterse a estudios diagnósticos como la PET/CT en servicios de medicina nuclear, lo que es ocasión para el hallazgo incidental de la infección. Se presentan las imágenes de tomografías computarizadas por emisión de positrones con 18-fluorodesoxiglucosa (F18) (Positron Emission Tomography and Computed Tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose, PET/CT F18-FDG) en las que se evidenció la COVID-19 en pacientes con diversas enfermedades oncológicas, pero sin sintomatología respiratoria.

Ophthalmological changes of the posterior segment in patients with testicular cancer in a mixed-race population of the General Hospital of Mexico. / Alteraciones oftalmológicas del segmento posterior en pacientes con cáncer testicular en población latino-mestiza del Hospital General de México.

INTRODUCTION: The curing of a testicular tumour is currently feasible in more than 95% of patients, and in 80% of those with metastases. Until now, there has been no study or series of cases that describe the ocular changes of the posterior segment associated with testicular cancer. OBJECTIVE: To evaluate patients with a diagnosis of testicular cancer in order to determine the presence of changes in the posterior segment and the relationship to the stage. MATERIAL AND METHOD: An observational, cross-sectional, and descriptive study was conducted on 21 male patients (42 eyes) with a diagnosis of testicular cancer. Age, histological type, time of evolution, stage, treatment, and comorbidities were recorded, as well as visual acuity measurement (LogMAR), biomicroscopy of the anterior segment, and photographic records of the posterior pole and peripheral retina. RESULTS: The mean age was 29 years (18-43 years). All (100%) of the patients were treated surgically. The most frequent histological type was classic seminoma (42.8%), followed by the mixed germinal tumour (38.0%). At the time of evaluation, 42.8% of patients had a stage II, and 23.8% had distant metastasis. The changes in the posterior segment were: vascular tortuosity (14.2%), retinopathy associated with cancer (9.5%), choroidal metastasis (9.5%), pigmentary changes of the retinal pigment epithelium (9.5%), and retinal metastasis (4.7%). CONCLUSIONS: It is possible to find changes at the level of retinal pigment epithelium, as well as vascular tortuosity, retinopathy associated with cancer, and choroidal and/or retina metastases.

[Renal metastasis of classic seminoma]. / Metástasis renal de seminoma clásico.

INTRODUCTION: Seminoma comprises approximately 50% of testicular germ cell tumors. Renal metastases are infrequent, and are usually recognized at necropsy. CLINICAL CASE: A 24 years-old man with history of left radical orchiectomy due to classical seminoma (stage I), and adjuvant radiotherapy, showed elevated levels of beta-human chorionic gonadotropin and lactate dehydrogenase in the eleven month follow-up. Computed tomography showed a 9 × 8 cm lobulated, heterogeneous tumor in the left kidney. The histopathological and immunohistochemical assay demonstrated a classical metastatic seminoma. CONCLUSION: The majority of renal tumors represent primary neoplasm; in patients with extra-renal tumors we must consider the possibility of a metastatic disease.

Inferior vena cava anomalies during laparoscopic retroperitoneal lymph node dissection.

PURPOSE: To report our experience with congenital inferior vena cava (IVC) anomalies found during laparoscopic retroperitoneal lymph node dissection (LRPLND). PATIENTS AND METHODS: Two men with a mean age of 31.5 years (range 26-37 years) underwent LRPLND because of nonseminomatous germ-cell tumors (NSGCT) between December 2003 and July 2004. A four-port technique was used. A left IVC anomaly was found in both patients. The two operations were performed with no serious immediate complications and minimal blood loss. Congenital IVC anomalies were identified intraoperatively. A left-sided template modified because of anatomic variation was used. RESULTS: Mean operative time was 95 minutes (range 60-130 min). Both patients remain without tumor recurrence at a median of 24.5 months of follow-up (range 15-34 months). CONCLUSION: Although uncommon, IVC anomalies must be considered when performing LRPLND because of potential complications. Preoperative studies are essential in surgical planning.

Criptosseminoma metastático: correlação radiológico-patológica / Metastatic cryptoseminoma: radiologic-pathologic correlation

Descrevemos um relato de caso de um paciente jovem do sexo masculino com tumoração abdominal de crescimento rápido, para cuja elucidação diagnóstica foi fundamental a união dos achadosdos métodos de imagem (tomografia computadorizada e ultra-sonografia) com o raciocínio clínico-radiológico, a fim de aventar a hipótese diagnóstica correta e orientar a terapêutica adequada. Apresentamos a correlação radiológico-patológica, assim como uma breve revisão da literatura relativa a esta entidade nosológica extremamente rara: seminoma metastático oriundode criptosseminoma em testículo pélvico.

We describe a case of a young male with a rapid-growing abdominal mass whose diagnosis required the correct interpretation of imaging findings (computerized tomography and sonography) along with clinical-radiologic reasoning, in order to arrive at the correct diagnostic hypothesis, and, hence, recommend optimal therapy.We hereby present a brief review of the literature and a radiologicpathologiccorrelation of this extremely rare entity: large metastatic cryptoseminoma originated from a small seminoma in a cryptorchid left pelvic testis.

Correlation between primary tumor pathologic features and presence of clinical metastasis at diagnosis of testicular seminoma.

OBJECTIVES: To compare several risk factors in the testicular biopsy of patients with pure seminoma with and without clinical metastasis at diagnosis. METHODS: We performed a retrospective study of patients with pure seminoma. The retroperitoneum was staged with computed tomography and the thorax with simple radiography and/or computed tomography, taking into account the original reports and clinical stage. The previous reports and original pathology plates were reviewed by pathologists who were unaware of the clinical stage of the patients. Patients with beta-human chorionic gonadotropin greater than 800 mUI/mL were excluded. RESULTS: A total of 86 patients had sufficient data and comprised the study cohort. Of the 86 patients, 62 had clinical Stage I (72%), 20 had Stage II (23%), and 4 had Stage III (5%). On univariate analysis, tumor size greater than 4 cm (P = 0.0135), testicular vascular invasion (P = 0.0042), rete testis invasion (P = 0.0002), tunica albuginea penetration (P = 0.00001), base of the spermatic cord invasion (P = 0.0002), epididymis invasion (P = 0.001), and vascular invasion of the cord (P = 0.024) were predictive of metastasis. On multivariate analysis, tumor size greater than 6 cm (odds ratio 6.9, 95% confidence interval 1.3 to 35, P = 0.02) and rete testis invasion (odds ratio 6.1, confidence interval 1.2 to 30, P = 0.025) remained as important predictors of metastasis (tumor size less than 6 cm was not significant on multivariate analysis). CONCLUSIONS: The results of this study have demonstrated that rete testis invasion and tumor size correlate independently with the presence of clinical metastasis at diagnosis of testicular seminoma.

Metástases de coróide de origem testicular: relato de caso / Choroid metastasis of testicular primary site: case report

Descrição do caso de um paciente masculino de 22 anos de idade, cor parda, com decréscimo da acuidade visual em olho esquerdo e com diagnóstico de tumor testicular e metástases para pulmão e rim. Avaliação da evolução da lesão coroideana compatível com metástase ocular de tumor testicular por meio de exame oftalmológico e ecográfico. Houve resolução da lesão intra-ocular juntamente com melhora radiológica pulmonar após quimioterapia durante aproximadamente 4 meses de acompanhamento. Apesar da remissão da lesão ocular, o paciente faleceu por complicações decorrentes de metástase cerebral. Abordada na literatura como rara, não foi encontrado qualquer relato de caso sobre a metástase de coróide com sítio testicular, sendo esta, talvez, sua primeira descrição.

Description of a male patient case, 22 years old, presenting visual acuity decrease in the left eye associated with the diagnosis of metastatic testicular tumor to lung and kidney. Evaluation of the evolution of a choroid lesion compatible with ocular metastasis of testis tumor through ophthalmologic and echographic examinations. There was resolution of the intraocular lesion together with lung radiologic improvement after chemotherapy during approximately 4 months of follow-up. In spite of the remission of the ocular lesion, the patient died due to complications of cerebral metastasis. Approached in the literature as rare, no report was found of a case of choroidal metastasis of a testicular site, this being, perhaps, its first description.

[Choroid metastasis of testicular primary site: case report]. / Metástases de coróide de origem testicular: relato de caso.

Description of a male patient case, 22 years old, presenting visual acuity decrease in the left eye associated with the diagnosis of metastatic testicular tumor to lung and kidney. Evaluation of the evolution of a choroid lesion compatible with ocular metastasis of testis tumor through ophthalmologic and echographic examinations. There was resolution of the intraocular lesion together with lung radiologic improvement after chemotherapy during approximately 4 months of follow-up. In spite of the remission of the ocular lesion, the patient died due to complications of cerebral metastasis. Approached in the literature as rare, no report was found of a case of choroidal metastasis of a testicular site, this being, perhaps, its first description.

Cardiac extension of primary mediastinal seminoma compressing the right ventricular outflow tract.

We report the case of a 33-year-old male with primary seminoma of the anterior mediastinum with initial clinical manifestations suggestive of heart disease.

Bone scintigraphy in testicular tumors.

PURPOSE: Testicular tumors do not occur frequently. Primary treatment is surgical, and radiotherapy and chemotherapy can play important roles in cases of metastatic disease. Bone scintigraphy is used largely for early detection of skeletal metastases from several tumors, and conventional radiographic studies are less sensitive than the nuclear technique for such a purpose. The aim of this study was to identify the role of bone scintigraphy in cases of testicular tumors, regardless of the grade. MATERIALS AND METHODS: The authors examined 28 patients (8 to 52 years old) with proved testicular tumors using Tc-99m MDP (750 MBq; 20 mCi) injected intravenously. Whole-body images were obtained 2 hours later, at 500,000 counts per image. Radiographic studies were obtained to investigate abnormal areas noted on scintigraphy. RESULTS: The results of bone scintigraphy were abnormal in seven cases, consisting of variable but diffuse uptake in the iliac bone on the same side as the affected testicle. MDP uptake was substantial in five of these patients (four seminomas, one nonseminoma; only two radiographic studies were abnormal), and the two other patients had moderate uptake of the radiopharmaceutical (two seminomas; radiographic studies were normal). Metastases were confirmed by biopsy in three cases. DISCUSSION: Early metastases from seminomas can occur through the lymphatic drainage toward the iliac lymph node chain. This could explain these findings. The scintigraphic aspects of the affected iliac bones seem characteristic. CONCLUSIONS: Early detection of metastases is very important to ensure the efficacy of radiotherapy and chemotherapy. Bone scintigraphy may play an important role in such cases and seems to be more sensitive than conventional radiography. Testicular tumor metastases should be considered when iliac involvement is observed. Paget's disease should be included in a differential diagnosis.

Extensäo cardíaca de seminoma primário do mediastino, comprimindo a via do ventrículo direito / Cardiac extension of primary mediastinal seminoma compressing the right ventricular outflow tract

We report the case of a 33-year-old male with primary seminoma of the anterior mediastinum with initial clinical manifestations suggestive of heart disease

[Probable pulmonary damage caused by bleomycin. Communication of 4 cases]. / Probable daño pulmonar por bleomicina. Comunication de 4 casos.

Four patients with advanced germinal cell testicular tumors were treated with cisplatinum, vinblastine and bleomycin. Histopathologic studies revealed pulmonary damage and various degrees of respiratory insufficiency developed in all patients, one of whom died. There was no instance of opportunistic infections in any patient. The pathophysiology relating pulmonary damage to the action of bleomycin is discussed.