RESUMO
Los leiomiosarcomas son tumores mesenquimales malignos, que se originan en las células del músculo liso. Las localizaciones de aparición más frecuentes son el miometrio y el tracto gastrointestinal. En la región de cabeza y cuello los leiomiosarcomas aparecen de forma excepcional. Presentamos el caso de un leiomiosarcoma en la región posterior del cuello, en un paciente radiado 20 años antes por un tumor de nasofaringe. La incidencia de este tipo de tumores que cumple los criterios de tumor radioinducido se sitúa entre el 0,035 y el 0,2%. Los sarcomas radioinducidos son difíciles de diagnosticar en estadios tempranos, debido a la induración y la fibrosis de la zona radiada y a la sintomatología inespecífica que presentan. Su pronóstico es malo (AU)
Leiomyosarcomas are mesenchymal malignant tumours that appear in smooth muscle cells. Their most frequent locations are the uterus and gastrointestinal tract. Their occurrence in head and neck is considered exceptional. We present a patient with a posterior neck region leiomyosarcoma who had received radiation for a nasopharyngeal carcinoma 20 years earlier. The incidence ratio of these tumours in radiated patients (therefore considered radiation-induced) ranges from 0,035 to 0,2%. Radiation-induced sarcomas are difficult to diagnose due to the induration and fibrosis in the radiated area and the non-specific symptoms that they present. Their prognosis is very poor (AU)
Assuntos
Humanos , Masculino , Idoso , Leiomiossarcoma/etiologia , Neoplasias Induzidas por Radiação/patologia , Neoplasias de Cabeça e Pescoço/patologia , Fatores de RiscoRESUMO
INTRODUCTION: Leiomyosarcomas are mesenchymal malignant tumours that appear in smooth muscle cells. Their most frequent locations are the uterus and gastrointestinal tract. Their occurrence in head and neck is considered exceptional. We present a patient with a posterior neck region leiomyosarcoma who had received radiation for a nasopharyngeal carcinoma 20 years earlier. The incidence ratio of these tumours in radiated patients (therefore considered radiation-induced) ranges from 0,035 to 0,2%. Radiation-induced sarcomas are difficult to diagnose due to the induration and fibrosis in the radiated area and the non-specific symptoms that they present. Their prognosis is very poor.
Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Leiomiossarcoma/diagnóstico , Neoplasias Induzidas por Radiação/diagnóstico , Idoso , Humanos , MasculinoRESUMO
La mucormicosis es una infección oportunista, producida por los hongos del orden mucorales. Tiene una baja incidencia. Es potencialmente letal y afecta a pacientes inmunocomprometidos. Presentamos 7 casos de mucormicosis rinocerebral en un estudio retrospectivo de 8 años (20002008) en pacientes hematológicos. Es preciso realizar un diagnóstico precoz, para lo cual se ha de mantener un alto índice de sospecha clínica en pacientes con factores predisponentes. El diagnóstico de certeza requiere la realización de cultivos o biopsias de las zonas afectadas que demuestren la invasión de los tejidos por las hifas características. La clave del tratamiento es el desbridamiento quirúrgico precoz y agresivo, junto con altas dosis de amfotericina B intravenosa. A pesar de este tratamiento, el pronóstico es desfavorable y la mortalidad es de un 7080% (AU)
Mucormycosis is an opportunistic fungal infection caused by fungi of the Mucorales order. It has a low incidence and is a potentially lethal infection which generally affects patients who are immunocompromised due to systemic disease. We report 7 cases of rhinocerebral mucormycosis in a retrospective study of 8 years (20002008) in hematologyc patients. An early diagnosis is essential, and therefore there must be a high level of clinical suspicion in patients with predisposing factors. Certainty diagnosis requires fungal cultures or biopsies of the affected areas which prove an invasion of the tissues by the characteristic hyphae. The key to treatment is early and aggressive surgical treatment, together with high intravenous doses of B amphotericyn. Despite this, prognosis is poor and mortality is about 7080% (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Mucormicose/diagnóstico , Mucormicose/terapia , Infecções Oportunistas/complicações , Infecções Oportunistas/diagnóstico , Anfotericina B/uso terapêutico , Endoscopia , Mucormicose/fisiopatologia , Mucormicose , Estudos Retrospectivos , Mucorales/isolamento & purificaçãoRESUMO
Mucormycosis is an opportunistic fungal infection caused by fungi of the Mucorales order. It has a low incidence and is a potentially lethal infection which generally affects patients who are immunocompromised due to systemic disease. We report 7 cases of rhinocerebral mucormycosis in a retrospective study of 8 years (2000-2008) in haematological patients. An early diagnosis is essential, and therefore there must be a high level of clinical suspicion in patients with predisposing factors. Certainty diagnosis requires fungal cultures or biopsies of the affected areas which prove an invasion of the tissues by the characteristic hyphae. The key to treatment is early and aggressive surgical treatment, together with high intravenous doses of amphotericin B. Despite this, prognosis is poor and mortality is about 70-80%.
