RESUMO
We report the case of a periampullary collision tumor, in which a duodenal-wall carcinoid and an adenocarcinoma of the head of the pancreas coexisted. We describe the case of a 64-year-old man with a recent history of diarrhea, who was diagnosed with obstructive jaundice. A duodeno-pancreatectomy was performed, and the specimen showed two independent neoplasms in the histopathologic study. Solid cords and nests of neuroendocrine cells in the duodenal wall formed the carcinoid tumor, whereas the other neoplasm was made up of a well-differentiated adenocarcinoma of the pancreas. Both were confirmed by immunohistochemical analysis. According to the literature reviewed, this is the sixth reported case of this rare neoplastic association.
Assuntos
Adenocarcinoma/patologia , Ampola Hepatopancreática , Tumor Carcinoide/patologia , Neoplasias do Ducto Colédoco/patologia , Neoplasias Duodenais/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Pancreáticas/patologia , Adenocarcinoma/cirurgia , Tumor Carcinoide/cirurgia , Neoplasias do Ducto Colédoco/cirurgia , Neoplasias Duodenais/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Pancreáticas/cirurgiaRESUMO
Presentamos un caso de tumor de colisión periampular en el que coexisten un tumor carcinoide de pared duodenal y un adenocarcinoma de cabeza de páncreas. El paciente era un varón de 64 años con historia reciente de diarreas al que se diagnosticó una ictericia obstructiva. Histopatológicamente el tumor resecado mostraba dos neoplasias independientes. Una de ellas constituida por cordones sólidos de células neuroendocrinas que afectaba pared duodenal. La otra está formada por un adenocarcinoma bien diferenciado procedente del páncreas. Ambas neoplasias fueron confirmadas inmunohistoquímicamente. Según la literatura anglosajona revisada tan sólo hemos encontrado seis casos de esta rara coexistencia neoplásica
We report the case of a periampullary collision tumor, in which a duodenal-wall carcinoid and an adenocarcinoma of the head of the pancreas coexisted. We describe the case of a 64-year-old man with a recent history of diarrhea, who was diagnosed with obstructive jaundice. A duodeno-pancreatectomy was performed, and the specimen showed two independent neoplasms in the histopathologic study. Solid cords and nests of neuroendocrine cells in the duodenal wall formed the carcinoid tumor, whereas the other neoplasm was made up of a well-differentiated adenocarcinoma of the pancreas. Both were confirmed by immunohistochemical analysis. According to the literature reviewed, this is the sixth reported case of this rare neoplastic association
Assuntos
Masculino , Pessoa de Meia-Idade , Humanos , Neoplasias Duodenais/patologia , Neoplasias Pancreáticas/patologia , Tumor Carcinoide/patologia , Icterícia Obstrutiva/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias do Ducto Colédoco/patologiaAssuntos
Granuloma de Células Plasmáticas/sangue , Esplenopatias/sangue , Trombocitopenia/etiologia , Acidentes de Trânsito , Feminino , Granuloma de Células Plasmáticas/complicações , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/cirurgia , Humanos , Pessoa de Meia-Idade , Baço/lesões , Esplenectomia , Esplenopatias/complicações , Esplenopatias/diagnóstico , Esplenopatias/cirurgiaRESUMO
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Assuntos
Adulto , Masculino , Humanos , Cotovelo , Parestesia , Recidiva , Afasia , Líquido Cefalorraquidiano , Diagnóstico Diferencial , Doença de Hodgkin , Infecções , Leucocitose , Cefaleia , Recidiva Local de Neoplasia , Transtornos de EnxaquecaRESUMO
Se presenta un nuevo caso de carcinoma insular de tiroides. Este término fue descrito por Carcangiu et al( 1) en 1984 para definir un tipo histológico de tumores pobremente diferenciados, y desde entonces se han publicado menos de un centenar de casos. Se trata de una paciente que consulta por sintomatología compresiva causada por una masa mediastínica, que durante la intervención se evidencia un lóbulo tiroideo izquierdo tumoral íntimamente adherido a estructuras vecinas, que resultó ser un carcinoma insular de tiroides. Tras la tiroidectomía total, la paciente ha recibido tratamiento con I131, y se halla asíntomática tras un año de segumiento. Se analiza el proceso diagnóstico y terapeútico y se lleva a cabo un diagnóstico diferencial con otros tumores tiroideos, poniéndose de manifiesto la rareza del caso y la necesidad de diagnóstico para realizar un tratamiento correcto y un exhaustivo seguimiento en este tipo de tumores, dada la agresividad y el mal pronóstico del mismo comparado con los tumores diferenciados de tiroides (AU)
Assuntos
Idoso , Feminino , Humanos , Carcinoma/patologia , Neoplasias da Glândula Tireoide/patologia , Carcinoma/diagnóstico , Carcinoma/terapia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/terapiaRESUMO
A new case of insular carcinoma of the thyroid gland is presented. It was described by Carcangiu et al(1) in 1984 as a poorly differentiated carcinoma, less of one hundred cases were published after its description. We report a case of a patient who was referred for compressive symptoms caused by a mediastinal mass. It was found a tumor of left thyroid lobe strongly adherent to adjacent structures, which was informed as a poorly differentiated insular carcinoma. She underwent total thyroidectomy and posterior treatment with an ablative dose of 1311. She is currently free of disease after one year of follow-up. The diagnosis, treatment, differential diagnosis with another thyroid carcinomas and the rarety of this type of tumors are analyzed. The importance of a correct diagnosis is fundamental in order to carry out an aggressive treatment and a more exhaustive follow-up in these patients, taken account its behavior and its poor prognosis when compared with well-differentiated carcinomas.
