RESUMO
Mediastinal pancreatic pseudocysts are rarely encountered complications of pancreatic diseases. Pseudocysts most often expand into surrounding structures, just rarely into the mediastinum. Usually, they present with abdominal pain, and the symptoms correlate with the location of the pseudocysts. We describe a case of a pancreatic pseudocyst that penetrated the thoracic cavity through the diaphragm and set up a communication with the bronchial tree developing an episode of massive hemoptysis. This case is of particular interest because just a few similar cases were published before. Based on this report, we emphasize the need for early accurate diagnosis; surgeons should maintain a higher index of suspicion for mediastinal pancreatic pseudocyst in patients with chronic pancreatitis.
RESUMO
The coexistence of cancer and other concomitant diseases is very frequent and has substantial implications for treatment decisions and outcomes. Beta-blockers, agents that block the beta-adrenergic receptors, have been related also to cancers. In the model of multicellular spheroids formed by colorectal cancer cells we described a crosstalk between beta-blockade by propranolol and tumour microenvironment. Non-selective beta-blocker propranolol decreased ability of tumour cells to adapt to hypoxia by reducing levels of HIF1α and carbonic anhydrase IX in 3D spheroids. We indicated a double action of propranolol in the tumour microenvironment by inhibiting the stability of HIF1α, thus mediating decrease of CA IX expression and, at the same time, by its possible effect on CA IX activity by decreasing the activity of protein kinase A (PKA). Moreover, the inhibition of ß-adrenoreceptors by propranolol enhanced apoptosis, decreased number of mitochondria and lowered the amount of proteins involved in oxidative phosphorylation (V-ATP5A, IV-COX2, III-UQCRC2, II-SDHB, I-NDUFB8). Propranolol reduced metastatic potential, viability and proliferation of colorectal cancer cells cultivated in multicellular spheroids. To choose the right treatment strategy, it is extremely important to know how the treatment of concomitant diseases affects the superior microenvironment that is directly related to the efficiency of anti-cancer therapy.
