RESUMO
Intussusception is defined as the invagination of a proximal segment of the bowel into the adjoining or distal segment. In most adults with intussusception, there is a demonstrable lead point with a definite pathologic abnormality. The clinical features of intussusception include chronic intermittent abdominal pain, nausea and vomiting, constipation, and a palpable abdominal mass. The present case report describes a 62-year-old woman with a 2-week history of abdominal pain and 9-day history of vomiting. Clinical, imaging, and histologic evaluations revealed a jejunojejunal intussusception with a gastrointestinal stromal tumor as the lead point. A gastrointestinal stromal tumor should be considered as a possible lead point in adult patients with intussusception. The implication of reducing the intussusception prior to tumor resection requires further evaluation in view of the risk of venous embolism, including direct spread of malignant cells, in cases involving a large polypoid mass with a necrotic surface that extends to the serosa as shown by intraoperative examination. Accordingly, the rationale for adjuvant therapy with imatinib also requires further evaluation.
Assuntos
Tumores do Estroma Gastrointestinal , Intussuscepção , Humanos , Intussuscepção/etiologia , Intussuscepção/cirurgia , Intussuscepção/diagnóstico , Intussuscepção/patologia , Intussuscepção/diagnóstico por imagem , Feminino , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Tumores do Estroma Gastrointestinal/diagnóstico , Pessoa de Meia-Idade , Doenças do Jejuno/etiologia , Doenças do Jejuno/cirurgia , Doenças do Jejuno/diagnóstico , Doenças do Jejuno/patologia , Tomografia Computadorizada por Raios X , Dor Abdominal/etiologiaRESUMO
Non-acquired immunodeficiency syndrome-defining cancers (NADCs) are malignancies in persons living with human immunodeficiency virus (PLWHIV) and are not primarily due to the host's immunodeficiency. There is renewed clinical interest in long-term morbidities in PLWHIV as well as malignancies that occur in this population. We herein describe a 36-year-old woman with a 2-year history of an anal wound and right breast mass. She had been diagnosed with HIV infection prior to the development of these lesions. Clinical and laboratory evaluations led to diagnoses of breast and anal cancers. Chemotherapy and antiretroviral therapy were begun, but the patient discontinued these treatments early and was lost to follow-up. NADCs will continue to be a major clinical issue as the global population ages. This presentation of two NADCs (breast and anal cancers) in a PLWHIV further highlights the burden of multiple malignancies on the depleted health of HIV-infected patients. Early identification and treatment of HIV upon patients' presentation to cancer care sites and screening for NADCs at HIV/AIDS care sites are recommended for improved outcomes.
Assuntos
Síndrome da Imunodeficiência Adquirida , Neoplasias do Ânus , Carcinoma , Infecções por HIV , Neoplasias , Feminino , Humanos , Adulto , Infecções por HIV/epidemiologia , Neoplasias/epidemiologia , Síndrome da Imunodeficiência Adquirida/epidemiologia , HIV , Neoplasias do Ânus/complicações , Neoplasias do Ânus/diagnósticoRESUMO
Extra gastrointestinal stromal tumour(EGIST) is rare and is regarded as gastrointestinal stromal tumour(GIST) that originates outside of the gastrointestinal tract. They originate from other intraabdominal tissues such as the omentum, mesentery and peritoneum. The cell of origin is the interstitial cell of Cajal(ICC), a pacemaker cell that controls gastrointestinal peristalsis and the tumor is characterized by the expression of KIT(CD117) a transmembrane tyrosine kinase receptor. Here, a 49-year-old female who presented with a 6 month history of abdominal pain, progressive abdominal swelling and the presence of an upper abdominal mass. She had surgical resection and adjuvant imatinib for the intraabdominal mass diagnosed on histology and immunohistochemistry as EGIST of the lesser omentum. Serial CT 14 months after surgery revealed no evidence of recurrence or metastasis. Clinicians should consider EGIST in the differential diagnosis of abdominal masses.
RESUMO
Purpose: The application of radiotherapy to the treatment of cancer requires the knowledge of photon interaction coefficients such as mass attenuation (µm) and mass energy-absorption coefficients (µen/ρ). Although these coefficients have been determined for different tissues, it is lacking for the colorectal cancer (CRC) tissue in the literature. This study determines the µm and µen/ρ for the CRC tissue within the radiotherapy energy range. Materials and Methods: The CRC tissue from autopsy patients was freeze-dried, grounded into a fine powder, and made into pellets of 1 cm thickness. The elements detected in the CRC tissue using Rutherford backscattering spectrometry were used in XCOM to determine the theoretical values of µm and µen/ρ. The CRC tissue was again exposed to X-rays of energies of 6 and 15MV, respectively, to determine its experimental values of µm and µen/ρ. Results: Elements detected included carbon, oxygen and nitrogen making up 96.67%, high atomic number and trace elements making up the remaining 3.33% fraction of the CRC tissue. Conclusion: The theoretical and experimental µm and µen/ρ values showed a good agreement of about 2% difference between them. These values can be used to simulate the CRC tissue with respect to µm and µen/ρ.