Assuntos
Anemia Aplástica/induzido quimicamente , Antivirais/efeitos adversos , Hepatite C Crônica/tratamento farmacológico , Interferons/efeitos adversos , Oligopeptídeos/efeitos adversos , Ribavirina/efeitos adversos , Viremia/tratamento farmacológico , Anemia Aplástica/tratamento farmacológico , Anemia Aplástica/terapia , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Transfusão de Componentes Sanguíneos , Quimioterapia Combinada , Filgrastim/uso terapêutico , Ácido Fólico/uso terapêutico , Hepatite C Crônica/complicações , Humanos , Interferons/uso terapêutico , Masculino , Pessoa de Meia-Idade , Oligopeptídeos/uso terapêutico , Polietilenoglicóis/efeitos adversos , Polietilenoglicóis/uso terapêutico , Prednisona/uso terapêutico , Ribavirina/uso terapêutico , Viremia/complicações , Vitamina B 12/uso terapêuticoAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/cirurgia , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico , Dor Abdominal/etiologia , Dor Abdominal , Hemorragia Gastrointestinal/fisiopatologia , Hemorragia Gastrointestinal , Neoplasias Renais , Metástase NeoplásicaAssuntos
Carcinoma de Células Renais/complicações , Hemorragia Gastrointestinal/etiologia , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/secundário , Neoplasias Renais/complicações , Idoso , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/patologia , Feminino , Hemorragia Gastrointestinal/diagnóstico por imagem , Neoplasias Gastrointestinais/patologia , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Necrose , Tomografia Computadorizada por Raios X , Trato Gastrointestinal Superior/patologiaAssuntos
Agranulocitose/induzido quimicamente , Anticorpos Monoclonais/efeitos adversos , Doença de Crohn/tratamento farmacológico , Doença de Crohn/imunologia , Fármacos Gastrointestinais/efeitos adversos , Adulto , Doença de Crohn/patologia , Feminino , Humanos , Infliximab , Tomografia Computadorizada por Raios X , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/imunologiaRESUMO
Primary Esophageal Melanoma (PEM) is an extremely rare neoplasm, with less than 270 cases described. Although clinical presentation is similar to any other esophageal neoplasm, MEP's behavior is more aggressive and fatal in most cases. We report two new cases of MEP diagnosed through endoscopy and anatomical-pathological analysis of collected biopsies. Both samples were positive for HMB-45 and S100, so the presence of primary melanoma in other location was ruled out. The form of presentation as left miosis with no eyelid ptosis or enophthalmos should be highlighted in the first case, which was described by this early manifestation. Unfortunately, the neoplasm could not be excised when diagnosed because the thoracic artery was found to be affected through echoendoscopy. In the second case, in spite of the fact that the neoplastic extension was only local, and neoplasm was subject to transhiatal esophagectomy, the patient had multiple post-surgical complications and died nineteen days after the surgical procedure. Furthermore, bibliographic review is applied to diagnosis, treatment options, and prognosis of this exceptional neoplasm.
Assuntos
Neoplasias Esofágicas/diagnóstico , Melanoma/diagnóstico , Idoso , Anisocoria/etiologia , Transtornos de Deglutição/etiologia , Neoplasias Esofágicas/patologia , Esofagectomia , Esofagoscopia , Evolução Fatal , Gastroplastia , Humanos , Metástase Linfática , Masculino , Melanoma/patologia , Melanoma/secundário , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Complicações Pós-Operatórias , PrognósticoRESUMO
El melanoma esofágico primario (MEP) es una neoplasia extremadamente rara, con menos de 270 casos descritos. Aunque la presentación clínica es similar a cualquier otra neoplasia esofágica, su comportamiento es más agresivo y fatal en la mayoría de los casos. Presentamos dos nuevos casos de MEP diagnosticados mediante endoscopia y estudio anatomopatológico de las biopsias obtenidas, siendo en ambos casos las muestras positivas para HMB-45 y S100, descartando así mismo la presencia de melanoma primario en otra localización. En el primer caso merece destacar la forma de presentación como miosis izquierda sin ptosis palpebral ni enoftalmos, siendo el primer caso descrito con esta manifestación inicial, lamentablemente al momento del diagnóstico fue irresecable, demostrando así mismo por ecoendoscopia afectación de la aorta torácica. El segundo caso a pesar de ser una neoplasia sin extensión locorregional y sometido a esofaguectomía transhiatal presentó múltiples complicaciones postoperatorias falleciendo al decimo noveno día de la intervención. Así mismo se hace una revisión bibliográfica sobre diagnóstico, opciones de tratamiento y pronóstico de esta excepcional neoplasia.
Primary Esophageal Melanoma (PEM) is an extremely rare neoplasm, with less than 270 cases described. Although clinical presentation is similar to any other esophageal neoplasm, MEP's behavior is more aggressive and fatal in most cases. We report two new cases of MEP diagnosed through endoscopy and anatomical-pathological analysis of collected biopsies. Both samples were positive for HMB-45 and S100, so the presence of primary melanoma in other location was ruled out. The form of presentation as left miosis with no eyelid ptosis or enophthalmos should be highlighted in the first case, which was described by this early manifestation. Unfortunately, the neoplasm could not be excised when diagnosed because the thoracic artery was found to be affected through echoendoscopy. In the second case, in spite of the fact that the neoplastic extension was only local, and neoplasm was subject to transhiatal esophagectomy, the patient had multiple post-surgical complications and died nineteen days after the surgical procedure. Furthermore, bibliographic review is applied to diagnosis, treatment options, and prognosis of this exceptional neoplasm.