Metástasis por contigüidad de carcinoma escamoso esofágico, invasivo. Caso clínico / Metastasis due to invasive squamous cell carcinoma of the oesophagus. A clinical case

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Manifestaciones oftalmológicas de la infección por toxoplasma en paciente portador del virus de la inmunodeficiencia humana. Descripción de un caso / Ophthalmic manifestations of toxoplasmosis in a human immunodeficiency virus-positive patient. Description of a case

La toxoplasmosis es una infección de distribución mundial causada por Toxoplasma gondii, que infecta a una gran proporción de la población mundial. Solo bajo ciertas circunstancias de inmunosupresión grave, el parásito puede reactivarse y causar enfermedad. La forma más frecuente de presentarse la enfermedad en los pacientes portadores del virus de la inmunodeficiencia humana (VIH) es la de abscesos encefálicos. Dentro de las formas extracerebrales tenemos la coriorretinitis toxoplásmica, la que daría lugar a la forma de retinitis crónica activa de lenta evolución. El diagnóstico lo hace el oftalmólogo observando el fondo de ojo y se confirma por la cicatrización obtenida después del tratamiento específico. Se presenta un caso de un paciente diabético e infectado por el VIH, al que en la retinografía ambulatoria anual de control se le detecta una lesión cicatricial toxoplásmica. Se decidió una conducta terapéutica conservadora con controles periódicos para la detección de posible activación de la enfermedad (AU)

Toxoplasmosis is an infection of worldwide distribution caused by Toxoplasma gondii, and infects a large proportion of the world population. Only under certain circumstances of severe immunosuppression can the parasite reactivate and cause disease. The most common form of presentation of this pathology in patients with positive HIV is the brain abscess. One of the extra-cerebral forms is toxoplasmic chorioretinitis, which could lead to a chronic active form of a slowly progressive retinitis. Diagnosis is made by observing the eye fundus and confirmed by the scarring obtained after specific treatment. We report a case of a patient with diabetes and positive HIV, in whom a toxoplasmic scar injury was detected in the annual retinography follow-up. A conservative therapeutic approach was decided, with regular check-ups for possible detection of disease activation (AU)

[Ophthalmic manifestations of toxoplasmosis in a human immunodeficiency virus-positive patient. Description of a case]. / Manifestaciones oftalmológicas de la infección por toxoplasma en paciente portador del virus de la inmunodeficiencia humana. Descripción de un caso.

Toxoplasmosis is an infection of worldwide distribution caused by Toxoplasma gondii, and infects a large proportion of the world population. Only under certain circumstances of severe immunosuppression can the parasite reactivate and cause disease. The most common form of presentation of this pathology in patients with positive HIV is the brain abscess. One of the extra-cerebral forms is toxoplasmic chorioretinitis, which could lead to a chronic active form of a slowly progressive retinitis. Diagnosis is made by observing the eye fundus and confirmed by the scarring obtained after specific treatment. We report a case of a patient with diabetes and positive HIV, in whom a toxoplasmic scar injury was detected in the annual retinography follow-up. A conservative therapeutic approach was decided, with regular check-ups for possible detection of disease activation.

[Horseshoe kidney, stone disease and prostate cancer: a case presentation]. / Riñón en herradura, enfermedad litiásica y adenocarcinoma de próstata. Presentación de un caso clínico.

The horseshoe kidney is the most common congenital renal fusion anomalies. It occurs in 0.25% of the population, or 1 in every 400 people. It is more frequent in males (ratio 2:1). The most observed complication of horseshoe kidney is stone disease, although there may be others such as, abdominal pain, urinary infections, haematuria, hydronephrosis, trauma and tumours (most commonly associated with hypernephroma and Wilms tumour). We describe a case of a male patient with horseshoe kidney, stone disease and adenocarcinoma of the prostate. One carrier of this condition who suffered a transitional cell carcinoma of the prostate was found in a review of the literature.

Riñón en herradura, enfermedad litiásica y adenocarcinoma de próstata. Presentación de un caso clínico / Horseshoe kidney, stone disease and prostate cancer: a case presentation

El riñón en herradura es la anomalía congénita de fusión más frecuente. Se presenta en el 0,25% de la población ó en 1 de cada 400. Más frecuente en el varón (proporción de 2:1). La litiasis es una de las complicaciones más frecuentes del riñón en herradura, aunque puede haber otras como: dolor abdominal, infecciones urinarias, hematuria, hidronefrosis, traumatismos y aparición de tumores, siendo los más comúnmente asociados el hipernefroma y el tumor de Wilms. Describimos el caso de un varón portador de riñón en herradura, enfermedad litiásica y adenocarcinoma de la próstata. En la literatura médica revisada encontramos un caso portador de esta entidad que presentó un carcinoma transicional de próstata (AU)

The horseshoe kidney is the most common congenital renal fusion anomalies. It occurs in 0.25% of the population, or 1 in every 400 people. It is more frequent in males (ratio 2:1). The most observed complication of horseshoe kidney is stone disease, although there may be others such as, abdominal pain, urinary infections, haematuria, hydronephrosis, trauma and tumours (most commonly associated with hypernephroma and Wilms tumour). We describe a case of a male patient with horseshoe kidney, stone disease and adenocarcinoma of the prostate. One carrier of this condition who suffered a transitional cell carcinoma of the prostate was found in a review of the literature (AU)

[Mucosecretor adenocarcinoma of the lung with pleural involvement presenting as a pneumothorax. Presentation of a clinical case]. / Adenocarcinoma mucosecretor de pulmón con diseminación pleural que se manifiesta con neumotórax. Presentación de un caso clínico.

The combination of a pneumothorax and lung cancer is rare and diagnosis is complex. Clinical suspicion of cancer must be based on radiological findings and the existence of risk factors. We discuss the mechanisms involved in the development of pneumothorax in patients with lung cancer, as well as the clinical significance, the recommended diagnostic approach, and therapeutic guidelines.

Adenocarcinoma mucosecretor de pulmón con diseminación pleural que se manifiesta con neumotórax. Presentación de un caso clínico / Mucosecretor adenocarcinoma of the lung with pleural involvement presenting as a pneumothorax. Presentation of a clinical case

La asociación de un neumotórax y un carcinoma broncopulmonar es infrecuente y el diagnóstico es complicado. La sospecha clínica debe hacerse a partir de los hallazgos radiográficos y la existencia de factores de riesgo. Son discutidos los mecanismos implicados en la aparición del neumotórax en pacientes con neoplasias de pulmón, así como el significado clínico y la conducta diagnóstica y terapéutica recomendada en estos casos (AU)

The combination of a pneumothorax and lung cancer is rare and diagnosis is complex. Clinical suspicion of cancer must be based on radiological findings and the existence of risk factors. We discuss the mechanisms involved in the development of pneumothorax in patients with lung cancer, as well as the clinical significance, the recommended diagnostic approach, and therapeutic guidelines (AU)

[Cutaneous horn, actinic keratosis and squamous cell carcinoma. Presentation of a clinical case]. / Cuerno cutáneo, queratosis actínica y carcinoma espinocelular. A propósito de un caso clínico.

The cutaneous horn is defined as a tumour, usually of conical appearance which prevails over the length of its diameter, with large hyperkeratosis in its extreme and due to varied causes. It may be associated with benign, pre-malignant (actinic keratosis) and malignant (squamous cell carcinoma) skin, usually requiring complete excision of the lesion and a histopathological examination. We report a case of a 94 year old woman with a cutaneous horn and an initial pathological diagnosis of actinic keratosis, which subsequently progressed to squamous cell carcinoma, along with and a brief review of the literature. The treatment is complete excision of the lesion, deepening its base due to the likelihood of association with malignant lesions.

Cuerno cutáneo, queratosis actínica y carcinoma espinocelular. A propósito de un caso clínico / Cutaneous horn, actinic keratosis and squamous cell carcinoma. Presentation of a clinical case

El cuerno cutáneo se define como una lesión tumoral, por lo general de aspecto cónico, en la cual prevalece la longitud sobre su diámetro, con gran hiperqueratosis en su extremo y de variadas causas. Puede asociarse con lesiones benignas, premalignas (queratosis actínica) y malignas (carcinoma espinocelular) de piel, por lo que es necesario la exéresis completa de la lesión además de un examen histopatológico. Presentamos el caso clínico de una mujer de 94 años con un cuerno cutáneo y diagnóstico anatomopatológico inicial de queratosis actínica, que posteriormente recidivó en un carcinoma espinocelular y se hace una breve revisión de la literatura médica. El tratamiento es la exéresis completa de la lesión, profundizando en la base de la misma, por el riesgo de asociación a lesiones malignas(AU)

The cutaneous horn is defined as a tumour, usually of conical appearance which prevails over the length of its diameter, with large hyperkeratosis in its extreme and due to varied causes. It may be associated with benign, pre-malignant (actinic keratosis) and malignant (squamous cell carcinoma) skin, usually requiring complete excision of the lesion and a histopathological examination. We report a case of a 94 year old woman with a cutaneous horn and an initial pathological diagnosis of actinic keratosis, which subsequently progressed to squamous cell carcinoma, along with and a brief review of the literature. The treatment is complete excision of the lesion, deepening its base due to the likelihood of association with malignant lesions(AU)

Tumor del vértice pulmonar derecho que produce un síndrome de Pancoast. Descripción de un caso clínico / Tumour of the right lung vertex that produced a Pancoast syndrome: description of a case

Se describe el caso clínico de una paciente, mujer de 80 años de edad, con antecedentes de enfermedad de Alzheimer, que acudió por presentar dolor en hombro derecho, parestesias y disminución de la fuerza en miembro superior derecho, ptosis palpebral en el ojo derecho, tos y disfagia. Tras la realización de exploración y pruebas complementarias se objetivó una gran masa en el lóbulo superior y vértice del pulmón derecho y adenopatías metastásicas supraclaviculares. La histología de la punción aspiración de la masa mostró un carcinoma poco diferenciado de células no pequeñas. Se remitió a Oncología que indicó tratamiento quimioterapéutico (AU)

We describe a clinical case of an 80 year-old woman, with a history of Alzheimer's disease, who presented with right shoulder pain, numbness and decreased strength in the right arm, with right eye ptosis, cough and dysphagia. The chest X-Ray and thoracic-abdominal computed tomography scan showed a large mass in the upper lobe and apex of the right lung, supraclavicular metastatic lymph nodes. In the fine needle aspiration biopsy: poorly differentiated non-small cell carcinoma. She was referred to Oncology to start chemotherapy treatment (AU)

Carcinoma epidermoide de esófago, estenosante, estadio IV, en mujer de 41 años. Descripción de un caso clínico / Stage IV stenosing sqamous cell carcinoma of the oesopahgus in a 41 year-old woman. A case presentation

Objetivos. Presentar un caso clínico de una mujer de 41 años con un carcinoma epidermoide de esófago en estadio IV. Método y pacientes. Mujer de 41 años. No hábitos tóxicos, DMNID, hiperferritinemia, resección de placa hemosiderina lingual, LOE hepática estudiada con ecografía y RMN con aumento del tamaño, sin lograr diferenciar entre hemangioma y hepatocarcinoma. Comienza con disfagia, progresiva, pérdida de peso. Esofagogastroscopía (FGC) con toma de biopsia: neoformación estenosante a 20cm. Estudio AP: carcinoma epidermoide. TAC toracoabdominal: lesiones esofágicas compatibles con proceso neoformativo. Metástasis pulmonares y adrenal izquierda, lesión hepática compatible con proceso neoformativo. Laboratorio: eritrosedimentación: 55mm. Se remite a Cirugía para realización de gastrostomía para alimentación enteral por sonda y a Oncología que indica tratamiento con quimioterapia paliativa. Conclusiones. El carcinoma epidermoide esofágico es el más frecuente. Los dos factores de riesgo más importantes son: el tabaco y el alcohol. El síntoma más frecuente es la disfagia (96%). El pronóstico es malo y tiene una elevada mortalidad. La Cirugía es el tratamiento estándar, cuando el tumor está localizado. La quimioterapia y radioterapia son tratamientos paliativos, sin que se haya demostrado claramente su eficacia (AU)

Objective. To present a clinical case of a 41 year-old woman, with a stage IV squamous cell carcinoma of the oesophagus. Methods and patients. We present a clinical case of 41 year-old woman with a history of type 2 diabetes mellitus, and resection of a haemosiderin plaque on the tongue. A space occupying lesion (SOL) was studied using ultrasound and Nuclear Magnetic Resonance (NMR), detecting, but unable to differentiate, a gradually increasing haemangioma or hepatocarcinoma. She was seen at the clinic due to dysphagia and loss of weight. In oesophagogastroscopy with biopsy a squamous cell carcinoma of the oesophagus was diagnosed. The Computed Tomography (CT) of the neck, thorax and abdomen showed a stenosing tumour in the oesophagus with metastasis in the lungs and left adrenal gland, and a SOL in the liver compatible with a neo-formative process. The erythrocyte sedimentation rate was 55mm. She was referred to Surgery and Oncology, who performed a gastrostomy for enteral feeding and started treatment with palliative chemotherapy. Conclusions. Squamous cell carcinoma of the oesophagus is very frequent. The two most important risk factors are alcoholism and nicotine poisoning. The dysphagia is the most common symptom (96% of the patients). The prognosis is a poor, with high mortality. Surgery is the standard treatment when the tumour is located. Chemotherapy and radiotherapy are palliative treatments, but has not shown to be very effective (AU)

[Stage IV stenosing sqamous cell carcinoma of the oesopahgus in a 41 year-old woman. A case presentation]. / Carcinoma epidermoide de esófago, estenosante, estadio IV, en mujer de 41 años. Descripción de un caso clínico.

OBJECTIVE: To present a clinical case of a 41 year-old woman, with a stage IV squamous cell carcinoma of the oesophagus. METHODS AND PATIENTS: We present a clinical case of 41 year-old woman with a history of type 2 diabetes mellitus, and resection of a haemosiderin plaque on the tongue. A space occupying lesion (SOL) was studied using ultrasound and Nuclear Magnetic Resonance (NMR), detecting, but unable to differentiate, a gradually increasing haemangioma or hepatocarcinoma. She was seen at the clinic due to dysphagia and loss of weight. In oesophagogastroscopy with biopsy a squamous cell carcinoma of the oesophagus was diagnosed. The Computed Tomography (CT) of the neck, thorax and abdomen showed a stenosing tumour in the oesophagus with metastasis in the lungs and left adrenal gland, and a SOL in the liver compatible with a neo-formative process. The erythrocyte sedimentation rate was 55 mm. She was referred to Surgery and Oncology, who performed a gastrostomy for enteral feeding and started treatment with palliative chemotherapy. CONCLUSIONS: Squamous cell carcinoma of the oesophagus is very frequent. The two most important risk factors are alcoholism and nicotine poisoning. The dysphagia is the most common symptom (96% of the patients). The prognosis is a poor, with high mortality. Surgery is the standard treatment when the tumour is located. Chemotherapy and radiotherapy are palliative treatments, but has not shown to be very effective.

[Tumour of the right lung vertex that produced a Pancoast syndrome: description of a case]. / Tumor del vértice pulmonar derecho que produce un síndrome de Pancoast. Descripción de un caso clínico.

We describe a clinical case of an 80 year-old woman, with a history of Alzheimer's disease, who presented with right shoulder pain, numbness and decreased strength in the right arm, with right eye ptosis, cough and dysphagia. The chest X-Ray and thoracic-abdominal computed tomography scan showed a large mass in the upper lobe and apex of the right lung, supraclavicular metastatic lymph nodes. In the fine needle aspiration biopsy: poorly differentiated non-small cell carcinoma. She was referred to Oncology to start chemotherapy treatment.