RESUMO
We present the clinical case of a 21-year-old male with abdominal pain in the left hypochondrium radiating to the ipsilateral lumbar area and a weight loss of 2kg over a month, secondary to a large palpable intra-abdominal mass in the examination. TAC revealed a large solid mass with necrotic-cystic component which depended of the pancreas, infiltrated the spleen, enveloped the celiac trunk and affected to the splenic vases. Inmunohistochemical and molecular study confirmed the diagnosis extraosseus Ewing sarcoma (EES).
RESUMO
We present two clinical cases, a 68-year-old male and a 55-year-old female, who are being studied for progressive solid food dysphagia. The initial gastroscopy revealed a polypoid lesion in the first case and a partially stenosing lesion in the second case. Both lesions were located in the mid-esophagus and presented a normal mucosa. Histological diagnosis confirmed an esophageal neuroendocrine carcinoma (NEC) of large cell and small cell types, respectively.
Assuntos
Carcinoma Neuroendócrino , Transtornos de Deglutição , Neoplasias Esofágicas , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Transtornos de Deglutição/complicações , Carcinoma Neuroendócrino/complicações , Carcinoma Neuroendócrino/diagnóstico por imagem , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologiaAssuntos
Humanos , Masculino , Idoso , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico por imagem , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Tomografia Computadorizada por Raios X , Endoscopia do Sistema DigestórioRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Equinococose Hepática/diagnóstico por imagem , Equinococose Hepática/cirurgia , Albendazol/administração & dosagem , Pró-Calcitonina , Abdome/diagnóstico por imagem , Abdome/patologia , Duodeno/patologia , Duodeno/cirurgia , Equinococose Hepática/complicaçõesRESUMO
No disponible
Assuntos
Humanos , Feminino , Adulto , Imunodeficiência de Variável Comum/complicações , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/tratamento farmacológico , Infliximab/uso terapêutico , Linfócitos B , Linfócitos T , Fator de Necrose Tumoral alfa/uso terapêuticoAssuntos
Imunodeficiência de Variável Comum/complicações , Infecções por Citomegalovirus/complicações , Fármacos Gastrointestinais/uso terapêutico , Infliximab/uso terapêutico , Enteropatias/tratamento farmacológico , Enteropatias/etiologia , Adulto , Feminino , Humanos , Índice de Gravidade de DoençaAssuntos
Falso Aneurisma/diagnóstico por imagem , Colecistite/complicações , Duodenopatias/etiologia , Vesícula Biliar/irrigação sanguínea , Hemorragia Gastrointestinal/etiologia , Xantomatose/complicações , Idoso , Falso Aneurisma/complicações , Artérias/diagnóstico por imagem , Duodenopatias/diagnóstico por imagem , Vesícula Biliar/diagnóstico por imagem , Hemorragia Gastrointestinal/diagnóstico por imagem , Gastroscopia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada MultidetectoresRESUMO
No disponible
Assuntos
Humanos , Masculino , Falso Aneurisma/sangue , Falso Aneurisma/patologia , Hemorragia Gastrointestinal/sangue , Hemorragia Gastrointestinal/genética , Colecistite/patologia , Hemobilia/sangue , Espectroscopia de Ressonância Magnética , Falso Aneurisma/genética , Falso Aneurisma/metabolismo , Hemorragia Gastrointestinal/metabolismo , Hemorragia Gastrointestinal/patologia , Colecistite/metabolismo , Hemobilia/patologia , Espectroscopia de Ressonância Magnética/instrumentaçãoRESUMO
INTRODUCTION: Partially covered self-expanding metal stents (SEMS), have been suggested as an alternative to surgery in the treatment of esophageal fistulas of benign etiology. Nevertheless, uncomplicated removal remains difficult. The use of fully covered (FC) SEMSs could solve this problem. OBJECTIVES: To review our experience with FC-SEMS placement in patients with benign upper gastrointestinal leaks or perforations. We wanted to assess successful closure of the perforations and short-term and long-term complications. MATERIALS AND METHODS: Multicenter study, including 3 tertiary centers. Retrospective review of patients who underwent FC-SEMS placement for benign perforations. RESULTS: Eighty-eight stents were placed in 56 patients. We achieved leak closure in 44 patients (78.6%). There were 18 migrations. All of them could be solved endoscopically. A severe septic situation was associated with a higher mortality rate (27.6% vs. 7.4%; P=0.049) and a lower success rate (34.5% vs. 7.4%; P=0.088), compared with those patients who did not present severe sepsis. However, these differences could not be confirmed by multivariable analysis. The results in the subgroup of 11 patients with leaks after sleeve gastrectomy were also good (73% success without surgery and 0% mortality). CONCLUSIONS: Temporary placement of FC-SEMS for benign perforations, fistulas, and leaks is feasible in sealing the leaks. All migrations could be solved endoscopically. It is very important to insert the stent before sepsis is established. This article also would be an addition to the growing body of literature supporting stenting as a good alternative if not standard approach to controlling these leaks.