RESUMO
Mesenteric or retroperitoneal actinomycosis is an extremely rare disease. The international databases have revealed only 10 cases affecting the mesenterium and another 52 cases affecting the retroperitoneum. We report a 78-year-old female who was admitted with complaints of abdominal pain. Laboratory examination revealed anemia and the clinical examination revealed an irregular mass in the abdomen. Ultrasound and computed tomography (CT) scans showed a solid mass in the mesenteric-retroperitoneal region. Biopsy of the nonresectable mass revealed the presence of chronic inflammation in the mesenteric area with Actinomyces colonies. The patient was treated with oral amoxicillin, 500 mg every 6 hours for 6 months. The symptoms disappeared, but the mesenteric-retroperitoneal mass remains, but smaller in size. Based on the review of the literature and the case reported here, we conclude that mesenteric-retroperitoneal actinomycosis is difficult to diagnose by means of noninvasive techniques as it can masquerade as a malignant process. An accurate diagnosis is always obtained in a histological or microbiological examination, often requiring surgical intervention. Treatment with penicillin has proven to be effective.
Assuntos
Actinomicose/diagnóstico , Mesentério/microbiologia , Espaço Retroperitoneal/microbiologia , Actinomicose/diagnóstico por imagem , Actinomicose/tratamento farmacológico , Idoso , Amoxicilina/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Penicilinas/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
Se presenta un caso de mesotelioma maligno en una paciente joven, localizado en la región inguinal y sin aparente relación con ningún saco herniario ni cavidad peritoneal. Se revisa la bibliografía existente, sin encontrar ninguna otra forma igual de mesotelioma (AU)
Assuntos
Adolescente , Feminino , Humanos , Mesotelioma/cirurgia , Mesotelioma/diagnóstico , Mesotelioma/etiologia , Membrana Serosa/cirurgia , Membrana Serosa/patologia , Laparoscopia/métodos , Laparoscopia , Abdome/patologia , Abdome , Neoplasias Primárias Desconhecidas/cirurgia , Neoplasias Primárias Desconhecidas/diagnóstico , Neoplasias Primárias Desconhecidas/etiologia , Neoplasias Primárias Desconhecidas , Neoplasias Primárias Desconhecidas/tratamento farmacológico , Neoplasias Primárias Desconhecidas/radioterapia , Imageamento por Ressonância Magnética , Mesoderma/patologia , Prognóstico , Neoplasias Mesoteliais/diagnóstico , Neoplasias Mesoteliais/epidemiologia , Neoplasias Mesoteliais/etiologia , Metástase Neoplásica/fisiopatologia , Metástase NeoplásicaRESUMO
Intestinal tuberculosis has been a clinical rarity in the western world since the tuberculostatic agents were discovered. The most common location of these lesions is usually the ileocecal region, lesions of the transverse colon being much less frequent and perforation of this viscus being exceptional. The etiological diagnosis is usually difficult because there are no specific radiological signs and false negatives are often found in biopsy material obtained by colonoscopy since the process is mainly submucous. This disease is often diagnosed during operation so treatment is usually resection. Should a preoperative diagnosis be made, the picture generally responds to tuberculostatics.
