RESUMO
Synovial sarcoma (SS) usually affects joints, bursae, and tendons of extremities and is very infrequent in the head and neck, abdomen, thorax, prostate and kidney, skin, blood vessels, and nerves. Primary intra-abdominal SS is exceeding uncommon and has non-specific symptoms or compress surrounding structures. The diagnosis is a challenge, and histopathological and immunohistochemical studies must confirm the hypothesis. We report the case of SS that has origin in peritoneal structures and a longstanding unsuspected course. The patient was a 64-year-old woman who claimed chronic pain in the left iliac fossa, without additional symptoms. She related laparoscopic oophorectomy, cholecystectomy, and abdominal hysterectomy in the previous three decades. There was neither local invasion nor lymph nodal, vascular or neural invasion, and her surgical treatment by open abdominal procedure was uneventful. The herein reported case aims to enhance the index of suspicion.
Assuntos
Parede Abdominal , Sarcoma Sinovial , Parede Abdominal/patologia , Feminino , Humanos , Histerectomia , Masculino , Pessoa de Meia-Idade , Sarcoma Sinovial/diagnóstico , Sarcoma Sinovial/patologia , TóraxAssuntos
COVID-19 , Coinfecção , Infecções Pneumocócicas , Coinfecção/diagnóstico , Humanos , SARS-CoV-2RESUMO
Lymphangiomas are rare and correspond to 0.7% to 4.0% of mediastinal tumors, and isolated mediastinal location occurs in 1% of cases. They are benign tumors that originate from a congenital malformation of the lymphatic vessels and are diagnosed more frequently in children less than 2 years of age. Chylous ascites is a clinical manifestation of thoracic duct lymphangioma and is composed of lymph accumulation caused by dilation of this lymphatic channel. It appears milky in the peritoneal cavity, containing triglyceride levels higher than 200 mg/dl. We report the case of a young patient with chylous ascites and lymphangioma of the thoracic duct, who was conservatively treated with octreotide and a low-fat diet with medium-chain triglycerides.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Idoso/estatística & dados numéricos , Transtornos Cognitivos/epidemiologia , Polimedicação , Avaliação Geriátrica , Transtornos Cognitivos/prevenção & controle , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Educação Médica , Prescrição Inadequada/efeitos adversos , Transtornos dos Movimentos/diagnósticoRESUMO
The diagnosis of neuroendocrine tumors of the small intestine is usually challenging. They are infrequent, and the clinical course is insidious with nonspecific manifestations. Routine endoscopic and abdominal imaging studies are more often unremarkable. Therefore, distant metastases are frequently detected at the time of diagnosis. The tumor markers chromogranin A, synaptophysin, and neuron-specific enolase, and capsule endoscopy, and device-assisted enteroscopy are useful resources to establish a diagnosis. The aim was to present a case of neuroendocrine tumor of small intestine diagnosed with base in findings of the capsule endoscopy and further open surgery.
El diagnóstico de tumores neuroendocrinos del intestino delgado suele ser un desafío. Son infrecuentes y el curso clínico es insidioso con manifestaciones inespecíficas. Los estudios de imágenes endoscópicos y abdominales de rutina suelen ser anodinos. Por tanto, las metástasis a distancia se detectancon frecuencia en el momento del diagnóstico. Los marcadores tumorales cromogranina A, sinaptofi-sina y enolasa neuronal específica, y la cápsula endoscópica y la enteroscopía asistida por dispositivo son recursos útiles para establecer un diagnóstico. El objetivo de este trabajo fue presentar un caso de tumor neuroendocrino de intestino delgado diagnosticado con base en hallazgos de la cápsula endoscópica y de una nueva cirugía abierta.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Relatos de Casos , Tumores Neuroendócrinos , Endoscopia por Cápsula , Cirurgia Geral , Diagnóstico , Neoplasias Gastrointestinais , Intestino DelgadoRESUMO
The scarcely reported hematogenous rectal metastases from breast cancer are rare and the diagnosis is challenging. They may be recognized before, concomitantly with, or after the diagnosis of the primary site of breast cancer. Invasive lobular cancer is the histological type more frequently described, and most of the affected patients have a late diagnosis. Tardive recognition is associated with poor outcomes, despite the management options. Endoscopic and imaging evaluations, mainly magnetic resonance studies, are useful, but the anatomopathological findings are mandatory to confirm the diagnostic hypothesis. We describe a middle-aged woman with advanced rectal metastases of unsuspected breast cancer found during the evaluation of manifestations due to intestinal implants. One must highlight long-term follow-up of breast cancers even if seeming in remission. The aim of this report is to enhance the suspicion index of primary health care workers.
