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1.
Wiad Lek ; 77(2): 358-362, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38593002

RESUMO

Bone metastases from liver cancer are rare. We report two cases of bone metastases revealing HBV-induced HCC. A 26-year-old african man presented with 4 months of low back pain in the context of general deterioration. Examination revealed a lumbar spinal syndrome and hepatomegaly. Abdominal ultrasound revealed a multinodular liver, and a CT scan of the spine revealed osteolytic lesions. Biological tests revealed a hepatic cytolysis syndrome, hepatic cholestasis and hepatocellular insufficiency. Alpha foetoprotein levels were elevated and hepatitis B serology was positive. We adopted the diagnosis of HCC of viral B origin with bone metastasis. The second case involved a 44-year-old African man admitted for 10 days with back pain. Examination revealed a spinal syndrome, paraplegia and hepatomegaly. A thoracic-abdominal-pelvic CT scan revealed typical HCC lesions and osteolytic lesions on the ribs, pelvis and vertebrae. The biology revealed a biological inflammatory syndrome, hepatic cytolysis, a hepatocellular insufficiency syndrome and a cholestasis syndrome. Alfa-feto proteins were elevated and HBV serology was positive. The diagnosis of bone metastasis of HCC secondary to HBV infection was accepted.


Assuntos
Carcinoma Hepatocelular , Colestase , Hepatite B , Neoplasias Hepáticas , Masculino , Humanos , Adulto , Carcinoma Hepatocelular/complicações , Neoplasias Hepáticas/complicações , Hepatomegalia/complicações , Hepatite B/complicações , Coluna Vertebral/patologia , Colestase/complicações
2.
Clin Case Rep ; 12(1): e8462, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38268619

RESUMO

This article presents the case of a young patient with severe acute left hip pain who tested positive for COVID-19. The diagnostic approach and management are presented, followed by a review of the literature. This 11-year-old student was admitted for acute left hip pain of abrupt onset, inflammatory, evolving for 24 h in a febrile context with no change in general condition. The initial workup revealed a hyperleukocytosis in the blood count, CRP 198.52 mg/L, and a 95 mm SV. The pelvic X-ray was unremarkable, and the hip ultrasound showed synovial hypertrophy, with no effusion on Doppler examination. The situation worsened 24 h later with the onset of acute respiratory distress syndrome. The chest X-ray showed bilateral alveolar interstitial lung disease, and the CT scan showed hyperdensity and crazy paving. The COVID-19 RDT test on a nasopharyngeal sample came back positive, as did the RT-PCR. Death occurred a few hours later in acute respiratory distress. Our case is consistent with what has been reported in the literature, but requires further study on an international scale to better define the phenotype of the disease.

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