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3.
Pan Afr Med J ; 36: 257, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33014253

RESUMO

Since asymptomatic infections as "covert transmitter", and some patients can progress rapidly in the short term, it is essential to pay attention to the diagnosis and surveillance of asymptomatic patients with SARS-COV2 infection. CT scan has great value in screening and detecting patients with COVID-19 pneumonia, especially in the highly suspected or probable asymptomatic cases with negative RT-PCR for SARS-COV2. This study aimed to detect incidentally COVID-19 pneumonia on medical imaging for patients consulting for other reasons.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pandemias , Pneumonia Viral/diagnóstico por imagem , Dor Abdominal/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Lesões Encefálicas/complicações , Dor no Peito/complicações , Criança , Pré-Escolar , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Achados Incidentais , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/etiologia , Masculino , Pessoa de Meia-Idade , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Pneumonia Viral/complicações , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodos , Tunísia/epidemiologia , Adulto Jovem
4.
Ther Umsch ; 77(8): 357-360, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054651

RESUMO

The adrenal incidentaloma Abstract. This article discusses the diagnostic workup of a patient with an incidentally discovered adrenal mass. Primarily, this situation raises two questions: Is the mass malignant? Is the mass hormonally active? The evaluation for malignancy is based on specific imaging characteristics ('imaging phenotype'). The evaluation for hormonal secretion is based on a targeted clinical examination and specific biochemical tests. In most cases, adrenal incidentalomas can be identified as benign, non-functioning adenomas. In unclear situations, patients should be referred for further evaluation.


Assuntos
Adenoma , Neoplasias das Glândulas Suprarrenais , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/terapia , Humanos , Achados Incidentais , Fenótipo
5.
Medicine (Baltimore) ; 99(41): e22486, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031282

RESUMO

RATIONALE: Prostate-specific membrane antigen positron emission tomography-computed tomography (F-PSMA-1007 PET/CT) imaging is an emerging method for the diagnosis of prostate cancer (PC), but its efficiency in detecting other accompanying diseases has rarely been investigated. PATIENT CONCERNS: A 77-year-old man presented with a complaint of bone pain throughout his entire body lasting for 2 weeks. Routine preoperative whole-body bone scanning revealed multiple osteogenic metastases. His alpha-fetoprotein and prostate-specific antigen levels were 108.2 ng/mL and 53.32 ng/mL, respectively. F-PSMA-1007 PET/CT imaging revealed high tracer uptake in the primary lesion in the liver and the peripheral zone of the prostate. DIAGNOSES: Due to the results from imaging and pathological examinations, a diagnosis of PC with multiple bone metastases accompanied by primary hepatocellular carcinoma was made. INTERVENTIONS: Taking into consideration the patient's age, interventional therapy was performed for the liver lesion, whereas the prostate and bone lesions were treated with endocrine therapy. OUTCOMES: The patient recovered well and was discharged uneventfully postoperatively. The patient was also doing well at the 6-month follow-up. LESSONS: PSMA-PET/CT imaging results must be interpreted cautiously when the uptake of PSMA increases in a single lesion instead of the most common sites of PC metastasis. Pathological examination of the suspected lesions is also recommended.


Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Idoso , Antígenos de Superfície , Radioisótopos de Flúor , Glutamato Carboxipeptidase II , Humanos , Achados Incidentais , Masculino , Neoplasias da Próstata
6.
Ther Umsch ; 77(8): 379-384, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054644

RESUMO

Thrombocytopenia as an incidental finding Abstract. Platelets play an important role in normal hemostasis and their number in the periphereal blood is normally very stable. Thrombocytopenia is frequently encountered in the clinic. As a first step, one has to exclude so called pseudothrombocytopenia due to preanalytic (EDTA as an anticoagulant) conditions. This can be done by determination of platelet counts in citrate or alternative (e. g. Thrombo-Exact) tubes or by performing a blood smear, where platelets are seen clumped. A blood smear is also the mainstay of further work-up as the differential diagnosis is very broad. In bleeding patients early therapeutic interventions have to be considered. Further work-up should be done stepwise and in collaboration with a hematologist. A definite diagnosis is essential in order to define specific therapeutic interventions, mainly in bleeding patients, in patients scheduled for surgery or patients taking antiaggregation and / or anticoagulation therapy.


Assuntos
Achados Incidentais , Trombocitopenia , Anticoagulantes/uso terapêutico , Ácido Edético , Humanos , Contagem de Plaquetas , Trombocitopenia/diagnóstico
7.
Ther Umsch ; 77(8): 371-378, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054645

RESUMO

Elevated liver function tests - as incidental finding in general practice Abstract. In general practice, elevated liver function tests are found in 25 % of patients presenting with unspecific symptoms or during a routine health checkup. Approximately 2.5 % of the general population are expected to show elevated values. Conversely, liver disease can present without abnormal liver function tests. Liver disease is not only frequent but may also imply a significant mortality. Worldwide its prevalence is steadily rising, and liver disease has become the fifth leading cause of death. Responsible for the rapidly increasing prevalence are primarily non-alcoholic fatty liver disease (NAFLD), alcohol-related liver disease (ARLD) and viral hepatitis. Due to the large range of possible differential diagnoses and the coexistence of aetiologies liver diseases represent a diagnostic challenge with important prognostic implication. In case of elevated liver function, a detailed medical history and a thorough clinical examination should be performed first. This allows narrowing down possible causes to the few most likely differential diagnoses. Subsequently, depending on the level of elevated liver function and the clinical presentation as hepatitis or cholestasis, screening tests for differential liver diseases are performed. Laboratory diagnostics and obligatory ultrasound scan can be supplemented by non-invasive methods (e. g. elastography, MRI / MRCP / CT) and in selected cases invasive methods (liver biopsy, ERCP). In the following article we delineate the diagnostic approach to elevated liver function tests using algorithms.


Assuntos
Medicina de Família e Comunidade , Achados Incidentais , Humanos , Testes de Função Hepática , Imagem por Ressonância Magnética , Ultrassonografia
8.
Ther Umsch ; 77(8): 385-389, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054647

RESUMO

Arrhythmia as an Incidental Finding Abstract. An arrhythmic pulse can be determined using clinical or technical examinations such as palpitation and ECG. Due to the rapid spread of wearables, more and more people have the opportunity to derive pulse curves or even ECGs themselves before seeking professional medical care, which increases the number of randomly detected arrhythmic pulse. Incidental findings naturally lead to relevant diagnoses in some of the people affected, but on the other hand they are also psychologically stressful for some individuals. Therefore, it is important to differentiate frequently found common benign causes from the causes with therapeutic consequence and to adequately inform patients about their rhythm. In particular bradyarrhythmias often have no therapeutic consequence as long as the patient remains asymptomatic. Pacemakers are usually only indicated for symptomatic bradycardia. Atrial fibrillation deserves special attention due to its frequency and the fact that, if undetected, this is associated with significantly increased morbidity and mortality. Supraventricular and ventricular extrasystoles increase with age. They are often "idiopathic", but they also can be an expression of still subclinical heart disease.


Assuntos
Fibrilação Atrial , Achados Incidentais , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/terapia , Bradicardia/diagnóstico , Bradicardia/terapia , Eletrocardiografia , Humanos
9.
Ther Umsch ; 77(8): 349-356, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054648

RESUMO

A heart murmur - a frequent incidental finding Abstract. Heart murmurs are very common and are present in up to 80 % of school children and 52 % of adults. They originate from the transition from laminar to turbulent blood flow in patients with a structural cardiomyopathy (so-called "organic" murmurs) or in patients with normal hearts (so-called "innocent" murmurs). A detailed history and physical examination help to discriminate innocent from organic murmurs. With the wide availability of transthoracic echocardiography (TTE) cardiac auscultation has lost a lot of its importance, although it remains an important skill for the initial evaluation and triage. An innocent murmur is a minor (1 / 6 - 2 / 6), crescendo-decrescendo, mostly position-dependent, mid-systolic murmur without radiation, which needs no further workup in asymptomatic patients with normal physical capacity. A TTE should be ordered if signs for a cardiac disease are present based on history, physical examination or other tests. Diastolic and continuous murmurs are mostly pathologic and warrant further workup.


Assuntos
Sopros Cardíacos , Achados Incidentais , Adulto , Criança , Ecocardiografia , Auscultação Cardíaca , Sopros Cardíacos/diagnóstico , Humanos , Exame Físico
10.
Ther Umsch ; 77(8): 401-405, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054652

RESUMO

Incidental finding of a high creatinine Abstract. In up to 10 % of patient visiting their General Practitioner and having blood tests an elevated creatinine or reduced kidney function are detected incidentally by the often automatically reported estimation of glomerular filtration rate (eGFR) by a creatinine-based formula. The most important step in this situation is to evaluate whether reduced kidney function is due to chronic kidney disease or whether the patient presents with an acute kidney injury (AKI). Early detection of AKI is crucial as any delay in accurate therapy can lead to further decline of kidney function and elevated mortality. In addition, intrinsic kidney diseases, which are less common should not be missed because early access to specialised management is crucial. Clinical history including history of medication, context of consultation, clinical evaluation and additional laboratory values will help to provide a first suspicion diagnosis. Further investigations (abdominal sonography, urinary sediment, proteinuria) will help to confirm the diagnosis. In any case of absence of an obvious cause of AKI, young patient, threatening severe renal insufficiency with rapid progression of kidney failure or suspicious laboratory abnormalities, the patient should be referred without any delay to a nephrologist for further evaluation and management.


Assuntos
Lesão Renal Aguda , Insuficiência Renal Crônica , Lesão Renal Aguda/diagnóstico , Creatinina , Taxa de Filtração Glomerular , Humanos , Achados Incidentais
11.
Tokai J Exp Clin Med ; 45(3): 144-147, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901904

RESUMO

A 14 year-old girl with a previous medical history of cholecystic polyps was referred to our department with throat discomfort during swallowing. The cervical ultrasound and magnetic resonance imaging revealed a massive polycystic formation with a diameter of 45 × 24 × 31 mm consistent with a right lobe goiter. However, there were no findings for suspected malignancy. Hemithyroidectomy was performed and the specimen was sent for histopathological assessment. Hematoxylin-eosin staining of the right lower nodule showed variably-sized follicles consistent with adenomatous goiter. The right upper nodule showed a growth of relatively compact sized follicles with a thick fibrous capsule. A satellite nodule lying outside of the tumor capsule was consistent with minimally invasive follicular thyroid microcarcinoma. We observed her without any additional treatment and no recurrence is seen at present.


Assuntos
Carcinoma/patologia , Bócio/patologia , Bócio/cirurgia , Achados Incidentais , Neoplasias da Glândula Tireoide/patologia , Adolescente , Feminino , Bócio/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Microscopia Acústica , Tireoidectomia/métodos
12.
Praxis (Bern 1994) ; 109(11): 879-887, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32873165

RESUMO

CME: Pituitary Incidentaloma in Adults: Key Knowledge for the General Practice Abstract. Incidentally detected pituitary masses, so-called pituitary incidentalomas, are increasing in frequency as the frequency of performing imaging increases. Evaluation of the imaging from a trained neuroradiologist as well as additional endocrinological and, if necessary, neuroophtalmological studies are part of the initial assessment that drives the treatment decision: in the case of benign small lesions with unremarkable assessment results, follow-up is indicated, whereas potentially malignant lesions or lesions with endocrinological or neuroophtalmological irregularities are usually treated. In borderline cases, interdisciplinary work is beneficial for the determination of the case-specific treatment procedure.


Assuntos
Medicina Geral , Neoplasias Hipofisárias , Adulto , Humanos , Achados Incidentais , Neoplasias Hipofisárias/diagnóstico
13.
Praxis (Bern 1994) ; 109(12): 952-954, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32933395

RESUMO

CME/Answers: Pituitary Incidentaloma in Adults: Key Knowledge for the General Practice Abstract. Incidentally detected pituitary masses, so-called pituitary incidentalomas, are increasing in frequency as the frequency of performing imaging increases. Evaluation of the imaging from a trained neuroradiologist as well as additional endocrinological and, if necessary, neuroophtalmological studies are part of the initial assessment that drives the treatment decision: in the case of benign small lesions with unremarkable assessment results, follow-up is indicated, whereas potentially malignant lesions or lesions with endocrinological or neuroophtalmological irregularities are usually treated. In borderline cases, interdisciplinary work is beneficial for the determination of the case-specific treatment procedure.


Assuntos
Medicina Geral , Neoplasias Hipofisárias , Adulto , Medicina de Família e Comunidade , Humanos , Achados Incidentais , Neoplasias Hipofisárias/diagnóstico
14.
Medicine (Baltimore) ; 99(38): e22307, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957393

RESUMO

RATIONALE: Schwannoma is a benign peripheral nerve sheath tumor composed of Schwann cells and caused by genetic mutation or deletion. It rarely occurs in seminal vesicles. The optimal therapic strategy for asymptomatic cases is still unclear. PATIENT CONCERNS: A 42-year-old man presented no clinical symptoms. A mass in his left seminal vesicle was found incidentally in a computed tomography scan and transrectal ultrasound-guided biopsy revealed the mass was schwannoma. DIAGNOSIS: The patient was diagnosed as schwannoma of the seminal vesicle with no significant extension to the surrounding tissues. INTERVENTIONS: The patient underwent computed tomography or magnetic resonance imaging scans periodically to estimate the alteration of the lesion and further strategy. OUTCOMES: After 20-month follow-up, computed tomography scans showed no significant alteration to the lesion and no clinical symptoms were reported by the patient. LESSONS: Conservative strategy might be an effective treatment option for asymptomatic patients with seminal vesical schwannoma. The period of follow-up depends on the size of the tumor.


Assuntos
Tratamento Conservador/métodos , Neoplasias dos Genitais Masculinos/terapia , Neurilemoma/terapia , Adulto , Neoplasias dos Genitais Masculinos/diagnóstico por imagem , Neoplasias dos Genitais Masculinos/patologia , Humanos , Achados Incidentais , Imagem por Ressonância Magnética , Masculino , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Glândulas Seminais/diagnóstico por imagem , Glândulas Seminais/patologia , Tomografia Computadorizada por Raios X
15.
J Med Imaging Radiat Oncol ; 64(5): 671-673, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32945110

RESUMO

We report the case of who has been hospitalized complaining about fever in the last 4 days. Laboratory data revealed lymphocytopenia and leucopenia with an elevation of C-reactive protein and positive real-time reverse transcription-polymerase chain reaction (RT-PCR). Six days before this hospitalization, when the patient was asymptomatic, 18 F-FDG PET/CT images were performed for the therapeutic control of liver metastases of colorectal cancer. Lung abnormality findings at 18 F-FDG PET/CT images, unrelated to cancer metastases, but suspicious for viral infection, may suggest the presence of COVID-19 disease in its early phase before symptoms onset. Since PET/CT is more sensitive than CT scan in detecting host's reaction, the added value of this technique could be monitoring disease progression and could be used as a biomarker of lung disease activity and therefore as an important tool for a better understanding of the factors that contribute to the progression of lung disease.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Betacoronavirus , Neoplasias Colorretais/patologia , Progressão da Doença , Fluordesoxiglucose F18 , Humanos , Achados Incidentais , Neoplasias Hepáticas/secundário , Pandemias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
16.
Medicine (Baltimore) ; 99(39): e22495, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991489

RESUMO

RATIONALE: Cavernous hemangioma is a benign vascular tumor, which very rarely occurs in the lung. When appearing as multiple nodules on chest CT, this tumor can be misdiagnosed as metastatic malignancy. PATIENT CONCERNS: A 72-year-old woman presented with incidentally found multiple lung nodules on chest radiograph. DIAGNOSES: Based on information derived from dual-layer spectral CT images, the possibility of slow flow vascular tumor such as cavernous hemangioma was suggested. A pathologic diagnosis of pulmonary cavernous hemangioma was made via video-assisted thoracoscopic biopsy. INTERVENTIONS: After tissue confirmation, the patient was discharged without further intervention. OUTCOMES: The patient recovered without any event. Follow-up chest CT performed 6 months later showed no significant interval change in nodule size and distribution. LESSONS: Material decomposition images obtained from dual energy CT can help physicians understand the character of tumor vascularity for an accurate diagnosis of pulmonary cavernous hemangioma.


Assuntos
Hemangioma Cavernoso/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Idoso , Feminino , Humanos , Achados Incidentais , Radiografia Torácica , Tomografia Computadorizada por Raios X
17.
Proc Natl Acad Sci U S A ; 117(40): 24790-24793, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-32948692

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, is considered a zoonotic pathogen mainly transmitted human to human. Few reports indicate that pets may be exposed to the virus. The present report describes a cat suffering from severe respiratory distress and thrombocytopenia living with a family with several members affected by COVID-19. Clinical signs of the cat prompted humanitarian euthanasia and a detailed postmortem investigation to assess whether a COVID-19-like disease was causing the condition. Necropsy results showed the animal suffered from feline hypertrophic cardiomyopathy and severe pulmonary edema and thrombosis. SARS-CoV-2 RNA was only detected in nasal swab, nasal turbinates, and mesenteric lymph node, but no evidence of histopathological lesions compatible with a viral infection were detected. The cat seroconverted against SARS-CoV-2, further evidencing a productive infection in this animal. We conclude that the animal had a subclinical SARS-CoV-2 infection concomitant to an unrelated cardiomyopathy that led to euthanasia.


Assuntos
Betacoronavirus/isolamento & purificação , Cardiomiopatia Hipertrófica/veterinária , Infecções por Coronavirus/veterinária , Pandemias/veterinária , Pneumonia Viral/veterinária , Animais , Cardiomiopatia Hipertrófica/patologia , Cardiomiopatia Hipertrófica/virologia , Gatos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Evolução Fatal , Humanos , Achados Incidentais , Pneumonia Viral/complicações , Pneumonia Viral/patologia
18.
Neurol Sci ; 41(11): 3063-3065, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32965525

RESUMO

BACKGROUND: Fahr's syndrome (or Fahr's disease) is a rare, neurological disorder characterized by bilateral calcification in the cerebellum, thalamus, basal ganglia, and cerebral cortex as a result of calcium and phosphorus metabolism disorder. The patients may be asymptomatic and clinical symptoms represent a wide range of neurologic manifestations and nonspecific neuropsychiatric disorders. We report an unusual case of Fahr's syndrome which was asymptomatic and incidentally diagnosed by generalized tonic-clonic seizure in a patient with SARS-CoV-2 (COVID-19) pneumonia. CASE PRESENTATION: The patient was a 68-year-old female and admitted to our emergency department suffering from cough and fatigue. After thorax computed tomography (CT) and SARS-CoV-2 PCR test, she was diagnosed as COVID-19 pneumonia. In the intensive care unit, the patient had a tonic-clonic convulsion starting from the left arm and spreading to the whole body. Fahr's syndrome was diagnosed after a cranial CT scan and blood metabolic panel test. CONCLUSIONS: As a result of the clinical, radiological, and biochemical evaluations, the patient was diagnosed incidentally as Fahr's syndrome associated with hypoparathyroidism. Seizures could be induced by hydroxychloroquine that was in the COVID-19 treatment or the inflammation caused by COVID-19 pneumonia. The association between the mortality of COVID-19 pneumonia and Fahr's syndrome is unknown which needs further research.


Assuntos
Doenças dos Gânglios da Base/diagnóstico , Calcinose/diagnóstico , Infecções por Coronavirus/complicações , Doenças Neurodegenerativas/diagnóstico , Pneumonia Viral/complicações , Convulsões/etiologia , Idoso , Doenças dos Gânglios da Base/complicações , Betacoronavirus , Calcinose/complicações , Evolução Fatal , Feminino , Humanos , Achados Incidentais , Doenças Neurodegenerativas/complicações , Pandemias , Pneumonia Viral/virologia
19.
Medicine (Baltimore) ; 99(30): e21094, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791684

RESUMO

RATIONALE: Excessive ingestion of licorice can cause pseudohyperaldosteronism. A few case reports in the available literature have described significant hypokalemia secondary to licorice consumption with clinical manifestations of muscle weakness, paralysis, or severe hypertension. To our knowledge, no report has discussed severe asymptomatic hypokalemia associated with licorice consumption. PATIENT CONCERNS: A 79-year-old man presented to the urology clinic with a several-month history of urinary frequency and a weak stream. Routine laboratory investigations revealed serum potassium (K) level of 1.8 mmol/L, and he was immediately admitted to the nephrology department. DIAGNOSES: He was in a good state of health, and systemic and neurological examinations were unremarkable. However, laboratory investigations revealed severe hypokalemia and metabolic alkalosis accompanied with renal K wasting and hypertension, suggesting a state of mineralocorticoid excess. Hormonal studies revealed low serum renin and aldosterone but normal serum cortisol levels. Detailed history taking revealed that he had used licorice tea daily during the preceding 18 months. INTERVENTIONS AND OUTCOME: The patient's serum K returned to normal levels after vigorous K replacement and discontinuation of licorice intake. He was also diagnosed with benign prostatic hyperplasia during hospitalization and was treated. LESSONS: Chronic licorice ingestion can precipitate severe hypokalemia, although patients may remain asymptomatic. This case report indicates that the severity of a patient's clinical presentation depends on individual susceptibility, as well as the dose and duration of licorice intake.


Assuntos
Glycyrrhiza/efeitos adversos , Hipopotassemia/etiologia , Preparações de Plantas/efeitos adversos , Chás de Ervas/efeitos adversos , Idoso , Doenças Assintomáticas , Humanos , Hipopotassemia/sangue , Achados Incidentais , Masculino , Preparações de Plantas/administração & dosagem , Potássio/sangue
20.
Plast Reconstr Surg ; 146(2): 117e-126e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740565

RESUMO

BACKGROUND: Occult breast carcinoma is occasionally found in breast reduction specimens. Although its incidence varies widely, there is a trend toward an increased incidence for women with a history of breast cancer. The authors performed a systematic review and meta-analysis of occult carcinoma incidence in breast reduction specimens. METHODS: The MEDLINE and Embase databases were searched for peer-reviewed studies with no language restrictions for studies that recorded the incidence of occult carcinoma in breast reduction specimens. Cancer incidence per specimen was pooled for women with and without a history of breast cancer. RESULTS: Forty-two studies were eligible for inclusion, of which 29 were quantitatively analyzed. The pooled incidence of carcinoma was higher within specimens from women with breast cancer (3.4 percent; 95 percent CI, 2.2 to 5.3 percent) than without (0.6 percent; 95 percent CI, 0.4 to 0.8 percent), and this increased likelihood was significant when populations were compared directly (OR, 6.02; 95 percent CI, 3.06 to 11.86; p < 0.0001). CONCLUSIONS: Women with a history of breast cancer have an increased incidence of occult breast carcinoma within their breast reduction specimens compared with women with no breast cancer history. There is a need for preoperative radiology screening, counseling, and histopathology guidelines to ensure adequate diagnosis and management of these women.


Assuntos
Neoplasias da Mama/cirurgia , Mama/cirurgia , Mamoplastia/efeitos adversos , Programas de Rastreamento/métodos , Mastectomia Segmentar/efeitos adversos , Recidiva Local de Neoplasia/epidemiologia , Mama/patologia , Neoplasias da Mama/diagnóstico , Feminino , Saúde Global , Humanos , Incidência , Achados Incidentais , Recidiva Local de Neoplasia/etiologia
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