Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 868
Filtrar
1.
BMJ Case Rep ; 14(2)2021 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-33563676

RESUMO

Retained thymic tissue may occur anywhere along the path of descent of the thymus. Cervical thymic cysts are a rare cause of benign neck masses. Thymopharyngeal duct cysts are thymic cysts that span the length of the neck and extend towards the mediastinum. These lesions are rare and classically have been described in paediatric patients. Here, we present the case of a 23-year-old woman with a left-sided neck mass, which was found to be a thymopharyngeal duct cyst. Multiple analytic modalities including the clinical presentation, imaging, operative findings and histology were required to confirm the diagnosis and are discussed below.


Assuntos
Cisto Mediastínico/diagnóstico , Cisto Mediastínico/cirurgia , Doenças Faríngeas/diagnóstico , Doenças Faríngeas/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Adulto Jovem
2.
J Craniofac Surg ; 31(5): e520-e522, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32569056

RESUMO

Cervical thymic cysts are rare and present in the first decade of life. They constitute 0.3% to 1% of congenital neck masses. Thymic tissue foci, which exist between the mandible and the mediastinum, can be found at the descent of the thymic primordium. Thymic cysts should be considered in pediatric patients who present with cervical neck masses. The diagnosis of thymic cysts can only be made by histopathologic examinations. In recent years, the number of reports of thymic cyst cases have increased, one possible cause being the heightened awareness of thymic cysts among pathologists.


Assuntos
Cisto Mediastínico/cirurgia , Pescoço/cirurgia , Criança , Humanos , Masculino , Cisto Mediastínico/diagnóstico
3.
Ann Thorac Surg ; 110(2): e107-e109, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31987824

RESUMO

Cystic thymoma is a rare clinicopathologic entity. Chronic inflammation within and around these tumors has been suggested to compromise the vascular supply, leading to hemorrhage into the lesion and necrosis. This can result in rapid expansion of the tumor and symptoms owing to local compression. We present the case of a patient with a biopsy-proven lymphocytic-predominant thymoma who underwent resection to reveal a hemorrhagic, necrotic mediastinal cyst adjacent to a focus of organizing pneumonia, with no residual thymoma.


Assuntos
Cisto Mediastínico/cirurgia , Timoma/cirurgia , Neoplasias do Timo/cirurgia , Idoso , Humanos , Masculino , Cisto Mediastínico/complicações , Timoma/complicações , Neoplasias do Timo/complicações
4.
Kyobu Geka ; 72(12): 989-992, 2019 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-31701908

RESUMO

Mediastinal enteric cysts are very rare among in adults and usually asymptomatic. A 54-year-old male was referred to our hospital due to an abnormal shadow incidentally found on a chest X-ray at health check. Chest computed tomography scan revealed a cystic mass in the posterior and inferior mediastinum surrounded by diaphragm, inferior vena cava, and esophagus. Based on many reports of thoracoscopic esophagectomy in the prone position in recent years, we chose thoracoscopic resection of the mediastinal tumor in the prone position with artificial pneumothorax. The prone position with artificial pneumothorax provided much better exposure of the operating field and the surgery was performed successfully.


Assuntos
Cisto Mediastínico , Pneumotórax Artificial , Esofagectomia , Humanos , Masculino , Cisto Mediastínico/cirurgia , Pessoa de Meia-Idade , Posicionamento do Paciente , Decúbito Ventral , Toracoscopia
5.
Acta Medica (Hradec Kralove) ; 62(3): 117-122, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31663505

RESUMO

Cervical thymic cyst is a rare clinical entity, with approximately one hundred cases reported in the literature so far. The purpose of this case report is to highlight some certain features, along with an extensive research of the relevant literature. A 6-year-old boy was admitted to the Otorhinolaryngology Department due to the presence of a left-sided, painless, latero-cervical swelling, first observed by his parents 2 weeks ago. Physical examination revealed a painless, well-delineated mass, with no signs of inflammation. No enlarged cervical nodes were present. The mass extended from the mandibular angle, under the sternocleidomastoid muscle, in proximity with the ipsilateral neurovascular bundle. Ultrasound transverse gray-scale panoramic view detected a wellcircumscribed lesion, with fine echogenic foci, appearing in close proximity with the upper pole of the left thyroid lobe and the ipsilateral common carotid artery. Elective surgical intervention with complete mass excision was performed. Histopathological examination confirmed the diagnosis of a cervical thymic cyst. Cervical thymic remnants represent a group of neck masses that pediatricians and pediatric surgeons should consider in differential diagnosis of both cystic and solid neck masses. Most cystic cervical thymic masses are found in the lower third of the anterior neck, extending deep to the sternocleidomastoid muscle, featuring close anatomic relationship with the composites of the ipsilateral carotid sheath. Elective surgery is kept as the treatment of choice, after ruling out the possibility of subject immunologic disturbance.


Assuntos
Coristoma , Cisto Mediastínico , Pescoço , Timo , Criança , Coristoma/diagnóstico , Coristoma/cirurgia , Humanos , Masculino , Cisto Mediastínico/diagnóstico , Cisto Mediastínico/cirurgia
6.
BMJ Case Rep ; 12(9)2019 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-31533948

RESUMO

The presentation of a fast-growing cervical mass necessitates prompt attention due to risk of the mass effect on vital structures and requires preferential screening for infections, bleeding and malignancies in an extensive list of differential diagnoses. This case report describes a 4.5-year-old boy with a fast-growing, unilateral lesion in the neck, with clinical features in keeping with malignant characteristics. Surgical excision with pathocytological examination revealed an exceptional diagnosis of haemorrhage in an ectopic cervical thymic cyst. Thymic cysts are a rare cause of unilateral masses in the neck, usually presenting as an asymptomatic, painless, slow-growing or stable mass anywhere along the thymopharyngeal duct. Spontaneous haemorrhages in thymic tissue can occur, often due to coagulation defects. Treatment of symptomatic thymic cysts is based on surgical excision. Partial resection of the thymus should be encouraged if possible, since clinical consequences of removing all thymic tissue in children are still unclear.


Assuntos
Coristoma/diagnóstico , Doenças Linfáticas/diagnóstico , Cisto Mediastínico/diagnóstico , Timo , Biópsia , Pré-Escolar , Coristoma/cirurgia , Diagnóstico Diferencial , Humanos , Doenças Linfáticas/cirurgia , Imagem por Ressonância Magnética , Masculino , Cisto Mediastínico/cirurgia , Lesões Pré-Cancerosas
8.
J Cardiothorac Surg ; 14(1): 134, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286963

RESUMO

BACKGROUND: Heterotopia of pancreatic tissue in the thorax and mediastinum is uncommon, although, a common developmental anomaly in the gastrointestinal tract where the aberrant tissue is a component of gastrointestinal duplication cysts, intralobular pulmonary sequestration or teratomas. CASE PRESENTATION: We report a case of an ectopic pancreas located in a giant mediastinal cyst in a 2-year old girl who presented with severe dyspnoea due to external compression of the intra-thoracic structures, mainly the right main bronchus. Surgical resection was carried out with complete relief of symptoms. The cyst was confirmed histopathologically to contain pancreatic tissue. Literature review showed that this is an uncommon presentation hence the need to report the case. CONCLUSION: Heterotopia of the pancreas although, an uncommon occurrence in the thorax and mediastinum, should be considered when dealing with cystic lesions of the mediastinum and surgery plays an important role in its management. TRIAL REGISTRATION: JUTH/DCS/ADM/127/XXV/203. Registered 2nd September 2018.


Assuntos
Coristoma/diagnóstico , Cisto Mediastínico/diagnóstico , Pâncreas , Pré-Escolar , Coristoma/cirurgia , Feminino , Humanos , Cisto Mediastínico/cirurgia
9.
J Craniofac Surg ; 30(4): e295-e297, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31166271

RESUMO

Cervical thymic cyst is rare lesions leading to cervical mass. As it is a rare entity, it might be confused with other congenital neck masses or neoplastic lesions. Preoperative diagnosis is almost impossible. In the present study, a patient who was operated with prediagnosis of branchial cyst and diagnosed with thymic cyst according to the histopathologic examination was presented. A 16-month-old girl was admitted to our clinic with the complaint of growing right neck mass that was realized about 4 months ago. Magnetic resonance imaging (MRI) of the neck demonstrated a rim-enhanced hypointense cystic lesion in the posterior aspect of the submandibular gland, without tracheal right lateral and mid plane on MRI, curving common carotid artery to the medial. Patients underwent surgery under general anesthesia in company with existing findings. Hypoglossal nerve was surrounded by the mass, and the mass was totally resected. The final pathology result was reported as thymic cyst. Cervical thymic masses might be unnoticed in the differential diagnosis of the cervical mass as they are rarely seen entities. Histopathologic examination of the thymus tissue was performed for diagnosis. Surgical excision is the ideal treatment approach and no postoperative recurrence has been reported.


Assuntos
Nervo Hipoglosso/cirurgia , Cisto Mediastínico/diagnóstico , Anestesia Geral , Branquioma/diagnóstico , Branquioma/cirurgia , Artéria Carótida Primitiva , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Cisto Mediastínico/cirurgia , Imagem Multimodal , Ultrassonografia
10.
Clin Neurol Neurosurg ; 180: 87-96, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30952036

RESUMO

OBJECTIVE: Evaluation of the presentation and outcomes associated with surgical marsupialisation of spinal arachnoid cysts and formulation of a putative hypothesis explaining their pathogenesis. PATIENTS AND METHODS: Cases were identified from electronic and theatre records at a single centre. All patients underwent pre-operative assessment and radiographic evaluation with subsequent spinal multidisciplinary discussion. Following surgery patients were reviewed at 6, 12 weeks, 6-months and beyond. RESULTS: A total of 17 patients with dorsal thoracic arachnoid cysts with a mean age at time of surgery of 58 years with a male to female ratio of 1.8:1 were identified. Paraesthesia (76%), neuropathic pain (76%), weakness (47%) and unsteadiness (53%) were the commonest presenting complaints. Abnormal gait (76%), altered sensation (71%) and weakness (47%) were the most commonly observed signs. Average cyst volume was observed to be 2570 mm3 (sd ±1682, range 544 to 7644 mm3), spanning a median of 2 thoracic levels, with a resultant reduction of cord volume of 33% (sd 12%). A syrinx was associated with 35% of SAC. All cases underwent marsupialisation of the arachnoid cyst. Six months following surgery all patients experienced improvement in at least of one their presenting symptoms and or clinical signs. Weakness, gait and paraesthesia were most likely to improve following surgery. Only 29% of cases had resolution of neuropathic pain, with 13% of the rest reporting an improvement in the sensitivity component of their pain. Clinical improvements correlated with an average 45% (sd 18%) volume increase in previously compressed cord. CONCLUSION: Intradural arachnoid cysts commonly present with paraesthesia, neuropathic pain and gait disturbance. Marsupialisation of the SAC heralds immediate and long-term improvement in symptoms. Cysts putatively arise within a dissection in the septum posticum and give rise to both dynamic and static compression of cord parenchyma secondary to the complex CSF flow dynamics within the thoracic spine.


Assuntos
Cistos Aracnóideos/cirurgia , Doenças da Medula Espinal/cirurgia , Adulto , Idoso , Cistos Aracnóideos/diagnóstico , Cistos Aracnóideos/fisiopatologia , Feminino , Transtornos Neurológicos da Marcha/etiologia , Humanos , Masculino , Cisto Mediastínico/diagnóstico , Cisto Mediastínico/fisiopatologia , Cisto Mediastínico/cirurgia , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Neuralgia/etiologia , Procedimentos Neurocirúrgicos , Parestesia/etiologia , Estudos Retrospectivos , Medula Espinal/diagnóstico por imagem , Medula Espinal/patologia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/fisiopatologia , Resultado do Tratamento
11.
Pediatr Surg Int ; 35(6): 673-677, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30838439

RESUMO

BACKGROUND: Foregut duplication cysts (FD) with a common muscular wall with the oesophagus are well recognised. Our case series highlights the existence of a common wall between superior mediastinal FD and the tracheo-bronchial tree. MATERIALS AND METHODS: Over the last 15 years, we have thoracoscopically resected 41 FD. Five cases were identified to have a common wall with the tracheo-bronchial tree at operation. The clinical history, radiology, findings at operation and pathology were evaluated to highlight learning points. RESULTS: Five superior mediastinal cysts with a common wall were identified, with two antenatally and three postnatally diagnosed. All three postnatal cases and one antenatal case presented with symptoms of respiratory compromise and stridor. Only one neonate was relatively asymptomatic before resection. CT similarities in all cases were: separation of trachea and oesophagus by the cyst, oesophageal deviation to the right or compression and compression of trachea/bronchus. Thoracoscopically, two cysts were resected without injury to the airway, while three had inadvertent tracheo-bronchial injury. Repair of the tracheal injury was possible in one case thoracoscopically, while two cases required conversions, as adequate oxygenation could not be maintained despite on-table endotracheal tube advancement beyond the injury and thoracoscopic manoeuvres. All cases had excellent outcomes at follow-up (median 25months, range 4-39months) with resolution of symptoms and no recurrences. CONCLUSIONS: Our report highlights the existence of a common wall between the superior mediastinal FD and the tracheo-bronchial tree. Thoracoscopic resections are feasible including repair of inadvertent airway injury, provided adequate oxygenation can be maintained.


Assuntos
Brônquios/diagnóstico por imagem , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/cirurgia , Traqueia/diagnóstico por imagem , Criança , Pré-Escolar , Esôfago/diagnóstico por imagem , Feminino , Humanos , Lactente , Recém-Nascido , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Sons Respiratórios/etiologia , Estudos Retrospectivos , Toracoscopia , Tomografia Computadorizada por Raios X
14.
Surg Laparosc Endosc Percutan Tech ; 29(3): e34-e36, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30801391

RESUMO

We herein report a case of myasthenia gravis (MG) in which thoracoscopic thymectomy was performed for a large thymic cystic lesion using a subxiphoid approach. We have previously suggested the usefulness of the subxiphoid approach in thymectomy. The indications of thoracoscopic thymectomy were recently expanded to include large thymic cystic lesions without intraoperative rupture of the lesions. The pathologic diagnosis of the lesion in the present case was multilocular thymic cyst with type A thymoma and micronodular thymoma. The postoperative complications were minimal without MG crisis. Thoracoscopic thymectomy using a subxiphoid approach seems to be an ideal procedure, even for large thymic cystic lesions. In addition, early-onset MG with a large thymic cystic lesion may suggest the presence of a small thymoma even if the lesion is not detected on a preoperative radiologic examination.


Assuntos
Cisto Mediastínico/cirurgia , Miastenia Gravis/complicações , Toracoscopia/métodos , Timoma/complicações , Neoplasias do Timo/complicações , Adulto , Feminino , Humanos , Achados Incidentais , Cisto Mediastínico/complicações , Cisto Mediastínico/diagnóstico por imagem , Cuidados Pré-Operatórios , Timoma/diagnóstico , Timoma/cirurgia , Neoplasias do Timo/diagnóstico , Neoplasias do Timo/cirurgia , Tomografia Computadorizada por Raios X
16.
J Med Case Rep ; 13(1): 1, 2019 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-30611283

RESUMO

BACKGROUND: Intrathoracic mesothelial cysts almost always arise in the mediastinum, and extramediastinal mesothelial cysts are extremely rare. Here we describe a case of mesothelial cyst derived from the chest wall pleura growing after thoracic surgery. CASE PRESENTATION: A 63-year-old Japanese woman was referred to our department. She had undergone total hysterectomy for cervical carcinoma and two lung wedge resections for metastatic lung cancer on the upper and lower lobes of her right lung and lower lobe of her left lung. After the thoracic surgery, an intrathoracic chest wall mass was found, which grew gradually. Computed tomography demonstrated a 2.0 × 1.8 cm low-density mass without contrast effect. Magnetic resonance imaging demonstrated a low-intensity mass in T1-weighted imaging and a high-intensity mass in T2-weighted imaging. Thoracoscopic excision of the mass was performed. The cystic mass was thought to be derived from her chest wall and was pathologically diagnosed as mesothelial cyst. Five years after the surgery, she has no evidence of recurrence of the cyst or cervical carcinoma. CONCLUSIONS: The genesis of extramediastinal mesothelial cysts may be related to inflammation. From this perspective, extramediastinal mesothelial cysts may have different characteristics from pericardial cysts and resemble peritoneal inclusion cysts. Although, extramediastinal mesothelial cysts are not established, their characteristics resemble peritoneal inclusion cysts; therefore, such interesting intrathoracic cysts should be carefully resected considering the risk.


Assuntos
Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Procedimentos Cirúrgicos Torácicos , Parede Torácica/diagnóstico por imagem , Parede Torácica/cirurgia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Pleura/diagnóstico por imagem , Pleura/cirurgia , Tomografia Computadorizada por Raios X
17.
J Cardiothorac Surg ; 14(1): 18, 2019 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-30670039

RESUMO

BACKGROUND: Video-assisted thoracic surgery (VATS) for mediastinal cysts has been used with increasing frequency. Both single-port VATS and three-port VATS procedures are used for mediastinal cystectomy. Few studies have been published to compare three-port VATS and single-port VATS procedures in mediastinal cystectomy. METHODS: Forty-five patients with mediastinal cysts who underwent single-port procedures (n = 23) or three-port procedures (n = 22) in our department from January 2016 to July 2018 were retrospectively analysed. The perioperative conditions and pathological findings were analysed. RESULTS: The single-port group showed shorter operation times [45 (35-60) vs 55 (45-80) min, p = 0.013], less retention time of the thoracic drainage tube [27(24-48) vs 48(48-70) p < 0.001)], shorter postoperative hospital stays [5(4-6) vs 7(5-7), p = 0.011] and less costs [2.0)1.2-2.5) vs 2.5(1.9-3.5), p = 0.032] than those of the three-port group. No difference was found in case conversions to open procedures (p > 0.99) or second operations (p > 0.99). Logistic regression analysis showed that the surgical method (p = 0.426) and surgeon experience (p = 0.719) were not independent prognostic factors for the success of surgery. CONCLUSIONS: The single-port VATS procedure was not inferior to the three-port VATS procedure for mediastinal cystectomy. The single-port VATS procedure is a feasible choice for mediastinal cystectomy.


Assuntos
Cisto Mediastínico/cirurgia , Cirurgia Torácica Vídeoassistida/instrumentação , Toracoscópios , Adulto , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Período Pós-Operatório , Estudos Retrospectivos
18.
Clin Nucl Med ; 44(2): 150-152, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30516688

RESUMO

A 34-year-old man with end-stage renal failure status post rejection of a deceased donor kidney transplant presented with bone pain in the setting of elevated serum parathyroid hormone and calcium levels. A Tc-MIBI SPECT/CT was performed before planned subtotal parathyroidectomy. SPECT/CT imaging revealed a 1.9-cm anterior mediastinal lesion with radiotracer uptake on both the immediate and delayed images. Surgical pathology of the lesion showed a benign thymic cyst with no parathyroid component.


Assuntos
Cisto Mediastínico/metabolismo , Tecnécio Tc 99m Sestamibi/metabolismo , Adulto , Transporte Biológico , Humanos , Masculino , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/cirurgia , Paratireoidectomia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único
19.
Thorac Cancer ; 10(1): 116-119, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30467988

RESUMO

A 44-year-old man was referred to our hospital after an anterior mediastinal tumor was noted on computed tomography during follow-up observation after left testicular seminoma resection. Chest computed tomography revealed an enhanced mass measuring 33 x 16 x 15 mm at the anterior mediastinum. Chest magnetic resonance imaging revealed high signal intensity on T2-weighted imaging, and F18 fluorodeoxyglucose-positron emission tomography showed a maximum standardized uptake of 12.45. Laboratory tests revealed no elevated tumor markers, except for mildly elevated interleukin-2. Based on these results, complete resection was performed under suspicion of a malignant tumor, mediastinal metastasis of seminoma, or malignant lymphoma. An extended thymectomy with partial merger pericardial resection was performed using a subxiphoid approach. Small nodules and multiple thymic cysts were observed the thymus in addition to the main mass. Microscopic examination of the tumor revealed fibrosis, lymphocyte infiltration with lymphoid follicular hyperplasia, and hyperplasia of the thymus. Numerous immunoglobulin G4 (IgG4)-positive plasma cells were found on immunohistochemical staining. The ratio of IgG4 to total IgG was approximately 60%. We ultimately diagnosed the patient with a thymic inflammatory pseudotumor with multilocular cyst caused by IgG4-related disease.


Assuntos
Granuloma de Células Plasmáticas/cirurgia , Doença Relacionada a Imunoglobulina G4/cirurgia , Cisto Mediastínico/cirurgia , Seminoma/cirurgia , Adulto , Granuloma de Células Plasmáticas/diagnóstico por imagem , Granuloma de Células Plasmáticas/etiologia , Granuloma de Células Plasmáticas/patologia , Humanos , Doença Relacionada a Imunoglobulina G4/diagnóstico por imagem , Doença Relacionada a Imunoglobulina G4/etiologia , Doença Relacionada a Imunoglobulina G4/patologia , Interleucina-2/genética , Imagem por Ressonância Magnética , Masculino , Cisto Mediastínico/complicações , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/patologia , Seminoma/complicações , Seminoma/diagnóstico por imagem , Seminoma/patologia , Timectomia , Tomografia Computadorizada por Raios X
20.
J Cardiothorac Surg ; 13(1): 120, 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458821

RESUMO

BACKGROUND: Intra-thymic bronchogenic cysts are a rare entity but should be considered in the differential of all non-invasive thymic masses. CASE PRESENTATION: We describe a 50-year-old patient who was found to have an incidental thymic mass on computer tomography of the chest. Non-invasive thymoma was suspected and a thoracoscopic thymectomy was performed. Final pathology revealed a bronchogenic cyst. CONCLUSION: Intra-thymic bronchogenic cysts are extremely rare tumors of the anterior mediastinum. It should be considered in differential diagnosis of anterior mediastinal masses.


Assuntos
Cisto Broncogênico/cirurgia , Cisto Mediastínico/cirurgia , Mediastino/cirurgia , Cisto Broncogênico/complicações , Cisto Broncogênico/diagnóstico por imagem , Cisto Broncogênico/patologia , Feminino , Humanos , Hipotireoidismo/complicações , Cisto Mediastínico/complicações , Cisto Mediastínico/diagnóstico por imagem , Cisto Mediastínico/patologia , Pessoa de Meia-Idade , Timectomia , Tomografia Computadorizada por Raios X
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...