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1.
S D Med ; 73(2): 54-58, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32135052

RESUMO

Primary lung tumors are very rare in children and constitute only 0.2 percent of all pediatric malignancies. Carcinoids are the most common primary pediatric lung tumor and account for 80 percent of all primary malignant bronchial tumors. Carcinoid tumors can be histologically categorized as typical or atypical. They are derived from neuroendocrine cells in the bronchial epithelium and are locally infiltrative. Surgical resection of endobronchial carcinoid tumors is the mainstay of treatment with a five-year survival of 95 percent. Endoscopic resection has been reported in adult patients with typical carcinoid tumors (less than 20 mm) with no extrabronchial disease. We present the first pediatric bronchial carcinoid tumor treated with endoscopic resection.


Assuntos
Tumor Carcinoide , Neoplasias Pulmonares , Pneumonia , Adulto , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico , Criança , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Pneumonia/etiologia , Síndrome
2.
Medicina (Kaunas) ; 55(12)2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31783507

RESUMO

Cushing's syndrome (CS) is a set of clinical symptoms which occur as a result of hypercortisolemia. Endogenous ACTH-dependent CS related to an ectopic ACTH-secreting tumour constitutes 12%-17% of CS cases and is one of the most common causes of paraneoplastic syndromes. This study presents a case of a 31 year-old man with diabetes, hypertension, rosacea, purple stretch marks and hypokalemia. Findings of diagnostic procedures include high concentrations of cortisol and ACTH, pituitary microadenoma and a tumour in the anterior mediastinum. Dynamic hormone tests determined the source of excess hormone secretion and ectopic ACTH-dependent CS was diagnosed. Due to increasing symptoms of superior vena cava syndrome, an emergency resection of almost the whole tumour was performed, with only a small part of the upper pole left because of the proximity of large vessels and a risk of damaging them. On the basis of histopathological tests, an atypical carcinoid tumour of the thymus was identified. Immediately after the surgical procedure, there was a significant reduction of clinical and laboratory traits of hypercortisolemia, yet, during the 46 weeks of postoperative observation, despite chemotherapy, the progression of residual masses of the tumour occurred with metastases and increased hormone indices. The presented case shows and discusses the differentiation of ACTH-dependent hypercortisolemia and its causes, difficulties in surgical therapy and chemotherapy, as well as prognosis for atypical carcinoid of the thymus, which is a rare disease.


Assuntos
Hiperfunção Adrenocortical/etiologia , Tumor Carcinoide/complicações , Síndrome de Cushing/etiologia , Neoplasias Hipofisárias/complicações , Neoplasias do Timo/complicações , Adulto , Humanos , Masculino
3.
BMJ Case Rep ; 12(11)2019 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-31712234

RESUMO

Lung neuroendocrine tumours (Lung NETs) are a rare group of pulmonary neoplasms often characterised by insidious clinical behaviour. Lung NET account for ~1%-2% of all lung malignancies in adults and 30% of all NETs. Incidence ranges from 0.2 to 2/100 000 population per year. While some patients may be asymptomatic, others may present with obstructive symptoms due to mass effect. Incidence of spontaneous pneumothorax as a complication of lung neoplasms is rare (0.05%-1.4% of all pneumothoraces). In this report, we present a case of recurrent pneumothorax due to Lung NET that was refractory to conservative management. We also discuss the diagnostic methods as well as surgical management approach, which is considered the treatment of choice in such tumours.


Assuntos
Tumor Carcinoide/complicações , Neoplasias Pulmonares/complicações , Pneumotórax/etiologia , Idoso de 80 Anos ou mais , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/cirurgia , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Masculino , Resultado do Tratamento
4.
J Pediatr Hematol Oncol ; 41(7): 568-570, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31569174

RESUMO

Appendiceal carcinoid tumors in children and adolescents are rare. This report describes a case of a multifocal appendiceal carcinoid tumor identified incidentally following appendectomy in an adolescent. In this report, we describe the staging process and surgical management for focal and locally invasive appendiceal carcinoid tumors and highlight the rarity of multifocality in this location. The diagnostic and pathologic challenges for this case are presented.


Assuntos
Neoplasias do Apêndice/patologia , Tumor Carcinoide/patologia , Adolescente , Neoplasias do Apêndice/complicações , Neoplasias do Apêndice/cirurgia , Apendicite/etiologia , Tumor Carcinoide/complicações , Tumor Carcinoide/cirurgia , Feminino , Humanos
5.
BMJ Case Rep ; 12(8)2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31439570

RESUMO

A constellation of newly diagnosed benign tumours and glioblastoma is an uncommon occurrence in a single individual. We present a case of a patient with a history of skin lipomas who presented with seizures and was found to have a left frontotemporal multifocal enhancing mass on MRI. Work-up for metastatic disease revealed a benign lung carcinoid tumour, a cervical schwannoma, adrenal masses, a growth hormone-secreting pituitary adenoma, and lastly a glioblastoma following brain biopsy.


Assuntos
Neoplasias Encefálicas/diagnóstico , Tumor Carcinoide/diagnóstico , Glioblastoma/diagnóstico , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neurilemoma/diagnóstico , Idoso , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Vértebras Cervicais , Evolução Fatal , Lobo Frontal , Glioblastoma/complicações , Glioblastoma/diagnóstico por imagem , Adenoma Hipofisário Secretor de Hormônio do Crescimento/complicações , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Convulsões/etiologia , Tomografia Computadorizada por Raios X
7.
J Pak Med Assoc ; 69(6): 899-901, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31201401

RESUMO

Treatment of Cushing syndrome depends on diagnosis of etiology responsible for hypercortisolism in the body, which sometimes presents with a challenge. Inferior petrosal sinus sampling for ACTH levels, followed by peripheral venous sampling is a proven tool to be a gold standard for differentiating between peripheral and central cause of ACTH dependent Cushing syndrome. This case report is of an elderly female who presented as an outpatient in the endocrinology clinic of Aga Khan university hospital on 22/6/2017 with clinical features of hypercortisolism. After workup she was found to have cushing syndrome secondary to ACTH secreting bronchial carcinoid tumour.


Assuntos
Hormônio Adrenocorticotrópico/metabolismo , Neoplasias Brônquicas/diagnóstico por imagem , Tumor Carcinoide/diagnóstico por imagem , Síndrome de Cushing/diagnóstico , Idoso , Neoplasias Brônquicas/complicações , Neoplasias Brônquicas/metabolismo , Tumor Carcinoide/complicações , Tumor Carcinoide/metabolismo , Síndrome de Cushing/etiologia , Síndrome de Cushing/metabolismo , Feminino , Humanos , Hidrocortisona/urina , Tomografia Computadorizada por Raios X
8.
Eur J Endocrinol ; 181(1): K1-K9, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31048558

RESUMO

Context: Cabergoline has been shown to have some effect in the treatment of moderate Cushing's disease, but its effectiveness in Cushing's syndrome of ectopic or occult origin remains to be investigated. Case series: In this case series, cabergoline was used in combination with steroidogenesis inhibitors in nine patients with severe Cushing's syndrome of ectopic or occult origin. Cabergoline's effectiveness enabled rapid withdrawal of the steroidogenesis inhibitors and long-term control of the hypercortisolism in three of the cases. Review of the literature: In the literature, we found only 11 cases of ectopic or occult Cushing's syndrome treated with dopamine receptor agonists, alone or in combination. Yet of these 11 cases, 10 responded. Conclusions: Although limited, the existing experience highlights the potential value of cabergoline in the treatment of ectopic or occult Cushing's syndrome.


Assuntos
Cabergolina/uso terapêutico , Síndrome de Cushing/tratamento farmacológico , Agonistas de Dopamina/uso terapêutico , Síndrome de ACTH Ectópico/complicações , Síndrome de ACTH Ectópico/diagnóstico , Adulto , Idoso , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/patologia , Síndrome de Cushing/etiologia , Síndrome de Cushing/metabolismo , Feminino , Humanos , Hidrocortisona/metabolismo , Cetoconazol/uso terapêutico , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Neoplasias Intraductais Pancreáticas/complicações , Neoplasias Intraductais Pancreáticas/diagnóstico por imagem , Neoplasias Intraductais Pancreáticas/patologia , Neoplasias Retais/complicações , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Inibidores da Síntese de Esteroides/uso terapêutico , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico por imagem , Neoplasias do Timo/patologia , Resultado do Tratamento
9.
Thorac Cancer ; 10(4): 791-798, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30758142

RESUMO

BACKGROUND: Bronchiectasis is a rare complication in patients with thymic neoplasm. The aim of this study was to investigate the clinical and radiological manifestations, laboratory tests, pathologic features, and outcome of treatment of bronchiectasis in patients with thymic neoplasm. METHODS: From January 2000 to January 2018, 20 patients with a diagnosis of thymic neoplasm and bronchiectasis were hospitalized at the Peking Union Medical College Hospital. Clinical data was retrospectively analyzed. RESULTS: The prevalence of bronchiectasis in thymic neoplasms in our cohort was 1.56% (20/1279). Eighteen patients were diagnosed with thymoma, while two patients were diagnosed with thymic carcinoid. The duration from diagnosis of thymic neoplasm to bronchiectasis varied. Distributions of bronchiectasis were bilateral in 17 patients and unilateral in three patients. Four patients were previously diagnosed with diffuse panbronchiolitis and another two were suspected with diffuse panbronchiolitis. Twelve patients had various parathymic syndromes, including Good syndrome, myasthenia gravis, and aplastic anemia. Thymectomy was performed in all of these patients. Macrolide antibiotics were administered to 10 patients, and the symptoms improved in 8. CONCLUSION: Bronchiectasis is a complication in thymic neoplasms, although prevalence is low. There may be multifactorial etiologies for bronchiectasis in patients with thymic neoplasms. Comprehensive treatment should be carried out to ensure optimal outcomes.


Assuntos
Bronquiectasia/epidemiologia , Tumor Carcinoide/epidemiologia , Timoma/epidemiologia , Neoplasias do Timo/epidemiologia , Adulto , Idoso , Antibacterianos/uso terapêutico , Bronquiectasia/tratamento farmacológico , Bronquiectasia/etiologia , Tumor Carcinoide/complicações , China/epidemiologia , Feminino , Hospitalização , Humanos , Macrolídeos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Timoma/complicações , Neoplasias do Timo/complicações , Resultado do Tratamento
10.
Medicine (Baltimore) ; 98(5): e14315, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30702609

RESUMO

RATIONALE: Sclerosing pneumocytoma accompanied with other type of tumor in one patient is very rare. Here, we report a case of a sclerosing pneumocytoma mixed with a typical carcinoid tumor in a same neoplasm. PATIENT CONCERNS: A 55-year-old woman incidentally detected a space-occupying lesion of right lung in routine health examination. The patient was asymptomatic and there were no positive findings in routine laboratory examination, physical examination, and pulmonary function test. Computed tomography revealed a solitary round mass in the middle lobe of the right lung. DIAGNOSIS: The lesion was diagnosed as a sclerosing pneumocytoma accompanied with a typical carcinoid tumor of the right lung. INTERVENTION: The patient underwent thoracoscopic lobectomy in our hospital. OUTCOMES: The postoperative course was uneventful. LESSONS: This case is rare and noteworthy for a lesion containing two different types of neoplasms, which may cause diagnostic difficulties.


Assuntos
Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Hemangioma Esclerosante Pulmonar/complicações , Hemangioma Esclerosante Pulmonar/diagnóstico , Tumor Carcinoide/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Pneumonectomia , Hemangioma Esclerosante Pulmonar/cirurgia , Toracoscopia , Tomografia Computadorizada por Raios X
11.
BMC Pulm Med ; 19(1): 44, 2019 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-30777035

RESUMO

BACKGROUND: Postpneumonectomy-like syndrome is a rare condition resulting from unilateral lung disease with severe lung volume loss leading to excessive mediastinal shift and herniation of the healthy lung into the contralateral hemithorax, mimicking the mediastinal shift observed in postpneumonectomy syndrome after pneumonectomy. We report a unique case of postpneumonectomy-like syndrome caused by an atypical bronchial carcinoid completely occluding the left main bronchus. CASE PRESENTATION: A 25-year-old woman presented with symptoms of chronic exertional dyspnea and productive cough. Imaging studies showed complete left lung atelectasis due to a mass occluding the left main bronchus, as well as extreme mediastinal deviation and substantial herniation of the right lung into the left hemithorax. Bronchoscopic biopsy of the tumor and subsequent left pneumonectomy with concurrent lymph node dissection revealed an atypical carcinoid. Sixteen months after surgery the patient has been asymptomatic with repeat imaging studies showing no change in mediastinal shifting. CONCLUSION: Bronchial carcinoids are notorious for causing bronchial obstruction. The present case represents an extreme complication of centrally located bronchial carcinoid, resulting in postpneumonectomy-like syndrome with severe mediastinal shift and herniation of the healthy lung into the diseased hemithorax.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Neoplasias Brônquicas/complicações , Tumor Carcinoide/complicações , Hérnia/etiologia , Pneumopatias/etiologia , Adulto , Obstrução das Vias Respiratórias/diagnóstico por imagem , Obstrução das Vias Respiratórias/cirurgia , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/cirurgia , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/cirurgia , Feminino , Hérnia/diagnóstico por imagem , Humanos , Pneumopatias/diagnóstico por imagem , Pneumonectomia , Complicações Pós-Operatórias , Síndrome
12.
BMC Pulm Med ; 19(1): 41, 2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30767776

RESUMO

BACKGROUND: Pulmonary carcinoids are included in the group of neuroendocrine tumors (NET) and derive from pulmonary neuroendocrine cells. The incidence of these tumors is increasing, but disease awareness remains low among clinicians. The synchronous presentation of lung cancer and mycobacterial infection is well known but the combination of pulmonary carcinoid and mycobacterial infection is rare. CASE PRESENTATION: We treated a 45-year-old female who presented with recurrent pneumonia. Chest X-ray showed a consolidation in the left upper lobe. The patient was treated with various courses of antibiotics without full recovery after six months. Computed tomography (CT) scan demonstrated a central mass in the left upper lobe. Bronchoscopy revealed an endobronchial, well-defined lesion that totally obstructed the left upper lobe bronchus. Bronchial biopsy showed typical carcinoid tumor. Rigid bronchoscopy with electrocautery was attempted, but we were unable to radically remove the tumor. Therefore lobectomy was performed. The surgical pathology specimen showed atypical bronchial carcinoid and consolidations in the lung parenchyma with granulomatous inflammation distally of the bronchial obstruction. Ziehl-Neelsen staining demonstrated acid fast bacilli indicative of mycobacterial infection. CONCLUSIONS: This case history illustrates the importance of careful surgical pathologic examination, not only of the resected tumor, but also of the postobstructive lung parenchyma. Specific postobstructive infections such as tuberculosis or nontuberculous mycobacteria (NTM) can have clinical implications.


Assuntos
Obstrução das Vias Respiratórias/patologia , Neoplasias Brônquicas/patologia , Tumor Carcinoide/patologia , Infecções por Mycobacterium/patologia , Pneumonia Bacteriana/patologia , Obstrução das Vias Respiratórias/etiologia , Biópsia , Neoplasias Brônquicas/complicações , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/cirurgia , Broncoscopia , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/cirurgia , Feminino , Humanos , Pulmão/patologia , Pessoa de Meia-Idade , Mycobacterium , Infecções por Mycobacterium/complicações , Pneumonectomia , Pneumonia Bacteriana/complicações , Tomografia Computadorizada por Raios X
13.
Kyobu Geka ; 72(2): 160-163, 2019 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-30772886

RESUMO

A 45-year-old woman, who had been treated for bronchial asthma, was referred to our hospital with symptoms of dyspnea. Upon examination, we found the right main bronchus to be almost completely occluded by an endobronchial tumor. For the purpose of diagnosis and relieving the dyspnea, we performed a rigid bronchoscopic tumor resection with a high frequency snare. The tumor was pathologically diagnosed as a typical bronchial carcinoid, and a right upper lobectomy and wedge resection of the right main bronchus was carried out 1 month later.


Assuntos
Neoplasias Brônquicas/cirurgia , Broncoscopia , Tumor Carcinoide/cirurgia , Asma/complicações , Brônquios/cirurgia , Neoplasias Brônquicas/complicações , Neoplasias Brônquicas/diagnóstico , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade
14.
Future Oncol ; 15(12): 1397-1406, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30734573

RESUMO

Aim: Elevated serotonin in patients with neuroendocrine tumors (NETs) may impact heart failure incidence but a quantitative relationship has not been established. Materials & methods: Systematic review and meta-analysis of studies assessing 24-h urinary 5-hydroxyindoleacetic acid (u5-HIAA) and mortality in patients with NETs (2007-2017) with a primary outcome of 1-year mortality risk and 24-h u5-HIAA. Results: We identified 1715 records of which 12 studies including 755 patients (3442 person-years with 376 deaths) were eligible for meta-analysis. Mean u5-HIAA was 149.2 mg/24 h (standard deviation: 96.6) and mortality was 13.0%. The meta-regression equation showed an 11.8% (95% CI: 8.9-17.0%; I2  = 93.0%) increase in 1-year mortality for every ten-unit increase in u5-HIAA. Conclusion: Serotonin measured by its metabolite u5-HIAA is predictive of 1-year all-cause mortality in patients with NETs.


Assuntos
Biomarcadores Tumorais/sangue , Doença Cardíaca Carcinoide/mortalidade , Tumor Carcinoide/mortalidade , Neoplasias Intestinais/mortalidade , Tumores Neuroendócrinos/mortalidade , Neoplasias Pancreáticas/mortalidade , Serotonina/sangue , Neoplasias Gástricas/mortalidade , Doença Cardíaca Carcinoide/sangue , Doença Cardíaca Carcinoide/etiologia , Tumor Carcinoide/sangue , Tumor Carcinoide/complicações , Humanos , Neoplasias Intestinais/sangue , Neoplasias Intestinais/complicações , Tumores Neuroendócrinos/sangue , Tumores Neuroendócrinos/complicações , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/complicações , Valor Preditivo dos Testes , Neoplasias Gástricas/sangue , Neoplasias Gástricas/complicações
15.
Intern Med ; 58(5): 655-659, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30333421

RESUMO

The incidence of carcinoid tumor in the small intestine is increasing; however, its preoperative diagnosis is difficult. We recently experienced three cases of multiple carcinoid tumors in the small intestine successfully detected using capsule endoscopy (CE), followed by a pathological diagnosis using double-balloon enteroscopy (DBE). To diagnose multiple carcinoid in the small intestine appropriately, we reviewed the information of five cases reported to date along with our three recent cases. The literature review demonstrated that CE and DBE are useful for detecting and diagnosing small intestinal carcinoids and tumor multiplicity, which aids in determining the appropriate resection range.


Assuntos
Endoscopia por Cápsula/métodos , Tumor Carcinoide/diagnóstico , Enteroscopia de Duplo Balão/métodos , Neoplasias Intestinais/diagnóstico , Idoso , Tumor Carcinoide/complicações , Feminino , Humanos , Neoplasias Intestinais/complicações , Intestino Delgado , Masculino , Melena/etiologia , Pessoa de Meia-Idade
16.
J Ultrasound ; 22(2): 207-213, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30361920

RESUMO

Renal ectopia and fusion anomalies are Congenital Anomalies of the Kidney and the Urinary Tract (CAKUT) that are usually incidentally detected and asymptomatic. Patients affected present a higher risk of complications like recurrent urinary tract infections or obstruction. Pancake kidney (PK) is one of the rarest types of renal anomaly with complete fusion of the superior, mild and inferior poles of both kidneys in the pelvic cavity. Each kidney has its own excretory system with two ureters that do not cross the midline. In the asymptomatic cases, a conservative approach should be performed. Surgical management may be needed when urological problems occur. PK is often associated with congenital anomalies of other organs. Ultrasound is the first line radiological examination for the diagnosis and the follow-up of kidney malformations. The main sonographic findings suggesting PK diagnosis are a large and lobulated renal mass consisting of two fused lateral lobes without an intervening septum located in the pelvic cavity. Each lobe usually has a separate pelvicalyceal system, the renal pelvis is anteriorly placed and the ureters are usually short and enter the bladder normally without crosses the midline. Ultrasonography gives useful information on the morphology and volume of the organ, and on its vascularization through the use of the Color- and Power-Doppler. Computer Tomography and Magnetic Resonance Urography are second level techniques used to confirm the diagnosis and to evaluate the presence of other abnormalities. The knowledge of the imaging findings and the anatomy of congenital renal malformations is important to avoid diagnostic pitfalls and misinterpretations. We report the case of a 14-years old female with PK who was misdiagnosed with a horseshoe kidney (HSK) during an abdominal ultrasound.


Assuntos
Rim Fundido/diagnóstico por imagem , Rim/anormalidades , Rim/diagnóstico por imagem , Adolescente , Neoplasias do Apêndice/complicações , Neoplasias do Apêndice/diagnóstico por imagem , Neoplasias do Apêndice/cirurgia , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/cirurgia , Diagnóstico Diferencial , Feminino , Rim Fundido/complicações , Humanos
17.
Ann Diagn Pathol ; 38: 71-79, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30502716

RESUMO

It is uncertain whether thymic neuroendocrine tumors (NET) associated with Cushing's syndrome (CS) produce corticotropin-releasing hormone (CRH) and adrenocorticotropin hormone (ACTH) and whether the thymus contains ACTH and/or CRH cells that could originate NET. The clinicopathologic features of 5 typical (TC) and 6 atypical carcinoids (ATC), 10 additional non-neoplastic thymi, 6 adrenal glands with bilateral nodular hyperplasia and 8 adrenal cortical adenomas were reviewed. Representative slides were immunostained for ACTH and CRH. Four (36.4%) of the 11 patients had CS. The incidence of Masaoka stage IV was higher (p < 0.0001) in patients with ATC than TC. Only 2 (18.1%) of the 11 patients were alive at follow-up. Ten NET were CRH immunoreactive and 6 were ACTH immunoreactive. Thymic NET with CS exhibited stronger immunoreactivity for ACTH and CRH than those without CS. Non-neoplastic thymi exhibited scattered ACTH and CRH immunoreactive cells. Normal adrenal cortex and glands with bilateral nodular hyperplasia showed diffuse CRH immunoreactivity while adrenal adenomas showed no or only focal CRH immunoreactivity. Literature review showed no association between thymic NET and adrenal adenomas. The thymus contains CRH and ACTH immunoreactive cells that are probably the origin of thymic NET. Neoplasms associated with CS exhibit strong immunoreactivity for both hormones, suggesting that CRH probably plays a role in the pathogenesis of CS. As adrenals with bilateral nodular hyperplasia exhibit diffuse CRH immunoreactivity and adrenal cortical adenomas either lack this finding or show few immunoreactive cells, this marker may be useful to distinguish these lesions.


Assuntos
Tumor Carcinoide/patologia , Síndrome de Cushing/etiologia , Células Neuroendócrinas/patologia , Neoplasias do Timo/patologia , Hormônio Adrenocorticotrópico/metabolismo , Adulto , Idoso , Tumor Carcinoide/complicações , Hormônio Liberador da Corticotropina/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Células Neuroendócrinas/metabolismo , Neoplasias do Timo/complicações , Adulto Jovem
18.
Br J Neurosurg ; 33(3): 285-286, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28612626

RESUMO

Currarino syndrome (CS) is a congenital disorder characterized by partial sacral agenesis, anorectal malformation and a presacral mass. Only three cases of carcinoid transformation of the presacral mass have been described in the literature. We present a case of carcinoid transformation of presacral dermoid cyst in patient with Currarino syndrome.


Assuntos
Canal Anal/anormalidades , Tumor Carcinoide/patologia , Cisto Dermoide/patologia , Anormalidades do Sistema Digestório/patologia , Reto/anormalidades , Sacro/anormalidades , Neoplasias da Coluna Vertebral/patologia , Siringomielia/patologia , Canal Anal/patologia , Tumor Carcinoide/complicações , Transformação Celular Neoplásica , Cisto Dermoide/complicações , Anormalidades do Sistema Digestório/complicações , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Reto/patologia , Sacro/patologia , Neoplasias da Coluna Vertebral/complicações , Siringomielia/complicações
19.
BMJ Case Rep ; 11(1)2018 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-30580296

RESUMO

Anaemia can present with symptoms of fatigue, shortness of breath, weakness, malaise, tachycardia and skin pallor. If left untreated, this can progress to life-threatening complications such as arrhythmias, cardiac hypertrophy and myocardial infarction. In this report, a 43-year-old woman, who was ambulatory with no exertional dysponea, presented with weakness, fatigue, bilateral lower extremity oedema and intermittent right sided chest pain for several months. This patient was subsequently found to have a haemoglobin of 18 g/L (1.8 g/dL) and haematocrit of 7.2%. She was admitted to the hospital and treated with seven units of blood. CT scan showed a 9.6 cm uterine fibroid in addition to a 5.9×5.4 cm mass near the right kidney, which was later diagnosed as metastatic carcinoid tumour. This case deserves attention due to the importance of looking for multiple causes of blood loss and the effects of low haemoglobin levels.


Assuntos
Anemia/sangue , Tumor Carcinoide/complicações , Hematócrito/estatística & dados numéricos , Hemoglobinas/análise , Doença Aguda , Adulto , Anemia/etiologia , Tumor Carcinoide/sangue , Doença Crônica , Feminino , Humanos
20.
J Fam Pract ; 67(10): 649-651, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30423001

RESUMO

Our patient presented with abdominal pain and worsening diarrhea. She had no significant medical history, but imaging studies helped us make the Dx.


Assuntos
Tumor Carcinoide/diagnóstico por imagem , Mesentério , Neoplasias Peritoneais/diagnóstico por imagem , Dor Abdominal/etiologia , Tumor Carcinoide/complicações , Diarreia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Peritoneais/complicações , Radiografia
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