Renal cell cancer metastases to esophagus and stomach successfully treated with radiotherapy and pazopanib.

Renal cell cancer has been rarely reported as a cause of gastric or esophageal metastases. They usually present with gastrointestinal bleeding and most cases have been managed surgically or endoscopically. We report the case of a 38-year-old man with a 4-year history of metastatic renal cell carcinoma admitted to the emergency room with melena and anemia. At endoscopy, three esophageal polypoid lesions (middle and distal thirds) and a 7 cm mass in the gastric fundus were identified. Biopsy revealed esophageal mucosa infiltrated by renal cell carcinoma. Radiotherapy was administered (30 Gy in 10 fractions), followed by pazopanib, with excellent tolerance and without new bleeding episodes. Computed tomography scan showed complete disappearance of the esophageal and fundic lesions at 3 months follow-up. Twenty-four months after being initiated on pazopanib, there is no radiological evidence of disease. This is the first reported case showing complete remission of gastric and esophageal metastases after treatment with radiotherapy and pazopanib.

Mechanical endovascular treatment of acute stroke due to cardiac myxoma.

BACKGROUND: Myxomas are rare cardiac tumors which often present with stroke caused by tumorous or thrombotic emboli. Treatment with intravenous recombinant tissue plasminogen activator (rtPA) and intra-arterial thrombolysis has been described previously but mechanical thrombectomy has not yet been reported, and treatment of myxoma-related ischemic stroke remains a clinical and technical challenge. METHODS: Two patients with ischemic stroke due to cardiac myxoma in which mechanical thrombectomy was performed are presented. RESULTS: Endovascular thrombectomy after intravenous rtPA (bridging therapy) was safely achieved in both cases, although with different clinical outcomes and degrees of recanalization. CONCLUSIONS: In stroke secondary to cardiac myxoma, mechanical thrombectomy might represent a safe and effective treatment option. The authors suggest the use of histological examination of the clot for diagnosis as its composition may explain the differences in treatment outcome.

Fine needle aspiration cytology of Castleman disease, plasma cell type. A report of three cases / Punción aspiración con aguja fina de la enfermedad de Castleman, tipo plasmocelular. Descripción de 3 casos

Plasma cell type Castleman disease (PC-CD) may present with multicentric lymph node involvement or as a solitary mass. It is a rare condition and there are very few reports of its cytology and no descriptions of aspiration cytology findings in the plasma cell type. We evaluated three patients in which the possibility of malignant lymphoma had been considered clinically. Cytology revealed features of lymphoid follicular hyperplasia with numerous plasma cells and no signs of malignancy. Surgical excision revealed features of PC-CD. The cytology of PC-CD shows the benign features characteristic of a reactive lymphoid pattern with numerous plasma cells. When combined with clinical and image findings, a preoperative diagnosis could be made (AU)

La enfermedad de Castleman de tipo plasmocelular (PC-CD) puede presentarse como afectación ganglionar multicéntrica o como lesión solitaria. Se trata de una entidad infrecuente, y no existen descripciones citológicas en material de punción de esta variante. Evaluamos 3 pacientes, y en los 3 casos la posibilidad de un linfoma fue considerada clínicamente. El estudio citológico reveló rasgos de hiperplasia folicular linfoide con numerosas células plasmáticas, sin signos de malignidad. La resección quirúrgica mostro rasgos de PC-CD. La citología de PC-CD muestra un patrón linfoide reactivo con numerosas células plasmáticas. La citología permite su diagnóstico como una entidad benigna. En un contexto clínico y de imagen adecuado puede considerarse preoperatoriamente (AU)