RESUMO
Despite the advances in managing left-sided infective endocarditis, complications are still not uncommon. Both aortic and mitral insufficiency can occur from infective endocarditis. In addition, valvular insufficiency due to rupture of valves presents acutely with cardiac decompensation and requires early surgical intervention. Here, we report a case of a 38-year-old intravenous drug user male with Group A Streptococcus-associated left-sided native valve infective endocarditis who presented with acute heart failure three months after his treatment of infective endocarditis. Infective endocarditis complications can lead to severe valve damage, causing acute heart failure, and may require immediate surgical intervention.
RESUMO
Renal cell carcinoma (RCC) is known for having unpredictable clinical behavior. Metastases can occur in unusual locations with a long-time lag after the treatment of the primary cancer. Despite being a sign of poor prognosis, aggressive metastasectomy may prolong survival. Presented is a case of delayed sequential metastases of RCC to the pancreas and the thyroid gland that occurred eight years after the radical nephrectomy. Both were resected. A history of remote nephrectomy for RCC is important and may be suggestive of metastatic disease. Ultrasound-guided fine needle aspiration can be diagnostic and helps in decision-making. Aggressive surgical intervention when possible is recommended.