RESUMO
We herein report a case of cecum cancer with synchronous adrenal solitary metastasis. A 62-year-old woman who had been treated for other disease complained of weight loss. Lower endoscopy revealed cecum cancer, and computed tomography( CT)demonstrated a solitary left adrenal tumor; thus, she was diagnosed with a metastatic tumor. We concluded that the patient was a possible candidate for surgical resection because she did not present with local metastasis other than in the adrenal glands. Ileocecal resection and left adrenalectomy were performed. The histological findings indicated moderately differentiated adenocarcinoma, which was compatible with cecum cancer. The patient was administered chemotherapy containing mFOLFOX6, and no recurrence has been detected 4 years after the surgery. Some patients who develop solitary adrenal metastasis from colonic cancer appear to be good candidates for surgery in anticipation of a good prognosis.
Assuntos
Adenocarcinoma , Neoplasias das Glândulas Suprarrenais , Neoplasias Intestinais , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Neoplasias das Glândulas Suprarrenais/secundário , Neoplasias das Glândulas Suprarrenais/terapia , Adrenalectomia , Ceco , Feminino , Humanos , Neoplasias Intestinais/patologia , Neoplasias Intestinais/terapia , Pessoa de Meia-Idade , Recidiva Local de NeoplasiaRESUMO
The patient was a 27-year-old woman who was clinically diagnosed with tuberous sclerosis complex (TSC). She developed hypercalcemia and hypophosphatemia at age 23. In a detailed examination at age 26, she was diagnosed with primary hyperparathyroidism due to parathyroid adenoma. After undergoing parathyroidectomy, her hypercalcemia and hypophosphatemia rapidly normalized. Subsequent genetic testing revealed mutations of the TSC1 gene. TSC with concomitant parathyroid adenoma is extremely rare; only three cases have been reported worldwide. However, each of these cases was diagnosed clinically. Therefore, our case is the first to be diagnosed with genetic testing.
Assuntos
Adenoma/complicações , Hiperparatireoidismo Primário/etiologia , Segunda Neoplasia Primária/etiologia , Neoplasias das Paratireoides/complicações , Esclerose Tuberosa/etiologia , Adulto , Feminino , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hipercalcemia/cirurgia , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/cirurgia , Mutação/genética , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/cirurgia , Hormônio Paratireóideo/sangue , Paratireoidectomia , Prognóstico , Esclerose Tuberosa/diagnóstico , Esclerose Tuberosa/cirurgia , Proteína 1 do Complexo Esclerose Tuberosa , Proteínas Supressoras de Tumor/genéticaRESUMO
A 66-year-old man with hypertension presented with fever which has started three days prior. Computed tomography (CT) revealed the presence of multiple low-density areas in the liver, the largest of which was over 10 cm in diameter, with clear demarcation. Streptococcus intermedius was detected in the blood culture, thus we diagnosed suspected liver abscess with bacteremia. Because the patient refused invasive drainage and was not poor general appearance, we had initiated intravenous meropenem followed by ceftriaxone plus metronidazole without any abscess drainage. After 6 weeks antibiotics treatment, liver abscess was almost completely diminished on the CT scan. To the best of our knowledge, this is the first report of a giant liver abscess caused by Streptococcus intermedius treated successfully without drainage.