RESUMEN
This study aimed to identify noninvasive biomarkers of clinically significant nephrouropathies in patients with antenatal renal and/or urinary tract alterations. Spot-urine levels of interleukin-6 (IL-6), transforming growth factor-ß1 (TGF-ß1) and tumor necrosis factor-α (TNF-α) were measured in 100 patients with antenatal detected nephrouropathies. Patients were divided in idiopathic hydronephrosis (n = 47), urinary tract malformations (n = 35), and dysplastic kidneys (n = 18). Urinary concentrations of TGF-ß1, IL-6, and TNF-α were compared between groups according to clinical and image findings. Receiver-operating characteristic (ROC) curves were analyzed for the overall diagnostic accuracy of TGF-ß1, IL-6, and TNF-α levels in discriminating infants with nephrouropathies. No significant differences in urinary TGF- ß1, IL-6, and TNF-α levels were found in the comparison between the groups. TGF-ß1 levels tended to be higher in patients with renal hypodysplasia compared to idiopathic hydronephrosis (p = 0.07). Twenty-nine patients had reduced DMSA uptake. In these cases, absolute urinary concentration of TGF-ß1 and levels standardized for creatinine were significantly higher than in patients with normal DMSA uptake, while IL6 and TNF-α did not differ between groups. Urinary cytokine measurements were not useful as a screening test for clinically significant nephrouropathies. Conversely, increased concentrations of TGF-ß1 pointed out to renal damage as indicated by reduced DMSA uptake.
Asunto(s)
Citocinas/orina , Factor de Crecimiento Transformador beta1/orina , Enfermedades Urológicas/congénito , Enfermedades Urológicas/orina , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Biomarcadores/orina , Estudios Transversales , Femenino , Humanos , Riñón/anomalías , Masculino , Persona de Mediana Edad , Curva ROC , Sistema Urinario/anomalías , Adulto JovenRESUMEN
The purpose of this article is to describe a patient with presumed choroidal metastasis from an eccrine adenocarcinoma of the scalp. A 45-year-old Caucasian woman presented with decreased visual acuity. Ophthalmologic examination was unremarkable. Her past medical history was significant for eccrine carcinoma of the scalp. The patient developed bilateral cervical lymph node metastases, and received chemotherapy and radiotherapy. She had recurrence of the scalp lesion and developed bone metastasis. The patient was again referred to an ophthalmologist owing to reduced visual acuity. Multiple choroidal metastases were detected in right eye, and one metastatic lesion in left eye. The patient passed away 2 months after choroidal metastases. This is the first report of choroidal metastases from an eccrine carcinoma. This is a rare aggressive neoplasm with poor outcome in most cases of metastatic disease, and in this case report, uveal metastasis was indicative of poor prognosis.
Asunto(s)
Adenocarcinoma/secundario , Neoplasias de la Coroides/secundario , Neoplasias Cutáneas/patología , Neoplasias de las Glándulas Sudoríparas/patología , Resultado Fatal , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Cuello , Cuero CabelludoRESUMEN
A 3-year-old girl presented with a distorted pupil and decrease of visual acuity. A ciliary body mass at the superior-temporal quadrant could be seen at slit-lamp examination. Ultrasound biomicroscopy revealed a lesion with lobulated surface, arising at the ciliary body, composed of compact and cystic areas. An iridocyclectomy was performed but the tumour recurred after a few months. The eye was then enucleated. Histopathologic evaluation showed sheets and cords of proliferated medullary epithelium. Cystic spaces and Flexner-Wintersteiner rosettes were also seen. Those findings correlated well with ultrasound biomicroscopic images. The knowledge of echographic characteristics can significantly assist in the diagnosis of medulloepithelioma of the ciliary body.
Asunto(s)
Cuerpo Ciliar/diagnóstico por imagen , Cuerpo Ciliar/patología , Tumores Neuroectodérmicos Primitivos/diagnóstico por imagen , Tumores Neuroectodérmicos Primitivos/patología , Neoplasias de la Úvea/diagnóstico por imagen , Neoplasias de la Úvea/patología , Preescolar , Cuerpo Ciliar/cirugía , Femenino , Humanos , Iris/cirugía , Microscopía Acústica , Procedimientos Quirúrgicos Oftalmológicos , Agudeza VisualRESUMEN
CASE REPORT: We report the case of a patient with small cell lung carcinoma who developed multiple metastases in the iris. The eye was enucleated after failure of a conservative approach. The specimen underwent histologic and immunohistochemical evaluation that confirmed the diagnosis. COMMENTS: Metastatic carcinoma is the most common form of intraocular malignancy, and breast is the most prevalent primary location, followed by lung. Small cell lung carcinoma constitutes 23.1% of lung neoplasias. It has a significantly worse prognosis than non-small cell carcinoma due to its propensity for early and widespread dissemination. Uveal metastases involve the choroid more often than the iris and ciliary body, probably because the arterial distribution is more abundant in the posterior than in the anterior uvea. Iris involvement represents only 9% of the metastatic uveal tumours.