RESUMEN
Small cell carcinoma (SCC) is commonly of pulmonary origin. Pleural small cell carcinoma is a very uncommon feature. We report here a case of small cell carcinoma of the pleura in a 36 year old man. The diagnosis of primary disease SCC of the pleura was established by transparietal pleural biopsy in absence of any mediastino-pulmonary or extrathoracic other lesions that could be the primary tumor. The treatment was based on chemotherapy with cisplatin and etoposide. The patient died four months in spite of cytotoxic chemotherapy. Extrapulmonary small cell carcinoma is a rare entity. Immunohistochemistry study is very useful for the diagnosis. The prognosis seems to be worse than the small cell lung cancer.
Asunto(s)
Carcinoma de Células Pequeñas/diagnóstico , Neoplasias Pleurales/diagnóstico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biopsia , Broncoscopía , Carcinoma de Células Pequeñas/tratamiento farmacológico , Carcinoma de Células Pequeñas/patología , Diagnóstico Diferencial , Resultado Fatal , Estudios de Seguimiento , Humanos , Masculino , Pleura/patología , Neoplasias Pleurales/tratamiento farmacológico , Neoplasias Pleurales/patología , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Subcutaneous dirofilariasis is zoonotic infection caused by Dirofilaria repens, the principal reservoir of which is the dog. Clinical expression is usually benign but problems of differential diagnosis are present in some cases. We report the first case of dirofilariasis diagnosed in our area (Sfax, southern Tunisia). OBSERVATION: A 21 year-old woman consulted for multiple erythematous and pruriginous papules on the shoulders, limbs and buttocks. She was treated with antihistamines and dermatological topical steroids without improvement. The diagnosis was confirmed by histological examination, which revealed sections of an adult dirofilaria about 200 microm in diameter with a multilayered cuticle. The condition resolved spontaneously with disappearance of lesions after 3 months. DISCUSSION: Subcutaneous dirofilariasis is rare in Tunisia. The prevalence is probably underestimated since clinical signs are non-specific and spontaneous cure is common.
Asunto(s)
Dirofilariasis/diagnóstico , Enfermedades Cutáneas Parasitarias/diagnóstico , Adulto , Femenino , Humanos , TúnezRESUMEN
Liposarcoma of the mediastinum is a rare tumor with various histologic features. We report a case of mediatinal pleomorphic liposarcoma in a 37-year-old man who complained of chest pain. Computed tomography showed an anterior expansive process within the mediastinum. Histological diagnosis was established by a trans-thoracic computed tomography guided core-needle biopsy. Despite a first cure of chemotherapy with gemcitabin/cisplatin, disease progression led to death 3 months after diagnosis. Mediastinal pleomorphic liposarcoma is an exceptional invading tumor affecting the middle-aged adult. This tumor, usually giant, becomes symptomatic by compression of mediastinal structures. Surgery is the best treatment when possible. The role of radiotherapy and chemotherapy are discussed. Prognosis depends both on the quality of resection and the grade malignancy.