RESUMEN
Cardiac myxomas are the most common primary benign tumors of the heart. The occlusion of peripheral arteries and complete obstruction of the abdominal aorta by a tumor embolus presents with distinct clinical manifestations. Herein, we present the case of a 38-year-old male with acute paresthesia, muscle weakness, erythematous, and violaceous changes in skin color localized to the dorsum of the left forefoot initially treated as cutaneous vasculitis. Further studies revealed the total occlusion of the terminal abdominal aorta by a saddle embolus from a cardiac myxoma. A multidisciplinary team consisting of cardiothoracic and vascular surgeons were involved in treating the patient, which resulted in full resolution of the case. This paper details the progression of acute bilateral limb ischemia to chronic limb threatening ischemia resulting from the total occlusion of the terminal abdominal aorta by a saddle embolus.
Asunto(s)
Neoplasias Cardíacas , Isquemia , Extremidad Inferior , Mixoma , Células Neoplásicas Circulantes , Humanos , Masculino , Mixoma/complicaciones , Mixoma/diagnóstico por imagen , Mixoma/cirugía , Adulto , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Resultado del Tratamiento , Extremidad Inferior/irrigación sanguínea , Isquemia/etiología , Isquemia/diagnóstico por imagen , Isquemia/terapia , Células Neoplásicas Circulantes/patología , Progresión de la Enfermedad , Enfermedad Aguda , Angiografía por Tomografía Computarizada , Arteriopatías Oclusivas/etiología , Arteriopatías Oclusivas/diagnóstico por imagen , Arteriopatías Oclusivas/terapia , Embolia/etiología , Embolia/diagnóstico por imagen , Embolia/terapia , Flujo Sanguíneo Regional , AortografíaRESUMEN
INTRODUÇÃO Os mixomas são tumores primários cardíacos correspondendo em sua grande maioria de natureza benigna e de constituição sólida, sendo a prevalência mais comum no lado esquerdo (75 a 80% dos casos), com predomínio no sexo feminino. Apesar da histogênese mais comum ser benigna deve-se prosseguir com exérese precoce devido às possíveis complicações, em especial morte súbita e acidentes vasculares. O ecocardiograma é o exame diagnóstico de escolha pois caracteriza tamanho, localização e mobilidade da tumoração assim como a capacidade de obstrução e/ou de formação de êmbolos. Outra opção é a ressonância magnética cardíaca pois além das características anatômicas nos fornece dados de características do microambiente do tumor. DESCRIÇÃO DO CASO Paciente do sexo feminino, 40 anos, proveniente de São Paulo (SP). Deu entrada neste Serviço referenciada de hospital secundário com história de palpitações em precórdio associada a dispneia e astenia intensa com duração de 20 minutos há cerca de 3 meses. Nega queixas durante o período interepisódio assim como nega dor torácica. Como antecedentes patológicos possui fibrilação atrial (FA) paroxística com controle de frequência cardíaca com propranolol 40mg/dia e hipertensão arterial sistêmica (HAS) em uso de losartana 50mg/dia. Nega internações prévios devido o quadro supracitado. Em ECOTT realizado no serviço de origem presença de imagem hiperecoica, homogênea, aderida ao septo interatrial em átrio esquerdo medindo em seus maiores diâmetros aproximadamente 2,6x2,2cm sugestiva de mixoma atrial esquerdo. Prosseguindo investigação realizou novo ECOTT no Instituto Dante Pazzanese de Cardiologia (IDPC) onde observou-se imagem sugestiva de linha de dissecção que se inicia logo após a emergência da artéria subclávia esquerda que se estende até a aorta abdominal proximal. Atualmente recebendo propranolol 40mg/dia e losartana 50mg/dia, evoluindo com bons controles pressóricos e frequência cardíaca sendo programado a exérese de mixoma localizado em atrial esquerdo pela equipe do miocárdio do IDPC e posterior acompanhamento no ambulatório da equipe. CONCLUSÃO Apesar de se tratar de tumores raros e possuírem histologia benigna, os mixomas devem ser investigados e prosseguir com ressecção tumoral com brevidade, devido aos riscos de embolização. Idealmente a investigação deve ser iniciada com o ecocardiograma, seja o transesofágico ou transtorácico, como foi no caso relatado acima onde flagrou-se o mixoma em átrio esquerdo.
Asunto(s)
Humanos , Femenino , Adulto , Atrios Cardíacos , Mixoma , Fibrilación Atrial , Dolor en el Pecho , Espectroscopía de Resonancia Magnética , Muerte Súbita , Disección , DisneaRESUMEN
PURPOSE: This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings. METHODS: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed. RESULTS: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%). CONCLUSIONS: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences.
Asunto(s)
Tumores Odontogénicos , Humanos , Femenino , Masculino , Adulto , Tumores Odontogénicos/patología , Tumores Odontogénicos/diagnóstico por imagen , Tumores Odontogénicos/cirugía , Adolescente , Persona de Mediana Edad , Niño , Anciano , Preescolar , Adulto Joven , Anciano de 80 o más Años , Mixoma/patología , Mixoma/cirugía , Mixoma/diagnóstico por imagen , Brasil , Neoplasias Maxilomandibulares/patología , Neoplasias Maxilomandibulares/diagnóstico por imagen , Neoplasias Maxilomandibulares/cirugíaRESUMEN
We describe two cases of umbilical cord (UC) angiomyxoma diagnosed prenatally by sonography in the second trimester of pregnancy. In both cases, a complex mass was detected at the placental insertion site, characterized by an echoic nodule surrounding the umbilical vessels and distal edematous Wharton's jelly. Follow-up scans showed that the mass grew mainly at the expense of its edematous component, with normal uteroplacental Dopplers throughout the remaining of the pregnancy. However, late-onset fetal growth restriction complicated the progress of pregnancy, requiring delivery by Cesarean section at 37 weeks' gestation in both cases. Neonatal courses were unremarkable. An extensive review of the English literature was also performed, collecting 45 similar cases including ours. Our experience as well as the review of the literature confirms that UC angiomyxoma is an uncommon, sporadic condition that is usually detected incidentally during prenatal sonography and presents as an isolated finding. Nevertheless, it represents a high-risk condition for pregnancy complications including prematurity, fetal growth restriction, and fetal demise.
Asunto(s)
Mixoma , Ultrasonografía Prenatal , Cordón Umbilical , Humanos , Embarazo , Femenino , Ultrasonografía Prenatal/métodos , Cordón Umbilical/diagnóstico por imagen , Cordón Umbilical/embriología , Adulto , Mixoma/diagnóstico por imagen , Mixoma/embriologíaRESUMEN
Cardiac tumors are rare entities, among which atrial myxoma (AM) stands as the most frequent, accounting for approximately half of all reported cases. The incidence of AM is estimated to range from 0.001% to 0.3% within the general population, yet only about 0.06% of these cases present with coronary embolic events. We report on a 33-year-old male smoker who experienced acute, severe precordial pain radiating to the left upper limb, lasting for one hour. The electrocardiographic evaluation demonstrated ST-segment elevation in leads D2, D3, and aVF, alongside significantly elevated serum troponin levels, confirming a diagnosis of ST-segment elevation myocardial infarction (STEMI). Subsequent coronary angiography revealed proximal occlusion of the right coronary artery due to thrombus. An initial attempt of thrombus aspiration was unsuccessful, followed by primary angioplasty with balloon inflation without stent placement. Further diagnostic exploration through transthoracic echocardiography identified a homogenous, smooth-surfaced mass measuring 5.2 cm x 2.3 cm attached to the interatrial septum. This mass, characterized by lobulations, prolapsed into the mitral valve and left ventricle during diastole, consistent with AM. Surgical resection of the mass was successfully performed, with the patient being discharged asymptomatic. In the reported case, the patient's profile, notably his age, and gender, diverges from the typical epidemiological characteristics associated with AM. This case adds to the limited number of reports where the inferior wall is affected by the right coronary artery being occluded. This report emphasizes the significance of differential diagnoses in younger patients presenting with STEMI.
Neoplasias cardíacas são raras, tendo como principal representante o mixoma atrial (MA), que corresponde a cerca de metade de todos os casos. O MA tem incidência estimada entre 0.001% e 0.3% na população em geral, no entanto apenas aproximadamente 0,06% desses cursam com eventos embólicos coronarianos. Homem de 33 anos, tabagista, admitido com quadro de precordialgia intensa e irradiação para membro superior esquerdo com duração de uma hora. O eletrocardiograma evidenciou elevação de segmento ST nas derivações D2, D3 e aVF troponina sérica elevada, confirmando infarto com supra desnivelamento do segmento ST (IAMCSST). Foi realizada cineangiocoronariografia, a qual revelou oclusão em terço proximal de artéria coronária direita por trombo. Realizada tentativa de aspiração do trombo, sem sucesso, seguido por angioplastia primária com balão sem colocação de stent. Durante a investigação do quadro, paciente realizou ecocardiograma transtorácico o qual demonstrou massa homogênea de superfície regular, de 5.2 cm x 2.3 cm, aderida ao septo interatrial, com lobulações de características emboligênicas prolapsando para valva mitral e ventrículo esquerdo na diástole, compatível com MA. Foi realizada ressecção cirúrgica com paciente evoluindo assintomático, recebendo alta para seguimento ambulatorial. O caso relatado difere em idade e sexo do perfil epidemiológico típico sendo um dos poucos descritos com acometimento da parede inferior apresentando a artéria coronária direita como culpada. Este relato ratifica a importância do diagnóstico diferencial frente às apresentações de IAMCSST em jovens.
Asunto(s)
Atrios Cardíacos , Neoplasias Cardíacas , Mixoma , Infarto del Miocardio con Elevación del ST , Humanos , Masculino , Adulto , Mixoma/diagnóstico por imagen , Mixoma/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/patología , Infarto del Miocardio con Elevación del ST/etiología , Infarto del Miocardio con Elevación del ST/diagnóstico por imagen , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Ecocardiografía , Electrocardiografía , Angiografía CoronariaRESUMEN
INTRODUCTION: Primary cardiac myxomas are rare tumors. Concurrent valvular lesion is a common finding on evaluation which is thought to be due to annular dilatation secondary to tumor movement across the valve, functional obstruction across the valve, and severe pulmonary hypertension secondary to chronic obstruction. A common belief among surgeons is that excision of myxoma leads to abatement of symptoms, and further valve intervention may not be warranted. METHODS: A 10-year retrospective descriptive study was designed to analyze patients who underwent excision of cardiac myxoma at our center. Data was analyzed regarding presenting features, echocardiographic findings of myxoma and valve morphology, intraoperative assessment, and postoperative outcome with/without valve repair/replacement in all patients. RESULTS: A total of 22 patients underwent surgery for myxoma. Six patients underwent successful mitral valve repair with ring annuloplasty, two had moderate mitral regurgitation, three had severe mitral regurgitation, and one patient had no mitral regurgitation on preoperative assessment, but moderate mitral regurgitation was found intraoperatively. Four of these patients had no residual mitral regurgitation in follow-up period while two had mild residual mitral regurgitation. One patient had severe mitral stenosis of concurrent rheumatic etiology and successfully underwent mitral valve replacement. CONCLUSION: Cardiac myxomas are rare benign tumors commonly associated with mitral valve insufficiency. Mitral valve should be assessed intraoperatively after excision of mass as preoperative assessment might often be insufficient. Concomitant mitral valve intervention might be needed with a case-specific tailored approach, and mitral valve repair with ring annuloplasty offers best surgical outcome in such cases.
Asunto(s)
Neoplasias Cardíacas , Insuficiencia de la Válvula Mitral , Mixoma , Humanos , Insuficiencia de la Válvula Mitral/cirugía , Estudios Retrospectivos , Válvula Mitral/diagnóstico por imagen , Ecocardiografía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Mixoma/complicaciones , Mixoma/diagnóstico por imagen , Mixoma/cirugía , Resultado del TratamientoRESUMEN
Odontogenic myxoma is a maxillofacial tumor that is benign in nature. It is characterized by a slow-growing, painless, and site-aggressive behavior. A main feature is that it is not encapsulated so it has high potential of invasiveness and penetration into peripheral tissues. Large lesions may cause extensive compromise of the region. Treatment strategy for Odontogenic Myxoma is still controversial. Radical resection with an appropriate surgical margin is recommended, but emerging evidence has suggested that a more conservative approach will result in less morbidity and adequate results. This report shows a remarkable result on a 16-year-old patient who had a Mandibular Odontogenic Myxoma treated with a conservative approach. Intra-lesional absolute alcohol irrigation was performed during a 5-month period. Considerable volume reduction of the lesion happened which allowed a minimal overall resection. No recurrence was found after a 3 year follow-up.
Asunto(s)
Humanos , Femenino , Adolescente , Técnicas de Ablación/rehabilitación , Mixoma/terapiaRESUMEN
Introducción: Los tumores cardíacos primarios se caracterizan por su baja prevalencia, son principalmente mixomas y se presentan frecuentemente de forma asintomática. Objetivos: Identificar el tipo histológico más común, edad de presentación, tipo de cirugías y sobrevida de un grupo de pacientes tratados por Tumores Cardíacos Primarios (TCP) en el Hospital Regional de Temuco. Métodos: Revisión de fichas clínicas de 14 pacientes portadores de TCP entre marzo 2015 y diciembre 2021. Resultados: El tipo histológico más común fue el mixoma (85,7%), seguido por el fibroelastomas papilar (14,3%). La edad promedio fue 62 años (39-85), 9 fueron mujeres y 5 hombres. Los antecedentes mórbidos más comunes fueron: Insuficiencia Cardíaca Congestiva (ICC), Hipertensión Arterial (HTA) y Accidente Vascular Encefálico (AVE). La localización anatómica más común fue la Aurícula izquierda (92%). El tratamiento en el 92% de los casos fue resección aislada y en el 7% restante resección y reparación con parche. Conclusiones: Nuestros resultados son concordantes con la literatura.
Background: primary cardiac tumors are characterized by a low prevalence. Most of them are myxomas and asymptomatic. Aim: To describe the most common histological type, the age of presentation, type of surgery performed and survival of a group of patients operated on for Primary Cardiac Tumors (PCT) in the Hospital Regional de Temuco (Chile). Methods: Review of clinical records of 14 patients with PCT operated on between March 2015 and December 2021. Results: By far the most common histological type was a myxoma (85.7%), followed by a papillary fibroelastoma (14.3%). Mean age was 62 years (39-85), 9 were women and 5 men. The most common associated medical conditions were Congestive Heart Failure (CHF), Arterial Hypertension and Stroke The usual anatomical location was the left atrium (92%). Surgical treatment was isolated resection in 92% of cases and along with a patch repair in the remaining patient. Conclusion: good results were obtained, similar to those described in the literature.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Cirugía Torácica/estadística & datos numéricos , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/epidemiología , Cirugía Torácica/métodos , Análisis de Supervivencia , Estudios Longitudinales , Fibroelastoma Papilar Cardíaco/cirugía , Fibroelastoma Papilar Cardíaco/epidemiología , Tiempo de Internación , Mixoma/cirugía , Mixoma/epidemiologíaRESUMEN
A 33-year-old woman with a history of high blood pressure since she was 8 years old, hypothyroidism, polycystic ovary syndrome, metabolic syndrome, multiple nevi, and a maternal family history of death at age 50 due to malignant high blood pressure and heart failure. Cushing's syndrome secondary to a secretory pituitary microadenoma was diagnosed, being the cause of secondary arterial hypertension, and ruling out other causes such as renal stenosis and coarctation of the aorta. A transthoracic and transesophageal echocardiogram was performed, which detected a left atrial myxoma. Given the presence of an atrial myxoma, Cushing's syndrome and polycystic ovary syndrome, a diagnosis of Carney Complex was made due to the presence of positive Stratakis criteria. The cardiac tumor was resected, and pathology confirmed that it was an atrial myxoma. She evolved clinically stable in outpatient controls in a 6-month follow-up. Resection of the pituitary microadenoma is planned as a curative treatment for Cushing's syndrome and arterial hypertension.
Mujer de 33 años, con antecedentes de hipertensión arterial desde los 8 años, hipotiroidismo, síndrome de ovario poliquístico, síndrome metabólico, nevos múltiples y antecedente familiar materno de muerte a los 50 años por hipertensión arterial maligna e insuficiencia cardiaca. Se diagnosticó síndrome de Cushing secundario a un microadenoma hipofisario secretor, siendo la causa de la hipertensión arterial secundaria, y descartándose otras causas como estenosis renal y coartación de aorta. Se realizó u n ecocardiograma transtorácico y transesofágico que detectaron un mixoma auricular izquierdo. Ante la presencia de un mixoma auricular, síndrome de Cushing y síndrome de ovario poliquístico se llegó al diagnóstico de Complejo de Carney por la presencia de criterios de Stratakis positivos. Se realizó la resección del tumor cardiaco, y la anatomía patológica confirmó que se trataba de un mixoma auricular. Evolucionó clínicamente estable en controles ambulatorios en un seguimiento de 6 meses, y se planifica la resección del microadenoma hipofisario como tratamiento curativo del síndrome de Cushing y la hipertensión arterial.
Asunto(s)
Fibrilación Atrial , Complejo de Carney , Síndrome de Cushing , Neoplasias Cardíacas , Hipertensión , Mixoma , Neoplasias Hipofisarias , Síndrome del Ovario Poliquístico , Femenino , Humanos , Persona de Mediana Edad , Adulto , Niño , Complejo de Carney/complicaciones , Complejo de Carney/diagnóstico , Síndrome de Cushing/diagnóstico , Síndrome de Cushing/etiología , Síndrome de Cushing/cirugía , Síndrome del Ovario Poliquístico/complicaciones , Fibrilación Atrial/complicaciones , Mixoma/complicaciones , Mixoma/diagnóstico por imagen , Mixoma/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Neoplasias Hipofisarias/complicaciones , Hipertensión/complicacionesAsunto(s)
Fibrilación Atrial , Neoplasias Cardíacas , Infarto del Miocardio , Mixoma , Humanos , Hallazgos Incidentales , Infarto del Miocardio/etiología , Electrocardiografía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Mixoma/complicaciones , Mixoma/diagnóstico , Atrios CardíacosRESUMEN
Cardiac myxoma is a relatively rare tumour, usually solitary, that occurs primarily in the left atrium of adults, but comprises only 30% of cardiac tumours in children. We recently treated a 12-year-old girl with multiple recurrent myxomas in three cardiac chambers(following surgical resection 3 years earlier). Genomic analysis showed the PKAR1A mutation typical for Carney complex.
Asunto(s)
Complejo de Carney , Neoplasias Cardíacas , Mixoma , Adulto , Femenino , Niño , Humanos , Complejo de Carney/diagnóstico , Complejo de Carney/genética , Complejo de Carney/patología , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Mixoma/diagnóstico , Mixoma/genética , Mixoma/cirugía , Atrios Cardíacos/cirugíaRESUMEN
It was to report a rare case of peripheral odontogenic myxoma removed with high-power diode laser and to do an extensive review of studies of odontogenic cysts and tumors treated with high-power laser (HPL). This is a rare case of a 63-year-old male patient with a peripheral odontogenic myxoma measuring approximately 10 cm in the attached gingiva region of tooth 16 removed with a high-power diode laser (808 nm, 3 W, in continuous mode, under constant suction, with 400-µm optical fiber). A literature review was also carried out looking for articles that involved the use of HPL in the treatment of odontogenic cysts and tumors, without restriction of year or language. In the present case, there was no need for suturing, no postoperative discomfort, and minimal bleeding during the procedure. In a 12-month follow-up period, there were no signs of recurrence. Only two cases of intra-osseous odontogenic myxomas treated with HPL and 10 cases involving other odontogenic cysts and tumors were found. All studies showing HPL to be effective in treating these lesions. Despite the different types of lasers used and different parameters, it is observed that lasers are effective in the treatment of odontogenic lesions.
Asunto(s)
Mixoma , Tumores Odontogénicos , Masculino , Humanos , Persona de Mediana Edad , Láseres de Semiconductores/uso terapéutico , Mixoma/cirugía , Mixoma/diagnóstico , Mixoma/patología , Tumores Odontogénicos/radioterapia , Tumores Odontogénicos/cirugía , Tumores Odontogénicos/diagnósticoRESUMEN
El angiomixoma agresivo pélvico es un tumor de partes blandas extremadamente raro, del cual se han reportado alrededor de 350 casos hasta la fecha. A continuación se reporta el caso clínico de una paciente que presentó dicho tumor y se describe el proceso diagnóstico y su tratamiento quirúrgico. Por otro lado, se realiza una breve revisión de la literatura disponible hasta el momento sobre el tema.
Aggressive pelvic angiomyxoma is an extremely rare soft tissue tumor, of which around 350 cases have been reported to date. This article aims at reporting the case of a patient presenting said tumor, as well as describing its diagnostic approach and its surgical treatment. On the other hand, it aims at briefly reviewing the available literature on the subject.
O angiomixoma pélvico agressivo é um tumor extremamente raro dos tecidos moles, tendo sido descritos até à data cerca de 350 casos. Relatamos o caso de uma doente que apresentava este tumor e descrevemos o processo de diagnóstico e tratamento cirúrgico. É também feita uma breve revisão da literatura disponível até à data sobre o assunto.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Neoplasias Pélvicas/cirugía , Neoplasias Pélvicas/diagnóstico por imagen , Mixoma/cirugía , Mixoma/diagnóstico por imagen , Biopsia , Imagen por Resonancia MagnéticaRESUMEN
Background: A cutaneous or superficial myxoma is a benign neoplasm of dermal or subcutaneous fibroblast origin. Although rare, it has been previously described in several species, including poultry. It presents as a single node or soft mass with a gelatinous cut surface. Histopathological analysis is essential for diagnosis and to differentiate it from other mesenchymal neoplasms and inflammatory or degenerative processes. Microscopically, it consists of dermal or subcutaneous lobules of plump, stellate, or spindle-shaped, bland-looking cells embedded in a basophilic myxoid matrix. This report describes the pathological findings in a rare case of cutaneous myxoma in a 42-day-old broiler flock. Cases: During ante mortem inspection of a 42-day-old broiler flock at a slaughterhouse under the authority of the Federal Inspection Service (southern Brazil), nodular lesions or encrusted areas with yellow and black areas were observed in the head skin of less than 1% of animals. These lesions, approximately 0.5 cm in diameter, were observed on the comb, in the periocular skin region, and close to the animals' nostrils. During the breeding period, no health or epidemiological events were observed. Fragments of the lesions in the comb and periocular skin were collected and fixed in buffered 10% formalin. The samples were sent to the laboratory, routinely processed, and stained with hematoxylin and eosin and Alcian blue. Microscopically, the lesions consisted of irregular multifocal proliferation of connective tissue showing spindle cells with poorly demarcated borders and scarce cytoplasm in a slightly basophilic myxoid aspect matrix. The adjacent epidermis is compressed due to neoplastic proliferation. No areas of epithelial hyperplasia or inclusion bodies were observed. According to the pathologic description and considering its descriptive epidemiology, our main clinical suspicion was cutaneous fowl pox, a pathology characterized by the appearance of nodules in regions devoid of feathers. However, the microscopic changes observed were compatible with those described for cutaneous myxomas. In addition, the extracellular matrix was positive for Alcian Blue staining, which is an indicator of myxoma. In the present case, the SIF did not report the same macroscopic lesions in other flocks of the same origin. Discussion: Connective tissue tumors, including myxomas, occur considerably less frequently under field conditions. In addition, these neoplasms are more frequent in mature birds and are not usually described in broilers, as observed in this report. The cutaneous myxoma described in broilers is usually a sporadic neoplasm that does not cause zootechnical losses, as observed in the case report. Its etiology is unknown and has been associated with various factors, such as local trauma and foreign bodies. Some fragments of plant material from the breeding environment were microscopically detected in the encrusted areas, which may indicate previous trauma or a foreign body. Myxoma has been associated with avian leukosis virus (ALV) subgroup A, but SIF did not report the same macroscopic lesions in other flocks of the same breeder hen's origin in the present case. Furthermore, sporadic connective tissue tumors associated with the virus occur in mature chickens but not in broilers. Myxoma lesions should be considered in the differential diagnosis of other connective tissue tumors and infectious agents that cause lesions in the skin and subcutaneous tissue.
Asunto(s)
Animales , Pollos/lesiones , Mixoma/veterinaria , Sacrificio de Animales , Neoplasias de Tejido Conjuntivo/veterinariaRESUMEN
Mixoma Odontogênico é um tumor de origem mesenquimal raro, de desenvolvimento lento e agressivo que acomete indivíduos entre os 10 e 40 anos de idade e principalmente, do gênero feminino. Este estudo teve como principal objetivo descrever um caso clinico de tratamento cirúrgico do mixoma odontogênico sem ressecção maxilar em uma paciente do gênero feminino que compareceu ao Ambulatório de Patologia Oral e Maxilo Facial, da Faculdade de Odontologia da UNIRG, na cidade de Gurupi-TO - Brasil. A paciente foi submetida ao tratamento cirúrgico conservador, através da curetagem e enucleação total do tumor. A proservação foi realizada em períodos de 12 meses, 24 meses e 48 meses aonde pode-se observar a sequencial e completam reparação óssea, inclusive a permanência dos dentes envolvidos que foram submetidos a tratamento endodôntico com total remodelação da lâmina dura e do ligamento periodontal... (AU)
Odontogenic Myxoma (OM) is a rare tumor of mesenchymal origin, of slow and aggressive development that affects individuals between 10 and 40 years of age and mainly female. This study aimed to describe a clinical case of surgical treatment of odontogenic myxoma with out maxillary resection in a female patient who attended the Outpa tient Clinic of Oral Pathology and Facial Maxillo, of UNIRG Dental School, in the city of Gurupi-TO - Brazil. The patient underwent con servative surgical treatment through curettage and total enucleation of the tumor. Proservation was carried out in periods of 12 months, 24 months and 48 months where it was possible to observe the sequential and complete bone repair including the permanence of the involved teeth that underwent endodontic treatment with total remodeling of hard blade and of the periodontal ligament... (AU)
El mixoma odontogénico es un tumor de origen mesenquimal poco frecuente, de desarrollo lento y agresivo que afecta a individuos entre 10 y 40 años de edad y principalmente mujeres. El objetivo principal de este estudio fue describir un caso clínico de tratamiento quirúrgico de mixoma odontogénico sin resección maxilar en una paciente femenina que asistió a la Clínica Ambulatoria de Patología Oral y Maxilo Facial, de la Facultad de Odontología de UNIRG, en la ciudad de Gurupi-TO - Brasil. El paciente se sometió a tratamiento quirúrgico conservador mediante legrado y enucleación tumoral total. La conservación se realizó en periodos de 12 meses, 24 meses y 48 meses donde es posible observar reparación ósea secuencial y completa, incluyendo la permanencia de los dientes implicados que fueron sometidos a tratamiento endodóntico con remodelación total de la durancia y ligamento periodontal... (AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Neoplasias Maxilares/cirugía , Tumores Odontogénicos , Maxilar/cirugía , Mixoma/cirugía , Enfermedades Maxilares/cirugía , Estudios de Seguimiento , Resultado del Tratamiento , Maxilar/fisiopatologíaRESUMEN
Las neoplasias cardíacas se dividen en tumores primarios y secundarios; estos últimos son 30 veces más frecuentes. La mayoría de las neoplasias cardíacas son benignas y dentro de este grupo destaca el mixoma auricular. La presentación clínica es muy variable en relación con su ubicación, tamaño y movilidad, y los hallazgos a nivel de las pruebas complementarias son inespecíficos. Dado que su historia natural muchas veces pasa inadvertida, el mixoma puede culminar en la obstrucción auriculoventricular, obstrucción del tracto de salida ventricular o incluso embolias sistémicas; de esta forma, es el causante de sintomatología severa como síncope, insuficiencia cardíaca y muerte súbita cardíaca. Su manifestación clínica como un síncope es bastante frecuente. Se expone el caso de un paciente de sexo masculino de 81 años que consultó en el servicio de urgencias por un síncope. Durante su valoración, se identificó el mixoma auricular como etiología de este.
Cardiac neoplasms are divided into primary and secondary tumors, the latter are 30 times more frequent. Most are benign and within this group the atrial myxoma stands out. The clinical presentation is very variable in relation to its location, size and mobility, and the findings in the complementary tests are nonspecific. Since its natural history often goes unnoticed, the myxoma can culminate in atrial ventricular obstruction, ventricular outflow tract obstruction or even systemic embolism, causing severe symptoms such as syncope, heart failure and sudden cardiac death. Its clinical manifestation as syncope is quite common. The case of an 81-year-old male patient who consulted at the emergency department for syncope is presented, in which the atrial myxoma was subsequently identified as the etiology of the event during the further evaluation.
As neoplasias cardíacas dividem-se em tumores primários e secundários, estes últimos são 30 vezes mais frequentes. A maioria são benignas e dentro deste grupo destaca-se o mixoma auricular. A apresentação clínica é muito variável em relação com sua localização, tamanho e mobilidade, e os achados a nível dos testes complementares são inespecíficos. Dado que a sua história natural muitas vezes passa despercebida, o mixoma pode culminar na obstrução aurículo-ventricular, obstrução do tracto de saída ventricular ou mesmo embolias sistémicas, sendo assim o causador de sintomatologia severa como síncope, insuficiência cardíaca e morte súbita cardíaca. Sua manifestação clínica como síncope é bastante comum. Apresenta-se o caso de um paciente de sexo masculino de 81 anos que consultou no serviço de urgências para um síncope. Durante a sua avaliação, se identificou mixoma auricular como etiologia deste
Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Síncope/etiología , Neoplasias Cardíacas/diagnóstico por imagen , Mixoma/diagnóstico por imagen , Ecocardiografía Transesofágica , Octogenarios , Atrios Cardíacos , Neoplasias Cardíacas/cirugía , Mixoma/cirugíaRESUMEN
Cardiac myxomas are the most common benign primary tumors and are most often located in the left atrium at the level of the interatrial septum, with the characteristic of being pedunculated and highly mobile, which is why they sometimes interfere with the functioning of the mitral valve, generating variable degrees of stenosis and mitral insufficiency. Diagnosis is by echocardiography and treatment is surgical resection. We present the case of a patient with a large atrial myxoma and severe double mitral lesion.
Asunto(s)
Humanos , Femenino , Anciano , Neoplasias Cardíacas/diagnóstico por imagen , Mixoma/diagnóstico , Ecocardiografía Transesofágica , Diagnóstico Diferencial , Atrios Cardíacos/patología , Atrios Cardíacos/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Mixoma/cirugía , Mixoma/clasificación , Mixoma/fisiopatologíaRESUMEN
Perioperative stroke is one of the complications that can occur during the surgical procedure and up to 30 days after it. A 52-year-old woman with no neurological symptoms and a diagnosis of intracardiac mass. She underwent cardiac surgery with resection of the tumor that was compatible with atrial myxoma. In the immediate postoperative, she presented neurological symptoms and was diagnosed with basal ganglia infarction of embolic etiology. Perioperative stroke appears most frequently in cardiovascular surgery but is rarely reported in heart tumor resection surgery.
El accidente cerebrovascular perioperatorio es una de las complicaciones que pueden presentarse durante el proceder quirúrgico y hasta los 30 días posteriores al mismo. Se presenta el caso de una mujer de 52 años, sin síntomas neurológicos y con diagnóstico de masa intracardiaca. Se le realizó cirugía cardiaca con resección del tumor, que resultó compatible con mixoma auricular. En el posoperatorio inmediato presentó sintomatología neurológica y se diagnosticó infarto de ganglios basales de etiología embólica. El accidente cerebrovascular perioperatorio aparece con mayor frecuencia en las cirugías cardiovasculares, pero rara vez es reportado en cirugías de exéresis de tumores cardiacos.
Asunto(s)
Neoplasias Cardíacas , Mixoma , Accidente Cerebrovascular , Femenino , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Humanos , Persona de Mediana Edad , Mixoma/complicaciones , Mixoma/diagnóstico , Mixoma/cirugía , Accidente Cerebrovascular/complicacionesRESUMEN
Primary cardiac tumors are rare, with an incidence between 0.0017 and 0.19%, and are asymptomatic in up to 72% of cases. Approximately 75% of tumors are benign, and nearly 50% of these are myxomas. Concerning location, 75% of myxomas are in the left atrium, 15 to 20% in the right atrium, and more rarely in the ventricles. The finding of cardiac myxomas usually implies immediate surgical excision to prevent embolic events and sudden cardiac death. Reports with documented growth rate are rare, and the actual growth rate remains a controversial issue. We report the rapid growth rate of a right atrial myxoma in an oligosymptomatic 69-year-old patient, with negative previous echocardiographic history in the last two years, who refused surgery upon diagnosis, enabling monitoring of myxoma growth.