RESUMO
O lipoma é um tumor frequente dos tecidos moles e pode localizar-se em qualquer parte do corpo; no entanto, sua apresentação na mão é rara. São chamados gigantes quando excedem 5cm; nestes casos, o diagnóstico diferencial deve ser feito com lipossarcoma. Os lipomas devem ser caracterizados no pré-operatório com um exame de imagem, e seu tratamento é cirúrgico. Apresentamos o caso de uma paciente com um lipoma gigante da mão dominante, tratada com sucesso com uma abordagem cirúrgica modificada de Bruner
Lipomas are frequent soft tissue tumors and can be found anywhere in the body; however, their location in hand is rare. They are called giants when they exceed 5 cm. In these cases, the differential diagnosis must be made with liposarcoma. These benign tumors must be characterized preoperatively with an imaging study, and their treatment is surgical. We present the case of a patient with a giant hand lipoma successfully treated with a modified Bruner incision approach
RESUMO
Bothrops atrox snakes are the leading cause of snake bites in Northern Brazil. The venom of this snake is not included in the antigen pool used to obtain the Bothrops antivenom. There are discrepancies in reports on the effectiveness of this antivenom to treat victims bitten by B. atrox snakes. However, these studies were performed using a pre-incubation of the venom with the antivenom and, thus, did not simulate a true case of envenomation treatment. In addition, the local lesions induced by Bothrops venoms are not well resolved by antivenom therapy. Here, we investigated the efficacy of the Bothrops antivenom in treating the signs and symptoms caused by B. atrox venom in mice and evaluated whether the combination of dexamethasone and antivenom therapy enhanced the healing of local lesions induced by this envenomation. In animals that were administered the antivenom 10 minutes after the envenomation, we observed an important reduction of edema, dermonecrosis, and myonecrosis. When the antivenom was given 45 minutes after the envenomation, the edema and myonecrosis were reduced, and the fibrinogen levels and platelet counts were restored. The groups treated with the combination of antivenom and dexamethasone had an enhanced decrease in edema and a faster recovery of the damaged skeletal muscle. Our results show that Bothrops antivenom effectively treats the envenomation caused by Bothrops atrox and that the use of dexamethasone as an adjunct to the antivenom therapy could be useful to improve the treatment of local symptoms observed in envenomation caused by Bothrops snakes.