RESUMO
BACKGROUND: Giant hepatic hemangiomas (GHHs) are those that are larger than 4 cm in size. AIMS: The aim of this study was to describe GHH clinical findings, their risk factors, diagnostic approach and management, and to compare these data with those of conventional hemangiomas. METHODS: We performed a retrospective analysis of patients diagnosed with hemangiomas, whether by imaging studies or histopathology, at our hospital within the time frame of 1990-2008. The medical records of each patient were reviewed to obtain clinical and surgical data. RESULTS: Of the 57 patients with liver hemangioma, 41 (72%) were women and 32 (56%) had GHH. Liver hemangioma median size was 4.49 cm. In regard to the patients with GHH, 31.2% were asymptomatic and when symptoms presented, pain was the most common. Both symptoms and oral contraceptive exposure were more common in the GHH patients. Nine patients with GHH underwent surgery: 2 open biopsies due to diagnostic uncertainty, one enucleation, and 6 resections. CONCLUSIONS: GHHs are more prevalent in women and when symptomatic, pain is the most frequent complaint. Diagnosis is usually made through imaging studies, but when there is diagnostic doubt, surgical exploration is sometimes needed. Oral contraceptive use is most likely more of a risk factor for GHH than for conventional hemangioma, but this association needs to be studied further.
Assuntos
Hemangioma/terapia , Neoplasias Hepáticas/terapia , Adulto , Idoso , Biópsia , Feminino , Hemangioma/patologia , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
Allelic variants in the promoter region of the serotonin transporter (5-HTT) gene have been implicated in several psychiatric disorders and personality traits. In particular, two common alleles in a variable repeat sequence of the promoter region (SLC6A4) have been differentially associated with a display of abnormal levels of anxiety and affective illness in individuals carrying the "s" allele. The aim of this study was to compare the basal cerebral metabolic activity of non-psychiatric subjects in fronto-limbic structures to determine whether differences exist in basal metabolic activity within this functional polymorphism. PET scans with fluorine-18 fluorodeoxyglucose as radiotracer were performed in 71 non-psychiatric subjects previously screened for psychopathology and subsequently genotyped for SLC6A4; PET images were compared with SPM2 according to s/s (n = 27), s/l (n = 25), and l/l (n = 19) groups considering a significance threshold in a priori selected areas of P < 0.001 and an extent threshold > or =5 voxels. The analysis showed an effect of interest among the three genotype groups in right anterior cingulate gyrus (ACC), left middle frontal gyrus, and left posterior cingulate gyrus (PCC). Comparison between l/l vs. s/s showed increased metabolism for l/l in left middle frontal gyrus and an increase for s/s in right ACC and left PCC. Comparison between s/s vs. s/l showed an increase for s/s in left PCC and right ACC. Increased basal metabolism in fronto-limbic structures for the s/s group may be conceived as an "overactive metabolic state" of these structures, possibly related to an increased susceptibility for developing an anxiety-depression spectrum disorder.