RESUMO
Signet ring cell carcinoma of the rectum is rare and typically presents with advanced disease. We report a case of a 68-year-old man who presented with left lower quadrant pain and was found to have signet ring cell carcinoma with intussusception. This case is unusual because of its polypoid growth pattern and apparent early pathological stage. We discuss the differential diagnoses and prognosis.
RESUMO
Background. Melanoma in blacks is uncommon and exceedingly rare in association with a diabetic ulcer. We present a case of a spindle cell melanoma masquerading as a diabetic ulcer. Case Report. A 57-year-old overweight woman presented to The Maria Holder Diabetes Centre for the Caribbean with a nonhealing ulcer of the right heel after being treated by various primary care physicians over the preceding year. Her general and systematic examinations were unremarkable. There was a 1 × 1.5 cm ulcer with a necrotic base which bled easily on contact with no evidence of peripheral neuropathy nor arterial insufficiency. Microscopic examination of a biopsy of the lesion showed fascicles of spindle cells with plump nuclei and intracytoplasmic yellow-brown pigment. Immunohistochemistry confirmed a diagnosis of melanoma. Discussion. There should be a high index of suspicion of malignancy with nonhealing diabetic ulcer especially when coupled with short disease duration. This case highlights the importance of a biopsy and histological evaluation in ulcers presenting in recently diagnosed diabetics with no evidence of peripheral neuropathy or vascular disease. Melanoma should be considered in spindle cell lesions especially with pigment and residual nevus cells.
RESUMO
A 65-year-old man diagnosed with adenocarcinoma of the prostate gland opted for hormonal manipulation and had bilateral orchiectomy. Histological evaluation showed tumour deposits in both epididymides. Despite the relatively common occurrence of adenocarcinoma of the prostate, epididymal metastasis is a rare occurrence. This case highlights the need for proper evaluation of the testes and para-testicular structures so that accurate staging of these tumours can be made.
Assuntos
Adenocarcinoma/secundário , Epididimo/patologia , Neoplasias da Próstata/patologia , Neoplasias Testiculares/secundário , Adenocarcinoma/terapia , Idoso , Terapia Combinada , Humanos , Masculino , Neoplasias da Próstata/terapia , Neoplasias Testiculares/terapiaRESUMO
A 65-year-old man diagnosed with adenocarcinoma of the prostate gland opted for hormonal manipulation and had bilateral orchiectomy. Histological evaluation showed tumour deposits in both epididymides. Despite the relatively common occurrence of adenocarcinoma of the prostate, epididymal metastasis is a rare occurrence. This case highlights the need for proper evaluation of the testes and para-testicular structures so that accurate staging of these tumours can be made
Assuntos
Humanos , Masculino , Idoso , Adenocarcinoma/secundário , Epididimo/patologia , Neoplasias da Próstata/patologia , Neoplasias Testiculares/secundário , Adenocarcinoma/terapia , Neoplasias da Próstata/terapia , Neoplasias Testiculares/terapia , Terapia CombinadaRESUMO
A retrospective review of all hepatic abscesses identified at autopsy over the 24-year period 1977-2000 at the University Hospital of the West Indies (UHWI), Kingston, Jamaica, was conducted. Post mortem and microbiology records were reviewed. Data collected included age, gender, predisposing factors, organisms isolated, number of abscesses and associated conditions, such as diabetes mellitus. Data for the adults was analyzed separately. Thirty-nine cases of pyogenic abscesses were identified from 7480 post-mortems. Thirty-three occurred in adults of mean age 59.5 years. Sixty per cent of the abscesses were solitary. Biliary tract disease was the predisposing factor in 33% of cases. Six per cent were cryptogenic: 11/33 patients were diabetic and these were significantly older than non-diabetics (p < 0.014) Klebsiella pneumoniae was the most common organism isolated from diabetics (6.9). Only 2/33 abscesses were diagnosed ante-mortem. The abscesses in children were more frequently multiple and associated with extra-abdominal infection. Gram positive cocci were the commonly isolated organisms in children. There were no cases of amoebic abscess. The prevalence of hepatic abscess was low. Diabetes mellitus was a significant contributing factor. A high index of clinical suspicion is therefore warranted particularly in elderly diabetics.
Assuntos
Infecções por Bactérias Gram-Negativas/patologia , Infecções por Bactérias Gram-Positivas/patologia , Hospitais Universitários , Abscesso Hepático/patologia , Fígado/patologia , Abdome/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia , Sistema Biliar/patologia , Criança , Pré-Escolar , Feminino , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Lactente , Abscesso Hepático/microbiologia , Masculino , Pessoa de Meia-Idade , Índias OcidentaisRESUMO
A retrospective review of all hepatic abscesses identified at autopsy over the 24-year period 1977-2000 at the University Hospital of the West Indies (UHWI), Kingston, Jamaica, was conducted. Post mortem and microbiology records were reviewed. Data collected included age, gender, predisposing factors, organisms isolated, number of abscesses and associated conditions, such as diabetes mellitus. Data for the adults was analyzed separately. Thirty-nine cases of pyogenic abscesses were identified from 7480 post-mortems. Thirty-three occurred in adults of mean age 59.5 years. Sixty per cent of the abscesses were solitary. Biliary tract disease was the predisposing factor in 33 of cases. Six per cent were cryptogenic: 11/33 patients were diabetic and these were significantly older than non-diabetics (p < 0.014) Klebsiella pneumoniae was the most common organism isolated from diabetics (6.9). Only 2/33 abscesses were diagnosed ante-mortem. The abscesses in children were more frequently multiple and associated with extra-abdominal infection. Gram positive cocci were the commonly isolated organisms in children. There were no cases of amoebic abscess. The prevalence of hepatic abscess was low. Diabetes mellitus was a significant contributing factor. A high index of clinical suspicion is therefore warranted particularly in elderly diabetics