RESUMO

BACKGROUND: Gastric non-Hodgkin lymphoma is a rare tumour that represents approximately 7% of all stomach cancers and 2% of all lymphomas. The most frequent location of gastric MALT (mucosa associated lymphoid tissue) lymphomas is in the antrum in 41% of the cases, and 33% can be multifocal. The risk of spontaneous perforation of a gastric MALT lymphoma is 4-10%. CLINICAL CASE: 24 year old male patient carrying the Human Immunodeficiency Virus, who began with signs and symptoms of acute abdomen and fever 72 hours before arriving in the emergency room. A computed tomography was performed that showed free fluid in the cavity, and gastric wall thickening. The patient underwent a laparotomy, finding absence of the anterior wall of the stomach, sealed with the left lobe of the liver, colon and omentum. Total gastrectomy, with oesophagosty and jejunostomy tube, was performed. CONCLUSIONS: Gastric perforation secondary to a MALT lymphoma is rare, with high mortality. There is limited information reported of this complication and should be highly suspected in order to provide appropriate treatment for a complication of this type.

Assuntos

RESUMO

BACKGROUND: The gastrointestinal tract lipomas are a rare, benign, slow-growth condition and can be a diagnostic challenge, they are more frequent in the colon. The gastric lipoma occurs in fewer than 5% of cases, and represents less than 1% of all gastric tumors, usually their finding is incidental and the initial presentation may be obstruction, bleeding and intussusception. The purpose of presenting this case for its rarity, the few symptoms that the patient present and collect the most current information about the diagnosis and treatment. CLINICAL CASE: We report the case of a 59 years-old male patient who after having suffered acute pancreatitis a tomography control was made looking for complications it found a pylorus-duodenal intussusception, an endoscopy was performed and a tumor about 6 cm was found and biopsies without confirm diagnosis, so it was decided to perform a partial gastrectomy, histopathology study confirmed the diagnosis of gastric lipoma as well as disease free margins. Was maintained with adequate postoperative evolution currently asymptomatic. CONCLUSIONS: The gastric lipoma is a rare benign entity that can mimic a malignancy, in our case an incidental finding which was managed by partial gastrectomy with satisfactory postoperative results.

Assuntos

RESUMO

BACKGROUND: Meckel's diverticulum is the most common congenital anomaly in the small intestine, which results from incomplete obliteration omphalomesenteric duct, usually the diagnosis is incidental, rarely reaching with bleeding, obstruction, diverticulitis or in rare cases a neoplasm. Clinic case: 67 year old woman that started her condition with urinary symptoms (dysuria, frequency, bladder tenesmus and pushing), within the study protocol a cystogram was performed and demonstrated a defect in the bladder dome edges with compression effect, the computed tomography reported a bladder infiltrating hypodense lesion, which is decided to resect finding Meckel's diverticulum with a tumor that infiltrates the bladder dome, the histopathological confirmed the diagnosis shown free edges but insufficient, which need a reintervention to increase margins; all the extension studies shown without tumor activity. CONCLUSIONS: Mucoproductor adenocarcinoma derived from a Meckel's diverticulum is a clinical entity that because of its nonspecific symptomatology and variability of presentation, is diagnosed incidentally on radiological images. The disease has a high mortality rate and a low prevalence.

Antecedentes: el divertículo de Meckel es la anomalía congénita más frecuente en el intestino delgado, que resulta de la obliteración incompleta del conducto onfalomesentérico; su diagnóstico suele ser incidental, pocas veces con sangrado, obstrucción, diverticulitis o en casos raros una neoplasia. Caso clínico: paciente femenina de 67 años de edad, que inició su padecimiento con síntomas urinarios (disuria, polaquiuria, pujo y tenesmo vesical). El cistograma demostró: defecto en el domo de la vejiga, bordes irregulares y efecto de compresión. La tomografía computada reportó: vejiga con lesión hipodensa infiltrante en el domo vesical, al resecarla se encontró un divertículo de Meckel con un tumor infiltrante; el estudio histopatológico confirmó el diagnóstico y demostró los bordes libres; todos los estudios de extensión resultaron sin actividad tumoral. Conclusiones: el adenocarcinoma mucoproductor derivado de un divertículo de Meckel es una entidad clínica que debido a sus síntomas inespecíficos y variabilidad de presentación sólo se diagnostica por lo que se aprecia en las imágenes radiológicas. Este adenocarcinoma tiene un alto índice de mortalidad pero baja prevalencia.

Assuntos