RESUMO
We present the case of a synovial sarcoma five years after primary total hip arthroplasty in a male 65 year-old patient who was surgically treated for left hip pain due to coxarthrosis. A 32 mm uncemented prosthesis with metal-on-polyethylene tribology was placed in the patient. The latter developed synovial sarcoma that caused lung metastasis. The association between total hip arthroplasty and malignancy is discussed, as well as its frequency worldwide.
Assuntos
Artroplastia de Quadril/efeitos adversos , Neoplasias Ósseas/etiologia , Prótese de Quadril/efeitos adversos , Sarcoma Sinovial/etiologia , Idoso , Humanos , Masculino , Metais , Polietileno , Desenho de PróteseRESUMO
In osteogenic sarcoma an increase in patient survival has been observed due to improvement of diagnostic and treatment methods. The objective of the investigation was to determine the usefulness of scintigraphy with 99mTc-MIBI in comparison to clinical revaluation, in order to assess tumor response (sarcoma) to chemotherapy previous to surgery. Patients with histopathological osteogenic sarcoma that received chemotherapy were included, clinical and scintigraphy response was assessed previous to the surgery. The gold standard for comparison was the degree necrosis histopathological analysis of the surgical specimen with measurement. Twelve patients met the inclusion criteria. A was observed a higher correlation between the 99mTc-MIBI and the histopathology. vs. clinical evaluation (0.89 vs. 0.59 respectively). Likewise the sensitivity (Se) and specificity (Sp) were superior (Se and Sp = 100% vs. Se 66.6% and Sp 75%) when therapeutically responses good and null were compared. We may conclude that scintigraphy with 99mTc-MIBI used to asses the response to presurgery chemotherapy in patients with osteogenic sarcoma, together with the clinical assessment, help the physician to make therapeutically decisions with more objectivity and certainly.
Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osteossarcoma/diagnóstico por imagem , Adolescente , Adulto , Antineoplásicos/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/tratamento farmacológico , Osteossarcoma/patologia , Osteossarcoma/cirurgia , Valor Preditivo dos Testes , Cintilografia , Compostos Radiofarmacêuticos , Tecnécio Tc 99m SestamibiRESUMO
A case of adenosquamous ovarian carcinoma in a 50 years old female is reported. The patient had marked improvement of her symptoms after resection of the tumor and chemotherapy. The knowledge of this association forces to rule out an ovarian carcinoma.