RESUMO
We report the case of a 36-year-old man who had acquired immune deficiency syndrome and developed suppurative mediastinitis extending over the left lung and anterior thoracic wall around the sternum, pericardial effusions, splenomegaly, and mesenteric and periaortic lymphadenomegaly due to Mycobacterium avium (genotype I). The organism was isolated from an axillary lymph node and the bone marrow. Mediastinitis associated with disseminated M. avium complex infection is uncommon and, to the best of our knowledge, this manifestation has not reported before.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Mediastinite/microbiologia , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/complicações , Derrame Pericárdico/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , Humanos , Imageamento por Ressonância Magnética , Masculino , Mediastinite/diagnóstico , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Derrame Pericárdico/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Folliculosebaceous cystic hamartoma (FSCH) is a cutaneous hamartoma of pilosebaceous origin that usually occurs on the face. We present what we believe is only the second reported case of FSCH of the external auditory canal, and the first in an adult. The patient was a 59-year-old woman who presented with a 4-year history of a firm nodule on the left external auditory canal that had caused hearing loss, pruritus, and pain. The lesion was excised, and histopathologic examination identified infundibular cysts, hyperplasia of the sebaceous lobules, and a large amount of mucin, features that are consistent with FSCH. One year postoperatively, the patient was asymptomatic, and no evidence of recurrence was noted.
Assuntos
Meato Acústico Externo/patologia , Neoplasias da Orelha/patologia , Hamartoma/patologia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias da Orelha/cirurgia , Feminino , Hamartoma/cirurgia , Humanos , Pessoa de Meia-Idade , Neoplasias das Glândulas Sebáceas/cirurgiaRESUMO
BACKGROUND: McCune-Albright syndrome is a relatively rare disease characterized by the trio of fibrous dysplasia, café-au-lait pigmentation, and endocrine disturbances. It predominantly affects females and may be associated with sarcomatous degeneration in 0.4% to 4% of the cases. CASE REPORT: This article reports on the case of a 24-year-old female patient who had presented a mass in the oral cavity for 30 days, probably originating from the left ramus of the mandible. She had a previous diagnosis of polyostotic fibrous dysplasia, along with café-au-lait spots and endocrine disorders, thus characterizing McCune-Albright syndrome. Histopathological examination of a biopsy specimen revealed osteosarcoma of the mandible. The patient underwent chemotherapy and a surgical procedure for lesion resection. One year has now passed since the patient's operation, and the disease is under control. DISCUSSION: The patient presented sarcomatous degeneration in areas of fibrous dysplasia, consisting of mesenchymal cells that produced osteoid. Malignant degeneration is rare when it is not associated with McCune-Albright syndrome. There is no curative treatment for the syndrome. Attending physicians need to bring endocrine disorders under control, with surgical treatment in cases of significant deformities, as well as providing clinical and psychological care.