RESUMO
Primary soft-tissue sarcomas (STSs) of the chest wall are uncommon. Complete surgical resection remains the mainstay of treatment being sternal resection ocassionally required. We present a 25-year-old man with an anterior chest wall STS. The patient underwent complete oncological resection with reconstruction using titanium bars combined with a free vascularised anterolateral thigh flap. STSs of the chest wall are very rare and they comprise a surgical challenge for both resection and reconstruction.
Assuntos
Procedimentos de Cirurgia Plástica , Sarcoma , Parede Torácica , Adulto , Humanos , Masculino , Sarcoma/cirurgia , Coxa da Perna/cirurgia , Parede Torácica/cirurgia , TitânioRESUMO
A man with a history of blind eye due to trauma 22 years earlier consulted at 53 years of age with a large conjunctival neoplastic lesion, compromising almost the entire temporal limbus, and reaching a size of approximately 16 mm on its larger diameter, in the conjunctiva. Management was started with topical and subconjunctival chemotherapy (interferon alpha-2b) in order to perform immunoreduction, but a dramatic response with total disappearance of the lesion was observed. In the follow-up time period of more than 7 years, there were no signs of recurrence.
Assuntos
Antineoplásicos/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias Oculares/tratamento farmacológico , Interferon alfa-2/uso terapêutico , Administração Tópica , Antineoplásicos/administração & dosagem , Seguimentos , Humanos , Interferon alfa-2/administração & dosagem , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
A 37-year-old Hispanic man with a right atrial intracardiac mass diagnosed as diffuse large B-cell lymphoma (DLBCL) was successfully treated with surgery and chemotherapy. During 4 years, several total-body positron emission tomography and MRI scans showed no extracardiac lymphoma. On year 5 after the cardiac surgery, patient presented with sleepiness, hyperphagia, memory loss, confabulation, dementia and diabetes insipidus. Brain MRI showed a single hypothalamic recurrence of the original lymphoma that responded to high-dose methotrexate treatment. Correction of diabetes insipidus improved alertness but amnesia and cognitive deficits persisted, including incapacity to read and write. This case illustrates two unusual locations of DLBCL: primary cardiac lymphoma and hypothalamus. We emphasise the importance of third ventricle tumours as causing amnesia, confabulation, behavioural changes, alexia-agraphia, endocrine disorders and alterations of the circadian rhythm of wakefulness-sleep secondary to lesions of specific hypothalamic nuclei and disruption of hypothalamic-thalamic circuits.
Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Neoplasias do Ventrículo Cerebral/complicações , Neoplasias Cardíacas/terapia , Linfoma Difuso de Grandes Células B/terapia , Metotrexato/uso terapêutico , Recidiva Local de Neoplasia/diagnóstico por imagem , Terceiro Ventrículo/patologia , Adulto , Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/fisiopatologia , Neoplasias do Ventrículo Cerebral/secundário , Diabetes Insípido/etiologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Humanos , Hiperfagia/etiologia , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/patologia , Imageamento por Ressonância Magnética , Masculino , Transtornos da Memória/etiologia , Recidiva Local de Neoplasia/fisiopatologia , Recidiva Local de Neoplasia/terapia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Terceiro Ventrículo/diagnóstico por imagem , Resultado do TratamentoRESUMO
Portal vein embolisation (PVE) is a well-established technique used for patients who require major hepatic resections without sufficient volume of future remnant liver (FRL). We describe a case of PVE in a patient with situs inversus. Computed Tomography (CT) 4 weeks after the procedure demonstrated significant hypertrophy of the FRL. However, the surgical procedure was aborted due to signs of extrahepatic progression.