Acantoma de Células Claras Abdominal. Lesión infrecuente en Localización Atípica Abdominal

Abstract Introduction: The concept of malignancy for pheochromocytoma is complex and the best definition is the presence of metastases, according to WHO. Anatomopathological scoring systems are not effective in predicting metastases. Malignancy should be considered when tumors larger than 8cm (> 80g), paragangliomas (especially retroperitoneal), dopamine / methoxythyramine increase, Ki67> 6% and SDHB mutation. At 5 years, survival ranges from 50-69%. Metastases may appear 20-40 years after initial treatment of pheochromocytoma. We describe a case that metastasis was identified 33 years after pheochromocytoma excision Case report: A 57-year-old female patient with a postoperative history of 33 years of right adrenal pheochromocytoma was discharged from the endocrinologist after 10 years of follow-up. At diagnosis 33 years ago, she had symptoms of hypertension with paroxysms and weight loss that disappeared after tumor removal. 2 years investigating weight loss with general practitioner without another celebratory. On physical examination, orthostatic hypotension was highlighted. Plasma methanephrine 0.8 nmol / L (VR <0.5) and plasma normetanephrine 1.8 nmol / L (VR <0.9), chromogranin A 5.7 nmol / L (VR <3 nmol / L) and clonidine test with 36.6% suppression of metanephrines, suggesting tumor recurrence. MRI localized recurrence of the adrenals and MIBG scintigraphy with I131 that showed, respectively, in the topography next to the paracaval and retroportal right diaphragmatic crura, isointense T1 and slightly hyperintense T2 at 1.8 cm and radiopharmaceutical hypercaptation in right adrenal topography. Genetic panel by NGS did not identify germline mutation in 22 pheochromocytoma-related genes. FDG PETCT was consistent with MRI and MIBG images. Gallium PETCT68 DOTATOC detected the lesions already described, in addition to a lytic lesion in the left femoral intertrochanteric medulla. Anatomopathological approached abdominal lesion confirming pheochromocytoma metastasis in lymph node conglomerate. Currently has a negative methanephrine plasma, however chromogranin A 142 ng / mL (VR <93), and was chosen by the observant approach. Conclusion: The case of the patient illustrates that pheochromocytoma should be followed indefinitely, as metastases may appear many years later and may present different aggressiveness potentials.

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Acute abdominal symptoms without intra-abdominal lesion: (?) Acute neuritis of the twelfth dorsal nerve

British Journal of Surgery ◽

10.1002/bjs.1800072821 ◽

1919 ◽

Vol 7 (28) ◽

pp. 549-550

Keyword(s):

Abdominal Symptoms ◽

Dorsal Nerve ◽

Abdominal Lesion

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A Case of Late Delayed Metastasis of Malignant Melanoma After 27 Years After First Excision

10.47363/jcrr/2020(2)121 ◽

2020 ◽

Vol 2 (2) ◽

pp. 1-2

Author(s):

Claudio Bravin ◽

◽

Carlo Braga ◽

Gaetana Rizzi ◽

◽

...

Keyword(s):

Malignant Melanoma ◽

Histological Examination ◽

Mitotic Rate ◽

Skin Tumor ◽

Melanocytic Lesions ◽

Long Term Follow Up ◽

Neoplastic Process ◽

Abdominal Lesion

We report a case of an ultra-late delayed metastasis of malignant melanoma 27 years after the excision of the first tumor. The patient is a 67 years old Italian woman. She underwent a primary excision of a skin lesion of 1cm in diameter on the lower third of the left leg in 1984 when she was 39. According to the histological examination the lesion was a lentigo malign melanoma with an epithelial histological pattern with intra- and subepidermal diffusion. The lesion was 2.2 mm in thickness (Breslow) and was a Clark level IV melanoma; mitotic rate was 6 mitosis/mm2. No melanocytic lesions were found on excision edges and no lymph nodes were removed and examined. In March 2011, when the woman was 67 years old, an inguinal lymph node and an intraabdominal lesion were considered suspect for neoplastic process during a clinical exam of the GP. A histological examination and an eco-imaging procedure described the lesions as metastasis of malignant melanoma probably related to the first skin tumor. Within a few days she was treated with the excision of the abdominal lesion, the total greater omentectomy and the lymphadenectomy of the left inguinal region. Histological examination confirmed the suspect of metastasis of the first melanoma with a predominant epithelioid growing pattern. This case underlines the need of a long-term follow-up period for patients with melanoma.

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Diagnostic Accuracy of Ultrasonography Correlated with Cytopathology by Direct Real Time Ultrasonography Guidance

Journal of Medical Science & Research ◽

10.47648/jmsr.2009.v1302.05 ◽

2009 ◽

Vol 13 (Number 2) ◽

pp. 25-30

Author(s):

M T Islam ◽

F Ahmad ◽

Hasanuzzaman ◽

S M Rumee

Keyword(s):

Gall Bladder ◽

Diagnostic Accuracy ◽

Small Body ◽

Needle Aspiration ◽

Body Parts ◽

Abdominal Lesions ◽

Ultrasonography Guidance ◽

Abdominal Lesion ◽

Real Time Ultrasonography ◽

Made In

Ultrasonographically (USG) guided fine needle aspiration neology (FNAC) is simple. quick. and abrrost accurate and essentially risk free procedure for the diagnosis of Mira-abdominal lesions including small bows in some superficial small body paris like thyroid. bream' etc. In the present study. USG guided FNAC in intrambdominal lumps as well as lump in some small body parts was performed USG ,findings prior to FNAC procedure was recorded with a possible rillmsorrographic diagnosis for each of die case with relevant clinical and associated USG correlation. FNAC for each of the cases was than carried out. Samples were sear for cympathology. Finally. USG findings were correlated with cyropathology reports. A total 4'111 cases was .thalied of which 53 were of liver. 17 gall bladder. seven lymph nod, four stomach, four bond, three common bile duct (CBD). three kidney, two suprarenal, two breast. Iwo rhyroid. nvo pancreas, three menu and three cases of ovary. Successfirl cytopathological correlarion was made in 106 cases. The sensitivity was 100%. specificin 96.77% and diagnostic accuracy rare was 99.099%. Hepatic malignancy was found in 41 cases out of 53 cases arid was the most common abdominal lesion followed by lesions from gall bladder, abdominal lymphaderropathies. GI track kidneys and others.

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Small cell desmoplastic tumour: Morphological findings from an abdominal lesion studied with fine-needle aspiration

Diagnostic Cytopathology ◽

10.1002/dc.20578 ◽

2006 ◽

Vol 35 (1) ◽

pp. 71-72

Author(s):

J. Ortiz ◽

R. Martin Polo ◽

M. Abad ◽

M.C. Garcia Macias ◽

A. Bullon

Keyword(s):

Fine Needle Aspiration ◽

Needle Aspiration ◽

Small Cell ◽

Fine Needle ◽

Morphological Findings ◽

Abdominal Lesion

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Metastatic malignancy mimics: a rare case of traumatic splenosis mimicking intra-abdominal malignancy

BMJ Case Reports ◽

10.1136/bcr-2019-232043 ◽

2020 ◽

Vol 13 (2) ◽

pp. e232043

Author(s):

Vinoth Nadesalingam ◽

Laura May Davis ◽

Gill Vivian ◽

Benjamin Corcoran

Keyword(s):

Abdominal Trauma ◽

Rare Case ◽

Red Cell ◽

Imaging Findings ◽

Spleen Tissue ◽

Technetium 99M ◽

Abdominal Malignancy ◽

Upper Abdominal ◽

Abdominal Lesion

We present a case of a patient, undergoing imaging for an unrelated presentation, whose adolescent abdominal trauma had caused an unrecognised disseminated intra-abdominal splenosis, resulting in an imaging presentation on CT that suggested intra-abdominal malignancy. The lack of correlative symptoms of disseminated malignancy, in addition to imaging findings suggesting previous upper abdominal trauma, led to a suggestion that the intra-abdominal lesion might represent spleen tissue. A denatured red cell scan with radio-labelled technetium-99m, allowed this tissue to be confirmed as splenic in nature, and an invasive, and potentially risky biopsy was averted.

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Extensive Subcutaneous Emphysema as a Presentation of Ischemic Colitis

Case Reports in Surgery ◽

10.1155/2015/587508 ◽

2015 ◽

Vol 2015 ◽

pp. 1-2

Author(s):

Ana Franky Carvalho ◽

Claudio Branco ◽

Pedro Leão ◽

Conceição Antunes

Keyword(s):

Emergency Department ◽

Case Report ◽

Abdominal Wall ◽

Sigmoid Colon ◽

Ischemic Colitis ◽

Subcutaneous Emphysema ◽

Elderly Woman ◽

Colonic Perforation ◽

Hartmann Procedure ◽

Abdominal Lesion

Introduction. Subcutaneous emphysema is usually benign and self-limited; however, it may be associated with a life-threating situation.Case Report. An elderly woman with progressive malaise with extensive subcutaneous emphysema (cervical to abdominal wall) was observed at the emergency department. Colonic perforation was diagnosed and the patient underwent surgery. Intraoperatively, necrosis and perforation of the sigmoid colon into the retroperitoneum were found and a Hartmann procedure was performed.Conclusion. Cervical and thoracic subcutaneous emphysema may be the first sign of intra-abdominal lesion.

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Reliability of an Intense Focal Abdominal Lesion Visualized Only with Gallium-67

Clinical Nuclear Medicine ◽

10.1097/00003072-199007000-00019 ◽

1990 ◽

Vol 15 (7) ◽

pp. 521-522

Author(s):

WILLIAM A. WEGENER ◽

SYDNEY HEYMAN

Keyword(s):

Gallium 67 ◽

Abdominal Lesion

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Ileal impaction resolution in a horse with colic via a standing right flank laparotomy ˗ case report

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/1678-4162-11749 ◽

2020 ◽

Vol 72 (4) ◽

pp. 1369-1374

Author(s):

J.A. Arantes ◽

G.M. Reginato ◽

R.G.S. Dória

Keyword(s):

Case Report ◽

Surgical Procedures ◽

Pain Control ◽

Standing Position ◽

Fast Recovery ◽

Viable Option ◽

Financial Problems ◽

Analgesic Treatment ◽

Abdominal Lesion

ABSTRACT This report describes a horse presenting ileal impaction that went through a right flank laparotomy procedure while standing. The decision to use this technique was made under the influence of several factors: the patient exhibited a calm temperament and demonstrated responsiveness to the analgesic treatment for pain control; the abdominal lesion was amenable to correction by a standing right flank approach. Also, the owner reported financial problems. Ileal obstruction was relieved successfully, and the horse recovery was satisfactory. This case highlights that, in specific cases of colic syndrome, the use of surgical procedures in the standing position might be a viable option and promote fast recovery.

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