scholarly journals Melanoma metastático em cólon: relato de caso / Metastatic melanoma in colon: a case report

2019 ◽  
Vol 64 (3) ◽  
pp. 261
Author(s):  
Raul Yao Utiyama ◽  
Fernando Viamont Guerra ◽  
Virginia de Paula Barbosa ◽  
Thiago Da Silveira Manzione ◽  
Fang Chia Bin
Keyword(s):  
Ct Scan ◽  
Metastatic Melanoma ◽  
De Novo ◽  
Colonic Neoplasms ◽  
Previous History ◽  
Excisional Biopsy ◽  
Abdominal Ct ◽  
Left Hand ◽  
Abdominal Ct Scan ◽  
History Of

Objetivo: Apresentar um caso de melanoma de pele com metástase para o cólon expondo a evolução incomum da doença e os possíveis caminhos terapêuticos disponíveis. Descrição: Relato de caso de um paciente do sexo masculino, de 57 anos, que buscou o serviço da Santa Casa de São Paulo em 2015 com uma história prévia de melanoma em quirodactilo e antebraço ipsilaterais, foi então indicada e realizada a exérese da lesão e a biopsia identificou um melanoma acral, com margens livres. Foi então iniciado tratamento com Interferon. Nos dois anos seguintes, uma metástase pulmonar e uma recidiva na mão esquerda foram diagnosticados e ambas as biopsia confirmaram ser do melanoma.    Em 2018 uma tomografia de abdome evidenciou uma tumoração no cólon e a biopsia e imunohistoquímica confirmaram se tratar de melanoma. Foi então realizada uma cirurgia para retirada da parte afetada. Além disso, nesse mesmo ano, o paciente teve que ser submetido a amputação do braço esquerdo devido a nova recidiva local.  Em junho do ano seguinte, uma colonoscopia e uma tomografia de abdome apresentaram imagens compatível com recidiva em cólon, além de invasão gástrica e em contato com a cauda pancreática. Após reunião com a equipe de coloproctologia, foi contraindicado o procedimento cirúrgico. O paciente está recebendo cuidados paliativos da equipe da oncologia com tratamento medicamentoso.Comentários: o melanoma metastático em cólon é raro, sendo linfonodos, pulmões, fígado e cérebro os sítios mais comumente atingidos. Inúmeros trabalhos mostram o aumento da incidência mundial do melanoma. Cerca de 70% dos casos se originam de nevos melanocíticos pré-existentes, e os 30% restantes surgem de novo. Dada a agressividade do melanoma, a sobrevida depende de um diagnóstico e tratamento precoces. No entanto, em alguns casos, mesmo com o tratamento cirúrgico, quimioterápico e radioterápico adequados, a agressividade do câncer impede que tais tratamentos tenham resultados satisfatórios.Descritores: Melanoma, Neoplasias do colo, Neoplasias cutâneas, Metástase neoplásicaAbstract Objective: To present a case of metastatic skin melanoma in colon, exposing the unusual evolution of the disease and the therapeutic possibilities. Description: A report of a 57-year-old male patient that in 2015 came to Santa Casa with a previous history of ipsilateral chirodactyl and forearm melanoma. At the time it was indicated the excisional biopsy that identified acral melanoma with free margins. Interferon treatment was then started. Over the next two years, a pulmonary metastasis and a recurrence in the left hand were diagnosed and both biopsies confirmed to be melanoma. In 2018 an abdominal CT scan showed a tumor in the colon and biopsy and immunohistochemistry confirmed that it was melanoma. Surgery was then performed to remove the affected part. In addition, that same year, the patient had to undergo amputation of the left arm due to new local recurrence. In June of the following year, a colonoscopy and a CT scan showed images compatible with colon recurrence, as well as gastric invasion and contact with the pancreatic tail. After discussion with the coloproctology team, the surgical procedure was contraindicated. The patient is receiving palliative care from the oncology team using drug treatment. Comments: Metastatic melanoma in colon is quite rare, with lymph nodes, lungs, liver and brain being the most common sites of metastasis. Numerous studies show the increasing incidence of melanoma worldwide. About 70% originate from pre-existing melanocytic nevi, and the remaining 30% arise again. Given the aggressiveness of melanoma, survival depends on early diagnosis and treatment.Keywords: Melanoma, Colonic neoplasms, Skin neoplasm, Neoplasm Metastasis 

scholarly journals No histology for diminutive duodenal neuroendocrine tumors: Is it safe?

2019 ◽  
Vol 07 (02) ◽  
pp. E308-E309
Author(s):  
Thomas Walter
Keyword(s):  
Natural History ◽  
Ct Scan ◽  
Neuroendocrine Tumors ◽  
Surgical Procedures ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Interesting Approach ◽  
History Of ◽  
Duodenal Neuroendocrine Tumors

AbstractFor the management of diminutive duodenal neuroendocrine tumors (d-NETs), Harshit et al. have proposed – in the work accompanying this editorial – an interesting approach, the endoscopic banding without resection (BWR) technique. Given the risks associated with classic endoscopic resections and surgical procedures, and the likely favorable natural history of diminutive d-NETs, BWR may be an option for these selected patients with a very low risk of LN + and recurrence. However, a close follow-up (endoscopic, EUS and thoraco-abdominal CT scan) is then required to guarantee the safety of this policy.

scholarly journals Pheochromocytoma in a Twelve-Year-Old Girl with SDHB-Related Hereditary Paraganglioma-Pheochromocytoma Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Daryl Graham ◽  
Megan Gooch ◽  
Zhan Ye ◽  
Edward Richer ◽  
Aftab Chishti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ct Scan ◽  
Medical Management ◽  
Elevated Blood Pressure ◽  
Clinical Implications ◽  
Elevated Blood ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of ◽  
Sdhb Gene

A twelve-year-old girl presented with a history of several weeks of worsening headaches accompanied by flushing and diaphoresis. The discovery of markedly elevated blood pressure and tachycardia led the child’s pediatrician to consider the diagnosis of a catecholamine-secreting tumor, and an abdominal CT scan confirmed the presence of a pheochromocytoma. The patient was found to have a mutation in the succinyl dehydrogenase B (SDHB) gene, which is causative for SDHB-related hereditary paraganglioma-pheochromocytoma syndrome. Herein, we describe her presentation and medical management and discuss the clinical implications of SDHB deficiency.

Bilateral pleural effusions as the first sign of mesenteric panniculitis

2020 ◽  
Vol 13 (7) ◽  
pp. e233423
Author(s):  
Juliana Sá ◽  
Céu Evangelista ◽  
Clara F Jorge ◽  
João Silva
Keyword(s):  
Pleural Effusion ◽  
Ct Scan ◽  
Mesenteric Panniculitis ◽  
Thoracic Pain ◽  
Abdominal Ct ◽  
Thoracic Ct ◽  
Mesenteric Fat ◽  
Abdominal Ct Scan ◽  
History Of ◽  
Thoracic Ct Scan

A 38-year-old woman presented to the emergency department with a history of thoracic pain and anorexia for 1 week. Thoracic CT scan showed bilateral pleural effusion, a thoracentesis was performed revealing a transudate liquid with polymorphonuclears and predominance of eosinophils. After admission, the patient developed abdominal pain and the abdominal CT scan showed densification of the mesenteric fat characteristic of mesenteric panniculitis (MP). The patient went through investigation for secondary causes of panniculitis including infection, neoplasia and autoimmune diseases, and no abnormalities were found. The patient was treated with corticosteroids over a period of 3 months with complete resolution and without any signs of remission or secondary cause of MP. Moreover, the patient remained asymptomatic for 2 years after being discharged, which strengthens the diagnosis of MP that presented with eosinophilic pleural effusion.

TRAUMA GINJAL

2020 ◽  
Vol 4 (1) ◽  
pp. 52-57
Author(s):  
Noflih Sulistia ◽  
Bambang Soeprijanto ◽  
Indrastuti Normahayu ◽  
Lenny Violetta
Keyword(s):  
Ct Scan ◽  
Pediatric Patients ◽  
Radiological Examination ◽  
Renal Trauma ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

Renal trauma in children is more common than in adults. Clinically in pediatric patients with renal trauma do not always describe the degreeof trauma. Radiological examination, especially abdominal CT-scan with contrast, can help evaluate the damage to the kidneys so that it candetermine the degree of trauma.

Study on the Radiation Dose of Abdominal CT Scan Using Dual Energy

2018 ◽  
Vol 20 (2) ◽  
pp. 123-132
Author(s):  
Dae-hyun Park ◽  
Young-Kyoon Kim ◽  
Jong-Ho Ahn ◽  
Kwang-Hyun Chang ◽  
Yoon-Chul Nam ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ct Scan ◽  
Dual Energy ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

scholarly journals Splenic abscess caused by Streptococcus anginosus bacteremia secondary to urinary tract infection: a case report and literature review

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 997-1002
Author(s):  
Hao Wu ◽  
Rui Zheng
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Ct Scan ◽  
Splenic Abscess ◽  
Low Density ◽  
Abdominal Ct ◽  
Streptococcus Anginosus ◽  
Abdominal Ct Scan ◽  
Tract Infections

AbstractOrgan abscesses caused by Streptococcus anginosus are relatively rare. We report the case of an elderly woman with splenic abscess caused by S. anginosus bacteremia after urinary tract infection. An 82-year-old woman had a history of frequency of urination, urgency, and fever with chills for over 10 days prior to admission. An abdominal computed tomography (CT) scan performed in the emergency room revealed a low-density lesion in the spleen, kidney cysts, some exudation around the kidney, and cystitis should be valued. She was treated with ceftriaxone and imipenem/cilastatin. After admission, the blood culture yielded positive results for S. anginosus. A contrast-enhanced abdominal CT scan showed that the low-density lesion previously found in the spleen was smaller than before. After percutaneous drainage of the splenic abscess and treatment with piperacillin/tazobactam based on the antibiotic sensitivity pattern, repeated abdominal CT scan revealed a significant reduction in the low-density lesion. The patient was discharged without recurrence or complications. A systematic review of organ abscess caused by S. anginosus bacteremia was performed. To our knowledge, there has been no report of splenic abscess caused by S. anginosus bacteremia secondary to urinary system tract infection, although urinary tract infections are also an important source.

scholarly journals Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Ct Scan ◽  
Duplication Cyst ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Abdominal Ct Scan ◽  
Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

Comparative analysis of the radiation shield effect in an abdominal CT scan

2014 ◽  
Vol 64 (6) ◽  
pp. 929-935
Author(s):  
Seon-Chil Kim ◽  
Young-Jae Kim ◽  
Joon-Seok Lee ◽  
Kyung-Rae Dong ◽  
Woon-Kwan Chung ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Ct Scan ◽  
Radiation Shield ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

Selective non-operative management of anterior abdominal stab wounds with emphasis on the value of follow-up abdominal CT scanning

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 194-202
Author(s):  
El Yamani Fouda ◽  
Alaa Magdy ◽  
Sameh Hany Emile
Keyword(s):  
Ct Scan ◽  
Ct Scanning ◽  
Operative Management ◽  
Abdominal Ct ◽  
Management Group ◽  
Abdominal Ct Scan ◽  
Laparotomy Group ◽  
Abdominal Stab Wounds ◽  
Non Operative Management

Background and aim Selective non-operative management of patients with penetrating abdominal stabs is the preferred treatment strategy. The present study aimed to assess the efficacy and safety of non-operative management with emphasis on the value of follow-up abdominal CT scanning in management of patients with penetrating anterior abdominal stab. Patients and methods This is a retrospective chart review of stable patients with anterior abdominal stab wounds. Patients were divided in terms of initial decisions into two groups: laparotomy group and non-operative management group. Abdominal CT scan was performed for patients in the non-operative management group on admission and follow-up CT scanning was performed in cases of clinical and/or biochemical deterioration. Results The laparotomy group included 82 patients and 68.2% of them had unnecessary laparotomies. The non-operative management group comprised 97 patients and 90.7% of them did not require subsequent laparotomy. Abdominal CT scan had a sensitivity of 88.9% and specificity of 100% in detection of intra-abdominal injuries. Follow-up CT scanning detected bowel injuries missed by initial CT scan in three patients. The non-operative management group had significantly lower post-operative complication rate than the laparotomy group (4.1% vs. 18.3%), with a significantly shorter length of stay. Conclusions Non-operative management is the optimal management strategy for stable patients with penetrating anterior abdominal stab to decrease unnecessary laparotomy rates, hospital stay and costs. Follow-up abdominal CT scanning facilitated the decision making for patients selected for non-operative management and is highly sensitive in the diagnosis of patients who require subsequent exploration.

Sign in / Sign up

Export Citation Format

Share Document