Alves, AJ; Ferreira, MA; Gallego-Poveda, J; Matos, A; Costa-Silva, A; Nobre, A; Lopez-Beltran, A
Intravenous leiomyomatosis (IVL) is an extremely rare variant of leiomyoma in which nodular masses of tumor grow within venous channels. Rarely, the tumor can reach the vena cava and right heart. We present a case of a 45-year-old woman, admitted with rapidly evolving exertional dyspnea. Cardiac ultrasonography revealed a "mass in the right chambers". She was submitted to right atriotomy plus tumorectomy, with intraoperative consultation requested. Grossly, the tumor was polypoid, firm, with a smooth surface. The frozen section showed a lesion composed of tortuous vessels and some areas with a fibrillar eosinophil extracellular matrix and others with spindle cells,...
Barbosa, S; Sequeira, M; Castro, S; Manso, R; Klut, C; Trancas, B; Santos, NB; Maia, T
Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013).
MATERIAL AND METHODS:
Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis. Patients transferred to other wards during their admission were not included.
Circulatory system diseases were the most prevalent causes of death, occurring in 2/3 of patients...
Lopes, S; Furtado, A; Oliveira, R; Cebola, A; Graça, B; Coelho, M; Ferrito, F; Gomes, FC
Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.
Peres, J; Cruz, S; Oliveira, R; Santos, L; Valverde, A
A 68-year-old Caucasian female was admitted to the emergency department with a progressive history of behavioural symptoms and anxiety followed by visual and auditory hallucinations, forgetfulness, and impaired gait in the previous 3 months. On examination she was psychotic and had a postural and rest tremor of the upper limbs, cogwheel rigidity of the four limbs, retropulsion on standing position, and inability to walk. During the following 2 weeks she developed xerostomia and unilateral parotiditis that improved with steroids. A simultaneous improvement of the cognitive abilities allowed for the detection of sensory ataxia of the lower limbs. Sensory ganglionopathy was...
Ferreira, J; Gasparinho, MG; Fonseca, R
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematopoietic tumor that was once believed to be derived from natural killer cells and is now recognized as originating from precursors of plasmacytoid dendritic cells. It generally involves the skin and has an aggressive clinical course. Due to its highly malignant behavior, a fast and accurate diagnosis of this condition is of the utmost importance.
Six cytology specimens from 5 patients diagnosed with BPDCN were reviewed as well as their clinical records. Findings were compared with 3 previously published cases.
Two exfoliative cytology specimens (cerebrospinal fluid) and 4 fine-needle aspiration specimens (3 lymph...
Santiago, I; Rodrigues, E; Germano, A; Costa, A; Manso, R; Gomes, A; Leichsenring, C; Geraldes, V
Neoadjuvant chemotherapy in potentially resectable high-risk Stage II and Stage III colon cancer has demonstrated promising results in the PRODIGE 22-ECKINOXE Phase II trial. Identification of adverse morphologic features, namely T3 with >5 mm extramural extension/T4 stages and/or N2, is fundamental and requires accurate noninvasive imaging. Our aim was to assess the value of optimized preoperative MDCT to stratify potentially resectable colon cancer patients for neoadjuvant therapy.
this is an observational prospective cross-sectional radiologic-pathologic agreement study. All patients with colon cancer referred to our Institution's Radiology department for preoperative MDCT staging between 01-10-2013 and 11-02-2015 underwent independent reading based on axial...
Paula, F; Amaral, M; Oliveira, Alves; Alves, J
A crise de retenção esplénica é uma complicação, frequentemente, fatal da drepanocitose. É rara em adultos, pela elevada
incidência de autoesplenectomia durante a infância. Heterozigóticos com traços de drepanocitose e de beta-talassémia têm
fenótipos menos graves, podendo manter um baço funcional até à idade adulta. Descrevemos um caso de crise de retenção
esplénica num homem de 19 anos, com concentração mínima de hemoglobina de 2,9g/dL, que resolveu após esplenectomia
emergente. Os poucos casos descritos na literatura acarretam uma mortalidade elevada. Um diagnóstico rápido e actuação
imediata são necessários para garantir a sobrevivência. É apresentada uma revisão da fisiopatologia e da...
Gonçalves, L; Ferreira, M
O programa “Saúde para Todos – Especialidades” é um
programa de cooperação na área da saúde ancorado em São
Tomé e Príncipe (STP), desenvolvido e sustentado pelo Instituto
Marquês de Valle Flôr (IMVF) com o apoio principal
da Cooperação Portuguesa (através do Camões – Instituto
da Cooperação e da Língua) e da Fundação Calouste Gulbenkian
e em parceria com o Ministério da Saúde da República Democrática de São Tomé e Príncipe.
Dores, J; Graça, B; Manso, R; Gomes, FC
Introduc¸ão: Até ao fim dos anos 80 defendia-se que qualquer nódulo testicular suspeito devia ser
excisado com orquidectomia radical. No entanto, com o aumento do diagnóstico incidental de
massas testiculares, a maior acuidade dos exames extemporâneos e a evidência das vantagens
potenciais da orquidectomia parcial, questionou-se se seria necessário sacrificar, sempre, todo
o testículo, mesmo na presenc¸a de um testículo contralateral normal.
Caso clínico: Apresentamos o caso de um doente de 23 anos, com o diagnóstico de um nódulo
testicular com 7,5 mm, não palpável, assintomático e marcadores tumorais negativos. Foi submetido
a orquidectomia parcial guiada por ecografia e exame extemporâneo, no entanto,
por suspeita anatomopatológica de provável...
Nunes, V; Santiago, I; Marinho, R; Pires, D; Theias, R; Gomes, A; Pignatelli, N
Rare adenosquamous carcinomas have no defined standard approach given their low incidence. They present with nonspecific imaging characteristics and are described as having worse prognosis than other lung malignancies, with greater likelihood of local invasion and early metastasis.
PRESENTATION OF CASE:
Male caucasian patient, 43 years, 26 pack-year smoking history, presented with watery diarrhea, early emesis and loss of 25% body weight (20kg) in four weeks. Colonoscopy identified a left colonic mass. Abdominal CT/ultrasound showed a large fistulous lesion between the 4th portion of the duodenum and left colon. CT showed a solid mass in the right upper lung lobe. Endoscopy and...
Oliveira, AM; Rodrigues, C; Borges, A; Martins, A; Santos, S; Pires, F; Araújo, JM; Deus, JR
BACKGROUND: Pseudomyxoma peritonei is an uncommon condition with an estimated incidence of one to two per million (worldwide) per year. It is characterized by the peritoneal deposition of mucinous tumors, most commonly of the appendix, and occasionally from the ovary, coupled by mucinous ascites.
CASE PRESENTATION: We report the case of a 76-year-old woman who presented with increased abdominal girth and dyspnea for 2 weeks. She was diagnosed as a case of pseudomyxoma peritonei. She was submitted to right oophorectomy, omentectomy, and pseudomyxoma debulking. The histology was compatible with a mucinous tumor of colorectal/appendicular origin. Chemotherapy was not administered because of...
Reis-Filho, J; Torio, B; Albergaria, A; Schmitt, F
BACKGROUND: p63 is a p53 homologue that is mapped to chromosome 3q27. This gene encodes six different isoforms, which have either transactivating or dominant negative effects on p53-reporter genes. It has been described that in contrast to p53, p63 seems not to be associated with tumor predisposition, as neither p63 knockout mouse models nor germline p63 mutations are related to an increased risk of tumorigenesis. It has been demonstrated that p63 is a reliable keratinocyte stem cell marker and that it is involved in the maintenance of the stem cell population. Scant data on p63 expression in normal skin, basal...
Reis-Filho, J; Torio, B; Albergaria, A; Schmitt, F
Maspin is a serine protease inhibitor whose gene is located on 3q27. Several lines of evidence point towards its putative role as tumor suppressor gene and angiogenesis inhibitor; however, there are compelling data showing that maspin is also expressed in the nuclear compartment and might be associated with the differentiation of specific cell lineages. No systematic study of maspin expression in normal skin and usual skin carcinomas have been published so far. We semiquantitatively analyzed the distribution and immunoreactivity pattern of maspin in 14 squamous cell carcinomas (SCCs) and 16 basal cell carcinomas (BCCs) and in the adjacent normal epidermis...
Rosado, E; Cabral, P; Campo, M; Tavares, A
We report a case of a mesenchymal hamartoma of the liver in a two-year-old boy. He presented to the emergency room with abdominal distention and vomiting. Abdominal ultrasound and computed tomography were performed and revealed a large, intra-peritoneal lesion, with thick wall, multiple cysts of variable size and solid septa. The lesion was surgically resected. Pathological examination revealed a mesenchymal hamartoma of the liver. We are including a short literature review, highlighting the main features of mesenchymal hamartoma of the liver, and discussing its differential diagnosis.
Capela, A; Martinho, A; Duarte, F; Garcia, H; Pires, F; Manso, R; Aparício, S; Costa, A
Os tumores oncocíticos da supra-renal são neoplasias pouco frequentes. Atualmente existem 147 casos publicados.
Os autores descrevem o caso de um homem de 34 anos admitido no hospital por lombalgias e febre. À observação identificava-se
massa no quadrante superior esquerdo do abdomen. Os doseamentos das hormonas da supra-renal foram normais e a angiotomografia
abdominal mostrou lesão retroperitoneal esquerda com 145 x 157 x 128 mm com extensas áreas necrosadas e hemorrágicas.
O doente foi submetido a ressecção cirúrgica completa da lesão. O tumor pesava 1495 g e o exame anatomo-patológico concluiu
tratar-se de tumor oncocítico da supra-renal com potencial maligno incerto.
A maioria dos tumores oncocíticos...
Santos, S; Pires, E; Figueiredo, A; Silva, S; Deus, JR
O uso de anti-inflamatórios não esteróides (AINE) tem sido associado a efeitos adversos gastrointestinais, não apenas ao nível do tracto gastrointestinal superior, mas também ao nível do jejuno, ileon e colon, com importante morbilidade e mesmo mortalidade.
Descrevemos o caso de um doente que desenvolveu um quadro de diarreia sanguinolenta, 48 horas apos o inicio de ibuprofeno. A observação endoscópica revelou a existência de múltiplas úlceras no cólon direito. A avaliação histológica foi sobreponível à descrita nas lesões farmacológicas, tendo-se verificado completa remissão clinica e endoscópica apos interrupção do fármaco.
É apresentada uma breve revisão da literatura sobre as lesões ao nível...