Lege Artis Medicinae

[Metastatic tumour with papillary structure in the colon]

CSERNI Gábor, BORI Rita, FEKETE Katalin, OLÁH Csaba, SVÉBIS Mihály, KOVÁCS Katalin, SZŰCS Miklós

APRIL 01, 2009

Lege Artis Medicinae - 2009;19(03)

[INTRODUCTION - Colorectal carcinomas are frequent and their diagnosis and treatment is generally considered a routine task in oncology, but in some cases, using a routine approach may cause unforeseeable difficulties. CASE REPORT - A 72-year-old woman underwent segmental bowel resection of a tumour diagnosed as colon cancer 15 months earlier. The tumour also metastasized in the lungs. Autopsy findings raised a high level of suspicion that her colon tumour was a metastasis from a uterine cervical adenocarcinoma undiscovered before the post mortem examination. CONCLUSION - Occasionally metastases do not arise from the tumour that we are aware of, and metastases may mimic primary tumours. Although the papillary structure of a colon cancer should raise the possibility of a metastatic nature, also primary - at least partially - papillary carcinomas may arise in the large intestines.]

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[INTRODUCTION - Malignant tumours arising from the wall of the pulmonary artery or the aorta are very rare. Two types are known, leiomyosarcoma and intimal sarcoma. Intimal sarcoma is usually associated with a thrombus that may close the lumen, which complication being important in case of pulmonary artery tumours. Such tumours can be diagnosed by magnetic resonance imaging (MRI). CASE REPORT - A 42-year-old woman was hospitalized with an anamnesis of three months of subfebrility/fever, dyspnea and hemoptysis. Right-sided pulmonary thromboembolism and exudative pleuritis were diagnosed. MRI findings suggested a tumour of the right pulmonary trunk. She underwent surgery with extracorporeal circulation; and a compact mass with a connected thrombus filling the right pulmonary trunk and its hilar branches were removed by thromboendarterectomy. Histology revealed intimal sarcoma of the pulmonary artery. The patient died of this tumour’s progression four years later. CONCLUSION - In case of pulmonary thromboembolism the possibility of intimal sarcoma has to be considered. Vascular tumours can be proven or excluded by MRI.]

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[Anemia observed in patients with infectious, inflammatory, or neoplastic diseases and persisting for more than one month is called anemia of chronic disease. The term anemia of chronic disease is far from perfect, the terms of anemia of inflammation, cytokine-mediated anemia, and anemia of defective iron reuse are also used. Anemia of chronic disease is more common than any other anemia syndrome - apart from anemia caused by iron deficiency secondary to blood loss. Erythrocytes usually are normocytic, but hypochromia and microcytosis may also be observed. In almost every case, this type of anemia is hypo-regenerative. Characteristic laboratory findings include hypoferremia, hyperferritinemia, and hypotransferrinemia. Cause of this anemia is complex; pathogenesis of this anemia includes moderate shortening of erythrocyte survival, blunted response to erythropoietin, reduced medullar erythropoiesis, and limited medullar iron availability. In addition to treating the underlying pathology, treatment opportunities are recombinant human erythropoietin, transfusions, and intravenous iron.]

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