Informes de casos clínicos y médicos

Los tumores duodenales con infiltración de la vesícula biliar son poco frecuentes, ya que conllevan una alta mortalidad y morbilidad, y son difíciles de tratar quirúrgicamente. Informamos de un caso de una mujer de 74 años con sangrado en la primera parte de un tumor duodenal con infiltración de la vesícula biliar.

El carcinoma en anillo de sello de mama (SRCC) es una forma poco frecuente de cáncer de mama con altas tasas de metástasis axilares y distantes. La mayoría de los informes de casos anteriores se centraron en las características clinicopatológicas en lugar del tratamiento del SRCC.

Informe de caso: En este artículo, informamos sobre el caso de una mujer de 39 años que tuvo una recurrencia distante de un carcinoma en anillo de sello con receptores de estrógeno positivos, receptores de progesterona negativos y Her-2 positivos en la mama que se extendió a los pulmones, el hígado, los huesos y el cerebro. Como no existían pautas estándar, dirigimos sus tratamientos de acuerdo con el estado hormonal y del receptor Her-2 y optimizamos la atención de apoyo. La linfangitis pulmonar y las metástasis hepáticas difusas se resolvieron mediante una tomografía computarizada y vivió durante 4 años después de la recurrencia.

Conclusión: A pesar de su biología agresiva, nuestro caso sugiere que el carcinoma en anillo de sello de mama debe tratarse de manera similar a otros cánceres de mama invasivos según el estado hormonal y del receptor Her-2.

Obstructive sleep apnea (OSA) is a common disorder established as an independent risk factor of cardiovascular morbidity and mortality. Cases of hearing impairment associated with sleep apnea have been described and multiple studies have tried to find a significant relationship between both disorders. Many pathophysiological pathway mechanisms have subsequently been suggested. We present a case of a 32-year-old male Tunisian patient with no relevant pathological history a part from smoking and obesity, who presented with a sudden sensorineural hearing loss (SSHL). He had a two-year-history of asthenia and daytime sleepiness. Physical examination was normal and so were the laboratory findings. Further investigations concluded that it was idiopathic sensorineural hearing loss and severe obstructive sleep apnea. The patient was treated with a continuous positive airway pressure device (CPAP). The asthenia and sleepiness notably improved. The right hearing impairment remained stable with a normal left hearing function.

Tuberculosis of female genital tract is common among the reproductive age group in developing countries. However, primary tuberculosis of cervix is a rare entity. Clinical presentation of cervical tuberculosis could be as a papillary growth on the cervix with ulceration simulating carcinoma of cervix or as a miliary lesion. In the present case the clinical appearance was that of an exophytic friable, polypoid and ulcerated lesion which created clinical suspicion of a neoplastic condition. However the cervical cytology was normal. Biopsy histopathology showed endocervical tissue with multiple well-formed caseating epithelioid cell granulomas and multinucleate Langhan’s type of giant cells. AFB was positive by Ziehl Neelsen’s stain. Hence a diagnosis of granulomatous inflammatory lesion with presence of AFB was given and the patient was referred for further management. The case is presented in view of rarity of the clinical presentation and importance of considering this lesion in the differential diagnosis of an ulcerated friable polypoid lesion of the cervix.