Antecedentes: Los teratomas representan el 3 % de las neoplasias malignas infantiles y son el tercer tumor retroperitoneal pediátrico más común. Reporte de caso: Femenina de 4 años que fue ingresada por dolor abdominal, distensión y masa intrabdominal palpable. En su abordaje la tomografía evidencia una masa compatible con teratoma, por lo que se realiza laparotomía exploradora donde se observa tumoración con múltiples adherencias, se logra resecar por completo sin complicaciones, cursa su postoperatorio sin incidentes y es egresada a los 5 días. La histopatología confirmó teratoma maduro. Conclusiones: El teratoma retroperitoneal a pesar de su poca incidencia, es una patología que verá cualquier medico de primer contacto inicialmente y se debe tener en cuenta en el diagnóstico diferencial ante un paciente con masa intraabdominal y dolor abdominal. Su manejo oportuno es imperativo.
Late hematoma is a rare complication on the use of breast implants but on recent year’s case reports become more frequent, there's no data regarding the incidence, authors report multiple theory’s about etiology. In this case report we report a patient who presented a spontaneous late hematoma, patient arrived at doctor’s office complaining about gradual increase over the last 15 days of left breast, we treated the hematoma with guided-ultrasound drainage with total improvement of the symptoms, 1 week later the patient returns for the same symptoms that occurred the first time, an ultrasound-guided drainage is performed again and it is decided to schedule the surgical date in 1 week, as reported on previous cases we tried non-invasive management with ultrasound guided drainage on 2 attempts but patient hematoma recurred and we decided to perform drainage, capsulectomy and implant replacement, we follow the patient through the outpatient clinic 7 months later, and she has not presented a hematoma recurrence.
Background: Giant prolactinomas are rare tumors representing only 0.5-4.4% of pituitary adenomas, and 2-3% of prolactin secreting tumors. Clinical presentation is similar than smaller prolactinomas. However, due to the large adenoma size (≥4 cm), the normalization of prolactin levels and reduction of the tumor volume becomes a significant therapeutic challenge and multimodal treatment might be necessary. Methods: Comparative, cross-sectional, observational, retrolective cohort, from January 1988 to December 2017. We included all patients with hyperprolactinemia, those with non-tumoral etiologies were eliminated. Our final sample consisted of 327 patients with prolactinomas. We classified them according to tumor diameter using magnetic resonance imaging (MRI), in microprolactinomas (<10mm), macroprolactinomas (≥10 mm) and giant prolactinomas with a diameter of ≥4 cm, together with prolactin level > 1000 ng/dl, and no concomitant growth hormone (GH) or adrenocorticotropic hormone (ACTH) secretion. Results: 244 (74.6%) cases had a microprolactinoma, 72 (22%) had a macroprolactinoma, and 11 patients (3.4%) met the selection criteria for giant prolactinomas (9 males). The most common presenting features included headache, impaired vision, and erectile dysfunction. The main hormone deficiency found in men was testosterone (77.8%), followed by Thyroid-stimulating Hormone (TSH) (63%). Mean prolactin (PRL) at presentation was 2,000 ng/mL (IC 95% 1727 - 4374). All patients were treated with dopamine agonists (DA), and only 3 (27%) patients required surgery. Tumor shrinkage for giant prolactinomas with dopamine agonist was 63% on average. All patients had improved visual field defects. Since patients responded well to DA, none required further treatment modalities. Conclusions: Giant prolactinomas are rare tumors with a male predominance. Dopamine agonists are a useful therapeutic strategy, and good response is seen with a similar average dose to those used in smaller prolactinomas. None of our patients required further medical treatment modalities although surgical debulking sometimes is necessary.
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