Primary breast lymphoma is a rare entity that accounts for only 1% of malignant breast neoplasms. It is characterized by the presence of a breast lump, with or without associated regional adenopathy and without systemic involvement. Imaging findings are nonspecific, and diffuse large B-cell lymphoma is the most common histological type. Given its rarity, there is still no consensus on the best approach, with chemotherapy being the most accepted treatment. This article aims to present a literature review as well as to present a clinical case.
The authors present a case of a presacral myelolipoma diagnosed in an 84-year-old male patient with longstanding pelvic pain and past medical history of bladder cancer. Pelvic computed tomography (CT) revealed a well-encapsulated and lobulated presacral mass, with mixed fat and soft-tissue attenuation. Magnetic resonance (MR) imaging provided further confirmation of macroscopic intralesional fat and excluded either adjacent bone invasion or bladder cancer recurrence. A presacral myelolipoma was suspected based on imaging findings, with liposarcoma and teratoma having also been considered for the differential diagnosis. The histological confirmation of the tumor was only attained postoperatively. This case report alerts to the possible presacral location of myelolipomas, which should be considered for every fat-containing lesion detected in this region. The main clinical, imaging, and differential diagnoses of this entity are reviewed in this paper.
Angiotensin-converting enzyme (ACE) inhibitors are the leading cause of drug-induced angioedema, being the face, tongue, lips and upper airway the most affected ones. We describe a case of a 32-year-old white female with angioedema of small intestine after 1 month of perindopril therapy. The patient presented severe abdominal pain, nausea and vomiting. Laboratory analyses revealed mild leukocytosis and abdominal computed tomography (CT) showed unspecific findings, including segmental jejunal wall thickening without obstruction and ascites. Regarding the clinical findings, similar to an acute abdomen with no clear cause, the patient underwent an emergency laparoscopy that excluded other pathological features. The symptoms recurred 1 month after and the CT scan revealed the same pattern. Perindopril was stopped and the patient improved, concluding that ACE inhibitor-induced visceral angioedema was responsible for this clinical presentation.
HELLP syndrome is a rare complication of pregnancy that may result in serious consequences such as hepatic rupture, one of the most feared and potentially life-threatening complications. This article aims to carry out a literature review on hepatic rupture in the context of HELLP syndrome as well as to present two clinical cases.
Gastric lipomas are rare, representing 2–3% of all benign tumours of the stomach. Most of these stomach neoplasms are small and detected incidentally during endoscopic or radiology evaluations. Computed tomography is highly specific imaging for lipoma diagnosis. Endoscopy and endoscopic ultrasound are other important diagnostic modalities to confirm the diagnosis. Identifying typical features can avoid biopsy or surgery in asymptomatic patients. In patients with larger lesions, usually more than 2 cm, clinical presentation may encompass haemorrhage, abdominal pain, pyloric obstruction and dyspepsia. As a result of its extreme low incidence, treatment is not standardized, though it is widely accepted that a symptomatic tumour mandates resection. Here, we present the case of a 60-year-old female presenting with abdominal pain and recurrent vomiting due to a giant gastric lipoma (80 × 35 × 35 mm). The patient underwent laparotomy and an enucleation was performed.
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