The long term functional and aesthetic impact of breast neoplasia treatment partly reflects the consequences of high dose irradiation of the skin and subcutaneous tissue. This work, based on a case observed in our department and a review of the literature, aims to discuss certain secondary manifestations following breast irradiation and their therapeutic options. Our work reports the case of a premenopausal 46-year-old patient, treated for a right breast neoplasia. In July 2019, the patient underwent a Patey with simple postoperative follow-up. Histology substantiated the presence of an infiltrating ductal carcinoma SBRI. Mastectomy was followed by locoregional irradiation and adjuvant chemotherapy. Thirteen months after the end of irradiation, the patient reconsulted for functional impotence and pain at the level of the right upper limb. The clinical examination showed cutaneous sclerosis and lymphedema. An X-ray showing the non-metastatic fracture of the clavicle. The patient underwent physiotherapy sessions with slight improvement on the functional level and clear improvement on the sensory level with progressive disappearance of pain. Therapeutic options for complications of breast irradiation include massage, bandages, and physical exercise, often used in combination. The precise localization of the tumor bed and the application of appropriate clinical target volumes and planning target volumes are essential, as these concepts are fundamental for partial breast irradiation and avoid the complications of radiotherapy.
Secondary localizations of cutaneous metastases from endometrial cancer are rarely observed with a prevalence of 0.8% and can be indicative of deep pelvic cancer (ovarian or endometrial). The prognosis is usually poor, with skin metastases most often indicating advanced disease. This work, based on a case observed in our department and a review of the literature, aims to highlight the existence of this dramatic form of cutaneous extension of a common disease. Dermatologists are often consulted due to the non-specific nature of the lesions and should be aware of this entity. As with other cutaneous metastases, an accurate diagnosis is based on a the patient’s thorough medical and surgical history in conjunction with histopathology
Adrenal infarction is usually associated with bilateral adrenal hemorrhage in the setting of antiphospholipid syndrome or hemodynamic variation. Few cases of unilateral non-hemorrhagic adrenal infarction have been described in the literature. Here, we report a case occurring during pregnancy. A 27-year-old woman was infected by coronavirus four months ago and presented at 35 weeks of gestation with sudden-onset right abdominal pain without contractions. Unilateral adrenal infarction was diagnosed following computed tomography. It showed an enlarged right adrenal, without hyperenhancement. The patient’s adrenal hormonal function was normal. Accurate diagnosis of non-hemorrhagic adrenal infarction remains difficult as its clinical presentation is not specific. It can only be performed with adrenal imaging. Magnetic resonance imaging shows diffuse enlargement of one or both adrenals and edema on T2-weighted images. Anticoagulation therapy may be discussed. Patients should be evaluated between 3 and 6months after the event to assess adrenal size and function. In summary, non-hemorrhagic adrenal infarction during pregnancy is probably underdiagnosed and obstetricians should be aware of this diagnostic difficulty.
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