RESUMO

INTRODUCTION: giant cell tumor (GCT) is a benign intramedullary bone tumor that frequently arises at the ends of long bones. After the distal femur and proximal tibia, the distal radius is the third most affected site with particularly aggressive tumors. Our objective is the presentation of the clinical case of a patient diagnosed with distal radius GCT classified in grade III of Campanacci who received a treatment adjusted to her economic possibilities. CASE REPORT: a 47-year-old female, without economic solvency and with some medical service. Treatment included block resection, reconstruction with distal fibula autograft, and radiocarpal fusion with blocked compression plate. Eighteen months later, the patient had good grip strength (80% on the healthy side) and had fine motor function in the hand. The wrist presented stability with pronation of 85o, supination of 80o, flexion-extension of 0o and a score of 6.7 in the DASH functional outcomes assessment questionnaire. His radiological evaluation five years after his surgery continued with no evidence of local recurrence and pulmonary involvement. CONCLUSION: the result in this patient, together with the published data, indicate that the block tumor resection technique, plus distal fibula autograft and arthrodesis with blocked compression plate provide an optimal result of functionality for the grade III distal radial tumor at low cost.

INTRODUCCIÓN: el tumor de células gigantes (TCG) es un tumor óseo intramedular benigno que surge con frecuencia en los extremos de los huesos largos. Después del fémur distal y la tibia proximal, el radio distal es el tercer sitio más afectado con tumores, particularmente agresivos. Nuestro objetivo es la presentación del caso clínico de una paciente con diagnóstico de TCG de radio distal clasificada en grado III de Campanacci que recibió un tratamiento ajustado a sus posibilidades económicas. REPORTE DE CASO: paciente femenino de 47 años, sin solvencia económica y sin ningún servicio médico. El tratamiento incluyó resección en bloque, reconstrucción con autoinjerto de peroné distal y artrodesis radiocarpiana con placa de compresión bloqueada. Dieciocho meses después, la paciente presentaba una buena fuerza de prensión (80% respecto al lado sano) y tenía una función motora fina en la mano. La muñeca presentó estabilidad con pronación de 85o, supinación de 80o, flexión-extensión de 0o y una puntuación de 6.7 en el cuestionario de evaluación de resultados funcionales DASH. Su evolución radiológica a cinco años después de su cirugía continuó sin datos de recidiva local y afectación pulmonar. CONCLUSIÓN: el resultado en esta paciente, junto con los datos publicados, indican que la técnica de resección tumoral en bloque, más el autoinjerto de peroné distal y la artrodesis con placa de compresión bloqueada proporcionan un resultado óptimo de funcionalidad para el tumor radial distal grado III a bajo costo.

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This case report is about the sickness of a 59 year old priest, politician and war veteran who died in 1844. The case history is based on the detailed report of his doctor, gathered in a diary and later published. The collected clinical data relied exclusively on touch and observation. The patient's illness started with a painful lump on his forehead that was in part excised. Surgical exploration revealed a soft tissue mass that bled easily and involved the frontal bone. In the following months, the lesion, which had been treated with complex topical medications, became ulcerated and extended to the orbit and the chin. The patient died postrated and in severe undernutrition one year after the onset of the symptoms. The case discussion, presented in the format of a clinicopathological conference, concluded that a metastasis of a renal cell carcinoma or an osseous lymphoma were the more likely diagnoses.

Assuntos

RESUMO

This case report is about the sickness of a 59 year old priest, politician and war veteran who died in 1844. The case history is based on the detailed report of his doctor, gathered in a diary and later published. The collected clinical data relied exclusively on touch and observation. The patients illness started with a painful lump on his forehead that was in part excised. Surgical exploration revealed a soft tissue mass that bled easily and involved the frontal bone. In the following months, the lesion, which had been treated with complex topical medications, became ulcerated and extended to the orbit and the chin. The patient died postrated and in severe undernutrition one year after the onset of the symptoms. The case discussion, presented in the format of a clinicopathological conference, concluded that a metastasis of a renal cell carcinoma or an osseous lymphoma were the more likely diagnoses.

RESUMO

The microcystic serous cystadenoma of pancreas or glycogen "rich"cystadenoma is a rare entity. Whe studiet five case of this cystadenoma in adult patients ages 47-68 (58 was the mean), four of wich were women (80 percent). The clinical presentation was varied. There was a prevalence of expansive manifestations with epigastric pain in three patients, and extrahepatic bile duct obstruction in other two. A distal tumour was revealed by the diagnostic methodology used (ultrasound and TAC) in three patients, and cephalic tumour in two, with a mean size of 8.8 cm. in diameter. A distal pancreatectomy was performed in two patients, a cephalic pancreatoduodenectomy was performed in one in relation with the presence of extrahepatic bile duct carcinoma, and the other two were treated with a partial cephalic pancreatectomy (enucleation). The nosological diagnose was post-surgical in all case of study. a prognosis for every case was dependat of the associated pathology. (AU)

Assuntos

RESUMO

The microcystic serous cystadenoma of pancreas or glycogen "rich"cystadenoma is a rare entity. Whe studiet five case of this cystadenoma in adult patients ages 47-68 (58 was the mean), four of wich were women (80 percent). The clinical presentation was varied. There was a prevalence of expansive manifestations with epigastric pain in three patients, and extrahepatic bile duct obstruction in other two. A distal tumour was revealed by the diagnostic methodology used (ultrasound and TAC) in three patients, and cephalic tumour in two, with a mean size of 8.8 cm. in diameter. A distal pancreatectomy was performed in two patients, a cephalic pancreatoduodenectomy was performed in one in relation with the presence of extrahepatic bile duct carcinoma, and the other two were treated with a partial cephalic pancreatectomy (enucleation). The nosological diagnose was post-surgical in all case of study. a prognosis for every case was dependat of the associated pathology.

Assuntos

RESUMO

The microcystic serous cystadenoma of pancreas or glycogen "rich" cystadenoma is a rare entity. We studied five case of this cystadenoma in adult patients ages 47-68 (58 was the mean), four of which were women (80%). The clinical presentation was varied. There was a prevalence of expansive manifestations with epigastric pain in three patients, and extrahepatic bile duct obstruction in other two. A distal tumour was revealed by the diagnostic methodology used (ultrasound and TAC) in three patients, and cephalic tumour in two, with a mean size of 8.8 cm. in diameter. A distal pancreatectomy was performed in two patients, a cephalic pancreatoduodenectomy was performed in one in relation with the presence of extrahepatic bile duct carcinoma, and the other two were treated with a partial cephalic pancreatectomy (enucleation). The nosological diagnose was post-surgical in all case of study. A prognosis for every case was dependent of the associated pathology.

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RESUMO

The insecticide effect of a lectin obtained from Ricinus communis (castor-oil plant) on a population of houseflies from San José de Las Lajas was evaluated. Assays were performed with adults and larvae. Mortality was higher as the time f exposure to the extract increased DL50 was of 353.4 p.p.m. after 72 hours of exposure. It was observed a remarkedly significant reduction of the pupal development in the presence of the extract, which shows its insecticide activity.

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