RESUMO
El carcinoma de células en anillo de sello es una variante histopatológica de cáncer gástrico que se encuentra en aumento, se caracteriza por un mal pronóstico. Se presenta el caso de un hombre joven al que se le hizo este diagnóstico en el contexto de una complicación rara como es el síndrome de estenosis gastroduodenal.
Signet ring cell carcinoma is a histopathological variant of gastric cancer that is increasing and is characterized by a poor prognosis. We present the case of a young man who underwent this diagnosis in the context of a rare complication such as upper gastrointestinal stenosis syndrome.
O carcinoma de células em anel de sinete é uma variante histopatológica do câncer gástrico que está aumentando e é caracterizado por um mau prognóstico. É apresentado o caso de um jovem que recebeu este diagnóstico no contexto de uma complicação rara como a síndrome de estenose gastroduodenal.
Assuntos
Humanos , Masculino , Adulto , Neoplasias Gástricas/diagnóstico , Carcinoma de Células em Anel de Sinete/diagnóstico , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/complicações , Carcinoma de Células em Anel de Sinete/cirurgia , Carcinoma de Células em Anel de Sinete/complicações , Constrição Patológica/etiologia , GastrectomiaRESUMO
The infiltration of the bone marrow y non-hematopoietic cells is called myelophthisis. In patients with gastric cancer, this invasion is extremely infrequent and the survival is usually less than three months. We present the case of a 35-year-old man with bone marrow involvement secondary to diffuse gastric carcinoma of signet ring cells.
Se denomina mieloptisis a la infiltración de la médula ósea por células no hematopoyéticas. En pacientes con cáncer gástrico esta invasión es extremadamente infrecuente y la supervivencia suele ser menor a tres meses. Presentamos el caso de un hombre de 35 años con compromiso de la médula ósea secundario a un carcinoma gástrico difuso de células en anillo de sello.
Assuntos
Anemia Mielopática/diagnóstico , Carcinoma de Células em Anel de Sinete/diagnóstico , Neoplasias Gástricas/diagnóstico , Adulto , Anemia Mielopática/etiologia , Carcinoma de Células em Anel de Sinete/complicações , Carcinoma de Células em Anel de Sinete/tratamento farmacológico , Evolução Fatal , Humanos , Masculino , Neoplasias Gástricas/complicações , Neoplasias Gástricas/tratamento farmacológicoRESUMO
Se denomina mieloptisis a la infiltración de la médula ósea por células no hematopoyéticas. En pacientes con cáncer gástrico esta invasión es extremadamente infrecuente y la supervivencia suele ser menor a tres meses. Presentamos el caso de un hombre de 35 años con compromiso de la médula ósea secundario a un carcinoma gástrico difuso de células en anillo de sello.
The infiltration of the bone marrow y non-hematopoietic cells is called myelophthisis. In patients with gastric cancer, this invasion is extremely infrequent and the survival is usually less than three months. We present the case of a 35-year-old man with bone marrow involvement secondary to diffuse gastric carcinoma of signet ring cells.
Assuntos
Humanos , Masculino , Adulto , Neoplasias Gástricas/diagnóstico , Carcinoma de Células em Anel de Sinete/diagnóstico , Anemia Mielopática/diagnóstico , Neoplasias Gástricas/complicações , Neoplasias Gástricas/tratamento farmacológico , Evolução Fatal , Carcinoma de Células em Anel de Sinete/complicações , Carcinoma de Células em Anel de Sinete/tratamento farmacológico , Anemia Mielopática/etiologiaAssuntos
Neoplasias Ósseas/secundário , Carcinoma de Células em Anel de Sinete/secundário , Neoplasias Gástricas/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/tratamento farmacológico , Carcinoma de Células em Anel de Sinete/diagnóstico , Carcinoma de Células em Anel de Sinete/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/tratamento farmacológicoRESUMO
We report a rare case of diffuse type of gastric cancer with signet ring cells in 10 years old boy who was admitted with a 12 months history with weight loss, dysphagia to solids first and to liquids later, anorexia, fatigue, dizziness, vomiting and later, with pain in the left upper quadrant. On examination, he appeared pale, malnourished, with café-au- lait spots over the trunk and extremities. Laboratory tests showed; Hb 7.5 g, albumin 2.62 g, Thevenon positive on stools. Abdominal ultrasound examination showed periaortic masses and diffuse space occupying lesions in the liver. Endoscopic examination of the stomach showed multiple elevated tumor lesions. One located at 3 cm on the subcardial region presented irregular borders, partially eroded, that bleed easily when rubbing its surface. Multiple biopsy samples were taken. They showed a diffuse gastric signet cell type carcinoma of the stomach. Immunohistochemistry was positive to CK 8. The patient died a year later with wide spread metastasis. The boy was born through a normal delivery after a normal pregnancy to a primipara mother. His family history recorded a grandmother aunt dying of gastric cancer.
Assuntos
Carcinoma de Células em Anel de Sinete/diagnóstico , Neoplasias Gástricas/diagnóstico , Carcinoma de Células em Anel de Sinete/patologia , Criança , Evolução Fatal , Humanos , Masculino , Neoplasias Gástricas/patologiaRESUMO
Gastric adenocarcinoma is a common neoplasia and is responsible for up to 30% of the overall deaths due to cancer. Advanced disease is mostly characterized by peritoneum, liver, and lung involvement. The spread of the disease to the bone is rare, and bone marrow dissemination is even rarer. In this setting, leukoerythroblastosis may be the initial manifestation of the disease. The authors report the case of a 64-year-old Caucasian man who sought medical care complaining of back pain, weakness, and weight loss. The physical examination revealed pallor, and the laboratory work-up depicted severe anemia and thrombocytopenia; the peripheral blood smear was consistent with leukoerythroblastosis. The ongoing investigation through a bone marrow biopsy showed massive involvement of the bone marrow by a signet ring cell adenocarcinoma. During hospitalization, the patient presented melena, and an upper digestive endoscopy depicted an ulcerated and infiltrative lesion in the cardia, upon which the histological examination revealed a signet ring cell adenocarcinoma. This case highlights the bone marrow invasion represented by bicytopenia and leukoerythroblastosis as the initial manifestation of this histological type of gastric cancer. Although treatment attempts were made with chemotherapy and radiotherapy, the patient died early on, showing the aggressive behavior of this form of tumoral presentation.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma/diagnóstico , Carcinoma de Células em Anel de Sinete/diagnóstico , Neoplasias Gástricas/diagnóstico , Anemia Mielopática/etiologia , Medula Óssea/patologia , Evolução Fatal , Doenças Hematológicas/etiologiaRESUMO
El objetivo del presente estudio fue presentar un caso extremadamente raro de adenocarcinoma gástrico difuso con células en anillo de sello en un niño de 10 años. Se presenta un niño de 10 años, con un tiempo de enfermedad de 12 meses con sintomatología de disfagia a sólidos, luego a líquidos, pérdida de peso, anorexia, astenia, mareos, vómitos y dolor en el hipocondrio izquierdo. Presenta desnutrición crónica, marcada palidez y máculas "café con leche" en tronco y extremidades. Los exámenes de laboratorio evidenciaron 7,5 gr de hemoglobina, albúmina 2,62 gr, thevenon en heces positivo. Una ecografía abdominal mostró masas periaórticas y lesiones difusas a nivel hepático. A la endoscopía se observó lesión elevada esófago-gástrica que obstruye la luz. A nivel subcardial tumoración de 3 cm de bordes irregulares, superficie erosionada y sangrante al roce. Se realizó biopsia múltiple. Murió un año después por metástasis generalizada. Nació de parto normal, de madre primigesta, con 3 500 gr de peso. Antecedentes familiares: tía abuela materna falleció de cáncer gástrico. La biopsia mostró un adenocarcinoma difuso con presencia de células en anillo de sello, PAS positivo y a la inmunohistoquímica fue positiva a la CK 8.
We report a rare case of diffuse type of gastric cancer with signet ring cells in 10 years old boy who was admitted with a 12 months history with weight loss, dysphagia to solids first and to liquids later, anorexia, fatigue, dizziness, vomiting and later, with pain in the left upper quadrant. On examination, he appeared pale, malnourished, with café-au-lait spots over the trunk and extremities. Laboratory tests showed; Hb 7.5 g, albumin 2.62 g, Thevenon positive on stools. Abdominal ultrasound examination showed periaortic masses and diffuse space occupying lesions in the liver. Endoscopic examination of the stomach showed multiple elevated tumor lesions. One located at 3 cm on the subcardial region presented irregular borders, partially eroded, that bleed easily when rubbing its surface. Multiple biopsy samples were taken. They showed a diffuse gastric signet cell type carcinoma of the stomach. Immunohistochemistry was positive to CK 8. The patient died a year later with wide spread metastasis. The boy was born through a normal delivery after a normal pregnancy to a primipara mother. His family history recorded a grandmother aunt dying of gastric cancer.
Assuntos
Criança , Humanos , Masculino , Neoplasias Gástricas/diagnóstico , Carcinoma de Células em Anel de Sinete/diagnóstico , Neoplasias Gástricas/patologia , Evolução Fatal , Carcinoma de Células em Anel de Sinete/patologiaRESUMO
Krukenberg tumor is a malignancy in the ovary from a primary lesion in the gastrointestinal tract and a metastatic signet ring cell adenocarcinoma to the ovary. Stomach is the most common primary site, but other organs can serve as a primary site. The lymphatic system is the most likely route for metastasis. CA 125 levels can be used for screening for early detection of ovarian metastasis as well as for monitoring the course of disease. The prognosis of Krukenberg tumor is poor and no curative treatment is currently available.
Assuntos
Carcinoma de Células em Anel de Sinete/secundário , Tosse/etiologia , Dispneia/etiologia , Tumor de Krukenberg/secundário , Neoplasias Pulmonares/secundário , Neoplasias Ovarianas/diagnóstico , Pneumonia/diagnóstico , Neoplasias Gástricas/patologia , Biomarcadores Tumorais/análise , Carcinoma de Células em Anel de Sinete/diagnóstico , Carcinoma de Células em Anel de Sinete/patologia , Diagnóstico Diferencial , Fadiga/etiologia , Feminino , Humanos , Tumor de Krukenberg/complicações , Tumor de Krukenberg/diagnóstico , Tumor de Krukenberg/diagnóstico por imagem , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Metástase Linfática , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico por imagem , Derrame Pleural Maligno/etiologia , Tomografia por Emissão de Pósitrons , Neoplasias Gástricas/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Las metástasis de carcinomas extragenitales al útero es rara y el compromiso al cuello uterino es excepcional, especialmente del tipo histológico de carcinoma de células en anillo de sello. Se presentan tres casos encontrados en 240 adenocarcinomas cervicales (1,25 por ciento) diagnosticados entre 1979-2012. Dos casos se presentaron en pacientes de 48 y 56 años originados en carcinomas lobulillares infiltrantes de la mama diagnosticados previamente. La primera paciente está viva a 19 meses del diagnóstico ginecológico y la segunda falleció a los 14 meses, siendo en ambas un hallazgo histológico incidental en cirugías realizadas por patología ginecológica benigna. El tercer caso se presentó en una paciente de 43 años que debutó por metrorragia y tumor cervical y fue originado en un carcinoma gástrico infiltrante difuso, encontrado en forma sincrónica y fallece a los 2 meses del diagnóstico. Se revisan los criterios diagnósticos entre metástasis y carcinoma primario de células en anillo de sello del cuello uterino y el aporte al diagnóstico de la histología convencional, la inmunohistoquímica y la tipificación molecular de HPV. Conclusión: Se concluye que la metástasis de carcinoma de células en anillo al cuello uterino es rara y el pronóstico es malo. La citoreducción y la quimioterapia podría tener un rol para casos seleccionados de carcinomas metastásicos de origen mamario y que estos casos no deberían ser considerados un evento preterminal.
The uterine metastatic involving of extragenital carcinomas is rare, especially the signetring cell type. Three of such a cases were found in 240 cases of adenocarcinomas of uterine cervix (1.25 percent) diagnosed between 1979-2012. Two of these cases occurred in patients aged 48 and 56 years with infiltrating lobular carcinomas arising in the breast previously diagnosed. The first patient is alive at 19 months after diagnosis and the second is deceased at 14 months after diagnosis. In both cases, the metastasis to the cervix was an incidental histological finding in surgeries performed by benign gynecological pathology. The third case was identified in a 43-years old patient who debuted with metrorrhagia and cervical tumor which was originated in a diffuse infiltrating gastric carcinoma that was found synchronously and she is dead at 2 months after diagnosis. The diagnostic criteria between metastases and primary cervix carcinoma of signet ring cells and the contribution to the diagnosis of conventional histology, immunohistochemistry and molecular typing of HPV are reviewed. The metastasis of signet ring cell carcinoma to the uterine cervix is rare and the survival is poor. Conclusion: The role of cytoreduction and chemotherapy for selected cases of metastasis from breast carcinomas should be considered and in such a case the gynecological involvement should not be considered a preterminal event.