RESUMO
Ocular metastases from systemic tumors are uncommon. The choroid is the most frequent target, with a preference for elderly individuals. Lung cancer is the predominant primary tumor that metastasizes to the eyes in males, although other ocular conditions such as uveitis and retinal lesions can mimic secondary tumor implants in ocular tissues. On fundoscopy, choroidal metastasis resembles other infectious processes, especially choroidal tuberculoma. Therefore, patients presenting with choroidal masses should undergo detailed clinical examinations, especially if the mass is the first manifestation of a systemic and severe disease. In this report, we describe a young man with a metastatic choroidal tumor secondary to papillary renal cell carcinoma mimicking a unilateral choroidal tuberculoma.
Assuntos
Carcinoma de Células Renais , Neoplasias da Coroide , Neoplasias Renais , Tuberculoma , Masculino , Humanos , Idoso , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/patologia , Corioide/patologia , Neoplasias da Coroide/diagnóstico , Neoplasias da Coroide/patologia , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Tuberculoma/diagnóstico , Tuberculoma/patologiaRESUMO
Interstitial keratitis is an inflammation of the corneal stroma without epithelium or endothelium involvement. The underlying causes are mostly infectious or immune mediated. Brazil has one of the highest incidence rates of tuberculosis in the world. Tuberculosis is considered one of the causes of interstitial keratitis. Malnutrition and anemia are risk factors of the disseminated disease. This is a case report of a 10-year-old child who presented with decreased visual acuity and a clinical diagnosis of bilateral interstitial keratitis and sclero-uveitis. The patient had been treated with topical steroids with partial improvement. Examinations revealed severe iron deficiency anemia, negative serologies for human immunodeficiency virus and syphilis, positivity for cytomegalovirus- and herpes simplex-specific IgG, and purified protein derivative of 17 mm. During the follow-up, the patient presented with tonic-clonic seizures, and magnetic resonance imaging findings suggested a central nervous system tuberculoma. Interstitial keratitis improvement was observed after specific tuberculosis treatment. This is the first case report describing the association of interstitial keratitis and central nervous system tuberculoma.
Assuntos
Ceratite Herpética , Ceratite , Tuberculoma , Tuberculose , Criança , Humanos , Ceratite/tratamento farmacológico , Tuberculose/complicações , Tuberculose/patologia , Substância Própria/patologia , Tuberculoma/complicações , Tuberculoma/patologia , Encéfalo , Ceratite Herpética/complicações , Ceratite Herpética/tratamento farmacológico , Ceratite Herpética/patologiaRESUMO
Tuberculosis is one of the main causes of death due to infection around the world. Although tuberculosis frequently involves lung parenchyma, tuberculoma is a rare complication. We describe an atypical pulmonary presentation of tuberculosis. A 15-month-old girl, previously healthy, was referred to the pulmonology department due to fever, poor weight gain, and a 2-months persistent lung image on chest x-ray despite antibiotic therapy. She had been in frequent contact with a respiratory symptomatic subject. She was admitted to the hospital with a TST of 13 mm and a heterogeneous bulky mass in the left upper lobe at chest computed tomography. Three gastric lavages were Masa pulmonar como manifestación primaria de tuberculosis en pediatría: reporte de un caso Pulmonary tuberculosis presenting as a lung mass in children: case report done and the patient underwent exploratory thoracoscopy and lung biopsy, with positive cultures for Mycobacterium tuberculosis. The diagnosis of pulmonary tuberculoma was confirmed, and the patient received standard anti- tuberculosis therapy with a favorable evolution.
La tuberculosis es una de las principales causas infecciosas de muerte en el mundo y es endémica en Argentina. La mayoría de los casos de tuberculosis son de localización pulmonar; el tuberculoma una complicación infrecuente. Se describe un caso clínico de presentación pulmonar atípica de tuberculosis. Se trata de una niña de 15 meses, previamente sana, derivada a neumología por fiebre, mal progreso de peso e imagen persistente por 2 meses en la radiografía de tórax a pesar de haber recibido antibioticoterapia. Antecedente de contacto estrecho con persona sintomática respiratoria. Se internó para estudio, mostró una PPD de 13 mm y una masa voluminosa heterogénea en el lóbulo superior izquierdo en la tomografía computada de tórax. Se realizaron tres lavados gástricos y toracoscopia exploratoria con biopsia pulmonar con rescate de Mycobacterium tuberculosis en cultivos. Se diagnosticó tuberculoma pulmonar y realizó tratamiento estándar con fármacos antituberculosos con evolución favorable.
Assuntos
Tuberculoma , Tuberculose dos Linfonodos , Tuberculose Pulmonar , Antibacterianos , Criança , Feminino , Humanos , Lactente , Pulmão/patologia , Tuberculoma/patologia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnósticoRESUMO
La tuberculosis es una de las principales causas infecciosas de muerte en el mundo y es endémica en Argentina. La mayoría de los casos de tuberculosis son de localización pulmonar; el tuberculoma una complicación infrecuente. Se describe un caso clínico de presentación pulmonar atípica de tuberculosis. Se trata de una niña de 15 meses, previamente sana, derivada a neumología por fiebre, mal progreso de peso e imagen persistente por 2 meses en la radiografía de tórax a pesar de haber recibido antibioticoterapia. Antecedente de contacto estrecho con persona sintomática respiratoria. Se internó para estudio, mostró una PPD de 13 mm y una masa voluminosa heterogénea en el lóbulo superior izquierdo en la tomografía computada de tórax. Se realizaron tres lavados gástricos y toracoscopia exploratoria con biopsia pulmonar con rescate de Mycobacterium tuberculosis en cultivos. Se diagnosticó tuberculoma pulmonar y realizó tratamiento estándar con fármacos antituberculosos con evolución favorable.
Tuberculosis is one of the main causes of death due to infection around the world. Although tuberculosis frequently involves lung parenchyma, tuberculoma is a rare complication. We describe an atypical pulmonary presentation of tuberculosis. A 15-month-old girl, previously healthy, was referred to the pulmonology department due to fever, poor weight gain, and a 2-months persistent lung image on chest x-ray despite antibiotic therapy. She had been in frequent contact with a respiratory symptomatic subject. She was admitted to the hospital with a TST of 13 mm and a heterogeneous bulky mass in the left upper lobe at chest computed tomography. Three gastric lavages were done and the patient underwent exploratory thoracoscopy and lung biopsy, with positive cultures for Mycobacterium tuberculosis. The diagnosis of pulmonary tuberculoma was confirmed, and the patient received standard anti- tuberculosis therapy with a favorable evolution.
Assuntos
Humanos , Feminino , Lactente , Tuberculoma/patologia , Tuberculose dos Linfonodos , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico , Pulmão/patologia , AntibacterianosRESUMO
To present a young immunocompetent patient with a fourth ventricle tuberculoma without pulmonary tuberculosis. A previously healthy young male patient presented with a history of headache, nausea, and blurred vision. Neuroimaging revealed a mass present in the fourth ventricle. The lesion was successfully resected. Histological and microbiological findings suggested the presence of a tuberculoma. Tuberculomas can be found in the posterior fossa in adults. This infectious pathology should not be forsaken when considering the differential diagnosis for infratentorial masses.
Assuntos
Quarto Ventrículo/microbiologia , Tuberculoma/diagnóstico , Tuberculose do Sistema Nervoso Central/diagnóstico , Adulto , Antibióticos Antituberculose/uso terapêutico , Diagnóstico Diferencial , Quarto Ventrículo/patologia , Cefaleia/diagnóstico , Cefaleia/tratamento farmacológico , Cefaleia/etiologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Neuroimagem , Tuberculoma/complicações , Tuberculoma/tratamento farmacológico , Tuberculoma/patologia , Tuberculose do Sistema Nervoso Central/tratamento farmacológicoAssuntos
Antituberculosos/uso terapêutico , Sistema Nervoso Central/fisiopatologia , Tuberculoma/diagnóstico , Tuberculoma/tratamento farmacológico , Tuberculose/complicações , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Colômbia , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Resultado do Tratamento , Tuberculoma/fisiopatologia , Tuberculose/fisiopatologiaRESUMO
ABSTRACT Choroidal tuberculomas are present in patients with ocular tuberculosis. They usually occur in a patient with previous history of tuberculosis, and are rarely the initial presentation, with no prior systemic manifestations. We present a patient with unilateral choroidal tuberculoma as the initial presentation of presumed ocular tuberculosis, which enabled earlier initiation of treatment.
RESUMO Os tuberculomas de coroide apresentam-se em pacientes com tuberculose ocular. Geralmente, ocorrem em indivíduos com história prévia de tuberculose e raramente têm apresentação inicial sem manifestações sistêmicas anteriores. Relatamos o caso de um paciente com tuberculoma de coroide unilateral com apresentação inicial de tuberculose ocular presumida, permitindo o início mais precoce do tratamento.