ResumenEl carcinoma de uraco es una neoplasia maligna poco frecuente de predominio masculino entre la quinta a sexta dé-cada de la vida. Se localizan típicamente en la cúpula de la vejiga, con patrón histopatológico predominante de adenocarcinoma en el 90% de los casos. Tiene un curso indolente con manifestaciones clínicas en etapas tardías caracterizadas por hematuria, dolor abdominal, disuria, mucosuria, entre otros. El diagnóstico se basa en el hallazgo de la lesión por métodos endoscópicos e imagenológicos. Dado lo infrecuente de esta patología, se describe el caso de una paciente en su cuarta década de vida con infección de vías urinarias recurrente, en quien se documentó por medio de urografía por tomografía computarizada multicorte (UROTAC) de pólipo vesical resecado por resección transuretral (RTU) con reporte histológico de adenocarcinoma de tipo entérico. Palabras clave: CARCINOMA DE URACO PRUEBAS DIAGNÓSTICAS DE RUTINA Key words:URACHAL CARCINOMA ROUTINE DIAGNOSTIC TESTS IntroducciónEl carcinoma de uraco es una neoplasia maligna que corresponde al 0,7% de todos los cánceres de vejiga y al 35% de adenocarcinomas vesicales (1) . Es más frecuente en hombres con una relación 5: 1 (2,15) , de predominio entre la quinta a sexta década de la vida (3) . En cuanto a su origen, el uraco es una estructura de 5 a 10 cm de longitud proveniente de la alantoides, que pasa desde la cúpula vesical hasta el ombligo y se convierte en un cordón fibroso obliterado en el adulto (4) . Se constituye de tres capas: una externa constituida por músculo liso, una intermedia constituida por tejido conectivo submucosa y una interna de tipo luminal. De las anteriores, las células epiteliales que constituyen cada capa dan lugar al carcinoma de uraco (5) . Caso clínicoPaciente mujer en su cuarta década de vida, presenta dos años con síntomas urinarios irritativos y mucosuria con infección de vías urinarias recurrentes, se indicó tratamiento antibiótico guiado por urocultivo. Se realizó UROTAC con hallazgo de lesión polipoide en vejiga de 22 mm. Posteriormente es llevada a cistoscopía, documentando hallazgo anterior en cúpula vesical, la cual es removida a través de RTU con reporte de histopatología de adenocarcinoma de tipo entérico. Se llevó a junta de oncología donde se conceptuó manejo para carcinoma de uraco a través de cirugía, por lo que se realizó cistectomía parcial más resección de seno uracal y linfadenectomía radical pélvica. Dos meses posteriores a la intervención quirúrgica, presentó dolor severo suprapúbico e inguinal, con sospecha de recaída 52
SARS-CoV-2 (COVID-19) infection is a current public health problem that has been shown to cause multiple complications, including pulmonary thromboembolism. The first presented case is a 59-year-old woman with a history of COPD, paroxysmal atrial fibrillation and COVID-19 infection in September 2020, consultation in December 2020 for atypical chest pain with suspected PE, AngioCT of pulmonary vessels was performed negative for emboli, subsequently [ 99m Tc]Tc MAA SPECT/CT was indicated with a report of multiple triangular defects concerning acute pulmonary thromboembolism. A second case is a 70-year-old man with a history of dyslipidaemia, presented COVID-19 infection in September 2020 with a complication of PE with involvement of the left pulmonary artery, followed by [ 99m Tc]Tc MAA SPECT/CT report multiple triangular and not triangles defects concerning pulmonary thromboembolism with signs of reperfusion.
Hyperparathyroidism is a common calcium metabolic disorder, characterized by the presence of high concentrations or inappropriately normal concentrations of parathyroid hormone (PTH) in the context of high calcium. Pharmacological and surgical management is available as treatment. The objective of diagnostic imaging is to determine the location of the causal lesion. For these purposes, non-invasive methods can be divided into anatomical or functional studies, with nuclear medicine studies being in the latter category. The objective of this review, is to establish the similarities and differences that exist in the clinical practice guidelines on conventional and molecular nuclear medicine studies in parathyroid disease.
Thyroid cancer is a common endocrinological malignancy worldwide, accounting for 3% of the global incidence of all cancers. Meta-analyses, systematic reviews, and descriptive reviews mention the use of positron emission tomography / computed tomography (PET/CT) as an alternative to morphological imaging such as computed tomography or magnetic resonance imaging to clarify the diagnosis. The aim: analysis of positron emission tomography/computed tomography tracers in the differential diagnosis of thyroid carcinomas. Materials and methods: Review about PET/CT tracers different than 2-[18F] fluorodeoxyglucose (FDG) in patients with diagnosed differentiated thyroid carcinoma. Evidence Synthesis: PET/CT is an alternative to morphological diagnosis imaging when is inconclusive or negative due to the suspicion of tumor persistence or recurrence, elevation of tumor markers, dedifferentiation thyroid carcinoma, non-conventional therapeutic options. 2-[18F] FDG is the most uses a tracer, but there are scenarios where can be negative or inconclusive, for this reason, in recent years other PET tracers have been used: [124I] NaI, [18F] Tetrafluoroborate, [68Ga] Ga-NOTE-PRGD2 or [18F] AIF-NOTE-PRGD2, [68Ga] Ga-DOTA-FAPI, [18F] Fluorocholine or [11C] C-Choline, [18F] or [68Ga] Ga-PSMA, [68Ga] Ga DOTA-TATE/TOC/NOC/LAN, [18F]-FAZA, L-[methyl-11C] Methionine and [89Zr] DFO-PAS200-Fab. Conclusions. There are multiple radiopharmaceuticals different than 2-[18F] FDG, which can be adequate in the context of differentiated thyroid carcinoma: 2-[18F] FDG PET/CT negative, TENIS syndrome, radioiodine-refractory thyroid cancer suspected, thyroid dedifferentiated carcinoma, and some cases theragnostic tools.
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