RESUMOIntrodução: A quimioembolização hepática é uma técnica amplamente usada para o tratamento do carcinoma hepatocelular. A principal complicação deste procedimento é a síndrome pós-quimioembolização. O principal objetivo deste estudo foi determinar fatores de risco para síndrome pós-quimioembolização. Material e Métodos: Análise retrospetiva unicêntrica de 563 procedimentos de quimioembolização hepática efetuados entre 1/1/2014-31/12/2015. A quimioembolização hepática foi efetuada com ½ -2 ampolas de microesferas 100 -300 μm carregadas com doxorrubicina. Os pacientes que desenvolveram síndrome pós-quimioembolização foram identificados pelo prolongamento do internamento por dor, febre, náuseas e/ou vómitos. Um grupo controlo com os pacientes que não desenvolveram síndrome pós-quimioembolização foi criado de forma randomizada (três controlos para um caso). Foi realizada análise descritiva e regressão logística multivariada. Resultados: A prevalência global de síndrome pós-quimioembolização foi 6,2%. Quimioembolização hepática com dose de doxorrubicina superior a 75 mg (mais de uma ampola), o tamanho do nódulo maior e o género feminino demonstraram relação estatisticamente significativa com o desenvolvimento de síndrome pós-quimioembolização (p = 0,030, p = 0,046 e p = 0,037, respetivamente , 2015. Hepatic transarterial chemoembolization was performed with ½ -2 vials of 100 -300 μm microspheres loaded with doxorubicin. Patients who experienced postembolization syndrome were identified based on prolongation of hospitalization due to pain, fever, nausea and/or vomiting. A control group with the patients who did not have postembolization syndrome was randomly created (three controls for one case). Descriptive analysis and multivariate logistic regression were performed. Results: The overall prevalence of postembolization syndrome was 6.2%. Hepatic transarterial chemoembolization with doxorubicin dosage above 75 mg (more than one vial), the size of the largest nodule and female gender had statistically significant relation with development of postembolization syndrome (p = 0.030, p = 0.046 and p = 0.037, respectively). Discussion: Doxorrubicin dosage above 75 mg is associated with a higher risk of postembolization syndrome. This result can be helpful for decision-making in clinical practice, whenever it is possible to avoid a higher dose without compromising the efficacy of the treatment. The size of the largest nodule and female gender also constitute risk factors for postembolization syndrome. The other variables studied were not related to the development of postembolization syndrome. Conclusion:The dose of doxorrubicin, the size of the largest nodule treated and female gender are potential risk factors for the development of postembolization syndrome after hepatic transarterial chemoembolization for hepatocellular carcinoma.
Granular cell tumors are uncommon, and are usually benign neoplasms that can mimic malignancy on breast imaging tests. These tumors can originate anywhere in the body and the breast accounts for only a few cases of all granular cell tumors. We report a case of a 54-year-old woman with a granular cell tumor of the breast presenting clinically on breast imaging (ultrasound, mammography and magnetic resonance) as a suspicious lesion. Core needle biopsy was performed for tissue diagnosis and was consistent with granular cell tumor that was confirmed in the histopathological report of the surgical specimen following a breast lumpectomy. Given the rarity of this tumor, we present this case to highlight this diagnostic hypothesis, that can be challenging and frequently confused with breast carcinoma.
The authors present a case of a 39-year-old man with alcoholic chronic pancreatitis that was admitted in the emergency department after a car accident, complaining of abdominal pain and looking pale. The patient was hemodinamically unstable, requiring blood transfusions. He underwent computed tomography angiogram of the abdomen and pelvis, showing a pseudoaneurysm of the gastroduodenal artery and a hemoperitoneum. He was referred to our interventional radiology unit and submitted to endovascular treatment, consisting of ‘backdoor’ and ‘frontdoor’ embolization of the gastroduodenal artery and pseudoaneurysm neck with coils, with total exclusion in control angiography. With this case description we intend to highlight the rarity of the pseudoaneurysm rupture of the gastroduodenal artery and to emphasize the importance of an interventional radiology response that had a fundamental role in the endovascular treatment, in an emergency context.
Mucinous cystadenocarcinoma of minor salivary glands is an extremely rare entity that has only recently been described, with a few published cases in the English literature. A 42-year-old woman with a history of a surgically excised mucinous cystadenoma of the oral tongue, presented with a painful swelling in the oral tongue slowly growing for 1 month. On clinical examination, there was a firm, relatively well-circumscribed mass in the left posterior border of the mobile tongue. Subsequent MRI scan revealed a heterogeneous lesion composed of multiple cysts separated by contrast enhancing septa, in the posterior two-thirds of the left tongue. Imaging findings were similar to those of the previously resected mass, suggesting local relapse of the primary lesion. A complete surgical excision was performed and the histopathological examination revealed typical features of a low-grade mucinous cystadenocarcinoma of minor salivary glands.
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