Abstract:
:Hemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without a history of exposure to carcinogens who presented with abdominal pain for two months. Diagnostic work-up revealed elevated gamma-glutamyl transferase and lactate dehydrogenase levels. Abdominal ultrasound described a large nodular lesion in the right lobe of the liver described as a hemangioma. One month later, a computed tomography-scan was made and revealed the same lesion, which had grown from 13.5 to 20 cm, maintaining typical imaging characteristics of a hemangioma. A right hepatectomy was performed and pathology revealed an angiosarcoma. After surgery, a positron emission tomography-computed tomography scan showed hepatic and bone metastasis. The patient started taxane-based chemotherapy and lumbar palliative radiotherapy, but died 10 months after surgery. This case shows how difficult it is to diagnose hepatic angiosarcoma relying only on imaging findings. Two abdominal computed tomography -scans were performed and none suggested this diagnosis. Angiosarcoma is a very aggressive tumour with an adverse prognosis. Surgery is the only curative treatment available. However, it is rarely feasible due to unresectable disease or distant metastasis. :Apesar do diagnóstico de hemangioma ser habitualmente simples e baseado na ecografia, a presença de sintomas, o crescimento rápido ou a presença de atipias imagiológicas devem-nos fazer considerar a hipótese de outras entidades, algumas delas malignas como o angiossarcoma. É descrito o caso de doente do sexo feminino de 46 anos, previamente saudável sem exposição a carcinogéneos, refere queixas de dor abdominal durante dois meses. O estudo analítico revelou elevação da gama glutamil transferase e lactato desidrogenase e a ecografia abdominal evidenciou uma lesão nodular de grandes dimensões no lobo direito do fígado, descrita como hemangioma. Um mês mais tarde, realizou uma tomografia computadorizada abdominal que revelou aumento das dimensões da lesão (13,5 para 20 cm), mantendo características imagiológicas de hemangioma. A doente foi submetida a hepatectomia direita e a histologia revelou a presença de angiossarcoma. Após cirurgia, uma tomografia por emissão de positrões-tomografia computadorizada evidenciou metastização hepática e óssea. A doente foi submetida a radioterapia e quimioterapia paliativa com paclitaxel, tendo falecido 10 meses após a cirurgia. Este caso exemplifica a dificuldade do diagnóstico do angiosarcoma baseado apenas nos exames de imagem. Foram realizadas duas tomografias computadorizadas abdominais e nenhuma sugeriu o diagnóstico. Os angiossarcomas são tumores muito agressivos com prognóstico reservado, sendo a cirurgia o único tratamento curativo. No entanto, raramente é realizada devido a doença irressecável ou disseminação à distância.
journal_name
Acta Med Portjournal_title
Acta medica portuguesaauthors
Garcia AR,Ribeiro J,Gervásio H,Castro E Sousa Fdoi
10.20344/amp.8593subject
Has Abstractpub_date
2017-10-31 00:00:00pages
750-753issue
10eissn
0870-399Xissn
1646-0758journal_volume
30pub_type
杂志文章abstract::Diaphragmatic Pacing was used to treat ventilatory failure in a young boy with bilateral diaphragmatic palsy secondary to cervical cord injury, on chronic mechanical ventilation for 6 months. The indications for diaphragmatic pacing in ventilatory failure were discussed, as well as the assessment of phrenic nerve inte...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract:INTRODUCTION:Cervix cancer is the fourth most common female cancer and the second most frequent in women aged 15 to 44 years. The infection by the human papillomavirus is a necessary condition in almost all of cervix cancer cases; it is a sexually transmitted disease and all women sexually active are at risk of being i...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:10.20344/amp.7095
更新日期:2016-06-01 00:00:00
abstract:INTRODUCTION:The aim of the study described in this paper is to screen medical curricula in relation to the attention paid to intimate partner violence, by applying a framework derived from the international literature. MATERIAL AND METHODS:We screened curricula of five Mozambican medical schools based on a state-of-t...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.12049
更新日期:2020-01-03 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the safety and efficacy in the first sixteen patients operated by endoscopic third ventriculostomy for triventricular obstructive hydrocephalus in the Hospital of S. João-Porto. METHODS:Operated from December 1998 to December 1999, there were one adult, one teenager...
journal_title:Acta medica portuguesa
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::Spontaneous ileopsoas hematoma is a rare and potentially lethal complication of liver cirrhosis, with exceptional mention in medical literature. In this article we present a clinical case diagnosed in a patient with alcoholic liver cirrhosis. ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::Hidrosadenitis supurativa is a chronic inflammatory disease with great physical and psychological impact. Although conservative treatments may be effective in mild forms of the disease, extensive surgical resection and reconstruction are necessary in more severe forms of the disease. The purpose of this paper is to de...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.8656
更新日期:2018-01-31 00:00:00
abstract::The Sclerosing Mesenteritis is a rare idiopathic disease. It represents the final stadium of progression of the chronic inflammatory illnesses of the intestinal mesentery, with predominance of fibrosis. The clinical manifestations are varied and unspecific. Diagnosis, that demands high degree of suspicion, can be pres...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2009-11-01 00:00:00
abstract::The authors present a case of disseminated tuberculosis in a patient under dialysis with endstage renal disease. Fever, nocturnal sweating, anorexia, asthenia, ascites, lymph node involvement and granulomatous involvement of the bone marrow were observed. In the twenty nine months of renal failure which preceded the b...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1996-07-01 00:00:00
abstract::The objective of this manuscript is to discuss the existing barriers for the dissemination of medical guidelines, and to present strategies that facilitate the adaptation of the recommendations into clinical practice. The literature shows that it usually takes several years until new scientific evidence is adopted in ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Meningococcal disease has a wide spectrum of clinical presentation. Occult bacteremia is not easily diagnosed and may have good prognostic. CLINIC REPORT:Three year-old African boy with fever, gonalgia and gait disorder with 24 hours of evolution. Observation was unremarkable. He presented leukocytosis (2...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract::Endometriosis was first described by Russel more than one-hundred years ago and still remains a clinical entity of difficult comprehension, with totally aberrant symptomatology, particularly in extra-genital situations. The present article describes a clinical case of recurring right-sided catamenial pneumothorax in a...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract::In the literature, there are few reports of posterior cerebral artery aneurysms resulting from isolated dissections. In these cases the treatment is still a matter of discussion and includes anticoagulation, surgical intervention, endovascular techniques and conservative management. We present five cases of Posterior ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2001-01-01 00:00:00
abstract::Pleural mesothelioma is a disease associated with exposure to asbestos. Although rare, it is the most common malignant pleural neoplasm. It is difficult to diagnose and it has a poor prognosis. We report the case of a 62-year-old male patient with a history of prolonged occupational exposure to asbestos, with dyspnea ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.11406
更新日期:2020-02-03 00:00:00
abstract::The authors report the importance of not only all over the world but also in Portugal and, particularly, in Dona Estefânia Hospital. Some considerations are made about the usefulness of molecular biology methods in prenatal diagnosis. With this tool can also be do the origins and migrations of populations, which contr...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract:INTRODUCTION:Menopause is a biological process that occurs as part of aging in women. The increase in average life expectancy and the decline in mortality have caused the aging of global population and, currently, women live about a third of their life in postmenopausal. The General Physician (GP) is usually the first ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2010-03-01 00:00:00
abstract::The authors present a case of a 60-year-old male patient, previously diagnosed with B-cell chronic lymphocytic leukemia, who was admitted to the Emergency Room with dyspnea. The initial evaluation revealed severe anemia (Hgb = 5.0 g/dL) with hyperleukocytosis (800.000/µL), nearly all of the cells being mature lymphocy...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2016-05-01 00:00:00
abstract::Two types of platelet alloantigens are considered: type I, which refers to platelet alloantigens shared by platelets and other cells; and type II, which comprises the platelet-specific alloantigens. The Human Platelet Alloantigens (HPA) System consists of five diallelic alloantigens and eleven low frequency antigens. ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract::Appropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2014-09-01 00:00:00
abstract::Several infectious, neoplastic or inflammatory skin diseases, may be early manifestations of HIV infection. We reviewed the clinical data of 226 HIV seropositive male patients with cutaneous disease, from a total of 337 inpatients at the Infectious Diseases Unit--Department of Medicine 1--Curry Cabral Hospital, from 1...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::Free radicals are highly reactive molecules, and therefore transient, which have an odd number of electrons and are generated in vivo as byproducts of normal metabolism. In this review we survey basic concepts on the chemistry of oxygen free radicals, their cellular sources and the reactions they can undergo. We also ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1989-05-01 00:00:00
abstract::The Portuguese population is affected by the highest mortality rates in all the countries of the European Union. The highest mortality rates occur in some districts on the north coast where, in 1995, the rates standardised by age were above 200/100,000/annum, with the lowest figures in some districts in the interior a...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1997-08-01 00:00:00
abstract:INTRODUCTION:Severity in systemic lupus erythematosus may vary from mild to even fatal consequences. There are no biomarkers to predict the disease's prognosis. The Systemic Lupus International Collaborating Clinics/ Systemic Damage Index defines systemic lupus erythematosus disease severity and is found to predict pro...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.8082
更新日期:2017-05-31 00:00:00
abstract::Embalming is a chemical process that aims the preservation and sanitization of the human body indefinitely. The technique of embalming is an important tool in teaching and research in anatomy enabling the preservation of cadaveric material in good conditions (lessening any significant structural changes and maintainin...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2013-05-01 00:00:00
abstract::After a brief introduction about the clinical, histological and therapeutic characteristics of myxopapillar spinal ependymoma of cone medullar and filum terminale, three cases with medullar and intracranial seeding of myxopapillar spinal ependymoma are retrospectively reviewed. Surgical resection was total in the chil...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2001-01-01 00:00:00
abstract:INTRODUCTION:MEN2A is an autossomal dominant cancer syndrome characterised by the presence of medullary thyroid cancer, pheochromocytoma and primary hyperparathyroidism. Germline mutations of the RET protooncogene constitute the molecular defect and can be identified in affected individuals. Genetic screening of family...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract::Biomedical simulation is an effective educational complement for healthcare training, both at undergraduate and postgraduate level. It enables knowledge, skills and attitudes to be acquired in a safe, educationally orientated and efficient manner. In this context, simulation provides skills and experience that facilit...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.8403
更新日期:2016-12-30 00:00:00
abstract::Our study included 42 patients with obstructive sleep apnea (OSAS) confirmed by polysomnography. In these patients we investigated the clinical manifestations, the results of the laboratory examinations, including polysomnography, ORL observations and tests of pulmonary function, as well as the therapeutic results. Ou...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::Suicidal behaviour still represents a serious public health problem. Although the existence of some consultations on this subject, their efficacy remains very far from what we wish. In that sense, the research on the biological markers of suicidal behaviour might be of considerable importance. The aim of this paper is...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2008-01-01 00:00:00
abstract::A case of acute ischemia of the right inferior limb after anti-tuberculous therapy in a 42-Year old woman is reported. This complication was confirmed by artheriography and the investigation revealed vasculitis and anti-histone antibodies. Drug-induced lupus was then diagnosed. A brief review about this subject is als...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:INTRODUCTION:The disruption of esophageal motility that characterizes achalasia typically provokes dysphagia, pain, loss of weight and malnutrition. Therefore, patients frequently report a reduction in quality of life and negative emotional states. Laparoscopic Heller myotomy proved to be an effective therapy, enabling...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.6758
更新日期:2016-02-01 00:00:00