Retrorectal cystic hamartomas are rare congenital lesions that can undergo malignant transformation, and adenocarcinoma is the most frequently described histological type. The authors describe a case of a 53-year-old ...Retrorectal cystic hamartomas are rare congenital lesions that can undergo malignant transformation, and adenocarcinoma is the most frequently described histological type. The authors describe a case of a 53-year-old female patient with a localized well-differentiated adenocarcinoma that developed in a retrorectal cystic hamartoma. The patient was submitted to surgery (a Kraske procedure), with an R1 resection, followed by adjuvant radio-chemotherapy. After 23 months of follow up, the patient remains free from disease recurrence. Given the rarity of this entity, this case allows us to reflect on the differential diagnosis, therapeutic approach and patients’ follow-up.展开更多
Locally advanced pancreatic carcinoma has an usually poor prognosis despite multimodal approaches and sequential chemotherapy.The authors present a case of a long-term survivor with stage III pancreatic adenocarcinoma...Locally advanced pancreatic carcinoma has an usually poor prognosis despite multimodal approaches and sequential chemotherapy.The authors present a case of a long-term survivor with stage III pancreatic adenocarcinoma achieving partial response after a multimodal approach including local and systemic treatments.However,three years after diagnosis and amidst several episodes of cholangitis,hepatic metastasis were suspected.Despite pancreatic adenocarcinoma being the obvious culprit for metastization,a hepatic biopsy was considered at that time given a stable primary disease and presenting three years since the initial diagnosis.At this point,a biopsy could have specific diagnostic,prognostic and therapeutic implications and after it was performed,an unexpected diagnosis of pancreatic neuroendocrine tumor was made.Therefore,we urge clinicians to consider hepatic biopsy in similar cases-generally when it may change prognosis and treatment strategies-and perform histological confirmation of metastatic disease whenever feasible,even if the answer may seem obvious at first impression.展开更多
文摘Retrorectal cystic hamartomas are rare congenital lesions that can undergo malignant transformation, and adenocarcinoma is the most frequently described histological type. The authors describe a case of a 53-year-old female patient with a localized well-differentiated adenocarcinoma that developed in a retrorectal cystic hamartoma. The patient was submitted to surgery (a Kraske procedure), with an R1 resection, followed by adjuvant radio-chemotherapy. After 23 months of follow up, the patient remains free from disease recurrence. Given the rarity of this entity, this case allows us to reflect on the differential diagnosis, therapeutic approach and patients’ follow-up.
文摘Locally advanced pancreatic carcinoma has an usually poor prognosis despite multimodal approaches and sequential chemotherapy.The authors present a case of a long-term survivor with stage III pancreatic adenocarcinoma achieving partial response after a multimodal approach including local and systemic treatments.However,three years after diagnosis and amidst several episodes of cholangitis,hepatic metastasis were suspected.Despite pancreatic adenocarcinoma being the obvious culprit for metastization,a hepatic biopsy was considered at that time given a stable primary disease and presenting three years since the initial diagnosis.At this point,a biopsy could have specific diagnostic,prognostic and therapeutic implications and after it was performed,an unexpected diagnosis of pancreatic neuroendocrine tumor was made.Therefore,we urge clinicians to consider hepatic biopsy in similar cases-generally when it may change prognosis and treatment strategies-and perform histological confirmation of metastatic disease whenever feasible,even if the answer may seem obvious at first impression.
