CORIOCARCINOMA PRIMITIVO MEDIASTÍNICO: A PROPÓSITO DE UN CASO
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Rev. Méd. La Paz
Abstract
El coriocarcinoma primitivo mediastínico es una entidad extraordinariamente infrecuente, con evolución que puede ser fatal, en la mayoría de los pacientes. Se presenta el caso de una mujer de 37 años de edad, que acude al Servicio de Emergencias del Instituto Nacional de Tórax con dolor en hemitórax derecho, tos no productiva y sangrado transvaginal, en cuya radiografía de tórax se observa una imagen radiopaca y con borde no bien definido en región infraclavicular y paracardiaca derecha, además de derrame pleural. La TAC de tórax muestra esta misma imagen en mediastino superior y hemitórax derecho. Tras estudio e intento de identificación histológica del tumor, sin resultado, se indicó exploración quirúrgica y se practicó resección de la misma. El diagnóstico anatomopatológico definitivo fue de coriocarcinoma. No obstante de la hemorragia genital, los estudios ginecológicos descartaron que hubiera afectación patológica por esta neoplasia. Si bien esta enfermedad es muy rara y resulta difícil establecer un tratamiento estandarizado, en la enfermedad localizada parece ser útil la resección quirúrgica seguida de quimioterapia, con las que pueden conseguirse supervivencia elevadas.
Primitive mediastinal choriocarcinoma is extremely rare entity, with developments that can be fatal in most patients. A case of a 37-year-old, who attends the National Institute Emergency Chest with right chest pain, nonproductive cough and bleeding transvaginal, whose chest radiograph shows a radiopaque image with edge not well defined and paracardiac right infraclavicular region, as well as pleural effusion. Chest CT shows this same image in the upper mediastinum and right chest. After study and attempt to identify the tumor, without result indicated underwent surgical exploration and resection of it. The final pathological diagnosis was a choriocarcinoma. However the genital bleeding, gynecological studies have ruled out involvement by this tumor pathology. Although this disease is very rare and difficult to establish a standardized treatment for localized disease appears to be useful surgical resection followed by chemotherapy, with high survival can be achieved.
Primitive mediastinal choriocarcinoma is extremely rare entity, with developments that can be fatal in most patients. A case of a 37-year-old, who attends the National Institute Emergency Chest with right chest pain, nonproductive cough and bleeding transvaginal, whose chest radiograph shows a radiopaque image with edge not well defined and paracardiac right infraclavicular region, as well as pleural effusion. Chest CT shows this same image in the upper mediastinum and right chest. After study and attempt to identify the tumor, without result indicated underwent surgical exploration and resection of it. The final pathological diagnosis was a choriocarcinoma. However the genital bleeding, gynecological studies have ruled out involvement by this tumor pathology. Although this disease is very rare and difficult to establish a standardized treatment for localized disease appears to be useful surgical resection followed by chemotherapy, with high survival can be achieved.
Description
Vol. 16, No. 2