AIMS AND BACKGROUND: Metastases of renal cell carcinoma to the head and neck are rare. We report on three cases with tumor spread to this area (nasal cavity, tongue and larynx) and present a review of the literature. PATIENTS: The first patient presented with lung and nasal cavity metastases five years after renal tumor resection. In patient 2 the diagnosis of primary renal carcinoma and lung and tongue metastases was concomitant. In case 3 a primary kidney tumor was not suspected until radical resection of a tongue lesion was performed. RESULTS: The first two patients received radiation therapy. They had been previously treated with interleukin + interferon and vinblastine + interleukin 2 and achieved a survival of 14 and 16 months, respectively. The third patient has not been given any treatment to date (apart from surgery) and remains asymptomatic four years after diagnosis. CONCLUSIONS: In patients with cell carcinoma the occurrence of lesions in the head and neck area may suggest metastases. In some cases they may precede the diagnosis of a renal tumor and mimic a primary head and neck tumor; otolaryngologists should be aware of this possibility. An individualized treatment approach is recommended. In the case of solitary metastases a surgical excision should be performed as palliation, if not cure.

Aged↗

PubMedDate not supplied

Testicular germ cell tumor and Down syndrome.

The association between Down syndrome and testicular germ cell tumors may be more frequent than expected according to chance, but few reports have focused on this excess. We report two cases of this association and review the English medical literature.

Adult↗

PubMedDate not supplied

[Hematin treatment of porphyric neuropathy].

The authors report a case of acute intermittent porphiria with peripheral motor neuropathy and a syndrome of inadequate ADH excretion in a male patient aged 36 years. Treatment with hypertonic glucose and prostigmine did not yield any beneficial results, while a subsequent treatment with hematine (4 mg/kg/day for a period of four days) produced a dramatic improvement in the clinical picture and in ALA and PGB levels. A back-to-normal shift of plasma and urinary electrolytes was also observed. It appears that there was a close relation between the administration of hematine and the clinical-biochemical remission.

Adult↗

PubMedDate not supplied

[Primary non-Hodgkin's lymphoma of the lung].

A case of small and large cells non Hodgkin lymphoma with an unusual involvement of the lung is presented. The tumor was located in the inferior lower lobe of the right lung and coincided with hemorrhagic pleural effusion. The cytopathological study of the fluid was negative for neoplastic cells, so were the aspiration biopsy of the lung and the pleural biopsy. The transmission and scanning electron microscopic study of the pleural fluid demonstrated lymphoid atypical cells. The patient was treated by resection of the lower right lobe and pleurectomy. The difficulties in the differential diagnosis of this type on non Hodgkin lymphoma are discussed. The importance of scanning and transmission electron microscopy is stressed when the light cytologic studies are negative in processes suggestive of being neoplasms. After one year of the lobectomy and treatment with vincristine-epirubicin-cyclophosphamide and methyl-prednisolone, the patient is in good condition without evidence of neoplastic activity.

Humans↗

PubMedDate not supplied