Browsing by Author "Cardosa, MF"
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- Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in ChildrenPublication . Martins, M; Cardosa, MF; Calhau, P; Caldas, G; Alves, RMalignant hepatic tumors are rare in children and hepatocellular carcinomas only represent 20% of cases. A previously healthy 10 year-old male was admitted for sudden abdominal pain. Ultrasound imaging showed an ileo-ileal intussusception with spontaneous resolution, but in the face of worsening pain, fever, and a palpable epigastric mass, abdominal magnetic resonance imaging was performed, showing a liver lesion. Laboratory tests presented elevated liver enzymes and C-reactive protein, so a liver abscess was considered and treated with metronidazole plus ceftriaxone. All of the microbiology tests as well as tumoral markers were negative. Despite clinical and laboratory improvement, the lesion persisted in the imaging. A liver biopsy confirmed a hepatocellular carcinoma, and the patient was submitted to surgical resection and chemotherapy. Contrarily to adults in whom most cases are secondary to chronic liver disease, children may not have risk factors for the disease, which makes it harder to make a prompt diagnosis.
- Perivascular Epithelioid Cell Tumor: A Case Report of a Rare EntityPublication . Cardosa, MF; Ferreira de Lima, S; Knoblich, M; Afonso, I; Mendes, CPerivascular epithelioid cell tumor is a rare mesenchymal tumor with myomelanocytic differentiation. It mainly occurs in middle-aged females and can be found at any location. The differential diagnosis is broad but the immunohistochemical biomarkers establish the diagnosis. A 4-year-old girl was referred to a pediatric gastroenterology clinic due to recurrent umbilical pain and the workup revealed biliary lithiasis. She remained in follow-up, asymptomatic, no physical findings, and stable ultrasound. Six years later, a supra-umbilical mass was detected by ultrasound, and the magnetic resonance imaging revealed a highly vascularized intraperitoneal tumor with well-defined limits. Surgical mass resection was performed, and the histology revealed morphological and immunohistochemical aspects of a perivascular epithelioid cell tumor of the abdominal wall. Given the size of the lesion (> 5 cm) and admitting uncertain malignant potential, she was submitted to margin enlargement. Four years later, she remains asymptomatic without clinical or imagiological evidence of relapse.