Browsing by Author "Dutra, E"
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- Cervical Haematoma Secondary to Spontaneous Thyroid HaemorrhagePublication . Almeida e Sousa, M; Dutra, E; Matos-Ferreira, GSpontaneous thyroid haemorrhage is rare, but it can be a potentially life-threatening condition in severe cases, due to acute upper airway compromise. We report the case of a 75-year-old patient on chronic anticoagulation therapy for atrial fibrillation, who presented with sudden painful neck bulging and dysphagia. Physical examination revealed a hard mass on the anterior left side of the neck. Preliminary laryngoscopy was normal. The diagnosis was made using ultrasonography and further characterization with computed tomography, showing haemorrhage of a thyroid nodule with capsular disruption and diffusion of the haematoma to the deep cervical spaces, causing important tracheal deviation and hypopharynx compression. The patient developed dyspnoea and ultimately required urgent hemithyroidectomy. This case also highlights the importance of having a high index of clinical suspicion and prompt imaging in patients with atypical presentations of a neck mass.
- Hyperleukocytosis in Solid Tumors: a Rare Paraneoplastic Syndrome Associated with Poor PrognosisPublication . Ferrão, J; Sardinha, M; Dutra, EHematological paraneoplastic syndromes are fairly uncommon. While mild leukocytosis in solid tumors is well reported, white blood cell (WBC) count over 50,000 u/L, described as paraneoplastic leukemoid reaction (PLR), is not. Indeed, when found, it is usually associated with a higher burden of disease, tumor activity and worse clinical outcomes. We report the case of a challenging and burdensome diagnosis of a presumptive hematological paraneoplastic syndrome in a patient with a locally advanced lung cancer admitted in the Internal Medicine ward. After the end of chemotherapy, clinical and laboratory benefit was observed; however, the aggressive course of the disease became clear, with progression and downhill course that was unresponsive to treatment.