Rektum Yerleşimli Medüller Kanser: Olgu Sunumu

Obstrüktif uyku apne sendromu (OUAS), tanısı sıklıkla gecikerek konan acil bir sorundur. Klinik ve laboratuvar bulgularıyla OUAS tanısı konan ve etyolojisinde juvenil myastenia gravis tanısı alan 15 yaşında kız olgunun sunulması ve konuya dikkat çekilmesi amaçlanmıştır. Hastamızın polisomnografi (PSG) sonucuna göre ağır OUAS ile uyumluydu.( Apne index 96.7/saat, apne hipopne indeksi 148/saat ). Egzersizle artan kas güçsüzlüğü ve gün içinde de değişen kas gücü nedeniyle Myastenia gravis düşünülerek pridostigmine başlandı, klinik yanıt başarılı olduğundan tanısı kesinleşti. Uyku sırasında da maske ile BIPAP başlandıktan sonra karbondioksit retansiyonu geriledi.(pCO2: 46 mmHg)

Rectum Located Medullary Cancer: Case Report

Obstructive sleep apnea syndrome (OSAS) which is often diagnosed lately is an emergency. We present a 15 years old girl who is diagnosed as OSAS and juvenile myasthenia gravis (MG) with clinical and laboratuary findings to attract attention to the subject. Her polysomnography (PSG) result was consistent with severe OSAS (Apnea index 96.7/hour, apneahypopnea index 148/hour). MG was thought due to diurnal variation of muscle strength and increase of muscle weakness after exercise. Significant clinical response to pridostigmine supported diagnosis. After initiation BIPAP with mask during sleep, carbondioxide retantion decreased (pCO2: 46mmHg)

___

  • 1. Wick MR, Vitsky JL, Ritter JH, Swanson PE, Mills SE.. Sporadic medullary carcinoma of the colon: a clinicopathologic comparison with nonhereditary poorly differentiated enteric-type adenocarcinoma and neuroendocrine colorectal carcinoma. Am J Clin Pathol. 2005 Jan;123(1):56- 65.
  • 2. U.S. Cancer Statistics Working Group: United States Cancer Statistics: 1999-2007 Incidence and Mortality Web-based Report. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute, 2010.
  • 3. Cunningham J, Kantekure K, and Saif MW. Medullary Carcinoma of the Colon: A Case Series and Review of the Literature. In Vivo. May-June 2014;28:311-4.
  • 4. Thirunavukarasu P, Sathaiah M, Singla S, Sukumar S, Karunamurthy A, Pragatheeshwar KD, Lee KK, Zeh H 3rd, Kane KM, Bartlett DL: Medullary cancer of the large intestine: a population based analysis. Int J Oncol 2010, 37:901–7.
  • 5. Differentiating the undifferentiated: immunohistochemical profile of medullary carcinoma of the colon with an emphasis on intestinal differentiation. Brody Winn, MDa, Rosemarie Tavares, BSca, Jacqueline Faniona, Lelia Noblea, John Gao,MDa, Edmond Sabo, MDa, and Murray B. Resnick, MD, PhDa. Hum Pathol. 2009 March; 40(3): 398–404.
  • 6. Shia J, Yantiss RA: Molecular mechanisms of colorectal carcinogenesis. In Colorectal Carcinoma and Tumors of the Vermiform Appendix. Edited by Yantiss RA. Philadelphia: Lippincott Williams and Wilkins; 2014:195–9.
  • 7.Samowitz WS: Practical issues related to ancillary testing of colorectal carcinoma. In Colorectal Carcinoma and Tumors of the Vermiform Appendix. Edited by Yantiss RA. Philadelphia: Lippincott Williams and Wilkins; 2014:207–9.