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The presence of several histologically different neoplasms affecting the same organ is called collision tumor, an infrequent event of a difficult clinical diagnosis. Much less frequent is its occurrence caused simultaneously by both breast carcinoma and lymphoma in the same anatomic area, with very few cases described in the literature. We present the case of one patient with metastatic breast carcinoma with pleural, ganglion and hepatic clinical involvement, coexisting the lymphoma with carcinoma metastasis of breast origin in the very same lymph ganglion. The importance of this research lies on the exceptional nature of the case, noticed after a close revision of the literature, the complex diagnosis and its therapeutic and prognostic implications. [ABSTRACT FROM AUTHOR]

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A clinical case study of a 50 year-old woman brought to the Rhematology Department is presented, who showed clinical dry syndrome with immune disorders (not currently defined) and developed tumors (benign at present) and analytical autoimmunity with positive antitopoisomerase type I (formerly Scl70) confirmed. The clinical case is commented and the metheorism causes are discussed, among it, a possible variation of abdominal epilepsy as ictal flatulence, secondary to a meningioma of the right brain convexity.

Forty-two elderly patients were subjected to a nutritional assessment and an intravenous magnesium load (0.5 mmol/kg). After 48 h, patients with protein-calorie malnutrition (PCM) showed magnesium retentions (MgR) above 20 per cent, thus indicating magnesium deficit, and greater (P < 0.001) than those from well-nourished patients. The discriminating cross-point for undernourished patients was at 28 per cent with 95 per cent sensibility and specificity. There were significant correlations between MgR and most nutritional parameters. An increase of the RMg constitutes a PCM indicator which may be useful to quantify it.

Naltrexone (NTX) has been shown to be a useful drug for the treatment of alcohol dependence (AD). Carbohydrate-deficient transferrin (CDT) in serum is a new biologic marker of alcohol abuse. To evaluate the efficacy of NTX (50 mg/d) in AD, a group of 20 alcoholics with CDT > 20 U/l was studied using monthly laboratory tests (CDT, ESR, AST, ALT, GGT) and specific psychological testing (CAGE). After the second month statistically significant differences in CDT levels were found. By the end of the study, 13 patients (responders) had normalized their CDT levels. There was no correlation between CDT values and the other laboratory markers. The difference in routine laboratory markers between responders and non responders was not significant. NTX was well tolerated by all the patients and significant alcohol abstinence was achieved. CDT was demonstrated to be a effective marker for the evaluation of alcoholic abstinence during treatment with NTX. Superior results were obtained in comparison with the routine customary markers for AD.

Spontaneous pyomyositis (primary pyomyositis) is an infrequent disease in non-tropical countries, caused by bacterial infection of skeletal muscle. Although pyomyositis is associated in many cases to septicemia, the occurrence of that disease as a secondary manifestation of bacteremia is very unusual, requiring a high-grade index of suspicion to diagnose it in the early stages. We present one case of cervical pyomyositis, caused by Fusobacterium necrophorum and group F streptococcus, during the course of a sepsis of sinusal origin, that was treated without surgical therapy. This so uncommon form of presentation of Fusobacterium septicemia, its diagnosis and treatment are discussed.

Paragangliomas are tumors of the chromaffin system producing catecholamines and both the adrenal extra-adrenal type have a common origin at the neural crest, which has been supported by the similarities of the paraganglions both from a histological and functional perspective. Most of the extra-adrenal paragangliomas are bending and non-functional. In addition, they are usually confined to just one site. We present the case of a young patient with benign multiple paraglanglioma in two different locations, juxtahepatic and juxtacarotic (Chemodectoma) and, thus, far away from each other. The extra-abdominal location is very rare, with a frequency lower than 2%. In addition, one of paraganglions was functional and the other one was not. Initially, a surgical intervention was performed on the functional abdominal tumoration and latter, another intervention was performed at the cervical level, both with excellent results. We also highlight the good response to the postoperative therapy with Prazosin.

Kikuchi's necrotizing lymphadenitis (KNL) is a benign disease of unknown etiology affecting lymphatic nodes and some times extranodal organs. We present a case of KNL with hepatic lesions simulating metastatic liver disease.