Acta Médica Colombiana

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Vol 43 # 2
Vol 43 # 2
VOL. 43 No 2 - 2018-07-11

Presentacin de casos / Case reports
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VOL. 43 No 2 - 2018-07-11

Panhipopituitarismo secundario a metstasis del sistema nervioso central por un adenocarcinoma broncognico

Jovani Osorno, Manuel Felipe Cceres, Juan David Cceres, Jaime Andrs Calle, Miguel Ignacio Roldn, Juan Paulo Sandoval

Mujer de 45 aos de edad con antecedente de extabaquismo pesado, curs con cuadro crnico de cefalea en regin occipital irradiado a regin temporal asociado a disminucin de la agudeza visual de ojo izquierdo. El cuadro empeor en los ltimos seis meses y se asoci a polidipsia y poliuria. Present cuadro sincopal con amnesia retrgrada, para lo cual se realiz una tomografa axial computarizada (TAC) contrastada de crneo que mostr mltiples lesiones parenquimatosas cerebrales y del cerebelo compatibles con metstasis. Se hizo estudio hormonal para evaluar la funcin hipofisiaria evidenciando un panhipopituitarismo secundario. Se detect foco primario neoplsico mediante TAC contrastada de trax, evidenciando una lesin espiculada en el lbulo superior derecho sugestiva de carcinoma broncognico, posteriormente se tom biopsia por fibrobroncoscopia el cual confirm por histopatologa e inmunohistoqumica el diagnstico de un adenocarcinoma broncognico  

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Panhypopituitarism secondary to metastasis of the central nervous system due to a bronchogenic adenocarcinoma

Jovani Osorno, Manuel Felipe Cceres, Juan David Cceres, Jaime Andrs Calle, Miguel Ignacio Roldn, Juan Paulo Sandoval

45-year-old woman with a history of heavy extabaquism presented with chronic headache in the occipital region irradiated to the temporal region associated with decreased visual acuity of the left eye. The picture worsened in the last six months and was associated with polydipsia and polyuria. She presented a syncopal picture with retrograde amnesia, for which a contrast computed tomography (CT) of the skull was performed, which showed multiple parenchymal brain and cerebellar lesions compatible with metastasis. Hormonal study was done to evaluate the hypophyseal function evidencing a secondary panhypopituitarism. A primary neoplastic focus was detected by a contrast chest CT scan, showing a spiculated lesion in the right upper lobe suggestive of bronchogenic carcinoma. A biopsy was subsequently taken by fibrobronchoscopy, which confirmed the diagnosis of a bronchogenic adenocarcinoma by histopathology and immunohistochemistry 

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