Ciencias de la Salud
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Item Necrosis Ganglionar Cervical Secundaria a Neoplasia(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Sánchez Barrionuevo, Rodrigo Sebastián; Romo López, Ángel Geovanny Dr. Esp.This case corresponds to a male patient, 84 years old, born in Guaranda and Ambato resident, married, primary education level, with a history of hypertension, COPD, coronary syndrome. Patient admitted to the ENT service of Hospital IESS Ambato, with progressive dysphonia, in addition to dyspnea great efforts, accompanied by cough with yellow sputum in moderate amounts, it has received multiple antibiotic therapy without resolution of symptoms regarding the service of Internal Medicine multiple findings of lymphadenopathy. At slightly erythematous ORF physical examination, lymphadenopathy was confirmed in right supraclavicular chain, no axillary lymphadenopathy. TAC Neck: cervical lymph nodal image shown right, with necrotic center, measures 2.6 x 2.2 cm in infratiroidea location. Chest CT: moderate pericardial effusion seen. Lymphonodal multiple images with necrotic center in all the major chains mediastinal masses in left hilar region is in intimate contact with thoracic vessels, including wraps the left lung field. Nasofibrolaryngoscopy erythema is evident at the regional level supra glottal, with the presence of increased vascularization also shift it to right medial latero paralysis aritenoides, vocal cord and left ventricular band, fold arietenoepiglotico tense presence of abundant secretion is observed. The patient is transferred to Oncology Unit to present symptoms compatible with adnexal mass ganglionic chain. clinical status, evolution, treatment, prognosis, as well as the critical points in patient care is analyzed and guidelines for improvement arises.