A linfangioleiomiomatose é uma doença rara multissitémica (1/1 000 000), apresentado-se tipicamente com doença pulmonar cística. Relatos de linfangioleiomiomatose ganglionar isolada são muito raros. Existe pouca informação relativamente ao tratamento e prognóstico. Descrevemos o caso de uma mulher de 48 anos com compressão uretérica por uma massa retroperitoneal. A biópsia mostrou linfangioleiomiomatose ganglionar. Foi submetida a ressecção parcial e mantém-se sob vigilância imagiológica há 3 anos, sem evidência de envolvimento pulmonar ou aumento das lesões abdominais. A doente evoluiu para menopausa 6 meses após o diagnóstico. Séries de casos sugerem que a linfangioleiomiomatose ganglionar pode preceder o envolvimento pulmonar em 1-2 anos, sendo as dimensões (>10 mm) da lesão um fator de risco. Está descrita estabilização da doença em mulheres pós-menopausa. Este caso evidencia uma apresentação e evolução atípicas, com uma lesão com >10 mm, com 3 anos de follow-up sem atingimento pulmonar, renal ou outras formas de atingimento linfático mais frequentes.

Lymphangioleiomyomatosis is a rare disease (1/1 000000) with multisystemic involvement, most commonly presenting with cystic lung disease. Reports of isolated nodal lymphangioleiomyomatosis rare. Its treatment and prognosis are not well established. We describe a 48-year-old female patient presenting with ureter compression by an extensive retroperitoneal mass. Biopsy showed nodal lymphangioleiomiomatosis. A partial surgical resection of the lesions was performed. She is under yearly thoraco-abdomino-pelvic computed tomography control, last performed 3 years after diagnosis, with no lung involvement or new abdominal lesions. She evolved to menopause after 6 months. Some case series suggest that isolated nodal lymphangioleiomyomatosis may precede lung involvement by one to two years, having size as a risk factor (>10 mm). Relative stabilization of the disease course in post-menopausal women is described. This case reports an atypical evolution, with two >10mm diameter lesion, with3-year follow-up without pulmonary, renal or other forms of lymphatic involvement.

Abstract Actinomycosis remains characteristically uncommon, but is still an important cause of morbidity. Its clinical presentation is usually indolent and chronic as slow growing masses that can evolve into fistulae, and for that reason are frequently underdiagnosed. Actinomyces spp is often disregarded clinically and is classified as a colonizing microorganism. In this review of literature, we concomitantly present 11 cases of actinomycosis with different localizations, diagnosed at a tertiary hospital between 2009 and 2016. We outline the findings of at least one factor of immunosuppression in > 90% of the reported cases.