Abstract Background: The rapidly progressive proptosis in neonates is not frequent, it comprises a broad spectrum of pathologies that might endanger life and ocular function. Case description: A 12-day male began with right rapidly progressive proptosis and palpebral edema. On examination, displaced proptosis was observed towards the superior temporal region, edema of both eyelids and chemosis in the right eye. A CT was performed evidencing a neoproliferative intraorbital lesion that reinforces with contrast. A BAAF was taken, evidencing neoplastic cells. The tumor was resected and histopathological study identified vascular neoplasia with a definitive diagnosis of epithelioid hemangioendothelioma. He received treatment with 6 courses of vincristine, actinomycin and cisplatin; in the re-evaluation, a residual tumor was found, therefore enucleation of the right eye was performed due to failure in the response to treatment. Currently, the patient is under surveillance. Discussion: The causes of ocular proptosis in the neonate are similar to those of other ages. Orbit primary tumors represent a large percentage of malignant causes. The epithelioid hemangioendothelioma is a vascular neoplasm which behavior is controversial, some cases are indolent and others present progression and metastasis. The treatment is the complete resection of the tumor; neither radiation therapy nor chemotherapy alone are curative options. Orbital malignancies in the child can be treated effectively with a timely diagnosis. The pediatrician in these cases should have an adequate suspicion and opportune referral.

Resumen La proptosis rápidamente progresiva en neonatos es infrecuente y puede resultar en detrimento de la función ocular e incluso poner en peligro la vida. Se presenta el caso de un varón de 12 días de vida con proptosis desplazada a temporal superior, edema bipalpebral y quemosis en ojo derecho. Se realizó tomografia computarizada evidenciando lesión intraorbitaria que refuerza con el contraste. Se toma biopsia por aspiración con aguja fina encontrando células neoplásicas. Se procedió a la resección tumoral y estudio histopatológico con diagnóstico definitivo de hemangioendotelioma epitelioide maligno (HEM). Recibió 6 cursos de quimioterapia: vincristina, actinomicina y cisplatino; en la reevaluación se encontró tumor residual, decidiéndose la enucleación del ojo derecho. Actualmente el paciente se encuentra en vigilancia. El HEM es una neoplasia vascular de comportamiento controvertido, desde indolente hasta progresión y metástasis. El tratamiento definitivo es la resección completa del tumor; la radioterapia o quimioterapia aisladas no son opciones curativas. Los tumores malignos orbitarios en el niño pueden tratarse eficientemente con un diagnóstico temprano. El papel del pediatra en estos casos debe ser un diagnóstico temprano y una referencia oportuna.

ABSTRACT: The central nervous system primary lymphoma is a very infrequent disease in the pediatric population. Currently there are no or few recommendations and/or clinical useful trials to define the best therapeutic option in this population. The objective is to report the case of a child with primary lymphoma of the central nervous system without any associated immunodeficiency, and to do a qualitative review of the literature regarding this disease in children. The possibility of cytoge-netic changes has been postulated explaining the heterogeneity in the behavior of this disease, since it has been seen that it is different from other lymphomas in usual presentations. The experience of treatment in pediatric patients with lymphoma is based on results obtained in adult population, mainly with the use of anti-metabolites such as methotrexate and citarabine. The use of cranial radiation therapy is still controversial and is recommended only in special cases.

RESUMEN: El linfoma no Hodgkin primario de sistema nervioso central es una afección poco frecuente en la población pediátrica. No existen (o son pocas) las recomendaciones o estudios clínicos que sean útiles para definir la mejor opción terapéutica. El objetivo de este trabajo es describir el caso de una niña con linfoma primario de sistema nervioso central, sin ninguna inmunodeficiencia asociada, y realizar de una revisión cualitativa de la literatura especializada sobre esta enfermedad en niños. Se ha postulado la posibilidad de cambios citogenéticos que pudieran explicar la heterogeneidad en el comportamiento de esta enfermedad pues se ha visto que es distinto al de otros linfomas en presentaciones habituales. La experiencia de tratamiento en niños con linfoma se basa en resultados de tratamientos obtenidos en pacientes adultos, con regímenes basados principalmente en antimetabolitos como metotrexato y citarabina. Aún es controvertida la utilidad de la radioterapia craneal, la cual sólo se recomienda en casos específicos.

O fenômeno do roubo coronário-subclávio é definido como o fluxo sanguíneo invertido de uma artéria coronária, por meio de enxerto de artéria mamária interna em direção à subclávia médio-distal, e ocorre devido à estenose significativa ou oclusão total da porção proximal desta última. É uma causa rara, mas significante, de isquemia cardíaca após cirurgia de revascularização miocárdica e pode originar uma síndrome de mesmo nome e com manifestações típicas. Relatou-se o caso de um paciente com esta enfermidade, que foi submetido à angioplastia percutânea com implante de stent. Também revisou-se a literatura a respeito.

The phenomenon of coronary-subclavian steal is defined as the reversed blood flow in a coronary artery, through internal mammary artery graft towards medial-distal subclavian artery, which happens due to severe stenosis or total occlusion of the proximal portion of the latter. It is a rare but significant cause of cardiac ischemia after coronary artery bypass surgery and it can cause a syndrome of the same name and with typical manifestations. We have reported the case of a patient with this disease, who underwent percutaneous angioplasty with stent implantation, and we also reviewed the literature on the subject.