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portugués al inglés: Spontaneous regression of metastatic renal cell carcinoma: case report General field: Medicina Detailed field: Medicina (general)
Texto de origen - portugués A 60 year old man, who was under regular haematological follow-up because of myelofibrosis, presented at a routine clinic visit complaining of increasing shortness of breath, weight loss and lethargy. Clinical examination of the chest was normal but a chest x–ray (CXR) showed multiple lung lesions consistent with metastatic deposits. A staging computed tomography (CT) scan done shortly afterwards showed marked splenomegaly, causing displacement of the left kidney medially. In the left kidney, there was a 5 cm soft tissue mass arising from the middle of the kidney with characteristics of primary renal cancer. The staging CT chest showed multiple pulmonary metastases in both lungs. The patient underwent laparospic cytoreductive nephrectomy without complications and agreed to have immunotherapy with alpha-interferon. Histology revealed clear renal cell carcinoma. Six weeks following the operation, just prior to commencing immunotherapy, he attended the haematology clinic as routine follow-up. His initial symptoms had completely resolved and a repeat chest radiography on that day showed clear lungs with no evidence of metastatic deposits. Although no histological confirmation of the metastatic nature of the lung lesions was obtained, it is highly likely that his pulmonary metastases had regressed spontaneously as the patient had not received any immunotherapy in the meantime. The patient remains well five months after the operation.
Renal cell cancer accounts for 2% of all cancers and its incidence is steadily rising. It usually presents in late adult life and is more common in males than females. Although they are associated with Von Hippel-Lindau disease, adult polycristic kdney disease and multicystic hephroma, most renal cell cancers develop spontaneously. The patient may present with urological symptoms such as haematuria or flank pain or with an abdominal mass or alternatively with systemic manifestations, such as anaemia and fever, or symptoms of metastatic disease and other rare phenomena. Approximately 20% to 30% of the patients with renal cell carcinoma present with metastatic disease, and 20% to 40% of patients undergoing nephrectomy for clinically localized disease will develop metastasis. If the tumor cannot be completely resected, the course is generally relentlessly progressive, with medians survival of 12 to 18 months after metastasis. 85% of relapses occur in the first three years.
Immunological factors almost certainly play a role in some cases of spontaneous tumour regression and perhaps removal of bulk tumour enables or stimulates the immune system to control residual disease.
Traducción - inglés Um homem com 60 anos de idade, que estava sob seguimento hematológico normal, devido à mielofibrose, compareceu numa consulta de rotina, queixando-se de dificuldade respiratória crescente, perda de peso e letargia. O exame físico do tórax encontrava-se normal, mas uma radiografia torácica demonstrou ter múltiplas lesões pulmonares compatíveis com depósitos metastativos. Uma tomografia computorizada (TC) pouco tempo depois realizada, mostrava esplenomegalia acentuada, causando deslocamento interno do rim esquerdo. No rim esquerdo, encontrou-se uma massa tecidual mole, surgindo a partir do centro do rim, cujas características eram coincidentes com cancro renal primário. A tomografia computorizada abdominal mostrava múltiplas metástases pulmonares em ambos os pulmões. O paciente foi submetido a nefrectomia citorredutora laparascópica sem quaisquer complicações e concordou submeter-se a imunoterapia com alfainterferon. A histologia revelou um carcinoma de células renais claras. Seis semanas após a intervenção cirúrgica, antes de iniciar a imunoterapia, apresentou-se na consulta periódica de hematologia. Os sintomas iniciais tinham desaparecido e uma nova radiografia feita nesse dia mostrou os pulmões limpos, sem qualquer evidência de depósitos metastáticos. Embora não tenha sido obtida confirmação histológica quanto à natureza metastática das lesões pulmonares, é muito provável que a metastização pulmonar tenha regredido espontaneamente, uma vez que o doente não tinha sido submetido, até então, a imunoterapia. O doente permanece bem após a cirurgia a que foi submetido.
O cancro das células renais representa 2% de todas as neoplasias e a sua incidência tem vindo a aumentar. Geralmente, apresenta-se na idade adulta tardia e é mais comum nos homens do que nas mulheres. Embora estejam associados à doença de Von Hippel-Lindau, a doença poliquística renal do adulto, o nefroma multiquístico, a maioria dos tumores das células renais desenvolve-se de uma forma espontânea. O doente pode apresentar-se com sintomas urológicos, tais como a hematária, dor no flanco, com uma massa abdominal palpável ou em alternativa apresentando manifestações sistémicas, tais como a anemia e piraxia ou sintomas de doença metastática e outros fenómenos raros. Aproximadamente 20% a 30% dos doentes com carcinoma das células renais apresenta doença metastática e entre 20% a 40% dos indivíduos submetidos a nefrectomia por doença clinicamente localizada desenvolvem metástases. Se o tumor não puder ser completamente excisado, a evolução da doença é, de um modo geral, inflexivelmente progressiva, com uma sobrevida média que varia entre os 12 e 18 meses após o aparecimento das metástases. 85% das recaídas ocorre nos primeiros três anos.
É quase certo que os fatores imunológicos representam um papel importante nalguns casos de regressão tumoral espontânea e talvez a excisão do tumor primário permita ou estimule o sistema imunitário a controlar a doença residual.
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Formación en el ámbito de la traducción
PhD - Faculdade de Letras da Universidade de Lisboa
Experiencia
Años de experiencia: 15 Registrado en ProZ.com: Oct 2012
Rúben Esteves is an experienced freelance translator specializing in audiovisual translation between English, Spanish, and European Portuguese. With over 13 years of professional experience, Rúben has translated more than 800,000 words, demonstrating a deep commitment to accuracy and cultural sensitivity in his work.
Rúben holds a PhD in Translation Studies and has completed various specialized courses, including legal translation and computer-assisted translation. His proficiency in English and Portuguese is at a native or bilingual level, while his Spanish proficiency is at a professional working level.
Throughout his career, Rúben has worked with notable clients such as Mars Translation, Translated, and Sfera Studios, where he has excelled in roles involving subtitling, proofreading, and quality assurance. His dedication to continuous learning and professional development is evident from his numerous certifications and participation in industry workshops.
In addition to his professional achievements, Rúben is an enthusiastic traveler, reader, and writer, with interests in web development and painting. His strong interpersonal skills, responsibility, flexibility, and dedication make him an invaluable asset to any translation project.
For more information or to discuss potential collaboration, Rúben can be reached via email at [email protected], or through his LinkedIn profile and Instagram account.
Palabras clave: Professional Translator, Audiovisual Translator, Legal Translator, English to Portuguese Translator, Spanish to Portuguese Translator, Portuguese to English Translator, Portuguese to Spanish Translator, Subtitling, Proofreading, Translation Quality Assurance. See more.Professional Translator, Audiovisual Translator, Legal Translator, English to Portuguese Translator, Spanish to Portuguese Translator, Portuguese to English Translator, Portuguese to Spanish Translator, Subtitling, Proofreading, Translation Quality Assurance, Translation Services, Freelance Translator, Translation Specialist, Localization Services. See less.
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