Chylothorax secondary to thoracic duct malformation due to Klippel-Trénaunay syndrome. Case report
Gámez-Saiz, Ilse1; López-Ocampo, Paris Samahel1; Álvarez-Ramos, Karen1; Sánchez-Zazueta, Eduardo1
2024, Number 1
2024; 83 (1)
ABSTRACT
Klippel-Trenaunay syndrome is a rare congenital syndrome with an incidence of 1/100,000 cases per year caused by a sporadic somatic mutation in the PIK3CA gene. It is characterized by a triad of capillary malformations, abnormal growth of soft tissues and bones, usually affecting the lower extremities, and varicose veins in atypical locations. The presentation of chylothorax is rare, and few cases with high recurrence have been documented. The diagnosis of Klippel-Trenaunay syndrome is made through imaging studies to corroborate the malformations and genetic studies that demonstrate the somatic mutation. Regarding the diagnosis of chylothorax, analysis of the pleural fluid is required with a triglyceride result greater than 110 mg/dL. The treatment for chylothorax in the Klippel-Trenaunay syndrome is multidisciplinary, requiring support from nutrition, internal medicine and pulmonology to manage complications, as well as cardiothoracic surgery for definitive treatment.
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Figura 1: Dermatosis diseminada en flanco derecho, región glútea y muñón de miembro pélvico derecho, constituida por una placa de neoformaciones vasculares no confluentes, de color vino, de no más de 0.5 cm, sobreelevadas, bien delimitadas, con zonas de descamación fina no pruriginosas.
Figura 2: Tomografía computada simple de tórax. Se observa colapso pulmonar, derrame pericárdico leve, así como ganglios reactivos mediastinales, derrame pleural masivo derecho con heterogéneo.