ABSTRACT
El carcinoma adenoideo quístico de la glándula de Bartolino (GB) es una entidad infrecuente, de crecimiento lento y comportamiento agresivo con alta recurrencia local y metástasis. Presentamos el caso de una paciente de 48 años, con antecedente de tratamiento quirúrgico de un absceso Bartolino derecho. La biopsia demostró un carcinoma adenoideo quístico (CAQ) de la GB, por lo que se realizó hemivulvectomía radical derecha y linfadenectomía inguinofemoral. El resultado de la biopsia mostró 4 ganglios positivos de 12 y margen lateral positivo a menos de 2 mm. Por lo que se realizó adyuvancia con radioterapia. La paciente no se presenta a su control y acude luego de tres años por dolor urente desde cadera izquierda hacia rodilla y cara lateral de la pierna y pie. Se realiza cintigrama óseo que muestra lesión osteoblástica sacroilíaca izquierda de 2 cm, por lo que se completó estudio de diseminación con tomografía computada de tórax, abdomen y pelvis con contraste que evidenció múltiples lesiones nodulares pulmonares bilaterales de distribución generalizada en parénquima central, periférico y subpleurales. Se deriva al Instituto Nacional del Tórax, completando estudio preoperatorio y se realizó una biopsia quirúrgica por video toracoscopía resecando un nódulo subpleural, el informe histológico señaló una metástasis de CAQ concordante con primario en GB. La paciente fue presentada en el comité oncológico y se indicó radioterapia paliativa a lesión sacroilíaca y control clínico ambulatorio. Ha evolucionado estable desde el punto de vista funcional pulmonar.
Adenoid cystic carcinoma of Bartholin glands (BG) is a rare, slow-growing but a highly aggressive tumor with remarkable capacity for local recurrence and distant metastasis. We present the case of a 48 year-old female patient with a history of surgical treatment for right Bartholin abscess. The biopsy showed a cystic adenoid carcinoma of the BG, which led to radical hemivulvectomy and inguinofemoral lymphadenectomy. The biopsy show inguinal lymph node metastasis on 4 of 12 lymph nodes and positive surgical resection margin. Adjuvant radiotherapy was applied. The patient doesnt present to her clinical follow up, and consult three years later with radiological evidence of sacroiliac metástasis on bone scintigraphy. Study was completed with thorax, abdomen and pelvis tomography scan, and showed multiple bilateral lung nodules. The patient was transfered to National Thoracic Institute, and preoperative study was performed. We decide to obtain histologycal confirmation by a video thoracoscopy, it was performed without incidents. Histology show metastasis of adenoid cystic carcinoma pattern, concordant with primary tumor. The patient was submitted to the oncology committee and palliative radiotherapy was indicated for sacroiliac lesion. The patient evolve stable and asintomatic at ambulatory clinical control.
Subject(s)
Humans , Female , Middle Aged , Bartholin's Glands/pathology , Vulvar Neoplasms/pathology , Carcinoma, Adenoid Cystic/secondary , Lung Neoplasms/secondary , Radiography, Thoracic , Tomography, X-Ray Computed , Carcinoma, Adenoid Cystic/diagnostic imaging , Lung Neoplasms/diagnostic imagingABSTRACT
Epithelioid hemangioendothelioma is a multifocal tumor that rarely metastasizes. It is difficult to diagnose, most often it is an incidental finding in young asymptomatic women. The radiologic pattern is heterogeneous. Histologic confirmation of Weibel-Palade bodies or immunohistochemistry based on specific tumor markers such as factor VIII and CD34 are the most important finding to confirm the diagnosis. We report a 21 years old woman Presenting with cough and dyspnea. A chest X ray was suggestive of tuberculosis. Sputum smears were negative for acid fat bacilli and the tuberculin test was negative. A chest CAT scan showed multiple nodular lesions. A surgical biopsy of the lesions confirmed the presence of a hemangioendothelioma. The patient was initially treated with prednisone and azathioprine without response. Thereafter, the patient is without treatment and without evidence of disease progression.
Subject(s)
Humans , Female , Young Adult , Hemangioendothelioma, Epithelioid/diagnosis , Lung Neoplasms/diagnosis , Azathioprine/therapeutic use , Prednisone/therapeutic use , Hemangioendothelioma, Epithelioid/drug therapy , Lung Neoplasms/drug therapy , Antimetabolites, AntineoplasticABSTRACT
La hipospadia es una de las malformaciones congénitas más frecuentemente observadas en la práctica de la cirugía pediátrica urológica a escala mundial y una de las causas de consultas iteradas en este territorio. A los efectos se realizó un estudio descriptivo, observacional y retrospectivo de 108 niños con el diagnóstico de hipospadia, atendidos en el Servicio de Urología del Hospital Pediátrico Sur de Santiago de Cuba, durante el período comprendido desde enero del 2000 hasta diciembre del 2006. El análisis efectuado reveló un predominio de los pacientes de 1 a 4 años y de la técnica quirúrgica de Snodgrass para la ejecución de la uretroplastia. La evolución clínica general resultó satisfactoria en 52,8 por ciento de los integrantes de la serie, pues los restantes requirieron nuevas intervenciones.
Hypospadias is one of the more frequently observed congenital malformations in the worldwide urologic pediatric practice and one of the reasons for repeated visits in this territory. In this respect a descriptive, observational and retrospective study was carried out in 108 children with diagnosis of hypospadias, who were attended in the Service of Urology of the Southern Children Hospital of Santiago de Cuba, from January, 2000 to December, 2006. The analysis revealed prevalence of patients aged between 1 and 4 years and of the Snodgrass's surgical technique for the urethroplasty. The general clinical course was satisfactory in 52,8 per cent of the series patients, and the remainder required new interventions.