Pseudoquiste mesentérico: reporte de un caso

Introducción: Los quistes mesentéricos se pueden encontrar a lo largo de todo el mesenterio del intestino. Los pseudoquistes de mesenterio se caracterizan por carecer de revestimiento endotelial. Generalmente son asintomáticos y el diagnóstico se realiza mediante estudios de imagen. Material y Método: Reporte de un caso clínico Resultados: Presentamos el caso de una mujer de 50 años sana que consulta por tumoración indolora en flanco izquierdo. Se solicita TC y RNM donde se visualiza tumoración quistica de paredes finas, homogenea de 88mm de diámetro mayor con septos y tabiques. Se realiza abordaje laparoscópico identificando masa de 12cm que se protruye a nivel del mesenterio de la segunda asa yeyunal, se reseca in incidentes. La anatomía patológica informó pseudoquiste mesentérico, sin elementos de malignidad. Buena evolución posterior. Conclusiones: Los quistes mesentéricos son extremadamente infrecuentes. General-mente se localizan en el mesenterio del intestino delgado como en el caso presentado. Teniendo en cuenta las características histopatológicas, se clasifican en seis grupos. Si bien es excepcional su transformación maligna, el tratamiento consiste siempre en su resección quirúrgica. Se prefiere la laparoscopía por sus conocidos beneficios.

Introduction: Mesenteric cysts can be found throughout the entire intestine mesentery. Mesenteric pseudocysts are characterized by lack of endothelial lining. They are generally asymptomatic and the diagnosis can be made by imaging studies. Material and Method: Report of a clinical case Results: We present the case of a healthy 50-year-old woman consulted for a painless tumor on the left flank. She requested a CT and MRI where a thin-walled, homogeneous cystic tumor of 88mm in greatest diameter with septa and partitions was visualized. A laparoscopic approach was performed identifying a 12cm mass that protruded at the level of the mesentery of the second jejunal loop, it was resected without incident. The pathological anatomy reported a mesenteric pseudocyst, without elements of malignancy. Good subsequent evolution. Conclusions: Mesenteric cysts are extremely rare. They are generally located in the mesentery of the small intestine, as in the case presented. Taking into account the histopathological characteristics, they are classified into six groups. Although its malignant transformation is exceptional, the treatment always consists of its surgical resection. Laparoscopy is preferred for its well-known benefits.

A Rare Case Of Retroperitoneal Mature Cystic Teratoma In A Young Male Patient

Retroperitoneal mature cystic teratomas are exceedingly uncommon in young male. They are more common in infants and in young females. We report an unusual case of 27 year old male presented with abdominal distension, abdominal fullness and vomiting. Patient underwent ultrasonography and contrast enhanced computed tomography (CT) scan of abdomen which were suggestive of large mature cystic lesion. Patient was planned for surgery and laprotomy was done. A huge retroperitoneal mass was observed and was totally excised. Onhisto-pathological examination (HPE) stratified squamous epithelium with keratin flakes, underlying fibromuscular tissue reveal hair shaft & sebaceous glands and mature cystic teratomawas diagnosed. Retroperitoneal mature cystic teratoma in an older maleis extremely rare. Primary gonadal teratoma with retroperitoneal metastasis should be excluded first. Evaluation of age and location of tumor are critical for its prognosis.

Pseudotumor toraco-abdominal asociado a Bartonella henselae y Eikenella corrodens en un paciente pediátrico inmunocompetente / Thoraco-abdominal pseudotumor associated with Bartonella henselae and Eikenella corrodens in an immunocompetent patient

Resumen Los pseudotumores inflamatorios son poco frecuentes y escasamente descritos en la literatura y han sido asociados a infecciones polimicrobianas. Se presenta el caso de un niño de 9 años, procedente de Bolivia, quien consultó por dolor abdominal, baja de peso y vómitos, diagnosticándose un pseudotumor tóraco-abdominal. El laboratorio clínico, mediante el estudio de biología molecular en tejido, permitió la identificación de uno de los probables agentes etiológicos.

Abstract Inflammatory pseudotumors are a rare pathology and scarcely reported in the literature and have been associated with polymicrobial infections. Here, we present the case of a 9 years old boy from Bolivia, who presented with abdominal pain, weight loss and vomiting, who was diagnosed with a thoraco-abdominal pseudotumor. The micro-biology and molecular laboratories in tissue allowed the identification of one of the probable etiological agents.

El reto del aneurisma de la aorta abdominal para especialistas en medicina general integral e internistas / The challenge of abdominal aortic aneurysm for general practitioners and internists

El aneurisma de la aorta abdominal es una enfermedad asintomática, frecuente en los adultos mayores del sexo masculino. Su aparición está asociada a enfermedades crónicas no transmisibles como la hipertensión arterial, la enfermedad arterial periférica, la diabetes mellitus, entre otras. A nivel comunitario constituye un problema de salud el diagnóstico tardío de la entidad en pacientes con factores de riesgo, por lo que se decide realizar el artículo de revisión con el objetivo de actualizar los aspectos de diagnóstico clínico, imagenológico, terapéutico y la conducta a seguir ante un paciente con sospecha de aneurisma de la aorta. Se realizó una revisión exhaustiva del tema en bases de datos como SciELO, MEDISAN, Revistas de Angiología y Cirugía Cardiovascular. Para lograr mejores resultados en el diagnóstico precoz y la atención a los pacientes con aneurisma de la aorta abdominal, es necesario mantener la actualización del tema, el uso del método clínico y el trabajo en conjunto de la atención primaria con el nivel secundario(AU)

Abdominal aortic aneurysm is an asymptomatic disease, common in older males. Its appearance is associated with chronic non-communicable diseases such as arterial hypertension, peripheral arterial disease, diabetes mellitus, among others. At the community level, the late diagnosis of the entity in patients with risk factors constitutes a health problem, so it was decided to carry out the review article with the aim of updating the clinical, imaging and therapeutic aspects of diagnosis and the behavior to be followed in a patient with suspected aortic aneurysm. We conducted an exhaustive review of the subject in databases such as SciELO, Medisan, Magazines of Angiology and Cardiovascular Surgery. To achieve better results in the early diagnosis and care of patients with abdominal aortic aneurysm, it is necessary to keep up-to-date on the subject, the use of the clinical method, and the joint work of primary care with the secondary level(AU)

A case report of primary ovarian leiomyoma

Primary ovarian Leimyoma is a rare benign mesenchymal tumour usually arising from smooth muscle of walls of ovarian blood vessels. It’s mostly discovered incidentally. Here we report a case in which a 24-year-old unmarried woman presented with pain and discomfort in lower abdomen since 10 days. On further evaluation through imaging and blood works, we proceeded with surgical management. Immunohistochemistry confirmed the final diagnosis of ovarian leiomyoma. However, it’s important to keep this entity as a differential diagnosis for solid ovarian tumors.

Case Report of a 10 cm Subdued Abdominal Mass: Diagnosis and Management of a Rare Primitive Mesenteric Leiomyosarcoma

Introduction:Specific management schemes of the exceedingly rare primitive mesenchymal leiomyosarcomasdo not exist. Reporting their behavior and management is necessary to be able to construct evidence-based directives. Case Report:We report a case of a 42-year-old Caucasian woman that presented with a large indolent abdominal mass evolving over 3 months. Two differential diagnosis were looked upon, either GIST or leiomyosarcoma. The abdomino-pelvic ct-scan proved that this tumor could be completely resected, so the patient was successfully operated within 2 weeks of the preliminary diagnosis. A monoblocnegative margin resection was performed and the patient recovered on the surgical floor. The anatomopathological studies and immunohistochemistry tests confirmed the presence of a primitive mesenchymal leiomyosarcoma. The patient was recommended a follow up every 4 months with a thoraco-abdomino-pelvic ct-scan due to her economic status. Conclusion:The management of rare tumors is always challenging due to the lack of knowledge concerning its behavior and response to the various treatment modalities. Reporting this rare case of mesenchymal leiomyosarcoma and similar cases will enable a better understanding of this disease and its treatment.

Series of rare diagnosis and presentations of abdominal mass in children: a great learning experience

Abdominal mass is a common finding in children, either palpable or radiologically evident surprisingly. Some of them are rare tumors. Functional active tumors are rarely palpable but present with varied arrays of symptoms. In this series authors are discussing few rare cases with atypical presentations such as- teratoma arising from adrenal gland, teratoma presenting with hypertension, fetus in fetu (Girl and Boy child), adrenocortical tumor presenting as precocious puberty and adrenal pheochromocytoma with features of cushing's syndrome. These atypical presentations may have pose a challenge in diagnosis and management for the treating team with first time occurrence specifically if they are handling them for first time.

The role of diagnostic laparoscopy in abdominal masses

Background: Diagnostic laparoscopy is an added tool that has become widely available for the assessment of abdominal masses in addition to conventional imaging. It is the best real time imaging technique due to the magnification and intense illumination provided. The aim of this work is the assessment of the impact of performing diagnostic laparoscopy at the start of operations intended for resection of an abdominal mass.Methods: This prospective study included 40 patients admitted for surgical resection of an abdominal mass. All Patients were subjected to thorough conventional investigations followed by diagnostic laparoscopy performed prior to the start of the definitive operation. We assessed the extra time needed, complications encountered, effect on decision making and the overall benefit of laparoscopy in this context.Results: Overall 21 patients (52.5%) did benefit from diagnostic laparoscopy somehow between upgrading the staging, affecting the laparotomy incision site and confirming feasibility of laparoscopic resection. Of the patients who proceeded to a laparotomy (n=30), diagnostic laparoscopy missed local invasion in 7 patients, which precluded the resection of the tumor in 5 of them. Only 1 complication related to diagnostic laparoscopy was encountered in the form of a port-site hematoma (2.5%).Conclusions: While diagnostic laparoscopy doesn't carry significant added morbidity, it might save the patient an unnecessary laparotomy by altering the preoperative staging and improving the accuracy of anatomical and pathological diagnoses. Laparoscopy has its limitations mainly in the assessment of the retroperitoneal space as well as direct tumor invasion to adjacent organs and vessels.

Clinical and pathological characteristics of abdominal ectopic spleen: 13 cases report / 解放军医学杂志

Objective To analyze the clinical manifestation, diagnosis and pathological features of abdominal ectopic spleen (AES) cases. Methods The clinical and pathological characteristics were retrospectively analyzed along with the followup data of patients diagnosed as AES in the Changhai Hospital affiliated to Naval Medical University from Jan. 2013 to Dec. 2018. Results A total of 13 cases of AES were diagnosed, of whom 7 cases (53.8%) were found due to medical examination, and only one case was diagnosed before operation, while the rest were considered as having tumor of the abdominal organ near the mass. Out of the 13 cases, the AES in 6 cases were located at the pancreas tail. The surgical excision samples showed an appearance of nodular lesion with clear contour, and the structure of spleen parenchyma could be identified under microscope. Among the 13 cases, spleen trabecular and obvious central arterioles were absent in 2 cases with history of surgery, while the rest 11 cases shared the pathological features of spleen trabecular, central arterioles and secondary follicles. All the 13 patients survived except one died due to progression of gastric cancer and another one missing of follow-up. Conclusions The AES lacks specific clinical features, which requires antidiastole with abdominal tumors. It is inferred from clinicopathological features that splenosis may differ from accessory spleen, that is, splenosis may lack typical spleen white pulp.

Duplicación intestinal en la primera porción del duodeno en neonato / Intestinal Duplication in the First Portion of the Neonatal Duodenum

RESUMEN Se denomina duplicación intestinal a un grupo de malformaciones congénitas de la vía digestiva, de estructuras diverticulares, quísticas o tubulares, que presentan paredes de músculo liso como las del intestino y un revestimiento mucoso de tipo gastrointestinal. Se localiza en cualquier segmento del tubo digestivo, desde la boca hasta el ano. La zona más afectada es el íleon y constituye la causa más frecuente de masa abdominal en el periodo neonatal. El diagnóstico puede ser prenatal a través, de ecografía o resonancia. En el periodo posnatal es la clínica la que establece los indicios para realizar exámenes complementarios, que pueden ir desde ecografía hasta estudios con Tecnecio 99. En la porción duodenal esta enfermedad representa el 5 por ciento de todas las duplicaciones intestinales. La descripción de casos en la primera porción es excepcional, por lo que la consideramos para tener en cuenta como diagnóstico diferencial en las enfermedades tumorales neonatales de origen abdominal(AU)

ABSTRACT Intestinal duplication defines a group of congenital malformations of the digestive tract, of diverticular, cystic or tubular structures, which have smooth muscle walls such as those of the intestine and a gastrointestinal-type mucous lining. It is located in any segment of the digestive tract, from the mouth to the anus. The most affected area is the ileum, while the condition constitutes the most frequent cause of abdominal mass in the neonatal period. The diagnosis can be prenatal through either ultrasound or resonance. In the postnatal period, the clinical indications establish, based on the signs, whether complementary tests are required, which can range from ultrasound to studies with technetium-99. In the duodenal portion, this disease represents 5 percent of all intestinal duplications. The description of cases in the first portion is exceptional, which is the reason why we consider it as a differential diagnosis in neonatal tumor diseases of abdominal origin(AU)

Gliomatosis peritonei arising in setting of immature teratoma of ovary: a case report

A 14 years old girl presented to the gynecology OPD with pain abdomen and huge abdominal lump since 2 months. On clinical examination, a large mass of 20x15 cm size was found extended upto the xiphoid process. Serum studies showed rise of CA-125 up to 406.9U/mL and LDH up to 310U/L. USG shows right ovarian cyst of 14.8x14.1x12.8 cm with internal calcification. MRI revealed a well encapsulated mass of 21x19x17cm with solid and cystic mass and upward peritoneal extension. Exploratory laparotomy was performed with right sided salpingo- ophorectomy with infracolic omentectomy, as the omentum appeared granular. She had an uneventful post-operative recovery. Subsequently HPE showed immature teratoma NORRIS grade 3 with co-existent peritoneal gliomatosis (grade 0). She is under regular follow-up and decided to give six cycles of combination chemotherapy with BEP at regional cancer hospital.

Laparoscopic excision of large omental cyst at department of pediatric surgery in Sanglah general hospital, Bali, Indonesia

Omental cyst is rare. All conditions most likely being of congenital or benign neoplastic lymphatic origin. Patients with Omental cysts usually present with abdominal distention and a painless abdominal mass. The most common physical finding of an omental cyst is a freely movable abdominal mass. The diagnostic procedure include CT scans. Complete excision by open or laparoscopically of the cysts is considered as the treatment of choice. Recurrence and malignant deterioration of omental cysts are rare. A case report of a large omental cyst which had been laparoscopically-treated using morcellator. Laparoscopic morcellation  is a technique used in gynecological surgeries such as hysterectomy and myomectomy to remove uteri and uterine fibroids (leiomyomas) through a small abdominal incision. Authors present a case of 3 year old female with pre-operative assessment tumor intra-abdominal suspect abdominal cyst. Subsequently, laparoscopic resection of omental cyst with morcellator was performed. The histopathological report was omental cyst. Omental cysts are rare, but can be shown to have atypical abdominal symptoms and radiologic findings, so clinicians must keep in mind that omental cysts causing abdominal symptoms can be misdiagnosed as simple ovarian cysts of inflammation. Omental cysts can be removed safety laparoscopically with morcellator without bowel or vessel injury.

Subcutaneous Sparganosis on Abdomen Mimicking Multiple Lipomas

Human sparganosis is a food-borne zoonosis mainly caused by the plerocercoid belonging to the genus Spirometra. The most common clinical sign of sparganosis is a subcutaneous mass in the trunk including abdominal or chest wall. The mass may be mistaken for a malignant tumor, thereby causing difficulty in terms of diagnosis and treatment. A 66-year-old woman visited our clinic for the removal of a lipoma-like mass. It was movable, hard, and painless. We identified 2 white mass, measuring 0.2×4 cm and 0.2×1 cm. Pathologic findings indicated the white mass was a sparganum. She recalled having eaten a raw frog approximately 60 years before. A 35-year-old who lived North Korea was also presented to our clinic with an asymptomatic nodule on her abdomen. Intraoperatively, we found sparganum approximately 24 cm size. Subcutaneous masses are associated with clinical signs of inflammation or they may mimic a soft tissue neoplasm. While the incidence rate of sparganosis has decreased with economic development and advancements in sanitation, surgeons still encounter patients with sparganosis in the clinical setting. Therefore, a careful history is required in order to diagnose sparganosis.

Difficult Retrieval of Glass Bottle in the Rectum: How the Story End?

@#Rectal foreign body is not an uncommon encounter in current medical practice. It reported occurs due to sexual eroticism, sexually abuse, assault or involuntary insertion. This condition possesses significant challenge among general surgeons on handling these cases. Diagnosis usually made by history taking, physical and radiological examination. We presented a case of a 43years old mentally challenge gentleman with retained rectal foreign body of three-week duration whom presented with non-specific abdominal pain, abdominal mass and loose stool. Due to low suspicion of rectal foreign body, the management flow skid from the norm. Attempt of removing rectal foreign body by various method was unsuccessful and his had to undergone exploratory laparotomy. Hence, propose flow of management in rectal foreign body is also included in this report.

Neuroblastoma infantil: características clínicas, tratamento e prognóstico / Infant neuroblastoma: clinical characteristics, treatment and prognosis

Introdução: O neuroblastoma é a mais prevalente neoplasia abdominal pediátrica com um impacto de 15% da mortalidade total por causa oncológica nessa população. Este trabalho tem como objetivo estabelecer os critérios que levam à suspeição, diagnóstico e tratamento deste tumor. Métodos: Elaborado estudo de revisão bibliográfica entre as principais fontes científicas, realizando uma análise comparativa entre os artigos estudados, desconsiderando informações defasadas ou artigos com baixo impacto científico. Resultados: Este trabalho conseguiu reunir as principais informações acerca do neuroblastoma, possibilitando que este artigo sirva como fonte de estudo para profissionais da saúde. Conclusão: Deve-se suspeitar do diagnóstico de neuroblastoma quando a anamnese e o exame físico estiverem associados ao efeito de massa e a síndromes paraneoplásicas. Apesar do neuroblastoma ser uma doença de métodos diagnósticos e tratamento há muito estabelecidos, novos protocolos de estadiamento têm surgido, aderindo novas informações acerca de fatores de risco e predisposições genéticas.

Introduction: Neuroblastoma is the most prevalent abdominal neoplasia among pediatric patients, with an impact of 15% of total mortality of oncologic causes in this population. This article aims to identify the criteria that leads to the suspicion, diagnosis and treatment of the tumor. Methods: We reviewed works in several databases, while doing a comparative analysis of the chosen articles, excluding outdated or with low scientific impact information. Results: This article has managed to summarize the main information about neuroblastoma, allowing it to serve as a go-to source for health professionals. Conclusion: The diagnosis of neuroblastoma should be suspected when anamnesis and physical examination are associated with mass effect and paraneoplastic syndromes. Despite neuroblastoma being a disease with diagnostic methods and treatment long established, new protocol of staging have been emerging, adding new information about risk factors and genetic predispositions.

An unusual abdominal wall mass in a child

ABSTRACT Abdominal tumors are one of the most common types of pediatric cancer. Therefore, they should always be included in the differential diagnosis of abdominal masses. Here, we present the case of a child whose initial hypothesis of diagnosis contemplated this possibility. Later, it was demonstrated that the abdominal mass found was secondary to a common parasitosis. A 2-year old, moderately malnourished and pale white boy was referred with a history of a rapidly growing, well-limited, middle abdominal mass. The mass was 10 by 3 cm, hard and poorly movable, apparently involving both abdominal rectus muscles. A complete resection was performed, revealing an abdominal wall abscess, with intense eosinophilic proliferation, secondary to a local and intense reaction to innumerous Ascaris lumbricoides eggs. Extra luminal infestations with Ascaris, that usually form peritoneal granulomas have been previously described. However, neither external trauma nor fistula, that could explain the superficial presence of the eggs, was found. This description reinforces the relevance of infectious diseases within the differential diagnosis of abdominal masses, particularly in areas with high prevalence of parasitic infestations.

Estudio de una masa abdominal en pediatría: revisión de la literatura / Study of an abdominal mass in pediatrics: review of the literature

Alrededor del 20 por ciento de los tumores diagnosticados en pediatría corresponden a masas intraabdominales y de ellos, el 20 por ciento son tumores malignos, por lo que un alto índice de sospecha asociado a un diagnóstico precoz pueden incidir positivamente en el pronóstico de los pacientes. El objetivo de este trabajo fue realizar una revisión actualizada de la literatura disponible sobre el estudio de una masa abdominal en pediatría, enfocado principalmente en la epidemiología y orientación diagnóstica que debería seguir el médico al enfrentarse a un paciente con este hallazgo. La forma de presentación clínica de una masa abdominal es variable. En un número importante de pacientes será de forma asintomática, lo que dificulta el diagnóstico precoz, por lo que es necesario mantener un alto índice de sospecha frente esta patología. Como herramientas para la evaluación de una masa abdominal contamos cada vez más con exámenes radiológicos, marcadores tumorales e histología, sin embargo, los exámenes deben realizarse orientados a comprobar la sospecha diagnóstica que obtengamos de una completa anamnesis y examen físico.

About 20 percent of the tumors diagnosed in pediatric patients correspond to intraabdominal masses. These can correspond to both benign and malignant pathology. Moreover, 20 percent of solid malignant tumors are located in the abdomen, so a high index of suspicion associated with an early diagnosis can positively affect the prognosis of these patients. The clinical presentation of an abdominal mass is variable. A significant number of patients will be asymptomatic, which makes early diagnosis difficult. This is why it is necessary to maintain a high index of suspicion in this pathology. As tools for the evaluation of an abdominal mass, we are increasingly counting on radiological examinations, tumor markers and histology. However, the examinations must be carried out in order to verify the diagnostic suspicion that we obtain from a complete anamnesis and physical examination. The objective of this work was to perform an updated review of the available literature on the study of abdominal mass in pediatrics, focused mainly on the epidemiology and diagnostic orientation that should be followed by the physician when confronting a patient with this finding.

Ectopic Spleen Presenting as Abdominal Mass: A Case Report.

Ectopic spleens are rare findings though spelenincule are common. It is due to failure of fusion of mesogastrium and the lining body wall epithelium, resulting in supports of the spleen become lax, and spleen position will be abnormally located. Hypermobile colon and prune belly syndrome are associated with the ectopic spleen. This is more common in children. In adults, it is more common in woman; especially in multipara. A rare case of mass per abdomen in right iliac fossa, turned out to be functional spleen with aneurysm of splenic artery is presented. There were no features of infarction, torsion or portal hypertension or splenic vein thrombosis. Splenectomy was done. The patient had uneventful recovery.

Sclerosing mesenteritis - rare cause of abdominal pain and intra-abdominal mass: a case report.

Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammatory disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because sclerosing mesenteritis lacks special clinical manifestations and typical signs, the patients are very easily misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination after laparotomy. We report a case of sclerosing mesenteritis in a 55-year-old male who presented with chronic abdominal pain and intra-abdominal mass. He was misdiagnosed as lymphoma by Computed Tomography and then underwent exploratory laparotomy. Histopathological examination revealed it to be sclerosing mesenteritis. This patient went well and lives without recrudescence till date.

Tumores del estroma gastrointestinal: revisión de nuestra experiencia / Surgery of gastrointestinal stromal tumors: review of our experience in the last five years

Objective: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Surgical resection is the standard treatment for localized primary GISTs. The aim of the study is to present our 5-year surgical experience, as well as the results obtained in terms of survival and disease progression. Material and Method: We conducted a descriptive, retrospective study of primary GISTs treated in our center between 2009-2013. We analyze the most relevant variables, criteria of risk of progression according Fletcher's classification from National Institutes of Health and the Miettinem's classification from the Armed Forces Institute of Pathology, as well as analysis of relapse-free survival (RFS) with Kaplan-Meier survival curves. Results: We present a series of 30 patients. Mean age 65 years (40-84 years). The most common location was the stomach (n = 14, 46.6 percent). The surgery was R0 in 23 cases of 30. The mean tumor diameter was 5.3 cm (0.5-18). 14 patients received adjuvant treatment with Imatinib. After an average follow-up of 31.2 months (6-62 months), it was found relapse in 4 patients, progression and exitus in 1, exitus in 3 and exitus in the immediate postoperative period in 1. RFS at one year was 96.7 percent, and 89.2 percent at 4 years. Mean survival time was 56.2 months (95 percent CI 51.8-60.6). Conclusion: The recommended attitude after radical surgery is follow-up. In selected patients with risk of relapse, adjuvant treatment with Imatinib delays the progression of the disease and increases the survival.

Objetivo: Los tumores del estroma gastrointestinal son las neoplasias mesenquimales más frecuentes del tubo digestivo. La resección quirúrgica es el tratamiento estándar en los GISTs primarios localizados. El objetivo del estudio es presentar nuestra experiencia quirúrgica en 5 años, así como los resultados obtenidos en cuanto supervivencia y progresión de la enfermedad. Material y Método: Serie de casos, estudio observacional descriptivo retrospectivo, que analiza los resultados obtenidos en cuanto al tratamiento quirúrgico de GIST primarios sometidos a resección quirúrgica en nuestro centro entre 2009-2013. Todas las intervenciones fueron realizadas por personal del Staff y dentro de los protocolos de las unidades de cirugía hepato-biliar y esófago-gástrica. Se analizan las variables de mayor relevancia, criterios de riesgo de progresión según la clasificación de Fletcher del National Institutes of Health y la clasificación de Miettinem del Armed Forces Institute of Pathology, así como análisis de la supervivencia libre de recaída (SLR) con curvas de Kaplan-Meier. Resultados: Presentamos una serie de 30 pacientes. Edad media de 65 años (40-84 años). La localización más frecuente fue estómago (n = 14, 46,6 por ciento). La cirugía fue R0 en 23 de los 30 pacientes. El diámetro tumoral medio fue de 5,3 cm (0,5-18, con una mediana de 4 cm. Catorce pacientes recibieron tratamiento adyuvante con Imatinib. Tras un seguimiento medio 31,2 meses (6-62 meses), se detectó recaída en 4 pacientes, progresión y exitus en 1, exitus en 3 y exitus en el postoperatorio inmediato en 1. La SLR al año fue del 96,7 por ciento, siendo del 89,2 por ciento a los 4 años. El tiempo medio de supervivencia fue de 56,2 meses (IC 95 por ciento 51,8-60,6). Conclusiones: La actitud recomendada tras una cirugía radical es el seguimiento. En pacientes seleccionados con riesgo de recaída el tratamiento adyuvante con Imatinib retrasa la progresión de la enfermedad y aumenta la supervivencia.