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Los tumores cutáneos presentan una alta prevalencia en dermatología en el mundo, siendo los benignos más frecuentes que los malignos; sin embargo, estos últimos son más estudiados debido a su morbimortalidad. El objetivo principal de este estudio fue conocer los principales diagnósticos y técnicas quirúrgicas correspondientes desarrolladas en el Centro de Tratamiento de Enfermedades de la Piel (CETEP) entre 1996 y 2019, evaluando aspectos clínicos y demográficos. Se realizó un estudio retrospectivo y observacional que incluyó todo paciente con lesión cutánea y posterior resolución quirúrgica de la misma. En la muestra analizada (N 6.659) hubo un predominio del sexo femenino (68%) y la media de edad fue 53 ± 21 años. Los pacientes residían mayoritariamente en Montevideo (58%). Los tumores benignos fueron los más frecuentes (41%), seguidos de los malignos (28%), dentro de éstos: carcinoma basocelular (CBC) 66%, carcinoma espinocelular (CEC) 21% y melanoma (MM) 5%. Las técnicas quirúrgicas realizadas fueron cirugías convencionales (57%), principalmente losange (93%), seguidas de procedimientos de cirugía dermatológica (42%), predominando biopsias (52%) y afeitado con electrocoagulación (23%). Se destaca que el CETEP resolvió un número mayor de pacientes de centros externos que del propio Centro Hospitalario Pereira Rossell (CHPR): 59% no CHPR vs 41% CHPR. En conclusión, este trabajo proporcionó información nacional sobre la epidemiología de distintos tumores cutáneos, así como las técnicas quirúrgicas más utilizadas en su resolución. Además, estableció la importancia de la cirugía dermatológica y la capacidad del CETEP en dar respuesta a pacientes propios tanto como referenciados desde otros centros del sistema público.
Cutaneous tumors have a high prevalence in dermatology worldwide, with benign tumors being more common than malignant ones. Nevertheless, the latter are more extensively studied due to their associated morbidity and mortality. The main objective of this study was to identify the primary diagnoses and corresponding surgical techniques developed at the Center for the Treatment of Skin Diseases (CETEP) between 1996 and 2019, while assessing clinical and demographic aspects. A retrospective, observational study was conducted, including all patients with cutaneous lesions and subsequent surgical resolution of the same. In the analyzed sample (N 6659), there was a predominance of females (68%), and the mean age was 53 ± 21 years. The majority of patients resided in Montevideo (58%). Benign tumors were the most prevalent (41%), followed by malignant tumors (28%), with the latter comprising basal cell carcinoma (BCC) at 66%, squamous cell carcinoma (SCC) at 21%, and melanoma (MM) at 5%. The performed surgical techniques included conventional surgeries (57%), primarily using the lozenge method (93%), followed by dermatologic surgery procedures (42%), with a predominance of biopsies (52%) and shave excision with electrocoagulation (23%). It is noteworthy that CETEP resolved a greater number of patients from external centers than from its own hospital, Pereira Rossell Hospital Center (CHPR). 59% non-CHPR vs. 41% CHPR. In conclusion, this study provided national information on the epidemiology of various cutaneous tumors, as well as the most commonly employed surgical techniques in their resolution Furthermore, it emphasized the importance of dermatologic surgery and highlighted the capacity of CETEP to respond to both its own patients and those referred from other centers within the public healthcare system.
Os tumores da pele apresentam alta prevalência na dermatologia em todo mundo, sendo os tumores benignos mais frequentes que os malignos, porém estes últimos são mais estudados devido à sua morbidade e mortalidade. O objetivo principal deste estudo foi conhecer os principais diagnósticos e correspondentes técnicas cirúrgicas desenvolvidas no Centro de Tratamento de Doenças da Pele (CETEP) no período 1996-2019, avaliando aspectos clínicos e demográficos. Foi realizado um estudo retrospectivo e observacional, que incluiu todos os pacientes com lesões cutâneas e com posterior tratamento cirúrgico. Foram estudados 659 pacientes com predomínio do sexo feminino (68%) e média de idade de 53 ± 21 anos. A maioria dos pacientes residiam em Montevidéu (58%). Os tumores benignos foram os mais frequentes (41%), seguidos dos tumores malignos (28%), entre estes: carcinoma basocelular (CBC) 66%, carcinoma espinocelular (CEC) 21% e melanoma (MM) 5%. As técnicas cirúrgicas realizadas foram cirurgias convencionais (57%), principalmente em forma de cunha (93%), seguidas de procedimentos cirúrgicos dermatológicos (42%), predominando biópsias (52%) e shaving com eletrocoagulação (23%). Destaca-se que o CETEP atendeu um número maior de pacientes de centros externos do que do próprio Centro Hospitalar Pereira Rossell (CHPR): 59% não-CHPR vs. 41% CHPR. Concluindo, este trabalho forneceu informações sobre a epidemiologia dos diferentes tumores de pele no país, bem como as técnicas cirúrgicas mais utilizadas no seu tratamento. Além disso, estabeleceu a importância da cirurgia dermatológica e a capacidade do CETEP de atender os pacientes do hospital e também os que foram encaminhados de outros centros da rede pública.
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"Penumbra sign" is a characteristic finding in magnetic resonance imaging (MRI) of Brodie's abscess, a rare variant of subacute osteomyelitis. We aimed to discuss the imaging finding penumbra sign that will help in the diagnosis of osteomyelitis and may be useful to clinicians in differential diagnosis. A 26-year-old male patient presented to the emergency department with complaints of pain and limping in the right knee that did not go away. He had a history of arthroscopic debridement and percutaneous fixation surgery due to osteochondral fragment 3 years ago. There were no additional findings in the patient's vital parameters, physical examination, and medical history. X-ray imaging revealed two screws in the distal femur and a well-defined sclerotic rim surrounding a radiolucent lesion anterior to the screws. MRI revealed a lesion in the distal femoral metaphysis with low-density fluid and hyperintense granulation tissue surrounding it. After surgical abscess drainage and local debridement, bone cement was placed in the resulting cavity. Teicoplanin treatment was started. The patient was discharged and complete recovery was achieved in the second month. The diagnosis of osteomyelitis is often missed or confused with bone tumors in non-traumatic cases presenting with persistent bone pain. MRI imaging is frequently used in differential diagnosis, and detection of characteristic imaging signs such as the penumbra sign accelerates the diagnosis. In this context, emergency department clinicians, in particular, should be cautious and not forget that early treatment can be started by recognizing these signs.
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ABSTRACT Objective: To perform the epidemiological and clinicopathological analyses of odontogenic tumors in Kerman for 20 years. Material and Methods: The present study investigated collected records from pathology departments of the Faculty of Dentistry, Bahonar, and Shafa teaching-medical hospitals for 20 years. Data on odontogenic tumors was recorded based on age, sex, and tumor location in the information forms. The statistical t-test and the Kappa coefficient computer codes were utilized for data analysis. Results: 38 samples of odontogenic tumors were considered in the present study. The mean age of participants was 31.7± 10.3 years. The frequency of tumors was higher in women (63.2%) and in the lower jaw) 78.9%). Among various tumors, ameloblastoma (63.1%) and odontoma (18.4%) were the most common tumors, respectively. The correlation between clinical and histopathologic diagnoses was 71.8% using the kappa coefficient. Conclusion: Ameloblastoma is the most common odontogenic tumor. The incidence of lesions was higher in the mandible, and odontogenic tumors were higher in women. Since the diagnosis of odontogenic tumors is based on radiographic and histologic appearances, clinical physicians and pathologists should collaborate for the definitive diagnosis of the disease.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Ameloblastoma/diagnosis , Odontogenic Tumors/diagnosis , Epidemiology/statistics & numerical data , Mandibular Injuries , Epidemiologic Studies , Medical Records , Cross-Sectional Studies/methods , Retrospective Studies , Analysis of VarianceABSTRACT
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal-derived tumors of the gastrointestinal tract. Tyrosine kinase inhibitors (TKIs) are the cornerstone of GIST therapy, but mutations in resistance genes pose many problems for treatment, especially the heterogeneity of KIT resistance mutations. In recent years, with the release of a number of GIST related drug research and experimental results, the great potential of targeted therapy, immunotherapy and combination therapy to treat GIST in different directions has been revealed, providing more therapeutic directions for GIST. This article will review the experimental research and future direction in recent years.
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@#The announcement of the 9th edition of TNM staging system for thymic tumors was one of the highlights at the World Conference on Lung Cancer 2023. The revision, based on a larger and more detailed database, provides changes and confirmation from the last system. The 9th edition of TNM staging system aims to balance statistical significance and clinical feasibility. The birth of an improved TNM staging system heralds the changes that will follow in clinical practice and scientific research.
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Objective@#To explore the clinical manifestations, histopathological characteristics, diagnosis, treatment, and prognosis of simultaneous unilateral primary tumors of different pathological types in the parotid gland.@*Methods@#A case of simultaneous unilateral primary parotid gland tumors, i.e., adenolymphoma and basal cell adenoma, was reviewed and analyzed in combination with the literature.@*Results@#The patient discovered a lump in the right parotid gland area one month prior to presentation, and a tumor was palpated in the shallow lobe of the right parotid gland before surgery. According to MR images, the initial diagnoses were tumors of the shallow and deep lobes of the right parotid gland. The tumors of the deep and shallow lobes were excised with part of the gland, and the facial nerves were dissected under general anesthesia. Postoperative pathology revealed an adenolymphoma in the shallow lobe of the right parotid gland and a basal cell adenoma with cystic transformation in the deep lobe. The surgical effect was good, with no complications, and there was no recurrence after 1 year of follow-up. A review of the relevant literature showed that multiple primary tumors of the parotid gland can manifest as the simultaneous presence of two or more types of tumors on both sides or on one side, and the disease is mainly treated with surgery.@*Conclusion@#Multiple unilateral primary parotid gland tumors are rare. Imaging examinations need to be combined with clinical evaluations to prevent missed diagnoses. Surgery is the first treatment option, and patients with benign tumors have a good prognosis.
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Originating but free from chromosomal DNA, extrachromosomal circular DNAs (eccDNAs) are organized in circular form and have long been found in unicellular and multicellular eukaryotes. Their biogenesis and function are poorly understood as they are characterized by sequence homology with linear DNA, for which few detection methods are available. Recent advances in high-throughput sequencing technologies have revealed that eccDNAs play crucial roles in tumor formation, evolution, and drug resistance as well as aging, genomic diversity, and other biological processes, bringing it back to the research hotspot. Several mechanisms of eccDNA formation have been proposed, including the breakage-fusion-bridge (BFB) and translocation-deletion-amplification models. Gynecologic tumors and disorders of embryonic and fetal development are major threats to human reproductive health. The roles of eccDNAs in these pathological processes have been partially elucidated since the first discovery of eccDNA in pig sperm and the double minutes in ovarian cancer ascites. The present review summarized the research history, biogenesis, and currently available detection and analytical methods for eccDNAs and clarified their functions in gynecologic tumors and reproduction. We also proposed the application of eccDNAs as drug targets and liquid biopsy markers for prenatal diagnosis and the early detection, prognosis, and treatment of gynecologic tumors. This review lays theoretical foundations for future investigations into the complex regulatory networks of eccDNAs in vital physiological and pathological processes.
Subject(s)
Male , Female , Animals , Humans , Swine , DNA, Circular/genetics , Genital Neoplasms, Female , Semen , DNA , ReproductionABSTRACT
Accessory spleen refers to the spleen tissue that exists outside of the normal spleen， with a similar structure to the main spleen and certain functions. Intrapancreatic accessory spleen （IPAS） completely enveloped by the pancreas has an incidence rate of only 2%， and it is easily misdiagnosed in clinical practice due to its atypical clinical symptoms and similar radiological features to pancreatic neuroendocrine tumor， pancreatic solid pseudopapillary tumor， and other pancreatic space-occupying lesions. This article reports the clinical data of two patients with IPAS who were misdiagnosed as pancreatic neuroendocrine tumor and pancreatic solid pseudopapillary tumor， respectively， analyzes the reasons for misdiagnosis， and summarizes the experience in diagnosis and treatment， in order to improve the ability for the differential diagnosis of IPAS in clinical practice.
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Patients with cancer-related fatigue are prone to symptoms and signs such as anorexia， weight loss， and abdominal distension， which seriously reduces the quality of life and becomes an independent risk factor affecting the survival rate of patients with malignant tumors. Therefore， it is urgent to find effective treatment strategies and drugs. In the past， the academic viewpoint of improving syndromes—a new strategy for tumor treatment was proposed based on the guidance of the Luobing theory. Based on this， this article proposes the pathogenesis of cancer-related fatigue is characterized by spleen and kidney deficiency， stasis and toxin internal obstruction， as well as the treatment method of strengthening the spleen and tonifying the kidney， resolving blood stasis and detoxification guided by the core theory of the Qiluo doctrine of Chengzhi Tiaoping. The representative drug Yangzheng Xiaoji capsules has been developed， not only has good therapeutic effect on solid tumors， but also shows good advantages in treating cancer-related fatigue， which can help to restore the homeostasis of tumor bearing survival in patients with malignant tumors and provide new drug choices for the clinical treatment of cancer-related fatigue.
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Fundamento: Los pineoblastomas son tumores cerebrales infrecuentes dentro del grupo de los tumores primitivos neuroectodérmicos. La presentación clínica por lo general está relacionada con la obstrucción del acueducto de Silvio, lo que ocasiona hidrocefalia e hipertensión intracraneal. Objetivo: Describir las características clínicas e imagenológicas de un paciente adulto con diagnóstico de pineoblastoma. Presentación de caso: Masculino, 33 años, que comenzó con disminución de la agudeza visual que evolucionó a la amaurosis bilateral y trastorno de la marcha. Se diagnosticó hidrocefalia obstructiva triventricular, por lo cual se realizó tercer ventriculostomía endoscópica. Se decidió un abordaje supracerebeloso infratentorial a la lesión tumoral, con apoyo endoscópico en posición semisentado; se logró la resección parcial. En estudio inmunohistoquímico se encontró Ki-67 mayor de 50 % de las células, neurofilamento y sinaptofisina positiva. Se concluyó como pineoblastoma. Recibió radioterapia convencional con Co-60, fraccionada, con un total de 30 dosis diarias de 2 Gy. La evolución del paciente a los 6 meses de operado fue satisfactoria. Conclusiones: El tratamiento combinado de cirugía y radioterapia constituye un esquema terapéutico ideal en este tipo de lesiones tumorales. La endoscopia es una herramienta de gran valor en los abordajes quirúrgicos a la región pineal.
Background: Pineoblastomas are infrequent brain tumors among the neuroectodermal primitive tumors. Clinical presentation is usually related to Silvian aqueduct obstruction, which causes hydrocephalus and intracranial hypertension. Objective: To describe the clinical and imagenological characteristics in an adult patient diagnosed with pineoblastoma. Case presentation: Male, 33 years old, who started with visual acuity decline that evolved to bilateral amaurosis and gait disorder. Triventricular obstructive hydrocephalus was diagnosed, therefore, an endoscopic third ventriculostomy was realized. It was decided to use an infratentorial supracerebellar approach to the tumor lesion, with endoscopic support in semi-seated position; partial resection was achieved. In immunohistochemical study, Ki-67 was found to be higher than 50% of the cells, neurofilament and synaptophysin positive. It was concluded as pineoblastoma. He received fractionated Co-60 conventional radiotherapy, with a total of 30 daily doses, 2 Gy. The evolution of the patient 6 months after surgery was satisfactory. Conclusions: The combined treatment of surgery and radiotherapy constitutes an ideal therapeutic scheme in this type of tumor lesions. Endoscopy is a tool of great value in surgical approaches to the pineal region.
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El mixoma cardiaco constituye uno de los tumores benignos más frecuentes entre los tumores cardiacos. El mismo se caracteriza por la obstrucción del flujo sanguíneo por trombosis o émbolo, resultando en causa de insuficiencia cardiaca con disfunción ventricular, síncope ortostático, isquemia de diferentes órganos de acuerdo a la arteria afectada, e incluso muerte súbita. Presentamos 2 casos en pacientes pediátricos: el primer caso, una adolescente con ACV isquémico y el segundo caso se trata de un adolescente con isquemia a nivel de miembros inferiores por una tromboembolia en la Aorta distal. En ambos casos se realizó la exéresis del tumor, con éxito.
Cardiac myxoma is one of the most frequent benign tumors among cardiac tumors. It is characterized by the obstruction of blood flow due to thrombosis or embolus, resulting in heart failure with ventricular dysfunction, orthostatic syncope, ischemia of different organs depending on the affected artery, and even sudden death. We present 2 cases in pediatric patients: the first case, an adolescent with ischemic stroke and the second case is an adolescent with ischemia in the lower limbs due to a thromboembolism in the distal aorta. In both cases, the exeresis of the tumor was performed successfully.
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El fibro-odontoma ameloblástico (FOA) es una neoplasia odontogénica benigna poco frecuente que afecta a los huesos maxilares. Posee un componente de tejido epitelial y ectomesénquima, por lo que hasta hace un tiempo era incluido dentro de la clasificación de tumores odontogénicos de origen mixto. Actualmente estas lesiones no están incorporadas en la última clasificación de los tumores odontogénicos y huesos maxilofaciales de la organización mundial de la salud y son consideradas como un odontoma en desarrollo. Clínicamente se presenta con mayor frecuencia en mandíbula y asociado a la falta de erupción de un diente. Presentamos el caso clínico de un niño de 6 años de edad que acudió a nuestro servicio maxilofacial por la no erupción de un diente temporal mandibular. El cuadro clínico y las investigaciones confirmaron la hipótesis diagnóstica de FOA con una impactación del segundo molar temporal inferior izquierdo hacia el margen basilar mandibular y el germen dentario del premolar por sobre la corona del diente retenido.
Ameloblastic fibro-odontoma (AFO) is a rare benign odontogenic neoplasm that affects the maxillary bones. It possesses both an epithelial and ectomesenchymal component, for which it was previously included in the classification of mixed odontogenic tumors. The AFO is currently not included in the latest classification of odontogenic and maxillofacial bone tumors, and is considered a developing odontoma. Clinically, it predominantly manifests in the mandible, in frequent association with the lack of eruption of a tooth. In this article, the authors present a case of a 6 year old boy with the query of an unerupted primary mandibular tooth. Both the clinical examination and the subsequent investigation confirmed the diagnostic hypothesis of an AFO with subsequent impaction of the primary left mandibular second molar, which was displaced against the base of the mandible, and the tooth germ for the left mandibular second premolar positionedover the crown of the retained tooth.
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This study aimed to compare the subgingival microbiota of subjects with and without breast cancer (BC). Patients with BC (Group 1; n= 50) and without BC (Group 2; n=50) with periodontitis (A) and without periodontitis (B). The study was conducted in two phases (P1 and P2). One biofilm sample was collected from each subject and analyzed by DNA-DNA Hybridization (Checkerboard DNA-DNA). The relative abundance of the subgingival microbiota differed between the Case and Control groups. However, some species were higher in patients in the Case than in Control subjects and differed between the groups in both phases. Composition of the subgingival microbial community according to the Socransky complex was related to periodontal disease, followed by clinical attachment of level (CAL ≥4mm), age, and tooth loss, which were found to be abundant in Cases when compared with controls. Patients with Tumor Grade II and III had a higher prevalence of tooth loss and CAL≥4mm. It was concluded that in individuals with BC, the sub-gingival microbiota exhibited atypical changes, but they developed periodontal disease.
El objetivo de este estudio fue comparar la microbiota subgingival de sujetos con y sin cáncer de mama (CM). Pacientes con CM (Grupo 1; n= 50) y sin CM (Grupo 2; n=50) con periodontitis (A) y sin periodontitis (B). El estudio se realizó en das fases (P1 y P2). Se recogió una muestra de biopelícula de cada sujeto y se analizó mediante hibridación ADN-ADN (tablero de ajedrez ADN-ADN). La abundancia relativa de la microbiota subgingival difirió entre los grupos de Caso y Control. Sin embargo, algunas especies fueron más altas en los pacientes del Caso que en los sujetos del Control y difirieron entre los grupos en ambas fases. La composición de la comunidad microbiana subgingival según el complejo de Socransky se relacionó con la enfermedad periodontal, seguida por el nivel de inserción clínica (CAL≥4mm), la edad y la pérdida de dientes, que se mostró abundante en los casos en comparación con los controles. Los pacientes con Tumor Grado II y III tuvieron mayor prevalencia de pérdida dental y CAL≥4mm. Se concluyó que en individuos con CM la microbiota subgingival presentó cambios atípicos, pero sin embargo, desarrollaron enfermedad periodontal.
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Introduction: The cecum is the first part of the large bowel. Cecectomy is a sufficient treatment for some patients, avoiding overtreatment by ileocolic resection. Purpose:The goal of this study was to review a surgeon's experience with laparoscopic cecectomy and provide a technical video demonstration of this uncommon operation. Methods: A retrospective chart review was conducted of all consecutive patients treated with laparoscopic cecectomy over a 16-year period. All operations were performed using a 3-trocar technique. The cecum was transected with 1 to 2 firings of a 60 millimeters linear stapler, preserving the ileocecal valve and ascending colon. Results: 19 patients were identified including 12 females (63.2%). Median age was 42 years (range 16-84). Indication for surgery included appendiceal pathology in 12 patients (63.2%) and cecal abnormality in 7 (38.9%). There was no conversion to open surgery. Median intraoperative blood loss was 25 ml (range 0-150 ml) and no patient received a blood transfusion. No intraoperative or postoperative complication was noted. The median length stay was 1 day (range 0-6). Readmission rate was 0%. Final appendiceal histopathology revealed acute/chronic appendicitis in 5 patients, mucinous cystadenoma in 4 patients. Cecal histopathology revealed adenoma in 4 patients. Median follow-up was 16 months (range 4-53). Conclusions: Laparoscopic cecectomy is a sufficient treatment for some patients with benign conditions of the appendix and cecum. It carries minimal morbidity. It should be considered as an alternative to segmental bowel resection in a select group of patients. (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Appendix/surgery , Cecum/surgery , Laparoscopy , Postoperative Complications , Retrospective StudiesABSTRACT
Introducción: Los tumores malignos ubicados en la región periampular pueden ser: ampular, biliar, pancreático o duodenal, y constituyen un problema de salud por su alta mortalidad. En su etiopatogenia se involucran múltiples factores de riesgo, cuyo comportamiento clínico y epidemiológico se desconoce en la población matancera. Objetivo: Determinar el comportamiento clínico y epidemiológico de los tumores periampulares malignos. Materiales y métodos: Se realizó un estudio descriptivo, prospectivo en 34 pacientes con diagnóstico de tumores periampulares malignos, atendidos en el Servicio de Gastroenterología del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, de enero a diciembre de 2021. Se estudiaron variables como: grupos de edad, sexo, factores de riesgo y antecedentes patológicos personales, tiempo de evolución de los síntomas y localización del tumor. Los resultados fueron recogidos en una planilla de recolección de datos. Resultados: Predominó el sexo masculino y el grupo de 50 a 69 años. Los factores de riesgo más frecuentes fueron el consumo de café, tabaquismo y diabetes mellitus. El íctero fue el síntoma más frecuente. La mayoría de los pacientes iniciaron los síntomas de 1 a 3 meses antes del diagnóstico. El cáncer de páncreas fue el más frecuente. Conclusiones: Los tumores periampulares predominaron en la población mayor de 50 años. Los hábitos tóxicos fueron los factores de riesgo más frecuentes. El cáncer de páncreas tuvo mayor incidencia. El comportamiento clínico estuvo relacionado con la localización de la lesión, el tiempo de evolución de los síntomas, y los factores de riesgo que predominaron.
Introduction: Malignant tumors located in the periampullary region can be ampullary, biliary, pancreatic or duodenal and are a health problem due to their high mortality. Their etio-pathogenesis involves many risk factors, whose clinic and epidemiological behavior is unknown by the population of Matanzas. Objective: To determine the clinical-epidemiological behavior of malignant periampullary tumors. Materials and methods: A descriptive, prospective study was conducted in 34 patients with diagnosis of malignant periampullary tumors, treated in the Gastroenterology Service of the Clinical-Surgery University Hospital Comandante Faustino Perez Hernandez, of Matanzas, from January to December 2021. Variables such as age group, sex, risk factors and personal pathological history, time of evolution of symptoms and tumor location were studied. The results were collected in a data collection form. Results: Male sex and the 50-69 years age group predominated. The most frequent risk factors were coffee consumption, smoking and diabetes mellitus. Jaundice was the most frequent symptom. Most of the patients started symptoms one to three months before the diagnosis. Pancreatic cancer was the most frequent. Conclusions: Periampullary tumors predominated in the population older than 50 years. Toxic habits were the most common risk factors. Pancreatic cancer had a higher incidence. Clinical behavior was related to the location of the lesion, the time of evolution of the symptoms, and the risk factors that predominated.
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Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm of the stomach usually arising in the gastric antrum, and its main differential diagnosis is gastrointestinal stromal tumor. Most common symptoms are hematemesis, anemia. Immunohistochemically, positivity for smooth muscle actin (SMA) and vimentin suggests the diagnosis of PF. We report the case of a 56-year-old female patient with a 30- day history of nausea at presentation 4 years ago. Gastroscopy at that time revealed a subepithelial lesion (SEL) in the gastric antrum, measuring approximately 20 mm in diameter, with leakage of serous fluid after biopsy. Histopathology showed only an inflammatory process. Follow-up gastroscopies were performed 24, 36, and 48 months later, with surveillance biopsy at each follow-up. The last gastroscopies showed changes in lesion appearance, reduction in size, and absence of fluid leakage. Histopathology showed bland spindle cell proliferation, with a vaguely plexiform/multinodular pattern, in a fibromyxoid stroma with an arborizing capillary network without mitoses. The tumor cells were positive for SMA and negative for DOG1, CD117, CD34, S100, desmin, EMA, CD10, calponin, and beta-catenin. The choice of treatment and follow-up depends on the SEL features, but because no cases of malignancy or metastatic disease have previously been reported, the patient chose a conservative approach.
El fibromixoma plexiforme (FP) es una rara neoplasia mesenquimatosa del estómago que generalmente surge en el antro gástrico. Su principal diagnóstico diferencial es el tumor del estroma gastrointestinal. Los síntomas más comunes de los FP son hematemesis y anemia. Inmunohistoquímicamente, la positividad para actina del músculo liso (SMA) y vimentina sugieren el diagnóstico de FP. Presentamos el caso de una paciente de 56 años de edad que inicia su enfermedad hace 4 años con náuseas de 30 días de evolución. La primera gastroscopia reveló una lesión subepitelial (SEL) en el antro gástrico, de aproximadamente 20 mm de diámetro, con fuga de líquido seroso después de la biopsia. La histopatología mostró sólo un proceso inflamatorio. Se realizaron gastroscopias de seguimiento a los 24, 36 y 48 meses con biopsia de vigilancia en cada seguimiento. Las gastroscopias siguientes mostraron cambios en la apariencia de la lesión, reducción de tamaño y ausencia de fuga de líquido. La última histopatología mostró una proliferación blanda de células fusiformes, con un patrón vagamente plexiforme/multinodular, en un estroma fibromixoide con una red de capilares arborizantes sin mitosis. Las células tumorales fueron positivas para SMA y negativas para DOG1, CD117, CD34, S100, desmina, EMA, CD10, calponina y beta-catenina. La elección del tratamiento y el seguimiento depende de las características del SEL, sin embargo, por ser una enfermedad que no presentaba rasgos de enfermedad maligna o metastásica, el paciente eligió un mantener un enfoque conservador.
ABSTRACT
Introducción. La neoplasia colorrectal es una patología oncológica muy frecuente a nivel mundial y una de las causas más comunes de mortalidad por cáncer. La epidemiologia, diagnóstico y tratamiento han sido ampliamente estudiadas, mientras que los datos sobre la enfermedad metastásica siguen siendo escasos. El hígado es el órgano más comúnmente afectado y algunos estudios sugieren diferencias en sobrevida y resecabilidad según la localización del tumor primario. El objetivo de este estudio fue establecer el comportamiento y resecabilidad de neoplasias avanzadas colorrectales en dos hospitales de la ciudad de Medellín, Colombia. Métodos. Estudio analítico retrospectivo para identificar los patrones de las metástasis hepáticas y sus características en función de las diferencias clínicas, histológicas y endoscópicas del tumor colorrectal primario entre 2015 y 2020. Resultados. Se recolectaron 54 pacientes con neoplasia colorrectal y metástasis hepáticas, 21 (39 %) derechas y 33 (61 %) izquierdas. El número de metástasis promedio fue de 3,1 en tumores del lado derecho y de 2,4 del izquierdo y el tamaño promedio de cada lesión fue de 4,9 y 4,2 cm, respectivamente. La tasa de resecabilidad fue del 42 % en los tumores derechos y del 82 % en los izquierdos. Las lesiones metacrónicas presentaron una tasa de resecabilidad del 90 % y las sincrónicas del 61 %. Conclusión. En este estudio, las lesiones originadas en neoplasias primarias del colon izquierdo y las lesiones metacrónicas fueron factores pronósticos favorables para la resecabilidad, un factor que impacta en la sobrevida y el tiempo libre de enfermedad de estos pacientes.
Introduction. Colorectal tumor is the most frequent pathology worldwide and one of the most common causes of mortality attributed to cancer. Epidemiology, diagnosis and treatment have been extensively studied, while information on metastatic disease remains scarce, despite being the main cause of death. Some studies suggest differences in terms of survival and resectability according to the anatomical location of the primary tumor. The aim is to establish the behavior and resectability of advanced cancers in two high-complex hospitals in the city of Medellín, Colombia. Methods. Cross-sectional observational study from secondary sources of information based on a retrospective cohort, using available data from adult patients with colorectal cancer and liver metastases between 2015 and 2020. Results. Fifty-four patients with colorectal neoplasms and liver metastases were collected, of which 21 (39%) were on the right side. The average number of liver metastases was 3.1 on the right side and 2.4 on the left, and the average size of each metastatic lesion was 4.9 cm and 4.2 cm, respectively. The resectability rate was 42% in the right tumors and 82% in the left ones. Metachronous lesions had a resectability rate of 90% and synchronous ones 61%. Conclusion. The complete resectability of liver metastatic lesions is the only therapeutic alternative with impact, in terms of survival and disease-free time in these patients. The favorable prognostic factors for the resectability of these lesions in our study were those originating from left primary tumors and metachronous lesions, where less liver tumor involvement was evidenced
Subject(s)
Humans , Colorectal Neoplasms , Neoplasm Metastasis , Metastasectomy , Hepatectomy , Liver NeoplasmsABSTRACT
Existem poucos dados na literatura sobre os resultados obstétricos e oncológicos de adolescentes com tumores borderline de ovário em estádio avançado trata- das com cirurgia preservadora da fertilidade. Uma adolescente de 15 anos com diagnóstico de tumor borderline de ovário estádio IIIc foi inicialmente tratada com tumorectomia ovariana bilateral e quimioterapia adjuvante com esquema de platina/taxano (seis ciclos). Durante o seguimento, foi submetida a outras três tumorectomias devido a tumor borderline de ovário (duas vezes) e cistadenoma ovariano (uma vez). Outra recidiva de tumor borderline de ovário ocorreu seis anos após o diagnóstico inicial, quando ela estava grávida; foi tratada com tumorecto- mia realizada durante a cesariana. Em sua última consulta ambulatorial, a mulher de 27 anos não apresentava evidência da doença e tinha um filho saudável. Mesmo em estádio avançado, a cirurgia de preservação da fertilidade foi segura e factível nessa paciente com tumor borderline de ovário.
There are few data in the literature regarding obstetric and oncological outcomes of adolescents with advanced-stage borderline ovarian tumors treated with fertility spa- ring surgery. A 15 years old adolescent who was diagnosed with a stage IIIc borderline ovarian tumor, was treated with bilateral ovarian tumorectomies and adjuvant chemotherapy with platinum/taxane regimen (six cycles). During follow up she was submitted to other three tumorectomies due to borderline ovarian tumor(twice) and ovarian cysta- denoma (once). Another borderline ovarian tumorrecurren- ce occurred six years after initial diagnosis, when she was pregnant; treated with tumorectomy performed during ce- sarean section. At her last outpatient visit, the 27-year-old woman had no evidence of disease and a had healthy child. Even at an advanced stage, fertility sparing surgery was safe and feasible in this patient with borderline ovarian tumor.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Ovary/surgery , Fertility Preservation , Carcinoma, Ovarian Epithelial/drug therapy , Ovary/diagnostic imaging , Pregnancy , Women's Health , Adolescent, HospitalizedABSTRACT
Introduction: ameloblastomas correspond to one of the most prevalent odontogenic tumors in developing countries, they are mainly located in the mandible, and their treatment has been widely discussed over the years, using radical or conservative treatments depending on different variables. Clinical case: we present two cases of patients with ameloblastoma who underwent conservative treatment without the use of adjuvant therapy, obtaining satisfactory results at 36 and 48 months. Discussion: due to a possible recurrence with conservative treatment, radical management has been suggested, however, the choice of treatment should be based on a series of clinical, histological, and radiographic characteristics.
Introducción: Los ameloblastomas corresponden a uno de los tumores odontogénicos más prevalentes en los países en desarrollo, se ubican principalmente en la mandíbula, y su tratamiento ha sido ampliamente discutido a lo largo de los años, utilizando tratamientos radicales o conservadores dependiendo de distintas variables. Caso clínico: se presentan dos casos de pacientes con un ameloblastoma a quienes se les realizó tratamiento conservador sin uso de terapia coadyuvante, obteniendo resultados satisfactorios a los 36 y 48 meses. Discusión: Debido a una posible recurrencia con un tratamiento conservador, se ha sugerido manejo radical, sin embargo, la elección de tratamiento debe ser en base a una serie de características clínicas, histológicas y radiográficas.
ABSTRACT
Introducción: El cistoadenocarcinoma biliar es un tumor quístico poco frecuente, que se origina a partir del epitelio hepatobiliar, cuyo crecimiento es lento y sus síntomas son variables e inespecíficos. Objetivo: Presentar el caso de un paciente portador de un cistoadenocarcinoma biliar. Presentación del caso: Se presenta el caso de una paciente femenina de 56 años de edad que acude a la institución por presentar dolor en el hipocondrio derecho, fiebre y pérdida de peso. Al examen físico se constata una masa palpable en dicha zona abdominal, de bordes lisos, no dolorosa, dura, de escasa movilidad y relacionada con el hígado. Conclusiones: El cistoadenocarcinoma biliar es una neoplasia quística maligna poco frecuente del hígado. La mayoría de los pacientes presentan dolor abdominal, masa palpable y pérdida de peso. El tratamiento quirúrgico es la norma y la resección con márgenes libres se considera la variante de tratamiento más empleada(AU)
Introduction: Biliary cystadenocarcinoma is a rare cystic tumor, which originates from the hepatobiliary epithelium, whose growth is slow, and whose symptoms are variable and nonspecific. Objective: To present the case of a patient with a biliary cystadenocarcinoma. Case presentation: The case is presented of a 56-year-old female patient who came to our institution with pain in the right hypochondrium, fever and weight loss. Physical examination revealed a palpable mass in such abdominal area, with smooth edges, nonpainful, hard, with low mobility and related to the liver. Conclusions: Biliary cystadenocarcinoma is a rare malignant cystic neoplasm of the liver. Most patients present with abdominal pain, a palpable mass and weight loss. Surgery is the standard treatment and margin-free resection is considered the most commonly employed treatment variant(AU)