ABSTRACT
El carcinoma mucinoso es un carcinoma ductal invasor de bajo grado de malignidad que se caracteriza por células tumorales inmersas en cúmulos de moco extracelular. Representa el 1% al 7% de todos los cánceres de mama, siendo más frecuente en mujeres mayores. Conocer las características clínicas, factores pronósticos, variedades histológicas, tratamiento aplicado y sobrevida global en pacientes con el diagnóstico de carcinoma mucinoso de mama en el Instituto de Oncología Dr. Miguel Pérez Carreño. Estudio descriptivo, transversal, pacientes con el diagnóstico de carcinoma mucinoso de mama vistos entre los años 2002-2011. Se evaluaron las historias clínicas de 17 pacientes, encontrando que el grupo etario más afectado es el de 36-45 años con un 29,4%, la mama con mayor afectación fue la izquierda con un 58,8%, el nódulo palpable fue el síntoma predominante, el cuadrante mayormente afectado fue el súpero externo en un 41,20%, el estadio IIA fue el más frecuente 41,17%, carcinoma mucinoso puro se encontró en 94,11%. El diagnóstico inmunohistoquímico de luminal A fue el de mayor incidencia en 54,54% de los pacientes, 47,05% recibió neoadyuvancia, 76,47% se le practicó una mastectomía radical modificada. 41,7% pacientes presentaron una supervivencia global a los 10 años. Carcinoma mucinoso de mama es una entidad poco frecuente que muestra altas tasas de cura y control con un adecuado tratamiento.
The mucinous carcinoma is invasive ductal carcinoma of low grade malignancy is characterized by tumor cells embedded in extracellular clumps of mucus. They represent 1% to 7% of all breast cancers, are most frequently in older women. Determine the clinical characteristics, prognostic factors, the histological types, the treatment applied and the overall survival in patients with the diagnosis of mucinous carcinoma of breast, viewed at the Oncology Institute Dr. Miguel Pérez Carreño. We realized a descriptive study of patients with the diagnosis of mucinous breast carcinoma viewed between the years 2002-2011. We evaluated the medical records of 17 patients and found that the age group most affected is the 36-45 years old with 29.4%, the most affected breast was the left with 58.8%, the palpable nodule was the predominant symptom, the most affected quadrant was the upper outer in a 41.20%, stage IIA was the most predominate, 41.17% pure mucinous carcinoma was found in 94.11%, the immunohistochemistry diagnosis of luminal A was the most prevalent in 54.54% of the patients. 47.05% of all the patients received neoadjuvant treatment, 76.47% were practicing modified radical mastectomy. 41.7% patients had an overall survival at 10 years. The mucinous carcinoma of the breast is a rare entity showing high rates of cure and control with a proper and adequate treatment.
Subject(s)
Humans , Female , Adult , Middle Aged , Adenocarcinoma, Mucinous/diagnosis , Adenocarcinoma, Mucinous/drug therapy , Adenocarcinoma, Mucinous/therapy , Neoplasm Staging/methods , Breast Neoplasms/diagnosis , Breast Neoplasms/drug therapy , Breast Neoplasms/therapy , Prognosis , Survival , Medical OncologyABSTRACT
Introdução: O adenocarcinoma mucinoso é uma rara neoplasia formada por células apócrinas da pele hipersecretoras de muco. Pálpebras, couro cabeludo e outras regiões da cabeça e do pescoço são os sítios primários mais acometidos. Relatodo caso: Os autores descrevem o caso de uma lesão suspeita em couro cabeludo, cuja excisão e análise confirmaram um adenocarcino mamucinoso de anexo cutâneo. Mesmo após a ressecção, surgiram lesões metastáticas nas regiões retroauricular, cervical, supraclavicular e couro cabeludo. Fez-se, então, quimioterapia e radioterapia. Meses depois, a paciente relatou dor na coluna e no braço com irradiação para a mão e parestesias. Após exames, confirmou-se metástaseem linfonodos axilares, em ossos da coluna vertebral, com iminente compressão medular. A radioterapia, então, foi realizada nessas regiões. A paciente apresentou melhora significativa e mantém acompanhamento. Conclusão: O adenocarcinoma mucinoso é uma rara neoplasia e as características do relato apresentado tornam-no ainda mais raro. O diagnóstico da doença exige uma correlação clínica, radiológica e patológica. Quando submetidos a tratamento precoce, os pacientesapresentam um bom prognóstico com raras chances de metástases, embora recidivas sejam comuns.
Subject(s)
Humans , Female , Adenocarcinoma, Mucinous/diagnosis , Adenocarcinoma, Mucinous/drug therapy , Adenocarcinoma, Mucinous/radiotherapy , Neoplasm Metastasis , Neoplasms/drug therapy , Neoplasms/radiotherapy , RecurrenceABSTRACT
Background : 5-Flourouracil (FU)-based chemotherapy (CT) and concurrent 45 Gy radiotherapy (RT) is one of the standard postoperative approaches currently used in gastric carcinoma. The high toxicity rates of this treatment leads to interruption of treatment in the majority of patients. In our study, we investigated the rates of toxicity and treatment discontinuation observed during postoperative FU-based chemoradiotherapy (CRT); retrospectively evaluated the effect of CRT and the other prognostic factors on local and distant control and survival. Patients and Methods: A total of 160 patients consisting of 97 total and 63 subtotal gastrectomy receiving postoperative CRT, have been studied retrospectively. Results : Patients who had to discontinue the treatment for a median of 6 (range, 3-13) days experienced toxicity during treatment at a rate of 43%. During the 21 (range, 4-68) months of follow-up local recurrences were observed in 8 (5%) patients and distant recurrences were observed in 41 (25.6%) patients. While the 1-3 year overall survival (OS) rates were 75% and 42%, 13-year disease-free survival (DFS) rates were 63% and 42%, respectively. In the univariate analysis for OS and DFS demonstrated statistical significance for below those 60 years of age, D1-D2 dissection type, negative surgical margin, early treatment beginning, the absence of invasion, and early stage disease. D1D2 dissection type, early treatment begining, age below 60 years and early stage disease significantly improve OS and DFS in multivarite analysis. Conclusions: Survival is worse in patients older than 60 years, had late treatment begining, advanced stage and D0 dissection.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Adenocarcinoma/therapy , Adenocarcinoma, Mucinous/drug therapy , Adenocarcinoma, Mucinous/radiotherapy , Adenocarcinoma, Mucinous/therapy , Adult , Aged , Antimetabolites, Antineoplastic/therapeutic use , Carcinoma, Papillary/drug therapy , Carcinoma, Papillary/radiotherapy , Carcinoma, Papillary/therapy , Carcinoma, Signet Ring Cell/drug therapy , Carcinoma, Signet Ring Cell/radiotherapy , Carcinoma, Signet Ring Cell/therapy , Combined Modality Therapy , Female , Fluorouracil/therapeutic use , Follow-Up Studies , Gastrectomy , Humans , Male , Middle Aged , Retrospective Studies , Stomach Neoplasms/drug therapy , Stomach Neoplasms/radiotherapy , Stomach Neoplasms/therapy , Survival Rate , Treatment OutcomeABSTRACT
Os autores descrevem um caso clínico diagnosticado como endocardite marântica, ocorrida em um jovem, militar, portador de carcinomatose peritoneal (adenocarcinoma mucinoso). Na discussao do caso, é feita breve revisao histórica da doença, discutida sua etiologia, patogenia, sinais e sintomas mais comuns, e a conduta terapêutica, concluindo-se que se deve pensar na ocorrência de endocardite marântica em pacientes portadores de neoplasias e com manifestaçoes clínicas sugestivas de processo embólico.