Melanoma del canal anal: a propósito de un caso / Melanoma of the anal canal: a propos of a case

RESUMEN Los melanomas mucosos son tumores poco frecuentes y de mal pronóstico. Presentan un comportamiento agresivo, y pueden tener varias localizaciones en el aparato digestivo. Este tipo de tumores es más frecuente en la región anorectal. Se presentó un caso de una paciente femenina de 59 años, con un cuadro de varios meses de evolución; caracterizado por ardor, prurito anal y sensación de masa que prolapsaba a través del ano. Se constató al examen físico masa tumoral aspecto polipoideo. Se realizó polipectomía donde la biopsia arrojó como resultados el aspecto histológico de un melanoma mucoso de canal anal.

ABSTRACT Mucous melanomas are few frequent and have a bad prognosis. They present an aggressive behavior and might have several locations in the digestive system. This kind of tumors is more frequent at the anus-rectal region. The authors presented the case of a female patient, aged 59 years, with clinical conditions of several months of evolution, characterized by burning, anal pruritus and the sensation of a mass prolapsing through the anus. A tumor mass of polypoid aspect was found at physical examination. Polypectomy was carried out and the biopsy showed the histologic aspect of a mucous melanoma of the anal canal.

Sarcoma de células claras del pie. Presentación de un caso / Clear cell sarcoma of the foot. Case presentation

RESUMEN El sarcoma de células claras fue descrito por primera vez por Franz M. Enzinger en 1965. Está íntimamente asociado a tendones y aponeurosis, excepcionalmente compromete la epidermis. Afecta fundamentalmente a pacientes jóvenes y se caracteriza por múltiples recurrencias locales y metástasis tardías. Se presenta un paciente de 22 años de edad, masculino que fue sometido a tratamiento quirúrgico radical (amputación transmetatarseana del 1er y 2do rayo). Los estudios anatomopatológicos confirmaron el diagnóstico de un sarcoma de células claras. El paciente se encuentra libre de la enfermedad después de 6 años de operado e incorporado a su vida social (AU).

ABSTRACT The clear cell sarcoma was firstly described by Franz M. Enzinger in 1965. It is intimately associated to tendons and aponeurosis, exceptionally compromising the epidermis. It mainly affects young patients and is characterized by multiple local recurrences and late metastases. We present a male patient, aged 22 years, who underwent a radical surgical treatment (transmetatarsal amputation of the 1st and 2nd rays). The anatomic-pathological studies confirmed the diagnosis of clear cell sarcoma. 6 years after surgery, the patients is free of the disease and reincorporated to his social life (AU).

Ultrastructure in resolving a diagnosis of poorly differentiated clear cell sarcoma of soft parts in an adolescent male.

Clear cell sarcoma of soft parts is a rare tumor in children and it requires a high index of suspicion for accurate diagnosis. Early diagnosis leads to radical surgical excision and limits the aggressive behavior of this tumor. We report a case of a 12-year-old boy with a recurrent soft-tissue tumor in the scalp, misdiagnosed on three occasions as epitheloid sarcoma owing to the poorly differentiated appearance of cells. In spite of focal S-100 expression, this tumor was not recognized as a tumor of melanocytic origin till melanosomes were demonstrated on electron microscopy (EM). Detection of melanosomes on electron microscopy helped in clinching the histology diagnosis, reiterating the definite role of EM in diagnosing these tumors. Failure to accurately diagnose this tumor resulted in institution of preoperative chemotherapy, delayed surgical excision, tumor progression and death of patient within a year and half of presentation.

Clear cell sarcoma of the kidney--a study of seven cases over a period of three years.

Clear cell sarcoma of the kidney (CCSK) can display diverse morphological patterns and mimic various other pediatric renal tumors. An accurate diagnosis of this tumour is important considering the therapeutic and prognostic implications. AIM: The present study was undertaken to describe the various histological patterns of CCSK. The histology of 7 cases and the available case files of CCSK accrued over a period of3 years were reviewed. Immunohistochemical (IHC) stains were performed in 3 cases. The histological patterns observed in this study were classical (observed in 4 cases), epithelioid trabecular, myxoid, palisading and hyaline sclerosis types. IHC revealed reactivity to vimentin and non-reactivity to cytokeratin, desmin, smooth muscle actin, neuron specific enolase (NSE) and S-100 protein. Since CCSK is essentially a histological diagnosis, the importance of an accurate diagnosis of CCSK by a pathologist cannot be overemphasized. This study describes the various histological patterns that can be observed in CCSK.

Review of the clinical features of skin cancer: a study of 1, 048 cases from a hospital in West China

Skin cancer [SC] is a group of malignancies which include primary and metastatic tumors which involve the skin and its appendages. Up to the present, only a few studies on the clinical features and the trend of S have been reported but the status in West China is still undetermined. The S cases were from a major hospital in West China. A total of 1048 cases from 1981 to 2006 were included in our study. The clinical features of S including age, gender, lesion location and pathological diagnosis were analyzed. In order to illustrate the trend of S incidence, the patients from 1981-1993 and 1994- 2006 were assigned to group A and B respectively. The percentage of S in all malignancies [Ms], including all kinds of internal carcinomas and skin cancers, and the percentage of S in inpatients and outpatients [IOPs] between group A and B were separately compared to illustrate the trend in S incidence in this area. [1] Of the 1048 S s included, 308 [29.4%] were squamous cell carcinoma [S C], 293 [28.0%] basal cell carcinoma [B] and 168 [16.0%] cutaneous malignant melanoma [MM] .Ratio of male to female was 1.5:1.0.Median age was 54.0 +/- 23.0 years.40.8%of the S s occurred on the head, 35.0%on the trunk and 24.2%on the extremities. Median age of MM [53.0 +/- 22.5] was less than those of B [58.0 +/- 18.3 years] and S [57.0 +/- 20.0 years] .83.6%of the B s, 49.8%of the S s and 13.5% of the CMMs occurred on the head. [2] Of the 168 MMs, 106 [63.1%] occurred on the acral, 23 [13.7%] on the head, 24 [14.3%] on the trunk and 15 [8.9%] on the limbs. Of the 106 acral melanoma [AM], 41 [38.7%] occurred on the plantar skin, 19 [17.9%] on the heel, 15 [14.2%] on the subungual skin of thumbs, 13 [12.3%] on the subungual skin of big toes and 18 [17.0%] on other acra. [3] The percentages of S in IOPs [S s/IOPs] in Group A and B were 0.0038% [325/8, 457, 672], 0.0066% [723/11, 037, 720], an increase of by 74%.The percentages of S in all Ms [S /Ms] were 2.1% [325/15, 363] and 3.1% [723/23, 364], an increase of 48%.During the same period, the percentages of Ms in IOPs [Ms/IOPs] were 0.18% [15, 363/8, 457, 672] and 0.21% [23, 364/11, 037, 720], increased only by 17%. In our study, S C, B and MM were major S types. The head and trunk are the main sites for S occurring. AM is the most common MM. In past 26 years, the percentages of S in all malignancies and in inpatients and outpatients have increased in this hospital. The finding in our study provides a clue for understanding of the trend of S in West China

Osteosarcomas: experiencia en el Hospital Oncológico Padre Machado: período enero 1987-dicembre 1996 / Osteosarcomas: experience in the Oncologycal Hospital Padre Machado

Se revisaron las historias clínicas de pacientes con diagnóstico de osteosarcoma durante 10 años en el Hospital Oncológico Padre Machado, obteniendo 97 casos. El sexo, ubicación anatómica, aparición y ubicación de metástasis, coinciden con bibliografía especializada. Fueron sometidos a tratamiento quirúrgico 77 pacientes, posterior a la cual 18 no regresaron, 25 abandonaron control posoperatorio, 27 fallecieron por causas conocidas y 37 pacientes presentaron metástasis torócicas y óseas. No fue posible valorar respuesta a quimioterapia por insuficiente información en las historias clínicas. La sobrevida a 5 años se estableció en sólo 8 pacientes.

Sarcoma de células claras de riñón metastásico a mandíbula. Informe de un caso / Clear cell sarcoma of kidney metastatic to the mandible. Report of a case

Se presenta el caso de un paciente masculino de 8 años de edad, con antecedentes de nefroblastoma (tumor de Wilms) a la edad de cinco años, con manejo terapéutico a base de nefrectomía, quimioterapia y radioterapia, quien treinta meses después presentó aumento de volumen en hemicara izquierda con lesión lítica en cuerpo y rama ascendente del lado izquierdo mandibular. La revisión de laminillas del tumor original se interpretó como sarcoma de células claras de riñón. La lesión mandibular mostró la misma imagen, con lo cual el diagnóstico fue de sarcoma de células claras de riñón, metastásico a hemimandíbula izquierda. Este caso es excepcional y en nuestro conocimiento el primero en la literatura mundial. Llamamos la atención sobre la dificultad diagnóstica, tanto en la entidad primaria como en la metástasis, en este último caso con diagnósticos diferenciaels de sarcomas primarios como metástasis