Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 7.404
Filter
1.
Article in English | LILACS | ID: biblio-1353442

ABSTRACT

ABSTRACT: Endometrial carcinoma is a very rare cause of cutaneous metastasis.The most frequent presentations of cutaneous metastasis are fast developing nodules or tumors, which are evi-dence of widespread dissemination in such patients.We report a case of scalp metastasis from an endometrial adenocarcinoma with a fatal prognosis. (AU)


RESUMO: O carcinoma endometrial é uma causa rara de metástases cutâneas.A apresentação mais frequente de metástases cutâneas são nódulos ou tumores de rápido desenvolvimento, que evidenciam uma disseminação generalizada nesses pacientes.Relatamos um caso de metástase no couro cabeludo de um adenocarcinoma endometrial com prognóstico fatal. (AU)


Subject(s)
Humans , Aged , Prognosis , Scalp , Adenocarcinoma , Endometrial Neoplasms , Neoplasm Metastasis
2.
Biomédica (Bogotá) ; 41(3): 531-540, jul.-set. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1345401

ABSTRACT

Resumen Introducción. El cáncer de mama es la neoplasia maligna más frecuente en las mujeres de todo el mundo. Los distintos subtipos intrínsecos tienen pronósticos diferentes y su prevalencia varía significativamente según los criterios establecidos en el Consenso de Saint Gallen. Objetivo. Clasificar los subtipos luminales del carcinoma de mama en una población de pacientes venezolanas según los consensos de Saint Gallen del 2009, 2011, 2013 y 2015. Materiales y métodos. Se hizo un estudio retrospectivo en 209 pacientes con carcinoma ductal infiltrante de mama, atendidas en el Instituto de Oncología "Dr. Miguel Pérez Carreño" de Valencia, Venezuela. Resultados. La distribución de los subtipos luminal A y B cambió después de reclasificar los casos según los consensos de 2011, 2013 y 2015; el subtipo luminal B fue el más común en la serie de estudio. Conclusiones. Mediante la clasificación basada en los últimos criterios de Saint Gallen, se determinó un número mayor de tumores luminales B, lo que ayudaría a seleccionar a aquellas pacientes que no requieran la quimioterapia adyuvante y a quienes puedan beneficiarse de la terapia hormonal adyuvante en la práctica clínica.


Abstract Introduction: Breast cancer is the most frequent malignancy in women worldwide. Different intrinsic subtypes have different prognoses and their prevalence varies significantly according to the criteria established in the Saint Gallen Consensus. Objective: To classify the luminal subtypes of breast carcinoma according to Saint Gallen 2009, 2011, 2013, and 2015 consensuses in a group of Venezuelan patients. Materials and methods: We conducted a retrospective study in 209 patients with infiltrating ductal carcinoma of the breast followed up at the Institute of Oncology "Dr. Miguel Pérez Carreno" in Valencia, Venezuela. Results: The distribution of the luminal A and B subtypes changed after the reclassification of the cases according to 2011, 2013, and 2015 Saint Gallen Consensuses. The luminal B subtype was the most common in the study series. Conclusions: With the use of a classification based on the latest Saint Gallen criteria we identified more luminal B tumors. This could contribute to selecting those patients who can avoid adjuvant chemotherapy and/or benefit from the adjuvant hormonal therapy in clinical practice.


Subject(s)
Breast Neoplasms , Venezuela , Adenocarcinoma
3.
Rev. cuba. med. mil ; 50(3): e1150, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1357319

ABSTRACT

Introducción: Entre las lesiones malignas que se describen, se encuentra el cáncer de pene. Esta entidad constituye del 2 al 5 por ciento de los tumores urogenitales masculinos; la lesión metastásica es muy poco frecuente. Objetivos: Describir las características clínicas y evolución tórpida de un paciente con metástasis en el pene, de una neoplasia del colon. Caso clínico: Paciente de 54 años, antecedentes personales de salud, fumador, historia de hiperplasia prostática benigna y prostatitis crónica. Ingresa con dolor en hemiabdomen inferior y tumoración abdominal. Se diagnostica plastrón intraabdominal. Es intervenido quirúrgicamente; la biopsia de la lesión informa adenocarcinoma de colon. A los 7 días de evolución aparecen lesiones en el glande, que resultaron metástasis del adenocarcinoma de colon. Fallece por complicaciones de la enfermedad. Conclusiones: Las metástasis de las neoplasias del colon, en el pene, son infrecuentes; indican un estadio avanzado de la enfermedad, con un pronóstico desfavorable(AU)


Introduction: Among the malignant lesions described is penile cancer. This entity constitutes 2 percent to 5 percent of male urogenital tumors, and metastatic lesion is very rare. Objectives: To describe the clinical characteristics and torpid evolution of a patient with metastases in the penis from colon neoplasia. Clinical case: 54-year-old patient, personal health history. Smoker, history of benign prostatic hyperplasia and chronic prostatitis, which begins with pain in the lower abdomen and abdominal tumor, intra-abdominal plastron is diagnosed and is surgically intervened with a biopsy of the lesion that reports colon adenocarcinoma. At 7 days of evolution, lesions appeared on the glans that resulted in metastasis of colon adenocarcinoma. He dies from complications of the disease within six months. Conclusions: Colonic neoplasm metastases in the penis are infrequent, they indicate an advanced stage of the disease, with an unfavorable prognosis(AU)


Subject(s)
Humans , Middle Aged , Penile Neoplasms , Prostatic Hyperplasia , Adenocarcinoma , Neoplasm Metastasis , Prognosis
4.
Rev. colomb. cir ; 36(4): 620-625, 20210000. fig, tab
Article in Spanish | LILACS | ID: biblio-1291155

ABSTRACT

Introducción. El grado de diferenciación celular en el estudio histopatológico del adenocarcinoma gástrico está descrito como un factor pronóstico determinante en el comportamiento clínico del tumor. El adenocarcinoma gástrico indiferenciado es considerado una variante agresiva de mal pronóstico, que se correlaciona con una alta tasa de metástasis ganglionares. Métodos. Estudio prospectivo descriptivo de una serie de casos en el cual se analizan los pacientes con adenocarcinoma gástrico indiferenciado, que fueron llevados a cirugía radical con gastrectomía y linfadenectomía DII y su correlación con la presencia de metástasis ganglionares en un período de dos años. Resultados. De enero de 2018 a enero de 2020 se recolectaron en la base de datos 113 pacientes con adenocarcinoma gástrico a quienes se les practicó gastrectomía total, disección ganglionar DII y reconstrucción esofagoyeyunal termino lateral con técnica de Orr más Y de Roux. Fueron clasificados histológicamente como adenocarcinoma gástrico indiferenciado 41 pacientes (36,3 %). La edad promedio de este grupo fue de 56 años con un rango entre 28-92 años. De ellos 30 fueron hombres (73 %) y 11 mujeres (27 %). El número promedio de ganglios linfáticos analizados por espécimen fue de 24. De los 41 pacientes con adenocarcinoma gástrico indiferenciado, 35 (85 %) tuvieron metástasis ganglionares, con 382 ganglios positivos en total, con un rango entre 1-38 y un promedio de 11 ganglios linfáticos positivos por espécimen. Discusión. En esta serie el adenocarcinoma gástrico indiferenciado se presentó en el 36,3 % de los casos y se correlacionó con un 85 % de presencia de metástasis ganglionares en estadios T3-T4


Introduction. The degree of cellular differentiation in the histopathological study of gastric adenocarcinoma is described as a determining prognostic factor in the clinical behavior of the tumor. Undifferentiated gastric adenocarcinoma is considered an aggressive variant with a poor prognosis, which is correlated with a high rate of lymph node metastasis.Methods. Descriptive prospective study of a series of cases in which patients with undifferentiated gastric adenocarcinoma who underwent radical surgery with DII gastrectomy and lymphadenectomy and their correlation with the presence of lymph node metastases in a period of two years. Results. From January 2018 to January 2020, 113 patients with gastric adenocarcinoma were collected in the database who underwent total gastrectomy, DII lymph node dissection and end-to-side esophagojejunal reconstruction with the Orr plus Roux-en-Y technique. Forty-one patients (36.3%) were histologically classified as undifferentiated gastric adenocarcinoma. The average age of this group was 56 years with a range between 28-92 years. Of these, 30 were men (73%) and 11 women (27%). The mean number of lymph nodes analyzed per specimen was 24. Of the 41 patients with undifferentiated gastric adenocarcinoma, 35 (85%) had lymph node metastases, with 382 positive nodes in total, with a range between 1-38 and a mean of 11 positive lymph nodes per specimen. Discussion. In this series, undifferentiated gastric adenocarcinoma occurred in 36.3% of cases and was correlated with 85% of the presence of lymph node metastases in T3-T4


Subject(s)
Humans , Prognosis , Stomach Neoplasms , Adenocarcinoma , Cell Differentiation , Neoplasm Metastasis
5.
Medicina (B.Aires) ; 81(4): 652-655, ago. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346521

ABSTRACT

Resumen La hemofilia adquirida A es un desorden hemorrágico inusual de origen autoinmune que resulta en la formación de autoanticuerpos dirigidos contra el factor VIII de la coagulación. Estos autoanticuer pos pueden actuar neutralizando parcial o completamente la activación o función del factor, o también pueden acelerar su eliminación de la circulación. La incidencia mundial de la enfermedad es de 1.5 casos por millón de habitantes por año. En cerca del 50% de los pacientes se puede detectar una enfermedad subyacente que se presume responsable de la producción de los autoanticuerpos. Se presenta el caso de un varón con hemofilia adquirida A, en contexto de adenocarcinoma de la ampolla de Vater.


Abstract Acquired hemophilia A is an unusual bleeding disorder of autoimmune origin resulting in the formation of autoantibodies directed against coagulation factor VIII. These autoantibodies can act by partially or completely neutralizing the activation or function of the factor, or they can also accelerate its elimination from the circulation. The global incidence of the disease is 1.5 cases per million inhabitants per year. In nearly 50% of cases, an underlying disease that is presumed responsible to produce autoantibodies can be detected. We report a case with acquired hemophilia A, in a patient with Vater's ampulla adenocarcinoma.


Subject(s)
Humans , Ampulla of Vater , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Common Bile Duct Neoplasms , Hemophilia A/complications , Hemophilia A/diagnosis , Autoantibodies
7.
Electron. j. biotechnol ; 52: 76-84, July. 2021. graf, ilus
Article in English | LILACS | ID: biblio-1283597

ABSTRACT

BACKGROUND: Butyrate is a histone deacetylase inhibitor that induces apoptosis and inhibits cell proliferation of colorectal cancer cells. To improve its anticancer activity, butyrate has been evaluated mixed with drugs and different molecules. Plant antimicrobial peptides are attractive anticancer alternative molecules because they show selective cytotoxic activity against different cancer cell lines. In this work, we explore if the plant defensin c-thionin (Capsicum chinense) can improve butyrate activity on Caco-2 cell line and we also determined the mechanism of death activated. RESULTS: The combined treatment of c-thionin (3.5 mM) and butyrate (50 mM) showed higher cytotoxicity on Caco-2 cells with respect to single treatments. Also, the combined treatment reduced cell proliferation and exhibited a higher rate of apoptosis than single treatments. Combined treatment induced caspases 8 and 9 activation to an extent comparable with that of butyrate while c-thionin did not activate caspases. Additionally, reactive oxygen species generation preceded the onset of apoptosis, and superoxide anion production was higher in cells treated with the combined treatment. CONCLUSIONS: The c-thionin from Habanero chili pepper improved the butyrate cytotoxicity on Caco-2 cells. This effect occurred through apoptosis induction associated with reactive oxygen species production. Therefore, the combination of butyrate with cytotoxic antimicrobial peptides could be an attractive strategy for cancer therapy.


Subject(s)
Humans , Butyrates , Capsicum/chemistry , Adenocarcinoma , Colonic Neoplasms , Cell Cycle , Reactive Oxygen Species , Apoptosis , Caco-2 Cells , Defensins , Thionins
8.
Revagog (Impresa) ; 3(2): ´54-59, Abr-Jun. 2021. tab
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344615

ABSTRACT

Con el objetivo de realizar la caracterización epidemiológica del cáncer de mama de las pacientes que asisten a la consulta externa de ginecología oncológica en el Instituto Guatemalteco de Seguridad Social (IGSS) de enero a marzo de 2,018, se realizó un estudio descriptivo transversal en 155 pacientes que acudieron a la clínica de mama del Hospital de Gineco Obstetricia del IGSS, con una media de edad de 62 años, el adenocarcinoma ductal infiltrante es el tipo histológico más frecuente en nuestra población tanto en edad reproductiva como en menopausia. Como factor protector el 69% dio lactancia materna. La etapa clínica más comúnmente diagnosticada es IIA. El Luminal A, el más frecuentemente diagnosticado por inmunohistoquímica, seguido del Luminal B y HER2neu. Se diagnostican pacientes mayormente en etapas clínicas tempranas (I y II).


In order to carry out the epidemiological characterization of breast cancer in patients attending the outpatient gynecology oncology consultation at the Guatemalan Social Security Institute (IGSS) from January to March 2018, a descriptive cross-sectional study was carried out in 155 patients who attended the breast clinic of the IGSS Obstetrics Gynecology Hospital, with a mean age of 62 years, infiltrating ductal adenocarcinoma is the most frequent histological type in our population both in reproductive age and in menopause. As a protective factor, 69% breastfed. The most diagnosed clinical stage is IIA. Luminal A, the most frequently diagnosed by immunohistochemistry, followed by Luminal B and HER2neu. Patients are diagnosed mostly in early clinical stages (I and II).


Subject(s)
Humans , Female , Adult , Middle Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Adenocarcinoma/diagnosis , BRCA1 Protein/analysis , BRCA2 Protein/analysis , Breast Feeding , Breast Neoplasms/prevention & control , Epidemiologic Studies , Risk Factors , Postmenopause/physiology
9.
J. coloproctol. (Rio J., Impr.) ; 41(2): 176-181, June 2021. ilus
Article in English | LILACS | ID: biblio-1286986

ABSTRACT

Introduction: Ovarian metastases of gastrointestinal origin, also called Krukenberg tumors, have a guarded prognosis. Physicians need to look for alternatives in diagnosis and treatment for this clinical condition in order to improve the outcome of the patients. Objectives: To report the experience of the authors in the treatment of these patients, and to perform a review of the literature on the epidemiology, clinical presentation, diagnosis, treatment, and prognosis for ovarian metastases from colorectal cancer. Methods: We collected clinical information regarding the patients treated for ovarian metastasis from colorectal adenocarcinoma at our coloproctology service, and performed a search on the PubMed database using the terms colorectal cancer, ovarian metastasis, Krukenberg tumor and surgery. Conclusion: Large abdominal tumors are the most frequent presentation of ovarian metastasis from colorectal cancer. The diagnosis is based on a histopathological analysis, levels of carcinoembryonic antigen (CEA) and cancer antigen 125 (CA-125), and immunohistochemical studies for the cytokeratin 20 (CK20), caudal-type homeobox 2 (CDX2) and vilina markers. Citoreductive surgical procedures are the most promising approach to treatment, with the highest impact on overall survival. The prognosis is negatively influenced by the extent of the metastasis, by citoreductive surgical procedures with persistence of macro- or microscopic foci of the disease, and by low scores on the general well-being index of the patient. (AU)


Introdução: As metástases ovarianas de tumores gastrointestinais, também chamadas de tumores de Krukenberg, são neoplasias de prognóstico reservado. Exigem conhecimento de alternativas diagnósticas e terapêuticas para garantir melhora da sobrevida das pacientes. Objetivos: Relatar a experiência dos autores no tratamento dessas pacientes, e fazer uma revisão da literatura sobre a epidemiologia, apresentação clínica, diagnóstico, tratamento e prognóstico das metástases ovarianas do câncer colorretal. Métodos: Foi realizada uma coleta de informações clínicas de pacientes tratados por metástases ovarianas de adenocarcinoma colorretal em nosso serviço de coloproctologia, em conjunto com uma pesquisa na base de dados PubMed com os termos colorectal cancer, ovarian metastasis, Krukenberg tumor, e surgery. Conclusão: Volumosas massas abdominais constituem a principal apresentação clínica da doença. As alternativas diagnósticas incluem a avaliação histopatológica, a identificação dos níveis de antígeno cárcino-embriônico (ACE) e de antígeno de câncer 125 (CA-125), e exame imunoistoquímico de espécimes cirúrgicos para os marcadores citoqueratina 20 (CK20), homeobox 2 do tipo caudal (CDX2), e vilina. O tratamento citorredutor completo demonstrou o maior impacto na sobrevida dos pacientes. O prognóstico é influenciado negativamente pela extensão da doença metastática, por cirurgia citorredutiva com persistência focos microscópicos ou macroscópicos da doença, e baixo escore de índice de bem-estar geral do paciente. (AU)


Subject(s)
Humans , Female , Ovarian Neoplasms/etiology , Adenocarcinoma , Krukenberg Tumor , Neoplasm Metastasis , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/therapy , Colorectal Neoplasms/complications , Cytoreduction Surgical Procedures
10.
J. coloproctol. (Rio J., Impr.) ; 41(2): 156-162, June 2021. tab, graf
Article in English | LILACS | ID: biblio-1286983

ABSTRACT

Objective: The present study evaluated the profile of endoglin (CD105) and vascular endothelial growth factor (VEGF) based on staging and histopathological grading of colorectal cancer as well as their relationship with bevacizumab therapy. Methods: A total of 88 cases of colorectal adenocarcinoma were included in the present study. The levels of VEGF and CD105 protein were evaluated with enzymelinked immunosorbent assay (ELISA). Results: There was a significant difference in the level of CD105 (p=0.002) between metastases and non-metastases subjects, showing that CD105 was higher in metastases subjects (4.59 ng/ml). Therewas no significant difference in the level of VEGF based on the presence of metastasis (p=0.625). There was a significant difference in the levels of CD105 (p=0.038) and VEGF (p=0.010) between the subjects who received chemotherapy and those who did not. The CD105 level was higher in the subjects who received chemotherapy (4.43 ng/ml); conversely, the level of VEGF was lower in subjects who received chemotherapy (543.65 pg/ml). There was a statistically significant difference in the levels of CD105 (p=0.003) and VEGF (p=0.002) between subjects who received bevacizumab therapy and subjects who did not. The levels of CD105 were higher in subjects who received bevacizumab therapy (5.11 ng/ml); in contrast, the level of VEGF was higher in subjects who did not receive bevacizumab therapy (645.92 pg/ml). There was a significant positive correlation between CD105 and VEGF in subjects who did not receive bevacizumab (p<0.01). Conclusion: The results of this study support a hypothesis of "escape mechanism" in the failure of anti-angiogenesis therapy (anti-VEGF). (AU)


Objetivo: Este estudo avaliou o perfil da endoglina (CD105) e do fator de crescimento endotelial vascular (FCEV) com base no estadiamento e graduação histopatológica do câncer colorretal, assim como sua relação com a terapia com bevacizumabe. Métodos: No total, 88 casos de adenocarcinoma colorretal foram incluídos no presente estudo. Os níveis das proteínas FCEV e CD105 foram avaliados com ensaio imunoenzimático (ELISA, na sigla em inglês). Resultados Houve uma diferença significativa no nível de CD105 (p=0,002) entre indivíduos commetástases e semmetástases, que indicou que o nível de CD105 émais alto em indivíduos com metástases (4,59 ng/ml). Não houve diferença significativa no nível de FCEV com base na presença de metástases (p=0,625). Houve diferença significativa nos níveis de CD105 (p=0,038) e de FCEV (p=0,010) entre os indivíduos que receberam quimioterapia e os que não receberam. Encontrou-se um nível de CD105 mais alto nos indivíduos que submetidos a quimioterapia (4,43 ng/ml); Em contrapartida, encontrou-se um nível de FCEV mais baixo em indivíduos que submetidos a quimioterapia (543,65 pg/ml). Houve uma diferença estatisticamente significativa nos níveis de CD105 (p=0,003) e de FCEV (p=0,002) entre os indivíduos submetidos e não submetidos à terapia com bevacizumabe. Os níveis de CD105 foram mais elevados em indivíduos submetidos à terapia combevacizumab (5,11 ng/ml); em contraste, observou-se um nível de FCEV mais alto em indivíduos que não foram submetidos à terapia com bevacizumabe (645,92 pg/ml). Houve uma correlação positiva significativa entre CD105 e FCEV em indivíduos que não receberam bevacizumabe (p<0.01). Conclusão: Os resultados deste estudo corroboram a hipótese de "mecanismo de escape" na falha da terapia anti-angiogênica (anti-FCEV). (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Colorectal Neoplasms/drug therapy , Adenocarcinoma , Receptors, Vascular Endothelial Growth Factor , Bevacizumab/therapeutic use , Neoplasm Metastasis
11.
J. coloproctol. (Rio J., Impr.) ; 41(2): 152-155, June 2021. graf
Article in English | LILACS | ID: biblio-1286997

ABSTRACT

Abstract Tumours of the appendix are rare and tend to be diagnosed incidentally, in cases of acute appendicitis. For some authors, appendiceal neuroendocrine tumours (ANETs) are the most frequent neoplasm of the appendix, observed in 0.3% to 0.9% of cases acute appendicitis. The present is a unicentric retrospective study conducted between January 2005 and March 2017. Out of a total of 3,007 surgeries for appendiceal pathologies performed in the adult population at the hospital where the present study was conducted, there were 70 (2.33%) malignant cases, 20 (28.6%) of which were ANETs. The patients had a median age of 44 years (range: 18 to 85 years), and were predominantly women (there were 1.9 times more women than men). In 16 cases (80%), a simple appendicectomy was performed (1 patient was submitted to a right hemicolectomy later). The cases of ANETs had a good prognosis in our series: 85% of the patients are either alive today or were alive after 5 years of follow-up. Despite the fact that ANETs are described as the most frequent tumor of the appendix, this was not confirmed in our series, in which they only represented 28.6% of the cases; adenocarcinoma was the most frequent tumor (65.7%) among our sample.


Resumo Tumores do apêndice são raros, e tendem a ser diagnosticados de forma incidental, em casos de apendicite aguda. Para alguns autores, tumores neuroendócrinos do apêndice (TNEAs) são as neoplasias mais frequentes do apêndice, e são observados em 0,3 a 0,9% de todos os casos agudos de apendicite. Este é um estudo monocêntrico e retrospectivo realizado entre janeiro de 2005 e março de 2017. Entre umtotal de 3.007 cirurgias para patologias do apêndice realizadas na população adulta no hospital em que o estudo foi conduzido, houve 70 (2,33%) casos de malignidade, 20 (28,6%) dos quais eram TNEAs. Os pacientes tinham uma idade média de 44 anos (gama: 18-85 anos), e eram predominantemente mulheres (havia 1,9 vezes mais mulheres do que homens). Em 16 casos (80%), realizou-se uma simples apendicectomia (1 paciente foi submetido a uma hemicolectomia direita mais tarde). Os casos de TNEAs tiveram um bom prognóstico em nossa série: 85% dos pacientes estão vivos hoje, ou estavam após um seguimento de 5 anos. Apesar de os TNEAs serem descritos como os tumores mais frequentes do apêndice, isso não foi confirmado nesta série, na qual eles representaram apenas 28,6% dos casos; adenocarcinoma foi o tumor mais frequente (65,7%) emnossa amostra.


Subject(s)
Humans , Male , Female , Appendiceal Neoplasms , Adenocarcinoma , Neuroendocrine Tumors , Appendectomy , Appendix/surgery
12.
J. coloproctol. (Rio J., Impr.) ; 41(2): 210-214, June 2021. ilus
Article in English | LILACS | ID: biblio-1286996

ABSTRACT

Abstract Jejunal adenocarcinoma is a rare type of primary small bowelmalignancy. It is generally diagnosed at late stages and as a surgical finding, with abdominal pain or discomfort being the main associated symptom. Cases presenting with perforation are even rarer, especially without disseminated disease. The relationship between cancer and coronavirus disease 2019 (COVID-19) is still being studied, as well as the postsurgical evolution of COVID-19 patients and its possible causality of intestinal perforation. We present the case of a perforated jejunal adenocarcinoma in a COVID-19-positive patient, in whom the symptomatology secondary to the perforation led to an early diagnosis, treatment and adequate postsurgical evolution, despite the concomitant condition.


Resumo O adenocarcinoma jejunal é um tipo raro de malignidade primária do intestino delgado, o qual geralmente é diagnosticado em estágios tardios e como achado cirúrgico, sendo a dor ou o desconforto abdominal o principal sintoma associado. Casos que apresentam perfuração são ainda mais raros, principalmente sem doença disseminada. A relação entre câncer e a cornonavirus disease 2019 (covid-19) ainda está sendo estudada, assim como a evolução pós-cirúrgica de pacientes com covid-19 e sua possível causalidade de perfuração intestinal. Apresentamos o caso de um adenocarcinoma jejunal perfurado em um paciente positivo para covid-19, em que a sintomatologia secundária à perfuração levou a um diagnóstico precoce, tratamento e evolução pós-cirúrgica adequada, apesar da condição concomitante.


Subject(s)
Humans , Female , Adenocarcinoma/diagnosis , COVID-19 , Intestinal Perforation , Adenocarcinoma/surgery , Intestinal Neoplasms
13.
Medisan ; 25(2)mar.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1250348

ABSTRACT

Introducción: El cáncer gástrico ocupa el quinto lugar en incidencia de todos los tipos de neoplasias malignas y la segunda causa de muerte por cáncer en el mundo, pues la mayoría de los pacientes presentan más de 60 años de edad al ser diagnosticados. Objetivo: Caracterizar a ancianos con cáncer gástrico según variables de interés. Métodos: Se realizó un estudio observacional y descriptivo, de serie de casos, de 56 pacientes mayores de 60 años con diagnóstico endoscópico e histológico de cáncer gástrico, quienes fueron ingresados en el Hospital Provincial Clínico-Quirúrgico Docente Saturnino Lora de Santiago de Cuba, en el período 2016-2019. Resultados: En la serie predominaron los ancianos de 60-69 años de edad (46,4 %), principalmente del sexo masculino (67,8 %), y los síntomas más frecuentes fueron la epigastralgia (82,1 %) y la saciedad precoz (67,8 %). Entre las características más relevantes de las lesiones tumorales figuraron la localización antropilórica (55,3 %), la forma ulcerada en la endoscopia (51,7 %) y la variedad hística adenocarcinoma moderadamente diferenciado (43,4 %); asimismo, se determinó la existencia de Helicobacter pylori en 52,5 % de los resultados anatomopatológicos de las biopsias. Conclusiones: Resulta importante considerar la presencia de un adenocarcinoma gástrico en los pacientes mayores de 60 años que refieran síntomas digestivos, sobre todos si son hombres y padecen epigastralgia, más aún si al realizarle la esofagogastroduodenoscopia se observa una lesión ulcerada de localización antropilórica.


Introduction: Gastric cancer occupies the fifth place in incidence among all types of malignancies and is the second cause of death in the world, as most of the patients are more than 60 years when being diagnosed. Objective: To characterize aged patients according to variables of interests. Methods: An observational, descriptive and series of cases study was carried out in 56 patients older than 60 years with endoscopic and histologic diagnosis of gastric cancer, who were admitted in Saturnino Lora Teaching Provincial Clinical-Surgical Hospital, during 2016-2019. Results: Elderly in the age group 60-69 years predominated (46.4 %), mainly of the male sex (67.8 %), and the most frequent symptoms were epigastralgia (82.1 %) and the early fullness sensation (67.8 %). Among the most relevant characteristics of the tumoral lesions there were the antropiloric location (55.3 %), the ulcerated presentation in the endoscopy (51.7 %), and the histic variety mildly differentiated adenocarcinoma (43.4 %), likewise, the existence of Helicobacter pylori was confirmed in 52,5 % of the pathological biopsy results. Conclusions: It is interesting to consider the presence of a gastric adenocarcinoma in patients older than 60 years expressing gastric symptoms, mainly if they are men or suffer from epigastralgia, even more if when carrying out the esophagogastroduodenoscopy, an ulcerated lesion of antropiloric location is observed.


Subject(s)
Stomach Neoplasms/diagnosis , Stomach Neoplasms/epidemiology , Aged , Adenocarcinoma/diagnosis , Endoscopy, Digestive System , Helicobacter pylori
14.
Arq. gastroenterol ; 58(1): 93-99, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248989

ABSTRACT

ABSTRACT BACKGROUND: As age advances, a higher burden of comorbidities and less functional reserve are expected, however, the impact of aging in the surgical outcomes of gastric cancer (GC) patients is unknown. OBJECTIVE: The aim of this study is to evaluate surgical outcomes of GC patients according to their age group. METHODS: Patients submitted to gastrectomy with curative intent due to gastric adenocarcinoma were divided in quartiles. Each group had 150 patients and age limits were: ≤54.8, 54.9-63.7, 63.8-72, >72. The outcomes assessed were: postoperative complications (POC), 90-day postoperative mortality, disease-free survival (DFS) and overall survival (OS). RESULTS: Major surgical complications were 2.7% in the younger quartile vs 12% for the others (P=0.007). Major clinical complications raised according to the age quartile: 0.7% vs 4.7% vs 5.3% vs 7.3% (P<0.042). ASA score and age were independent risk factors for major POC. The 90-day mortality progressively increased according to the age quartile: 1.3% vs 6.0% vs 7.3% vs 14% (P<0.001). DFS was equivalent among quartile groups, while OS was significantly worse for those >72-year-old. D2 lymphadenectomy only improved OS in the three younger quartiles. Age >72 was an independent risk factor for worse OS (hazard ratio of 1.72). CONCLUSION: Patients <55-year-old have less surgical complications. As age progresses, clinical complications and 90-day mortality gradually rise. OS is worse for those above age 72, and D2 lymphadenectomy should be individualized after this age.


RESUMO CONTEXTO: Conforme a idade avança, se esperam mais morbidades e menor reserva funcional. Entretanto não está claro qual o impacto do envelhecimento nos resultados cirúrgicos do câncer gástrico (CaG). OBJETIVO: O intuito deste estudo é avaliar os resultados cirúrgicos de pacientes com CaG de acordo com o grupo etário. MÉTODOS: Pacientes submetidos a gastrectomia por adenocarcinoma gástrico com intuito curativo foram divididos em quartis. Cada grupo incluiu 150 indivíduos e os limites etários foram: ≤54,8; 54,9-63,7; 63,8-72; >72. Os resultados avaliados foram: complicações pós-operatórias (CPO), mortalidade em 90 dias, sobrevida livre de doença (SLD) e sobrevida global (SG). RESULTADOS: Complicações cirúrgicas maiores ocorreram em 2,7% dos pacientes no quartil mais jovem vs 12% para os demais (P=0,007). A incidência de complicações clínicas maiores aumentou conforme o quartil: 0,7% vs 4,7% vs 5,3% vs 7,3% (P<0,042). A pontuação ASA e a idade foram fatores de risco independentes para CPO maiores. A mortalidade em 90 dias aumentou progressivamente conforme o quartil etário: 1,3% vs 6,0% vs 7,3% vs 14% (P<0,001). A SLD foi equivalente entre os quartis, enquanto a SG foi significativamente pior para os >72 anos de idade. Linfadenectomia D2 aumentou a SG apenas para os 3 quartis mais jovens. Idade > 72 foi fator independente de risco para pior SG (razão de chances de 1,72) CONCLUSÃO: Pacientes < 55 anos tem menos complicações cirúrgicas. Conforme a idade avança, as complicações clínicas e a mortalidade em 90 dias aumenta gradualmente. A SG é pior se >72 anos e a indicação de linfadenectomia D2 deve ser individualizada a partir dessa idade.


Subject(s)
Humans , Aged , Stomach Neoplasms/surgery , Adenocarcinoma/surgery , Postoperative Complications , Survival Rate , Retrospective Studies , Gastrectomy/adverse effects , Lymph Node Excision , Middle Aged
15.
J. coloproctol. (Rio J., Impr.) ; 41(1): 63-69, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286971

ABSTRACT

Abstract Objective Type-I collagen (Col-I) is one of the main macromolecules of the extracellular matrix, and it is involved in the desmoplastic stromal reaction, an indicator of worse prognosis in cases of colorectal cancer (CRC). The purpose of the present study was to investigate Col-I expression in cases of CRC and adenoma and to correlate with the clinical data and the data regarding the lifestyle of the patients. Methods A retrospective study including 22 patients with adenoma and 15 with CRC treated at a coloproctology service. The clinical and lifestyle data were obtained through medical records, and Col-I expression was investigated by immunohistochemistry. Results Women represented most cases of adenoma (63.64%), whereas CRC was found mainly in men (73.33%) (p=0.0448). Immunoexpression of Col-I showed a basement membrane thickening in areas of lining of epithelium and around the glands in both lesions. The cases of CRC had a quite evident fibrosis process in the stroma. The quantitative analysis demonstrated a higher protein expression in CRCs compared to adenomas (p=0.0109), as well as in female patients (p=0.0214), patients aged ≥ 50 years (p=0.0400), and in those with a positive family history of colorectal disease (p=0.0292). These results suggested a remodeling of the microenvironment of the Worked developed at the Department of Morphology, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, ES, Brazil. Conclusion The immunohistochemical analysis encourages the performance of more comprehensive studies to ascertain if our results could be a tool for the diagnosis and monitoring of the patients.


Resumo Objetivo O colágeno tipo I (Col-I) é uma das principais macromoléculas da matriz extracelular, e está envolvido na reação desmoplástica estromal, um indicador de pior prognóstico em casos de câncer colorretal (CCR). O objetivo foi investigar a expressão do Col-I emcasos de CCR e adenoma, e correlacioná-la comdados clínicos e de estilo de vida dos pacientes. Metodologia Foi realizado umestudoretrospectivo com22pacientes comadenoma e 15 comCCR tratadosemumserviço de coloproctologia.Os dados dos pacientes foramobtidos dos prontuários médicos, e a expressão do Col-I foi investigada por imunohistoquímica. Resultados As mulheres representaram a maioria dos casos de adenomas (63,64%), enquanto o CCR (73,33%) (p=0,0448) foi mais comum entre os homens. A imunoexpressão de Col-I mostrou espessamento da membrana basal em áreas de revestimento do epitélio e em volta de glândulas em ambas as lesões. O CCR apresentou fibrose no estroma. As análises quantitativas demonstraram maior expressão proteica no CCR (p=0,0109), assim como em mulheres (p=0,0214), pacientes com idade ≥ 50 anos (p=0,0400), e em pacientes com histórico positivo de doença colorretal na família (p=0,0292). Estes resultados sugerem a remodelação do microambiente tumoral na carcinogênese do CCR. As correlações clínico-patológicas positivas mostram uma ligação plausível entre o perfil do paciente e os achados imunohistoquímcos, o que indica uma possível forma de estratificação dos pacientes. Conclusão As análises imunohistoquímicas estimulam a execução de estudos mais abrangentes para confirmar se nossos resultados poderão ser uma ferramenta para o diagnóstico e o monitoramento dos pacientes.


Subject(s)
Humans , Male , Female , Colorectal Neoplasms/metabolism , Colorectal Neoplasms/pathology , Adenocarcinoma/diagnosis , Biomarkers, Tumor/metabolism , Gene Expression Regulation, Neoplastic , Collagen Type I/genetics , Extracellular Matrix/metabolism , Tumor Microenvironment/immunology
16.
J. coloproctol. (Rio J., Impr.) ; 41(1): 1-7, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286970

ABSTRACT

Abstract Objective The present study describes the epidemiological profile of patients with colorectal cancer (CRC) from the Hospital de Clínicas de Passo Fundo, Passo Fundo, RS, Brazil, between January 1, 2007 and December 31, 2016. Method Retrospective analysis of secondary data of 1,001 patients from the Hospital Cancer Registry. Results Most subjects were Caucasianmales, with a mean age of 63.68 years old. The majority of patients had incomplete elementary education and were married. In addition, 44.5% of the patients had a family history of cancer. Most subjects with a positive past or current history of alcohol intake or smoking were male. The diagnosis was mostly based on anatomopathological findings, with a predominance of adenocarcinomas and upper rectum and distal colon localization. Most lesions were in advanced stages, and the liver was the most common site for metastasis. The predominant treatment was surgery with neoadjuvant/adjuvant therapy. After the first treatment, 49.0% of the patients reported complete remission. The survival rate was 78.8% in 10 months. Conclusion The present research analyzed the profile of CRC patients.


Resumo Objetivo Descrever o perfil de pacientes com câncer colorretal (CCR) no Hospital de Clínicas de Passo Fundo, Passo Fundo, RS, Brasil, de 01 de janeiro de 2007 a 31 de dezembro de 2016. Método Análise retrospectiva de dados secundários de 1.001 pacientes obtidos através do Registro Hospitalar de Câncer. Resultados Evidenciou-se predomínio do sexo masculino, com média de idade de 63,68 anos, majoritariamente caucasianos. O grau escolar prevalente foi fundamental incompleto e o estado civil foi casado. Um total de 44,5% dos pacientes tinha histórico familiar de neoplasia. Em relação ao consumo de álcool/cigarro, dentre os que faziam ou já fizeram uso, a maioria era homem. O diagnóstico foi majoritariamente por meio anatomopatológico, com predomínio de adenocarcinoma e localização no reto superior e no cólon distal, ocorrendo mais comumente em estágios avançados, com a metástase hepática sendo a mais presente. O tratamento predominante foi cirurgia com adjuvância/neoadjuvância. Após o primeiro tratamento, 49,0% dos pacientes apresentaram remissão completa. A sobrevida foi de 78,8% em 10 meses. Conclusão A presente pesquisa possibilitou a análise do perfil dos pacientes com CCR.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Colorectal Neoplasms/pathology , Adenocarcinoma/diagnosis , Health Profile
17.
J. coloproctol. (Rio J., Impr.) ; 41(1): 23-29, Jan.-Mar. 2021. tab
Article in English | LILACS | ID: biblio-1286969

ABSTRACT

Abstract Background Colorectal cancer (CRC) is the third most common cancer among men, and the second among women worldwide. In Brazil, the incidence andmortality of CRC continues to increase. In colonoscopies, adenoma detection rates (ADRs) higher than 25% are associated linearly with better outcomes and lower rates of interval cancer. Objective To assess the colonoscopy quality indexes. Methods This is a cross-sectional retrospective study in which anatomopathological data and data regarding the colonoscopies were collected from the patient records of Hospital Moinhos de Vento, in Southern Brazil. The exams were performed by doctors from the Colorectal Service from June to August 2015. Results A total of 430 exams were included. Most patients were women (60.9% [262]), with a mean age of 56.96 years. The cecal intubation rate was of 96.7% (416). The quality of the bowel preparation was excellent or good in 92.95% (396) of the cases. The average time of removal of the colonoscope in normal exams was of 6.15 minutes. Polyps were detected in 201 patients (46.7%), and adenomas, in 125 patients (29.1%); 12 patients (2.8%) had advanced adenomas, and 6 (2.3%) had malignant neoplasms. The proximal serrated lesion detection rate (PSLDR) was of 6.7% (29). The prevalence ratio (PR) of adenomas among men was 1.78 times greater than in women (95% confidence interval [95%CI]: 1.16-2.75). The PR of adenomas among people aged 50 years or older was 2.41 times that of those under 50 years of age (95%CI: 1.43-4.06). Conclusion The data obtained are in line with international quality criteria in colonoscopy. More studies are needed to assess the ADR in the Brazilian population.


Resumo Introdução O câncer colorretal (CCR) é o terceiro mais comum em homens e o segundo mais comum em mulheres em todo o mundo. A incidência e mortalidade do CRC continuam a aumentar no Brasil. Taxas de detecção de adenoma superiores a 25% em colonoscopias estão associadas linearmente a melhores resultados emenores taxas de câncer de intervalo. Objetivo Avaliar a qualidade das colonoscopias analisadas. Métodos Este é um estudo transversal e retrospectivo no qual dados anatomopatológicos e relacionados às colonoscopias foram coletados de registros dos pacientes do Hospital Moinhos de Vento, no Sul do Brasil. Os exames foram realizados por médicos do Serviço de Coloproctologia de junho a agosto de 2015. Resultados Foram incluídos 430 exames. A maioria dos pacientes era do sexo feminino (60,9% [262]), com idade média de 56,96 anos. A taxa de intubação cecal foi de 96,7% (416). A qualidade do preparo intestinal foi excelente ou boaem92,95% (396) dos casos.O tempomédio de retirada do colonoscópio emexames normais foi de 6,15 minutos. Pólipos foram detectados em 201 pacientes (46,7%), e adenomas, em 125 (29.1%); 12 pacientes (2,8%) tinhamadenomas avançados, e 6 (2,3%), neoplasias malignas. A taxa de detecção de lesões serrilhadas foi de 6,7% (29). A razão prevalência (RP) de adenomas emhomens foi de 1,78 vezes emrelação amulheres (intervalo de confiança de 95% [IC95%]: 1,16-2,75). A RP de adenomas entre pacientes com 50 anos ou mais foi 2,41 vezes maior do que a daqueles com mais de 50 anos (IC95%: 1,43-4,06). Conclusão Os dados obtidos estão de acordo com os critérios internacionais de qualidade em colonoscopia. Mais estudos são necessários para avaliar as taxas de detecção de adenoma na população brasileira.


Subject(s)
Humans , Male , Female , Middle Aged , Colorectal Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Colonic Polyps/diagnosis , Colonoscopy/statistics & numerical data
18.
J. coloproctol. (Rio J., Impr.) ; 41(1): 87-95, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286967

ABSTRACT

Abstract Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection. Methods A literature search was performed in the PubMed and Web of Science databases. Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3-95.7%, coefficient of variation [CV]=28.5%) and the estimated specificity was 73.6% (47.4-100.0%, CV=37.5%). For lesions up to 9mm, the sensitivity was 82.5% (62.0-99.9%, CV =25.1%) and the specificity was 79.2% (32.0-98.0%, CV=22.9%). For lesions>9mm, the sensitivity was 90.2% (64.0-100.0%, CV=7.4%) and the specificity was 94.7% (80.0-100.0%, CV=6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p=0.0958); however, the specificity was higher for lesions>9mm (p<0.0001). Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.


Resumo Objetivo Esta meta-análise teve como objetivo avaliar a sensibilidade e especificidade da colonografia por tomografia computadorizada na detecção de pólipos colorretais. Métodos Foi realizada uma pesquisa bibliográfica nas bases de dados da PubMed e da Web of Science. Resultados Um total de 1.872 pacientes, 57,2% homens e 42,8% mulheres, com idades entre 49 a 82 anos de idade (média de 59,7 ± 5,3 anos) foram incluídos nesta meta análise. A sensibilidade da colonografia por tomografia computadorizada foi estimada em 88,4% (46,3-95,7%; coeficiente de variância [CV]=28,5%) e a especificidade em 73,6% (47,4%-100,0%; CV=37,5%). Para lesões de até 9mm, a sensibilidade foi de 82,5% (62,0-99,9%; CV=25,1%) e a especificidade de 79,2% (32,0-98,0%; CV=22,9%). Para lesõesmaiores que 9mm, a sensibilidade foi de 90,2% (64,0-100,0%; CV=7,4%) e a especificidade de 94,7% (80,0-100,0%; CV=6,2%). Não houve diferença estatisticamente significante entre as sensibilidades por tamanho da lesão (p=0,0958), porém a especificidade foi maior em lesões acima de 9mm (p<0,0001). Conclusão A maioria dos estudos analisados no presente trabalho foi realizada antes de 2010, cerca de uma década depois que a colonografia por tomografia computadorizada passou a ser indicada como método de triagem pelas diretrizes europeias e americanas. Portanto, são necessários mais estudos com o objetivo de analisar a técnica apósmaiores avanços tecnológicos, o que poderia levar ao desenvolvimento de dispositivos mais modernos.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Colorectal Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Colonography, Computed Tomographic/statistics & numerical data
19.
Rev. cir. traumatol. buco-maxilo-fac ; 21(1): 36-39, jan.-mar. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1254737

ABSTRACT

The Polymorphous Low Grade Adenocarcinoma (PLGA) is a common minor salivary gland carcinoma. It mostly affects the buccal mucosa and retromolar region, but the palate is an unusual site. As the carcinoma is low grade the recurrence is also uncommon. Our patient had a PLGA initially in the palate which was treated initially through surgical management but had a recurrence after four years. Hence we planned a partial maxillectomy along with level I nodes. Post-operatively follow-up is successful till date. So the management of a recurrent PLGA through careful surgery and post-operative follow ­up with prosthetic rehabilitation is discussed in this article... (AU)


Subject(s)
Humans , Female , Aged , Salivary Glands, Minor , Mouth Neoplasms , Adenocarcinoma , Mouth Mucosa , Palate , Recurrence
20.
Rev. colomb. gastroenterol ; 36(1): 87-92, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1251526

ABSTRACT

Resumen A través del presente reporte se describe un caso de gastritis enfisematosa, una rara condición clínica consistente en la invasión de la pared gástrica por microorganismos productores de gas. Puede resultar en una situación fatal debido a lo inespecífico de su clínica y a lo tórpido de su evolución. En este caso se describe a un paciente anciano de 77 años, con alta fragilidad, quien cursaba con un cuadro de gastritis enfisematosa que no respondió a manejo médico y requirió gastrectomía de urgencia. Adicionalmente, cursaba con un adenocarcinoma gástrico ulcerado infiltrante, que previamente no había sido diagnosticado, como probable factor condicionante y desencadenante.


Abstract This report describes a case of emphysematous gastritis, a rare clinical condition consisting of invasion of the gastric wall caused by gas-producing bacteria. It can lead to fatal outcomes due to the unspecific nature of the symptoms and its torpid course. The following is the case of a highly fragile 77-year-old male patient, who presented with symptoms of emphysematous gastritis that did not respond to medical treatment and required emergency gastrectomy. In addition, the patient had an infiltrating ulcerated gastric adenocarcinoma, which had not previously been diagnosed and was a probable conditioning and triggering factor.


Subject(s)
Humans , Male , Aged , Adenocarcinoma , Gastritis , Emergencies
SELECTION OF CITATIONS
SEARCH DETAIL