Traumatismos de la mama / Breast trauma

Se presentaron 45 casos de traumatismos de mama, observados en la práctica hospitalaria y privada, clasificados de la siguiente manera: 1) Contusiones y heridas leves y moderadas: 11 casos; 2) Contusiones y heridas graves 24 casos y 3) Cuerpos extraños 10 casos. Las contusiones y heridas graves estuvieron integradas, a vez, por: a) contusiones graves (7 casos); b) heridas contusas graves (2 casos); c) heridas punzantes y/o cortantes (8 casos) y d) heridas por arma de fuego (7 casos). Se destaca la posibilidad de que, en heridas penetrantes, la lesión mamaria sea la puerta de entrada al tórax. En este caso las características del compromiso intratorácico marcarán la táctica terapéutica. La lesión mamaria en sí se tratará médicamente o con sutura, según las características y profundidad, tratando de prevenir la complicación infecciosa. Los cuerpos extraños metálicos son raros y se preconiza su extracción. De los no metálicos, los más importantes y frecuentes son los implantes de material protésico con fines estéticos, que producen una situación traumática cuando no son tolerados (por material inadecuado, mala técnica o rotura de prótesis). En estos casos deben extraerse. Se originan a veces, secundariamente, colagenopatías autoinmunes que no curan con la extracción del cuerpo extraño

Tumor phyllodes / Pyllodes tumor

The phylloid tumor (cystosarcoma phyllodes; cellular intracanalicular fibroadenoma, etc.) is a rare condition of the female breast. Recent medical papers assume that 700 cases have been published world wide. We believe this cipher low. We have seen 47 cases (8 of then are very recent, so we use 39 for statistical purposes). It represents, in our series, 0.29% of all breast conditions; 0.27% of the benign ones; and 1.35% in relation to cancer. It is a mostly benign fibroepitelial tumor that, in certain circumstances becomes malignant (qo.25% of sarcomatous transformation in our series). It is most frequent (52%) in the fifth decade of life. also it is found in young women, but very seldon after 60. Microscopical findings are: 1§) "invaginating distortion" of lobular elements (acini and ductules) induced by stromal compression; 2§) stromal hypercellularity; 3§) stromal cells frequently with variable degree of atypia (not always indicative of malignancy); 4§) lobular epithelial hyperplasia (inconstant). Its size, when not surgically treated early, can reach to hugemagnitude (we have one "gigantic" of 40 cm diameter and 7K of weight). Clinically shows a lobulated aspect, and alternancy of hard (fibrous), and rather soft (mucinous, or encephaloid) zones. In big tumors, compression can ulcerate skin (10.25%). Cut surface shows clefts (leaflike aspect: phylloid); haemorragic zones; and cavities full of old blood, or encephaloid substance. Auxiliary diagnostic means are useful. Mammography shows lobulated contour and non homogeneous density. Paradoxically - for a condition mostly benignant teletermography shows a "hot" image.. Criteria of malignancy are: Histologic criteria, unfaithful, histological alarming images, not always are followed by a malignant evolution. Evolutive course: simple local recurrence (18% of our series) does not imply malignancy, unless when it shows sarcomatous transformation (10.25%). Methastases are clear indicative of malignancy...