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RESUMEN Fundamento: los sarcomas de partes blandas son tumoraciones agresivas que pueden provocar la muerte de los pacientes, existen muchos tipos histológicos y se pueden localizar en cualquier parte del cuerpo humano. Objetivo: conocer un paciente con sarcoma pleomórfico indiferenciado en la región del muslo derecho. Presentación del caso: paciente de 52 años de edad, de raza blanca, masculino, sin antecedentes mórbidos de salud, acude a la consulta externa de Ortopedia y Traumatología por referir tener una bolita en el muslo derecho que en el último mes ha crecido y se acompaña de ligero dolor en la zona. Mediante la exploración física se observó aumento de volumen a nivel del muslo derecho en la cara posterolateral. A la palpación se comprobó la tumoración de bordes irregulares, mal definidos, móvil de localización por debajo de la fascia y consistencia dura. Al tener en cuenta todos los elementos anteriores, se decidió llevar el paciente al quirófano, para tratamiento de tipo quirúrgico, donde se realizó exéresis de la tumoración descrita con anterioridad, la que fue enviada al Departamento de Anatomía Patológica para estudio histológico que reveló sarcoma pleomórfico indiferenciado con células gigantes. Conclusiones: el sarcoma pleomórfico indiferenciado es una tumoración maligna infrecuente de partes blandas con un pronóstico reservado. Los síntomas y signos son más evidentes en el periodo de crecimiento rápido. Los exámenes imagenológicos como el ultrasonido de alta definición y la imagen de resonancia magnética son los más importantes. El tratamiento de elección primario es el quirúrgico, seguido de la radio y quimioterapia.
ABSTRACT Background: soft tissue sarcomas are aggressive tumors that can cause the death of patients, there are many histological types and can be located anywhere in the human body. Objective: to report a patient with undifferentiated pleomorphic sarcoma in the right thigh region. Case report: a 52-year-old white male patient with no morbid health history, who goes to the external Orthopedics and Traumatology clinic referring to have a little ball in the right thigh that has grown in the last month and it is accompanied by slight pain in the area. On physical examination, an increase in volume was observed at the level of the right thigh in the posterolateral area. On palpation, the tumor of irregular, bad-defined edges, mobile location below the fascia and hard consistency was checked. Taking into account all the previous elements, it is decided to take the patient to the operating room, for surgical treatment, where the tumor described above was extracted, it was sent to the Pathology department for histological study that revealed undifferentiated pleomorphic sarcoma with giant cells. Conclusions: undifferentiated pleomorphic sarcoma is an uncommon soft tissue tumor with a poor prognosis. Symptoms and signs are more evident in the period of rapid growth. Imaging tests such as high definition ultrasound and magnetic resonance imaging are the very importants. The primary treatment of choice is surgery, followed by radio and chemotherapy.
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RESUMEN Fundamento: los sarcomas de partes blandas son lesiones frecuentes en la actualidad y pueden afectar a un gran número de pacientes a cualquier edad, sus tipos histológicos son muy variados de allí el comportamiento clínico de estas enfermedades. Objetivo: conocer una paciente con mixofibrosarcoma en la región anterior de la rodilla derecha. Presentación del caso: paciente de 56 años de edad, femenina de raza blanca con antecedentes de hipertensión arterial esencial, acude a la consulta externa de Ortopedia y Traumatología por referir tener una tumoración en la parte anterior de la rodilla derecha que se acompaña de ligero dolor e incapacidad funcional. Esta apareció hace dos años, pero ha incrementado su tamaño de forma rápida en los últimos tres meses. Al tener en cuenta todos los elementos anteriores, se decidió llevar a la paciente al quirófano, para tratamiento de tipo quirúrgico, donde se realizó exéresis de la tumoración descrita con anterioridad a través del tejido sano circundante con margen de seguridad. La pieza fue enviada al departamento de anatomía patológica para estudio histológico, que luego informó tumoración de tipo mixofibrosarcoma. Conclusiones: el mixofibrosarcoma es una lesión maligna que se localiza en la extremidad inferior, de crecimiento lento con ausencia o poco dolor, los medios imagenológicos aportan información muy importante para su diagnóstico, en específico el ultrasonido de alta resolución y la imagen de resonancia magnética. El tratamiento quirúrgico oportuno mediante la resección amplia mejora el pronóstico.
ABSTRACT Background: soft tissue sarcomas are frequent lesions today and can affect a large number of patients at any age, their histological types are very varied hence the clinical behavior of these entities. Objective: to present a patient with myxofibrosarcoma in the anterior region of the right knee. Case report: 56-year-old white woman with a history of essential arterial hypertension, who goes to the outpatient department of Orthopedics and Traumatology for referring to having a tumor in the anterior part of the right knee that is accompanied by slight pain and functional disability. It appeared two years ago, but it has increased its size rapidly in the last three months. Taking into account all the previous elements, it was decided to take the patient to the operating room, for surgical treatment, where the tumor described above was removed surgically through the surrounding healthy tissue with safety margin, the piece was sent to the department of pathological anatomy for histological study, which later reported a tumor of myxofibrosarcoma type. Conclusions: myxofibrosarcoma is a malignant lesion that is located in the lower limb, of slow growth with absence of little pain, the imaging means provide very important information for its diagnosis, specifically high resolution ultrasound and magnetic resonance imaging. Timely surgical treatment through extensive resection improves the prognosis.
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Abstract Primary Ewing sarcoma in the spine is very rare, and the treatment for it is multidisciplinary. There is no consensus regarding the optimal method of local control; however, en bloc resection is associated with an improvement in survival rates. The authors report a case of a 5-year-old girl who initially presented low back pain, and was diagnosed with Ewing sarcoma after being submitted to imaging studies by radiography, magnetic resonance and bone biopsy. A spondylectomy was performed in accordance with the Euro Ewing protocol. At the three-year follow-up, the patient had no restrictions regarding her daily activities, and there has been no evidence of recurrence to date.
Resumo O sarcoma de Ewing da coluna vertebral é raro, e seu tratamento é multidisciplinar. Não há consenso sobre o método ideal de controle local do tumor; no entanto, a ressecção em bloco com margens negativas está associada a uma melhora da sobrevida. Os autores relatam um caso de uma paciente de 5 anos do sexo feminino que inicialmente se apresentou com dor lombar, tendo sido diagnosticada com sarcoma de Ewing de acordo com o estudo imagiológico por radiografia, ressonância magnética e biópsia óssea. A paciente foi submetida a vertebrectomia após quimioterapia, de acordo com o protocolo Euro Ewing. Aos três anos de seguimento, não apresentou restrições nas atividades da vida diária, e, até o momento, não houve evidência de recidiva.
Asunto(s)
Humanos , Femenino , Preescolar , Sarcoma de Ewing/cirugía , Neoplasias de la Columna Vertebral , Biopsia , Espectroscopía de Resonancia Magnética , Osteosarcoma/cirugía , Dolor de la Región Lumbar , Vértebras Lumbares , NeoplasiasRESUMEN
Abstract Case report of a pediatric patient with a diagnosis of bony histiocytic sarcoma of the scapula, submitted to oncologic resection (Tikhoff-Linberg type II surgery), who returned to previous activities and was disease-free after 24 months of follow-up.
Resumo Relato de caso de paciente pediátrico com diagnóstico de sarcoma histiocítico ósseo em escápula, submetido à ressecção oncológica (cirurgia de Tikhoff-Linberg tipo II), com retorno às atividades prévias e livre de doença após 24 meses de seguimento.
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Humanos , Masculino , Adolescente , Sarcoma Histiocítico/cirugía , Sarcoma Histiocítico/patología , Sarcoma Histiocítico/diagnóstico por imagenRESUMEN
Myxoid liposarcoma is the major subtype of liposarcoma and commonly presents in the extremities, particularly in the thigh. We introduce an unusual case of a myxoid liposarcoma presenting as a large perineal swelling occupying the para-rectal and para-anal spaces in a 49-yearold male patient. The diagnosis, management, and prognosis of myxoid liposarcoma are discussed. A literature review is performed for myxoid liposarcoma.