Epidemiología y características anatomoclínicas del melanoma maligno en un instituto oncológico / Epidemiology and clinical features of malignant melanoma. Analysis of 274 cases

BACKGROUND: Malignant melanoma (MM) is the most fatal cutaneous neoplasm. Its incidence is increasing progressively, which cannot be explained only by early diagnosis. Chilean population, due to the geography of the country, has a very varied solar exposure. AIM: To know the incidence of MM in a Chilean population, according to the level of sun exposure and to describe its clinical and histopathological characteristics. MATERIAL AND METHODS: Two hundred seventy-four surgeries for malignant melanoma with histological confirmation, carried out between 2016 and 2018 in an oncological institute were included. RESULTS: The annualized incidence of MM was 13.83 cases per 100,000 people over 15 years of age in the 2016-2018 period. The geographical distribution of the incidence did not have a clear relationship with sun exposure. The most frequent locations of the primary lesions were trunk, head/neck and lower limb. Sixty-one per cent of cases were invasive MM; lesion thickness and presence of ulceration were associated with a higher risk of sentinel node involvement. CONCLUSIONS: No association between the level of sun exposure and the incidence of MM was observed in this study.

Cirugía radioguiada en hiperparatiroidismo primario: caso clínico / Radioguided surgery in the treatment of primary hiperparathyroidism: report of 1 case

Primary hyperparathyroidism is the main cause of hypercalcemia in ambulatory patients. Classic surgical resolution of this disease includes bilateral cervical exploration with exhibition of the four parathyroid glands and evaluation of the suspicious gland with a rapid biopsy. We report a 79 years old female with a primary hyperparathyroidism in whom the adenoma causing the disease was located with the help of an intraoperatory gamma-probe that detected the zone of higher radiation counting of Tc99m Sestamibi, that was injected preoperatively. The patient was discharged with normal serum calcium and phosphate levels

Colgajo libre antebraquial: utilización en cirugía oncológica de cabeza y cuello / Ante-brachial free flap: usefulnes in oncological surgery of head and cervix

El colgajo antebraquial, también conocido como colgajo chino, fue descrito en 1978 por Yang Gufan. Es un congajo versátil de gran utilidad, una de sus principales características es su pedículo largo, mayor a 20 cm. si se necesita, además, es fácilmente moldeable al lugar del defecto. Nosotros lo hemos utilizado para reparar defectos luego de una resección oncológica con márgenes negativos. En el primer caso un carcinoma de maxilar en el que por el compromiso del piso de órbita, se buscó la mejor solución. En el segundo caso resultó ideal en un carcinoma de la mucosa de la mejilla izquierda, su largo pedículo permitió una anastomosis a los vasos cervicales in dificultad, y su espesor no abultó la pared de la cavidad oral, ni produjo defectos cosméticos externos. En el carcinoma de labio, permitió reparar en un solo tiempo el defecto de la resección amplia que incluía parte del cuerpo de la mandibula, con buenos resultados funcionales y estéticos. Concluimos este trabajo mencionando que el colgajo libre de antebrazo, utilizado adecuadamente, representa una alternativa útil en la reconstrucción de la cirugía oncológica de cabeza y cuello