Atypical presentation of fibroepithelial polyp: a report of two cases / Apresentação atípica de pólipo fibroepitelial: um relato de dois casos

ABSTRACT Fibroepithelial polyps are benign non-epithelial tumors arising from mesodermal tissue and are commonly found on the skin. They can develop on the eyelid and surrounding area and rarely appear at other sites. While most cutaneous cases are diagnosed incidentally, the lesions may be symptomatic based on their location. The etiology of fibroepithelial polyps is not fully understood but may involve trauma, chronic irritation, allergic factors, and developmental or congenital causes. Although fibroepithelial polyps are benign lesions, they can be malignant in extremely rare cases. Herein we discuss 2 cases of fibroepithelial polyp with an atypical presentation and their treatment.

RESUMO Pólipos fibroepiteliais são tumores benignos não-epiteliais que surgem do tecido mesodérmico e são comumente encontrados na pele. Eles podem se desenvolver na pálpebra e na área adjacente, e raramente aparecem em outros locais. Embora a maioria dos casos cutâneos seja diagnosticada incidentalmente, as lesões podem ser sintomáticas com base em sua localização. A etiologia dos pólipos fibroepiteliais não é completamente compreendida, mas pode envolver trauma, irritação crônica, fatores alérgicos e causas de desenvolvimento ou congênitas. Apesar dos pólipos fibroepiteliais serem lesões benignas, podem ser malignos em casos extremamente raros. Aqui discutimos 2 casos de pólipo fibroepitelial com uma apresentação atípica e seu tratamento.

Vocal Fold Polyps: Literature Review

Abstract Introduction Vocal fold polyps are one of themost frequent benign laryngeal lesions, impacting the quality of life of those affected by them, primarily the vocal production. Despite being a well-established therapy in conjunction with surgery, speech therapy alone may also be effective in treating these lesions. As such, otolaryngologists and speech therapists need updated bibliographic knowledge on the issue. Objective To describe the literature findings on vocal fold polyps that discuss prevalence, etiology, histology, physiopathology, vocal characteristics or treatment. Data Synthesis The present study is a review article based on a bibliographic search using platforms, databases and search engines, with no restrictions on means of publication, methodological quality or language. All the articles on vocal fold polyps pertaining to the object of study published in the past 15 years were included. Among the characteristics investigated, the most discussed were prevalence of men, smoking as an etiological cofactor, the possibility of histological differentiation from vocal nodules, the relationship with cover minor structural alterations, and the indication and effectiveness of different treatment options. Conclusion Despite the discrepancies found in the present literature review on vocal fold polyps, there has been a notable scientific progress in the otolaryngologic techniques and in the effectiveness of speech therapy as initial treatment, with direct and indirect techniques, corroborating the need for scientific investigation of the issue.

Preoperative care of Polypoid exposed mucosal template in bladder exstrophy: the role of high-barrier plastic wraps in reducing inflammation and polyp size

ABSTRACT Objective To assess the role of high-barrier plastic wrap in reducing the number and size of polyps, as well as decreasing the inflammation and allergic reactions in exstro- phy cases, and to compare the results with the application of low-barrier wrap. Materials and Methods Eight patients with bladder exstrophy-epispadias complex (BEEC) that had used a low density polyethylene (LDPE) wrap for coverage of the exposed polypoid bladder in preoperative care management were referred. The main complaint of their parents was increase in size and number of polyps. After a period of 2 months using the same wrap and observing the increasing pattern in size of polyps, these patients were recommended to use a high-barrier wrap which is made of polyvinylidene chloride (PVdC), until closure. Patients were monitored for the number and size of polyps before and after the change of barriers. The incidence of para-exstrophy skin infection/inflammation and skin allergy were assessed. Biopsies were taken from the polyps to identify histopathological characteristics of the exposed polyps. Results The high barrier wrap was applied for a mean ± SD duration of 12±2.1 months. Polyps' size and number decreased after 12 months. No allergic reaction was detected in patients after the usage of PVdC; three patients suffered from low-grade skin allergy when LDPE was applied. Also, pre-malignant changes were observed in none of the patients in histopathological examination after the application of PVdC. Conclusion Polyps' size and number and skin allergy may significantly decrease with the use of a high-barrier wrap. Certain PVdC wraps with more integrity and less evaporative permeability may be more "exstrophy-friendly".

Pólipos endometriales: Actualización en diagnóstico y tratamiento / Endometrial polyps: update on diagnosis and treatment

ANTECEDENTES: Los pólipos endometriales son protrusiones nodulares benignas de la superficie endometrial con características clínico-patológicas propias y de origen desconocido. Su prevalencia es alta, especialmente en pacientes con sangrado uterino anormal, se asocia a infertilidad y a cáncer de endometrio, lo que se traduce en que se trata de una patología muy importante en el quehacer ginecológico habitual. OBJETIVOS: Revisar la patogenia, actualizar y evaluar los métodos diagnósticos, y definir las mejores opciones terapéuticas de esta frecuente patología. MÉTODO: Revisión sistemática de la literatura publicada en el tema, mediante búsqueda en base de datos Pub Med. RESULTADOS: La patogenia es aun desconocida, es una patología muy heterogénea y no hay causa única, se han reportado varios hallazgos relacionados con alteraciones genéticas. La ultrasonografía de alta definición, la hidrosonografia y la histeroscopia son el estándar actual en el diagnóstico. Las opciones terapéuticas se extienden desde la observación y seguimiento con imágenes, hasta la histerectomía con biopsia contemporánea, siendo la histeroscopia quirúrgica el método más costo efectivo. CONCLUSIÓN: La patogenia de los pólipos endometriales se encuentra actualmente en revisión, no hay ninguna teoría que explique la génesis de todos los pólipos. La ultrasonografía con contraste y la histeroscopia constituyen el estándar en el diagnóstico. En el tratamiento, la indicación es la cirugía histeroscopica y en especial la resección electroquirúrgica, que permite una extracción completa del pólipo bajo visión directa, con enfoque diagnóstico y terapéutico, con riesgos bajos y recurrencia mínima.

BACKGROUND: Endometrial polyps are benign nodular protrusions of the endometrial surface with clinical and pathological features of unknown origin. Its prevalence is high, especially in patients with abnormal uterine bleeding, it is associated with infertility and endometrial cancer, what constitutes a common and important disease. AIMS: To review the pathogenesis, to update and evaluate diagnostic methods, and to define the best treatment options for this common condition. METHODS: A systematic review of the published literature on the subject by searching PubMed database. RESULTS: The pathogenesis is still unknown, it is a very heterogeneous disease and there is no single cause, there have been several findings related to genetic alterations. High definition ultrasonography, the hidrosonography and hysteroscopy are the current standard in diagnosis. Therapeutic options range from observation and follow up with images to the hysterectomy using contemporary biopsy, surgical hysteroscopy being the most cost effective method. CONCLUSION: The pathogenesis of endometrial polyps are currently under review, there is no theory to explain the genesis of all polyps. Contrast ultrasonography and hysteroscopy are standard in the diagnosis. In the treatment, the indication is histeroscopy surgery and especially electrosurgical resection, which allows complete removal of polyps, diagnostic and therapeutic approach, with low risk and low recurrence.

Sistematización en el proceso de evaluación y terapia del pólipo de cuerda vocal: encuesta a médicos otorrinolaringólogos chilenos / Assessment and therapy process systematization of vocal fold polyps: a survey to Chilean otorhynolaryngologists

Esta investigación tiene por propósito describir las indicaciones terapéuticas, prescritas por médicos otorrinolaringólogos a pacientes diagnosticados con pólipo cordal. Se describen las etapas de evaluación, reposo vocal e indicaciones terapéuticas. El estudio intenta develar la presencia de una sistematización en el proceso anterior. Dicha información es recabada a partir de una encuesta vía mail aplicada a 29 médicos pertenecientes a la Sociedad Chilena de Otorrinolaringología (N=205). Los datos obtenidos permiten concluir que no existe un estándar en las indicaciones que se preguntan en la encuesta. Sin embargo, el total de médicos consultados manifiesta que sería útil la elaboración de protocolos para la evaluación y tratamiento de los pacientes con alteración vocal.

This research is aimed at describing the therapeutic indications, prescribed by otorhynolaryngologists polyp patients diagnosed with tailpiece, including assessment, voice rest and therapeutic indications. The study attempts to reveal the presence of systematization in the previous process. This information is collected from a survey via e-mail applied to 29 physicians belonging to the Chilean Society of Otolaryngology (n =205). The data obtained indicate that there is no standard in the information asked for in the survey. However, the total number of doctors surveyed stated that the development of protocols for assessment and treatment of patients with vocal alteration would be useful.

Manejo de pólipos gástricos / Management of gastric polyps

Most of gastric polyps are benign and do not need specific treatment. However, some types have significant malignant potential that can lead to gastric cancer if they are not managed appropriately. The malignant potential depends on the histological type of the polyp, therefore it is important to sample and make biopsies.

La mayoría de los pólipos gástricos son benignos y no requieren tratamiento específico; no obstante, algunos de ellos pueden malignizarse. Si estos pólipos no son tratados pueden ser causa de cáncer gástrico. El potencial maligno depende del tipo histológico del pólipo, por lo que estas lesiones debieran ser siempre biopsiadas.

Vocal cord polyps, gross features, pathology and management prospective study

This is a study of [84] cases of laryngeal [vocal cord] polyp presented with change of voice. The clinical, endoscopic and pathological features of the causative lesion were studied. It is found that adults are more affected than other age groups without significant sex differences. The anterior part of the vocal cord is the most common site for attachment of the polyp. The relation of voice abuse with the development of this lesion is not clear. Histopathology reports concentrates on identifying the material as laryngeal biopsy and exclusion of malignancy

Pólipos endometriais: diagnóstico e tratamento / Endometrial polyps: diagnosis and treatment

Com o avanço dos métodos de imagem e o maior acesso ao exame histeroscópico, o diagnóstico do pólipo endometrial passou a fazer parte do dia-a-dia do ginecologista. Após a confirmação diagnóstica vem a pergunta (principalmente nas pacientes assintomáticas): todo pólipo endometrial deve ser retirado? A taxa de malignização do pólipo endometrial está em torno de 0,5 porcento. Esta taxa justifica, por si só, a retirada rotineira dos pólipos endometriais? Esta taxa de malignização é semelhante à do mioma uterino e nem por isso as pacientes assintomáticas com miomas pequenos são operadas pelo risco de transformação maligna do mioma. Seguindo o mesmo raciocínio, pólipos endometriais pequenos (em pacientes assintomáticas) também poderiam ser apenas acompanhados. Porém, o pólipo endometrial apresenta suas particularidades. O acompanhamento dos miomas já é feito há muito tempo, trazendo certo grau de confiança ao clínico. A identificação e o conseqüente acompanhamento do pólipo endometrial não é tarefa fácil para a ultra-sonografia. A histeroscopia diagnóstica nem sempre consegue diferenciar o pólipo endometrial benigno do maligno, sendo necessária sua exérese completa. Além disso, a polipectomia histeroscópica é considerada de baixa complexidade e com morbidade mínima. Todas essas características apontam para a retirada rotineira dos pólipos endometriais

Polipo fibroepitelial del ureter: aporte de un nuevo caso: Revisión de la literatura / Fibroepithelial polyp of the ureter: case report: Review of the literature

Los pólipos fibroepiteliales son tumores benignos que se pueden manifestar a lo largo de todo el tracto urinario. Se presenta un caso de pólipo fibroepitelial en uréter. Revisamos la literatura y discutimos las características clínicas, diagnósticas y terapéuticas de esta rara entidad

Pólipo maligno colorectal: resultados del tratamiento y del seguimiento a largo plazo / Colorectal malignant polyp: results of treatment and follow-up

Presentamos los resultados del tratamiento y del seguimiento a 5 años o más, de 26 pacientes que tuvieron pólipo maligno colorectal que fueron extirpados por polipectomia colonoscópica. 17 pacientes fueron de sexo masculino y 9 de sexo femenino, cuyas edades fluctuaron entre 25 a 85 años, con un promedio de 60.4 años. El grado histológico fue del tipo bien diferenciado y moderado bien diferenciado. En 10 pacientes hubo 36 lesiones sincrónicas, de las cuales 77 por ciento fueron adenomas. 22 pacientes fueron tratados sólo con polipectomia y 4 tuvieron polipectomia y resección de colón complementaria; en los operados, no se encontró cáncer residual en el sitio de la polipectomia, ni tuvieron metástasis ganglionar. Durante el seguimiento después de 5 años o más, 2 pacientes fallecieron por causas diferentes a la lesión; 1 paciente se perdió y 23 permanecen libres de tumor. La polipectomía colonoscópica puede ser un excelente método de tratamiento del pólipo maligno colorectal si se aplica en forma estricta los criterios endoscópicos y anátomo patológicos del carcinoma invasivo, así como la edad y la condición clínica de los pacientes.

Pólipos de colon y recto: diagnóstico y tratamiento. Experiencia multicéntrica con un electrobisturí de radiofrecuencia / Colon and rectal polyps: diagnosis and treatment. With a radiofrecquency electrocautery

Se analiza una experiencia multicéntrica de resecciones de colonoscópicas de pólipos colo-rectales con un electrobisturí de radiofrecuencia. Fueron testeados 1016 pacientes con 1720 pólipos. Hubieron 63.87 por ciento pacientes masculinos y la edad promedio fue de 58.4 años. El 17,02 por ciento tenía lesiones múltiples y el 60,8 por ciento eran pólipos sésiles. La localización más frecuente fue en el sigmoides (50,9 por ciento) y luego el recto (27,09 por ciento). El exámen histológico mostró un 89,19 por ciento de adenomas y con una malignización del 8,64 por ciento. Las complicaciones fueron: hemorragia en 21 (1,3 por ciento) enfermos y perforación en 2 (uno de ellos fue operado). No hubo mortalidad.

A importancia da colonoscopia na deteccao precoce do cancer colo-retal / Importance of colonoscopy in the early detection of colorectal cancer

Os indices de sobrevida para os doentes portadores de cancer colo-retal submetidos nas ultimas tres decadas, tem-se mantidos estaveis. Foram abordados aspectos referentes a importancia do diagnostico precoce do cancer colo-retal e a grande diferenca obtida em relacao a sobrevida dos doentes quando da realizacao do diagnostico precoce. Ressaltou-se a importancia do emprego da colonoscopia como metodo diagnostico e terapeutico, com seus beneficios, e principalmente para uma mudanca efetiva de casos de sobrevida dos doentes portadores de cancer colo-retal. Ficou demonstrada a maior exatidao no diagnostico do polipo do intestino grosso e na realizacao de polipectomia transcolonoscopica que contribuiu para quebrar o ciclo descrito por Morson: a evolucao do polipo adenomatoso para cancer.

Pólipos vesiculares: segundo taller de consenso de la Asociación Chilena de Hepatología / Gallbladder polyps: second consensus workshop of the chilean hepatology association

During workshop, hepatologists analyzed and gave recomendations about gallbladder polyps. They arrived to the following agreements: gallbladder polyps of less than 10 mm should be followed with ultrasonography at 3, 6 and 12 months if there is no enlargement. If there is enlargement, a cholecystectomy should be performed. Polyps larger than 10 mm should be subjected to cholecystectomy

Cáncer temprano rectocolónico: seguimiento luego de la terapéutica endoscópica / Early colorectal cancer: follow-up after endoscopic therapy

Aproximadamente el 90% de las polipectomías endoscópicas, correctamente indicadas, para los cánceres correctales tempranos, ya sean "invasivas" o no, son "curativas", siempre que se adopte un criterio estricto en el estudio patológico de la muestra resecada. La vigilancia por tiempo ilimitado de los pacientes es obligatoria, dado que tumores benignos (más frecuentemente) o recurrencias malignas aparecen en un 30-40%