ABSTRACT
El síndrome de SAPHO fue propuesto a finales de los años 80 para agrupar diversas manifestaciones osteoarticulares con hallazgos radiológicos propios como la hiperostosis de la pared anterior del tórax. La prevalencia, la causa y la patogénesis de la enfermedad son desconocidas. El diagnóstico se realiza tanto por la clínica como por la imagen específica gammagráfica de «asta de toro» en la articulación esternoclavicular. Se presenta el caso de una mujer de 64 años diagnosticada de carcinoma ductal infiltrante de mama derecha pT1N0Mx. En el estudio de extensión de la enfermedad se evidenció imagen gammagráfica de lesión blástica, difusa, en manubrio esternal, sospechosa de enfermedad de Paget o lesión metastásica. Se completó el estudio con TC torácica en la que se evidenció esclerosis del manubrio esternal, sugerente de metástasis. Por el resultado de los estudios se pensó en el síndrome de SAPHO como opción diagnóstica más probable. El bajo estadio tumoral de la paciente hizo pensar en posibles alternativas diagnósticas. Conocer esta entidad clínica puede evitar errores a la hora de clasificar en estadios tumorales más avanzados a un sujeto y, por tanto, evitar tratamientos quimioterápicos y radioterápico más agresivos (AU)
SAPHO syndrome was proposed in the late 80s in order to group different osteoarticular manifestations with specific radiological findings such as the hyperostosis of the front part of the chest wall. Prevalence, etiology and pathogenesis of the disease are unknown, while diagnosis is made both clinically and by the specific gammagraphic image of «bull horn» in the sternoclavicular joint. The following case of a 64-year-old woman diagnosed with infiltrating ductal carcinoma of the right breast pT1N0Mx is reported. When studying the extent of the disease, a gammagraphic image of diffuse blast injury in the sterna manubrium was evidenced, which allowed the suspicion of Paget's disease or metastatic injury. Study was completed with a chest CT in which manubrium sclerosis was evidenced, suggesting metástasis. Res ults of the studies pointed out SAPHO syndrome as the most likely diagnostic option. The low tumor stage of the patient prompted the idea of possible alternative diagnoses. A deeper knowledge of this clinical condition may be crucial to avoid mistakes when classifying a subject in more advanced tumor stages, and consequently, to prevent the use of more aggressive chemotherapy and radiotherapy treatment (AU)
Subject(s)
Humans , Female , Middle Aged , Acquired Hyperostosis Syndrome/complications , Acquired Hyperostosis Syndrome/radiotherapy , Acquired Hyperostosis Syndrome , Diagnosis, Differential , Neoplasm Metastasis/radiotherapy , Neoplasm Metastasis , Acquired Hyperostosis Syndrome/pathology , Breast Neoplasms/complications , Breast Neoplasms/pathology , Breast Neoplasms/radiotherapy , Tomography, Emission-Computed/methodsABSTRACT
SAPHO syndrome was proposed in the late 80s in order to group different osteoarticular manifestations with specific radiological findings such as the hyperostosis of the front part of the chest wall. Prevalence, etiology and pathogenesis of the disease are unknown, while diagnosis is made both clinically and by the specific gammagraphic image of «bull horn¼ in the sternoclavicular joint. The following case of a 64-year-old woman diagnosed with infiltrating ductal carcinoma of the right breast pT1N0Mx is reported. When studying the extent of the disease, a gammagraphic image of diffuse blast injury in the sterna manubrium was evidenced, which allowed the suspicion of Paget's disease or metastatic injury. Study was completed with a chest CT in which manubrium sclerosis was evidenced, suggesting metástasis. Res ults of the studies pointed out SAPHO syndrome as the most likely diagnostic option. The low tumor stage of the patient prompted the idea of possible alternative diagnoses. A deeper knowledge of this clinical condition may be crucial to avoid mistakes when classifying a subject in more advanced tumor stages, and consequently, to prevent the use of more aggressive chemotherapy and radiotherapy treatments.
Subject(s)
Acquired Hyperostosis Syndrome/diagnosis , Bone Neoplasms/secondary , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/secondary , Sternum , Bone Neoplasms/diagnosis , Carcinoma, Ductal, Breast/diagnosis , Diagnosis, Differential , Female , Humans , Middle AgedABSTRACT
Heterotopic ossification or ectopic bone formation represents a widely known complication after surgery involving joint spaces. Posttraumatic heterotopic ossification can be found at any site. The most common postsurgical site is the hip following total hip arthroplasty. This review explores the treatment options to prevent ectopic bone formation after major surgery of hip, especially, the role of radiotherapy.
Subject(s)
Ossification, Heterotopic/prevention & control , Ossification, Heterotopic/radiotherapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , HumansABSTRACT
La gestión clínica es, sin duda, el instrumento innovador con más fuerza de los que se hayan podido manejar para la transformación de los sistemas sanitarios. La importancia de la información en la atención sanitaria radica en que se trata de un entorno cambiante, donde la innovación es continua, contecnologías y tareas cada vez más complejas. Por eso el sistema de información y recogida de datos es un Servicio de una gran importancia. A partir de la descripción del proceso radioterápico contemplado en el Real Decreto, 1566/1998 de 17 de julio, desarrollamos en colaboración con la Unidad de Informática Médica una aplicación informática (PONTO) para su utilización en la Gestión Clínica del Servicio de Oncología Radioterápica del Hospital Universitari Sant Joan
No disponible
Subject(s)
Humans , Oncology Service, Hospital/organization & administration , Hospital Information Systems/organization & administration , Health Services Administration/trendsABSTRACT
PURPOSE: In this study we evaluated the acute toxicity of the combined treatment with chemoradiotherapy, according to the scheme of McDonald et al, in patients diagnosed with gastric cancer, after radical curative surgery. METHODS: From July 2001 to December 2005, a total of 24 patients, with diagnosis of adenocarcinoma of the stomach or adenocarcinoma of the gastroesophageal junction, who were operated with total or subtotal gastrectomy with free resection margins, were treated at our service with a combined scheme of adjuvant chemoradiotherapy. RESULTS: Grade 3 toxicity or higher appeared in three patients (12%) and grade 2 in five of the twenty-four patients (21%). Two patients (8%) needed to suspend treatment before the scheduled end date of treatment due to acute toxicity. No acute toxicity of cardiological, hepatic or renal nature was registered, and the most frequent toxicity was the gastrointestinal toxicity (detected in the 79% of the patients). CONCLUSIONS: Combined treatment with chemoradiotherapy, according to the scheme of Macdonald, in diagnosed patients with gastric cancer, after radical curative surgery is a well tolerated treatment, with a low degree of acute toxicity, thus the treatment compliance is not difficult.
Subject(s)
Adenocarcinoma/therapy , Stomach Neoplasms/therapy , Adult , Aged , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Dose Fractionation, Radiation , Female , Gastrectomy , Humans , Lymph Node Excision , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Antineoplastic Protocols , Combined Modality Therapy/adverse effects , Stomach Neoplasms/therapy , Postoperative Complications , Adenocarcinoma/drug therapyABSTRACT
Hypoxia and/or anaemia have an adverse prognostic impact in locally-advanced cancers of uterine cervix. Moreover, these parameters are independent of other well-known prognostic factors. However, the mechanisms by which treatment efficacy and survival are compromised by anaemia are not fully understood. Although it is clear that erythropoietin can reduce the need for transfusions for cancer patients with anaemia, there is no proof that the use of erythropoietin is in any way superior to transfusions with respect to the impact on clinical outcome, especially for patients receiving radiation therapy. Whether haemoglobin levels at the start of therapy, during therapy, or at the end of therapy are of prognostic value for better disease-free and overall survival, are matters for further studies as is the question of the best option for increasing the level of the patient's haemoglobin.
Subject(s)
Anemia/etiology , Hypoxia/etiology , Uterine Neoplasms/complications , Anemia/drug therapy , Erythropoietin/therapeutic use , Female , HumansABSTRACT
Hypoxia and/or anaemia have an adverse prognostic impact in locally-advanced cancers of uterine cervix. Moreover, these parameters are independent of other well-known prognostic factors. However, the mechanisms by which treatment efficacy and survival are compromised by anaemia are not fully understood. Although it is clear that erythropoietin can reduce the need for transfusions for cancer patients with anaemia, there is no proof that the use of erythropoietin is in any way superior to transfusions with respect to the impact on clinical outcome, especially for patients receiving radiation therapy. Whether haemoglobin levels at the start of therapy, during therapy, or at the end of therapy are of prognostic value for better disease-free and overall survival, are matters for further studies as is the question of the best option for increasing the level of the patient's haemoglobin
La hipoxia y/o la anemia son factores pronósticos en los tumores localmente avanzados de cérvix. Además, estos parámetros son independientes de otros factores pronósticos conocidos. Sin embargo, los mecanismos por los cuales la eficacia del tratamiento y la supervivencia se ven afectados por la existencia de anemia no están del todo claros. Aunque parece evidente que la eritropoyetina puede reducir la necesidad de realizar transfusiones en las pacientes anémicas con cáncer, no hay pruebas concluyentes que su uso sea superior a las transfusiones, con respecto a los resultados del tratamiento con radiaciones ionizantes. Si los niveles de hemoglobina al principio, durante o al final de la radioterapia son factores pronóstico para la supervivencia libre de enfermedad o la supervivencia global, así como cuál es la mejor opción terapéutica para mejorar los niveles de hemoglobina, está todavía por determinar
