Adjuvant hormonal therapy in perimenopausal patients.

This section considers the treatment options for perimenopausal women with breast cancer. The perimenopause period begins in the so-called stage 2 of menopausal transition (early menopausal transition, where the length of the cycles changes by 7 days or more) and ends after 12 months of amenorrhea. It is characterized by an early increase in follicle-stimulating hormone and is associated with the presence of anovulatory cycles, irregular periods, and loss of menstrual cycles. The recommended treatment is tamoxifen (TAM) with or without ovarian ablation for 2 or 3 years followed by a re-evaluation. TAM should be maintained if the patient is premenopausal and aromatase inhibitors (AI) are recommended once the menopausal status is confirmed. Ovarian suppression is an acceptable adjuvant therapy in those patients with hormone-sensitive tumors. AI should only be used in postmenopausal women or in combination with chemical castration in premenopausal women. This supplement paper includes the key points of roundtable presentations and discussions of hormonal therapy in breast cancer.

[Pharyngeal branchial cyst: description of one clinical case]. / Quiste branquial faríngeo: descripción de un caso clínico.

Brachial cysts are abnormalities in the development of the branchial apparatus, being the more common ones those of the second arch. Cysts localized in the pharyngeal wall (Bailey's type IV) are extremely rare; therefore its differential diagnosis should include all benign and malignant lesions that can be found in the pharyngeal wall. Treatment is the total excision of the cyst through per oral or external cervical approach in order to avoid recurrences.

[Prognostic factors in pediatric myringoplasty. A review of 90 cases]. / Factores pronósticos en las miringoplastias infantiles. Revisión de 90 casos.

Although tympanic membrane perforations continue to be a significant source of otologic morbidity in the pediatric population, myringoplasty in children still elicits debate. The records of 76 patients under 18 who underwent 90 myringoplasties at the 12 de Octubre University Hospital (Madrid, Spain) over a recent 8-year period were reviewed. The overall short-term surgical success rate was 64.8%. The overall success rate evaluated at least one year after surgery was 58%. The audiological threshold improved in 68% per cent of successful cases. Surprisingly, females had lower graft take rates than males. The outcome of surgery was unrelated to age at operation, duration, mechanism, size, and location of the perforation, or condition of the opposite ear.

[Lingual abscess with atypical clinical presentation]. / Absceso lingual con presentación clínica atípica.

Lingual abscesses have become extremely rare since the discovery of antibiotics, with only about 200 cases reported in the last 160 years. Diagnosis on the basis of clinical symptoms alone is quite difficult. Imaging studies are essential for the diagnosis of lingual abscesses and for their differentiation from related pathologies with similar clinical symptoms. We report a case of lingual abscess with otherwise unremarkable clinical findings that was diagnosed by CT scan. The etiology, pathophysiology, bacteriology, diagnosis, and treatment of these uncommon infections is discussed.

[Primary nasal sinus malignant melanomas]. / Melanomas malignos primarios nasosinusales.

Primary malignant melanoma of the mucosa of the nasal and paranasal sinuses is rare, difficult to treat, and usually has a poor prognosis. Seven cases, six women and one man (mean age 76.5 years), were treated at the Hospital 12 de Octubre (Madrid, Spain) during the period 1982-1994. The presenting symptoms, diagnostic evaluation, morphology, therapeutic modalities, histological evaluation, and clinical course were reviewed. Three patients were treated surgically and three received palliative irradiation. All had local recurrence or distant metasfases within 15 months after concluding treatment. The seventh patient refused treatment.