ABSTRACT
Thyroid cancer is the malignant tumor that is increasing most rapidly in the world, mainly at the expense of sporadic papillary thyroid carcinoma. The somatic alterations involved in the pathogenesis of sporadic follicular cell derived tumors are well recognized, while the predisposing alterations implicated in hereditary follicular tumors are less well known. Since the genetic background of syndromic familial non-medullary carcinoma has been well established, here we review the pathogenesis of non-syndromic familial non-medullary carcinoma emphasizing those aspects that may be useful in clinical and pathological diagnosis. Non-syndromic familial non-medullary carcinoma has a complex and heterogeneous genetic basis involving several genes and loci with a monogenic or polygenic inheritance model. Most cases are papillary thyroid carcinoma (classic and follicular variant), usually accompanied by benign thyroid nodules (follicular thyroid adenoma and/or multinodular goiter). The possible diagnostic and prognostic usefulness of the changes in the expression and/or translocation of various proteins secondary to several mutations reported in this setting requires further confirmation. Given that non-syndromic familial non-medullary carcinoma and sporadic non-medullary thyroid carcinoma share the same morphology and somatic mutations, the same targeted therapies could be used at present, if necessary, until more specific targeted treatments become available.
Subject(s)
Multiple Endocrine Neoplasia Type 2a , Neoplastic Syndromes, Hereditary , Thyroid Neoplasms , Carcinoma, Medullary/congenital , Carcinoma, Neuroendocrine , Humans , Neoplastic Syndromes, Hereditary/diagnosis , Neoplastic Syndromes, Hereditary/genetics , Neoplastic Syndromes, Hereditary/pathology , Thyroid Cancer, Papillary/diagnosis , Thyroid Cancer, Papillary/genetics , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/genetics , Thyroid Neoplasms/pathologySubject(s)
Chordoma/diagnosis , Coccyx/pathology , Neuroimaging , Sacrum/pathology , Spinal Neoplasms/diagnosis , Tomography, X-Ray Computed , Chordoma/complications , Chordoma/pathology , Chordoma/surgery , Coccyx/surgery , Female , Humans , Low Back Pain/etiology , Magnetic Resonance Imaging , Middle Aged , Rectum , Remission Induction , Sacrococcygeal Region , Sacrum/surgery , Spinal Neoplasms/complications , Spinal Neoplasms/pathology , Spinal Neoplasms/surgeryABSTRACT
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Subject(s)
Humans , Female , Middle Aged , Chordoma/pathology , Peripheral Nervous System Neoplasms/pathology , Sacrococcygeal Region/pathology , Low Back Pain/etiologyABSTRACT
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. The presence of malignant lesions arising in the diverticulum is very rare, the most common malignant lesion being sarcoma, followed by carcinoid tumors, and less frequently by adenocarcinomas. We present the case of an 86-year-old man who developed acute abdomen. Surgery revealed a perforated Meckel's diverticulum. Histology identified a poorly-differentiated adenocarcinoma arising in Meckel's diverticulum. We provide a review of the literature.
Subject(s)
Adenocarcinoma/complications , Ileal Neoplasms/complications , Meckel Diverticulum/complications , Abdomen, Acute/etiology , Adenocarcinoma/diagnosis , Adenocarcinoma/epidemiology , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged, 80 and over , Diverticulitis/complications , Diverticulitis/diagnosis , Diverticulitis/surgery , Humans , Ileal Neoplasms/diagnosis , Ileal Neoplasms/epidemiology , Ileal Neoplasms/pathology , Ileal Neoplasms/surgery , Incidental Findings , Intestinal Perforation/etiology , Laparoscopy , Laparotomy , Male , Meckel Diverticulum/epidemiology , Meckel Diverticulum/surgery , Multicenter Studies as Topic , Surgical Wound Dehiscence/surgeryABSTRACT
Resumen El divertículo de Meckel es la anomalía congénita más común del tracto gastrointestinal. La presencia de lesiones malignas sobre el divertículo es muy infrecuente, la más común corresponde a los sarcomas, seguidas del tumor carcinoide y, por último, de los adenocarcinomas. Presentamos el caso de un paciente de 86 años intervenido por un cuadro de abdomen agudo; en la cirugía se identificó un divertículo de Meckel perforado, la histología demostró un adenocarcinoma pobremente diferenciado. Finalmente se ha realizado una revisión de la literatura médica relacionada (AU)
Abstract Meckels diverticulum is the most common congenital anomaly of the gastrointestinaltract. The presence of malignant lesions arising in the diverticulum is very rare, themost common malignant lesion being sarcoma, followed by carcinoid tumors, and less frequentlyby adenocarcinomas. We present the case of an 86-year-old man who developed acuteabdomen. Surgery revealed a perforated Meckels diverticulum. Histology identified a poorly differentiated adenocarcinoma arising in Meckels diverticulum. We provide a review of theliterature
Subject(s)
Humans , Male , Aged, 80 and over , Adenocarcinoma/surgery , Ileal Neoplasms/surgery , Meckel Diverticulum/pathology , LaparotomyABSTRACT
Introducción El propósito del estudio es exponer y analizar nuestra experiencia en adrenalectomía laparoscópica (AL).Material y métodos Estudio descriptivo y retrospectivo sobre AL realizada en nuestro centro desde enero de 2000 hasta diciembre de 2008.ResultadosSe realizaron un total de 43 AL a 41 pacientes mediante abordaje transperitoneal lateral. La mediana de edad de los pacientes intervenidos se situó en 53 años. La principal indicación en frecuencia de nuestra serie fue el hiperaldosteronismo (19), seguido de incidentalomas (8), feocromocitomas (6), síndrome de Cushing (6), lesiones metastásicas (3) y carcinoma suprarrenal primario (1). La media de estancia hospitalaria poscirugía fue de 3 días y la media del tamaño de las masas fue de 30mm (rango: 4155mm). No hubo mortalidad en nuestra serie. La necesidad de conversión se redujo a un caso; en ningún caso fue necesario reintervenir a un paciente. ConclusionesLa AL es una técnica segura y eficaz en el tratamiento de tumores suprarrenales que puede realizarse con riesgo y morbilidad mínima (AU)
Introduction The aim of the study was to present and analyse our experience in laparoscopic adrenalectomy (LA).Materials and methods Descriptive and retrospective study including LA performed over 8 years, between 2000 and 2008 in our hospital. Results A total of 43 LA were performed to 41 patients using a transperitoneal lateral approach. Indications for adrenalectomy included hyperaldosteronism (19), non-functioning adenoma (8), phaeochromocytoma (6), Cushing's syndrome (6), metastasis (3) and adrenal primary tumour (1). Median postoperative hospital stay was 3 days and the median size of the masses was 30mm (range: 4155mm) Complications occurred in 3 patients (2 respiratory infections, and 1 intraoperative bleeding). There was no mortality. Only one case needed conversion to open adrenalectomy; no patients required reintervention. Conclusion Laparoscopic adrenalectomy is a safe and effective method in the treatment of adrenal masses and it can be performed with minimal risk and morbidity (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Adrenal Gland Diseases/surgery , Adrenalectomy/methods , Retrospective StudiesABSTRACT
INTRODUCTION: The aim of the study was to present and analyse our experience in laparoscopic adrenalectomy (LA). MATERIALS AND METHODS: Descriptive and retrospective study including LA performed over 8 years, between 2000 and 2008 in our hospital. RESULTS: A total of 43 LA were performed to 41 patients using a transperitoneal lateral approach. Indications for adrenalectomy included hyperaldosteronism (19), non-functioning adenoma (8), phaeochromocytoma (6), Cushing's syndrome (6), metastasis (3) and adrenal primary tumour (1). Median postoperative hospital stay was 3 days and the median size of the masses was 30mm (range: 4-155mm) Complications occurred in 3 patients (2 respiratory infections, and 1 intraoperative bleeding). There was no mortality. Only one case needed conversion to open adrenalectomy; no patients required reintervention. CONCLUSION: Laparoscopic adrenalectomy is a safe and effective method in the treatment of adrenal masses and it can be performed with minimal risk and morbidity.
