ABSTRACT
Objetivo: Analizar la relación entre la presencia de lesiones sincrónicas en el cáncer colo-rectal y su pronóstico. Método: Revisamos 369 cánceres colo-rectales resecados. Comparamos el porcentaje de cirugía aparentemente curativa, la progresión y recidiva tumoral, aparición posterior de cáncer extra-colónico y mortalidad entre los cánceres sincrónicos y el resto. Analizamos los cánceres con adenomas sincrónicos frente al resto de casos. Repetimos el estudio estratificando los casos según su estadio pTNM: estadios 0-I-II versus III-IV. Resultados: Registramos un 7,6% de cánceres sincrónicos y un 54,7% de adenomas sincrónicos. El seguimiento entre los grupos con y sin cáncer sincrónico fue de 70,8 ± 22,9 vs 67,2 ± 24,5 meses (p = 0,55). Los cánceres sincrónicos mostraron mayor mortalidad: 35,7% vs. 14,4%:p = 0,006; OR = 3,31 (1,33-8,13), mayor progresión tumoral: 39,3 vs.19,1%: p = 0,011; OR = 2,75 (1,14-6,56) y mayor recidiva: 10,7 vs.3,5%: p = 0,096. Al estratificar según el estadio, los pacientes con estadio 0-I-II y cáncer sincrónico mantuvieron peor pronóstico: mortalidad =27,7 vs. 8,1% p = 0,019; OR = 4,45 (1,20-15,10), progresión tumoral =27,8 vs. 8,5% p = 0,02; OR = 4,12 (1,14-14,19), cáncer extra-colónico =16,7 vs. 6,4% p = 0,095. No encontramos diferencias entre los casos con y sin adenomas sincrónicos. Conclusiones: Los cánceres sincrónicos muestran peor pronóstico tras la resección, con mayor tasa de progresión tumoral y mortalidad. Esta diferencia se centra en los casos diagnosticados en estadios 0-I-II, perdiéndose en los estadios III-IV. En nuestra serie, la presencia de adenomas sincrónicos no influye en el pronóstico
Aim: To analyze the relationship between synchronous lesions in patients with colorectal cancer and their prognostic value. Patients and methods: We have retrospectively reviewed 369 patients with resected colorectal cancer. We compared the rate of apparently curative surgery, progression and tumoral relapse, development of extracolonic cancer and mortality between patients with and without synchronous cancer. Afterwards, we analyzed the same parameters incolorectal cancer with and without synchronous adenomas. Finally, were peated the analysis after stratification of cancers in 2 groups accordingto pTNM staging: 0-I-II stage vs III-IV. Results: We found synchronous adenomas in 54.7% of our patients and synchronous cancers in 7.6%. Follow-up period of groups with and without synchronous lesions were: 70.8 ± 22.9 and 67.2 ± 24.5 months (p= 0.55) respectivelly. Synchronous cancers showed higher mortality: 35.7 vs. 14.4%: p = 0.006; OR = 3.31 (1.33-8.13), higher tumoral progression: 39.3 vs. 19.1%: p = 0.011; OR = 2.75 (1.14-6.56) and higher relapse rate: 10.7 vs. 3.5%: p = 0.096. Stratifying according to stage, patients with stage 0-I-II and synchronous cancer showed worse prognosis:mortality = 27.7 vs. 8.1%, p = 0.019; OR = 4.45 (1.2-15.1), tumoral progression = 27.8 vs. 8.5%, p = 0.02; OR = 4.12 (1.14-14.19), and extracolonic cancer = 16.7 vs. 6.4% p = 0.095. There were no statistical differences between cases with and without synchronous adenomas. Conclusions: Synchronous cancers showed worse prognosis after resection, with higher rate of tumoral progression and mortality. This difference is focused on the cases diagnosed in stage 0-I-II, not being found inIII-IV. The presence of synchronous adenomas doesnt influence prognosis
Subject(s)
Humans , Male , Female , Prognosis , Colorectal Neoplasms/complications , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Carcinoma/diagnosis , Carcinoma/epidemiology , Retrospective StudiesABSTRACT
AIM: To analyze the relationship between synchronous lesions in patients with colorectal cancer and their prognostic value. PATIENTS AND METHODS: We have retrospectively reviewed 369 patients with resected colorectal cancer. We compared the rate of apparently curative surgery, progression and tumoral relapse, development of extracolonic cancer and mortality between patients with and without synchronous cancer. Afterwards, we analyzed the same parameters in colorectal cancer with and without synchronous adenomas. Finally, we repeated the analysis after stratification of cancers in 2 groups according to pTNM staging: 0-I-II stage vs III-IV. RESULTS: We found synchronous adenomas in 54.7% of our patients and synchronous cancers in 7.6%. Follow-up period of groups with and without synchronous lesions were: 70.8 +/- 22.9 and 67.2 +/- 24.5 months (p = 0.55) respectively. Synchronous cancers showed higher mortality: 35.7 vs. 14.4%: p = 0.006; OR = 3.31 (1.33-8.13), higher tumoral progression : 39.3 vs. 19.1%: p = 0.011; OR = 2.75 (1.14-6.56) and higher relapse rate: 10.7 vs. 3.5%: p = 0.096. Stratifying according to stage, patients with stage 0-I-II and synchronous cancer showed worse prognosis: mortality = 27.7 vs. 8.1%, p = 0.019; OR = 4.45 (1.2-15.1), tumoral progression = 27.8 vs. 8.5%, p = 0.02; OR = 4.12 (1.14-14.19), and extracolonic cancer = 16.7 vs. 6.4% p = 0.095. There were no statistical differences between cases with and without synchronous adenomas. CONCLUSIONS: Synchronous cancers showed worse prognosis after resection, with higher rate of tumoral progression and mortality. This difference is focused on the cases diagnosed in stage 0-I-II, not being found in III-IV. The presence of synchronous adenomas doesn't influence prognosis.
Subject(s)
Adenoma/mortality , Adenoma/surgery , Colorectal Neoplasms/mortality , Colorectal Neoplasms/surgery , Neoplasms, Multiple Primary/mortality , Adenoma/pathology , Colorectal Neoplasms/pathology , Humans , Prognosis , Retrospective StudiesABSTRACT
We present the case of a 63-year-old woman with heterotaxy syndrome and polysplenia who presented with clinical signs and symptoms of recurrent acute pancreatitis in which the biliary origin had been seen in the most recent episode. This syndrome is rare in adult patients because it is associated with congenital heart defects. It is important to know the visceral anomalies that are common in this syndrome to avoid confusing them with pathological processes.
Subject(s)
Abnormalities, Multiple/diagnostic imaging , Spleen/abnormalities , Spleen/diagnostic imaging , Viscera/abnormalities , Viscera/diagnostic imaging , Female , Humans , Middle Aged , Syndrome , Tomography, X-Ray ComputedABSTRACT
Presentamos el caso de una mujer de 63 años de edad, con syndrome de heterotaxia con poliesplenia, que presentaba clínica de pancreatitis aguda recidivante, visualizándose en el último episodio su origen biliar.Este síndrome es raro en la edad adulta, debido a que se asocial con malformaciones cardíacas congénitas. Es importante conocer las anomalías viscerales de este síndrome, para evitar confundirlas con procesos patológicos
We present the case of a 63-year-old woman with heterotaxy syndrome and polysplenia who presented with clinical signs and symptoms of recurrent acute pancreatitis in which the biliary origin had been seen in the most recent episode. This syndrome is rare in adult patients because it is associated with congenital heart defects. It is important to know the visceral anomalies that are common in this síndrome to avoid confusing them with pathological processes
Subject(s)
Humans , Female , Abnormalities, Multiple , Viscera/abnormalities , Viscera , Spleen/abnormalities , Spleen , Tomography, X-Ray Computed , SyndromeABSTRACT
El hamartoma de glándulas de Brunner es un raro tumor duodenal localizado con mayor frecuencia a nivel de la primera porción, que si bien puede ser asintomático no es raro que produzca cuadros de hemorragia digestiva u obstrucción intestinal. Su diagnóstico se realiza por gastroscopia o estudio digestivo baritado y su tratamiento consiste en la resección endoscópica o quirúrgica, con muy buen pronóstico. Presentamos el caso de una mujer de 59 años que acude al hospital con un cuadro clínico de hemorragia digestiva alta presentando en la endoscopia realizada una úlcera sobre un pólipo en bulbo duodenal. Se realizó polipectomía correspondiendo en el estudio histológico a un hamartoma de glándulas de Brunner en cuyo interior aparecía un granuloma parasitario. La determinación de IgE para Anisakis así como los test cutáneos fueron positivos. La asociación de hamartoma de glándulas de Brunner y granuloma parasitario por Anisakis no se había descrito nunca (AU)
Brunner´s gland hamartoma is a rare duodenal tumor generally localized in the duodenal bulb. Normally assymptomatic, it might cause upper gastrointestinal bleeding or intestinal obstruction. The diagnosis is based on upper gastrointestinal endoscopic or barium examination findings, and its treatment includes surgical or endoscopic ressection, with an optimum prognosis. We present the case of a 59-year-old woman who was admitted to the hospital with an upper gastrointestinal bleeding picture. Endoscopic examination showed an ulcerated polyp in duodenal bulb which was cut with polipectomy wire. Histological slides showed a parasitic granuloma within a Brunner´s gland hamartoma. Skin prick test and specific IgE determination were positive for Anisakis. Up to our knowledge, this association has never been described before (AU)
Subject(s)
Middle Aged , Female , Humans , Brunner Glands , Anisakiasis , Duodenal Diseases , Gastrointestinal Hemorrhage , HamartomaABSTRACT
Brunner's gland hamartoma is a rare duodenal tumor generally localized in the duodenal bulb. Normally assymptomatic, it might cause upper gastrointestinal bleeding or intestinal obstruction. The diagnosis is based on upper gastrointestinal endoscopic or barium examination findings, and its treatment includes surgical or endoscopic resection, with an optimum prognosis. We present the case of a 59-year-old woman who was admitted to the hospital with an upper gastrointestinal bleeding picture. Endoscopic examination showed an ulcerated polyp in duodenal bulb which was cut with polipectomy wire. Histological slides showed a parasitic granuloma within a Brunner's gland hamartoma. Skin prick test and specific IgE determination were positive for Anisakis. Up to our knowledge, this association has never been described before.
Subject(s)
Anisakiasis/complications , Brunner Glands , Duodenal Diseases/complications , Gastrointestinal Hemorrhage/etiology , Hamartoma/complications , Female , Humans , Middle AgedABSTRACT
OBJECTIVES: to analyze retrospectively our hospital records on patients diagnosed during the period from 1983 to 1993 as having Crohn's disease or ulcerative colitis, and to estimate the incidence and epidemiological characteristics of these diseases in the Pamplona health administration area. METHODS: 246 patients were diagnosed has having inflammatory bowel disease (147 with ulcerative colitis, 97 with Crohn's disease, and 2 with indeterminate colitis. RESULTS: mean incidence was 2.47 +/- 0.96 per 100 000 inhabitants for Crohn's disease, and 3.75 +/- 1.5 per 100 000 inhabitants for ulcerative colitis (p < 0.05). There was a nonsignificant increase in incidence during the study period. Age, sex, alcohol intake, smoking habit and familial aggregation were analyzed. CONCLUSIONS: mean estimated incidence of Crohn's disease and ulcerative colitis in our setting during 1983-1993 was similar to that reported more recently for other parts of Spain. In our setting, ulcerative colitis was significantly more frequent that Crohn's disease, and familial aggregation was lower among patients who had the former disease. Crohn's disease was diagnosed at earlier ages, and cigarette smoking was more frequent among patients with this disease.
