Atypical double colorectal metastasis: spleen and uterus.

Oligometastatic disease is a relatively new concept that refers to an intermediate stage between disseminated and localized cancer. Most frequent locations for colorectal metastasis are lung and liver. We present an a typical case of an 85-year-old woman who was diagnosed with a low-grade adenocarcinoma in left colon; she underwent a left laparoscopic hemicolectomy which resulted in a stage IIIb. After 24 months of follow-up, an increase of carcinoembryonic antigen (CEA) leads to the diagnosis of two metastatic lesions in two uncommon locations: spleen and myometrium. Stepwise surgical resection of both lesions was performed without complications. Spleen and uterus are organs that are rarely affected in colorectal cancer, the affection of both organs being even more infrequent. Despite the atypicality, surgical treatment is a valid strategy in this case of oligometastatic disease, which enables the disease-free survival of the patients.

Obstetric Outcomes of SARS-CoV-2 Infection in Asymptomatic Pregnant Women.

Around two percent of asymptomatic women in labor test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Spain. Families and care providers face childbirth with uncertainty. We determined if SARS-CoV-2 infection at delivery among asymptomatic mothers had different obstetric outcomes compared to negative patients. This was a multicenter prospective study based on universal antenatal screening for SARS-CoV-2 infection. A total of 42 hospitals tested women admitted for delivery using polymerase chain reaction, from March to May 2020. We included positive mothers and a sample of negative mothers asymptomatic throughout the antenatal period, with 6-week postpartum follow-up. Association between SARS-CoV-2 and obstetric outcomes was evaluated by multivariate logistic regression analyses. In total, 174 asymptomatic SARS-CoV-2 positive pregnancies were compared with 430 asymptomatic negative pregnancies. No differences were observed between both groups in key maternal and neonatal outcomes at delivery and follow-up, with the exception of prelabor rupture of membranes at term (adjusted odds ratio 1.88, 95% confidence interval 1.13-3.11; p = 0.015). Asymptomatic SARS-CoV-2 positive mothers have higher odds of prelabor rupture of membranes at term, without an increase in perinatal complications, compared to negative mothers. Pregnant women testing positive for SARS-CoV-2 at admission for delivery should be reassured by their healthcare workers in the absence of symptoms.

Abordaje multidisciplinar de un tumor phyllodes maligno de mama en una mujer de 16 años / Multidisciplinary approach to a malignant phyllodes tumour of the breast in a 16-year-old woman

INTRODUCCIÓN: El tumor phyllodes (TP) es una tumoración fibroepitelial que representa el 0,3-0,9% del total de tumores de mama. Si bien puede aparecer a cualquier edad, acostumbra a presentarse en mujeres jóvenes (edad media 40-45 años) como una masa palpable no dolorosa, de rápido crecimiento y de gran tamaño. Los TP presentan una elevada tasa de recurrencia local y raramente metastatizan. CASO CLÍNICO: Se presenta el caso de una paciente de 16 años, con antecedente de exéresis de un fibroadenoma de 70mm. A los 15 meses presentó reaparición de una masa ipsilateral filiada como TP maligno de mama. Fue sometida a tumorectomía amplia, pero dada la afectación de varios márgenes de resección finalmente se realizó mastectomía con reconstrucción inmediata. RESULTADOS: Los TP suponen un reto en cuanto al diagnóstico, a veces complejo, tanto mediante pruebas de imagen como histológico. El tratamiento principal es quirúrgico mediante resección amplia (cirugía conservadora o mastectomía) de la lesión sin abordaje axilar. La recurrencia local se asocia mayoritariamente a afectación de márgenes de resección. Con frecuencia es necesario recurrir a técnicas de oncoplastia dado el elevado volumen de mama afectado. CONCLUSIONES: El manejo de este tipo de tumores requiere un abordaje completo y multidisciplinar

INTRODUCTION: Phyllodes tumour of the breast (PT) is a fibroepithelial mass representing 0.3-0.9% of all breast tumours. Although it can appear at any age, it usually develops in young women (mean age 40-45 years) as a painless, palpable, large, rapidly-growing mass. These tumours have a high local recurrence rate and rarely metastasize. CASE REPORT: We present the case of a 16-year-old female patient who had undergone extirpation of a 70mm fibroadenoma. Fifteen months later, an ipsilateral mass developed, which was diagnosed as a malignant PT of the breast. She underwent wide local excision, but given the involvement of various resection margins, mastectomy with immediate reconstruction was performed. RESULTS: PT are a diagnostic, and sometimes complex, challenge both through imaging and histological tests. The main treatment is surgical, through wide (breast-conserving surgery or mastectomy) resection of the lesion without axillary clearance. Local recurrence is mainly associated with involvement of the resection margins. It is often necessary to resort to oncoplastic techniques due to the volume of affected breast tissue. CONCLUSIONS: Management of this type of tumour requires a comprehensive and multidisciplinary approach