ABSTRACT
OBJECTIVE: Report of one case of desmoid tumor in a patient who had been treated of a testicular seminoma 26 months before, with excision of a retroperitoneal mass and chemotherapy. On followup he presented with a mesenteric abdominal mass which was clinically labeleled as a recurrence of the seminoma. RESULTS: Histologically it was reported as a mesenteric desmoid tumor. Differential diagnosis with gastrointestinal stromal tumor was performed with immunohistochemical studies. CONCLUSIONS: Desmoid tumor is rare. There are few cases reported in patients with history of previous testicular tumor. It should be included in the differential diagnosis of testicular tumor recurrences.
Subject(s)
Fibromatosis, Aggressive/diagnosis , Mesentery , Peritoneal Neoplasms/diagnosis , Seminoma/diagnosis , Testicular Neoplasms/diagnosis , Adult , Diagnosis, Differential , Humans , Male , Neoplasm Recurrence, Local/diagnosisABSTRACT
Objetivo: Presentar un caso de un tumor desmoide en un paciente tratado de un seminoma testicular que simulaba una recidiva del tumor testicular. Método: Presentamos el caso de un paciente de 41 años, tratado de un seminoma testicular 26 meses antes, mediante extirpación de una masa testicular retroperitoneal y quimioterapia, que presenta en el seguimiento, una masa abdominal mesentérica que se etiquetó clínicamente de recidiva de seminoma. Resultado: Histológicamente se informa de tumor desmoide mesentérico. Se hace diagnóstico diferencial con un tumor de estroma gastrointestinal mediante el estudio inmunohistoquímico. Conclusiones: El tumor desmoide es un tumor raro. Se han descrito pocos casos en pacientes afectos previamente de tumor testicular. Debe incluirse en el diagnóstico diferencial de las recidivas por tumor testicular (AU)
Objective: Report of one case of desmoid tumor in a patient who had been treated of a testicular seminoma 26 months before, with excision of a retroperitoneal mass and chemotherapy. On follow-up he presented with a mesenteric abdominal mass which was clinically labeleled as a recurrence of the seminoma. Results: Histologically it was reported as a mesenteric desmoid tumor. Differential diagnosis with gastrointestinal stromal tumor was performed with immunohistochemical studies. Conclusions: Desmoid tumor is rare. There are few cases reported in patients with history of previous testicular tumor. It should be included in the differential diagnosis of testicular tumor recurrences (AU)
Subject(s)
Male , Adult , Humans , Fibromatosis, Aggressive/etiology , Seminoma/complications , Testicular Neoplasms/complications , Neoplasm Metastasis/diagnosis , Fibromatosis, Aggressive/diagnosis , Fibromatosis, Aggressive/pathology , Seminoma/drug therapy , Seminoma/surgery , Diagnosis, Differential , Mesentery/pathology , Testicular Neoplasms/drug therapy , Testicular Neoplasms/surgery , Neoplasm Metastasis/pathologyABSTRACT
Objetivo. Estudiar la presentación y la evolución clínica de pacientes adultos con hernias externas incarceradas y tratar de identificar los factores que podrían tener algún efecto en su curso evolutivo. Pacientes y método. Se ha revisado retrospectivamente a 230 pacientes adultos intervenidos de urgencia por una hernia externa incarcerada durante el período 1992-2001. Se estudiaron las características de la presentación clínica, el tipo de anestesia, los métodos quirúrgicos, las complicaciones y la mortalidad. También se realizó un análisis univariable para determinar los factores con posible influencia en la evolución clínica. Resultados. Hubo 77 hernias crurales, 70 inguinales, 43 umbilicales y 40 eventraciones. Un total de 74 enfermos (32,2%) acudió con más de 48 h de evolución. En 135 pacientes (58,7%) había enfermedades asociadas significativas. En 140 pacientes (60,9%) se usó anestesia general, en 86 raquianestesia y en 4 anestesia local. Los métodos quirúrgicos más utilizados fueron la reparación anatómica y la hernioplastia sin tensión. En 31 casos (13,5%) fue necesaria una resección intestinal. Las tasas de morbilidad global y mayor y de mortalidad fueron del 37,8, el 10 y el 3,9%, respectivamente. Los factores asociados de manera significativa con una evolución desfavorable fueron una sintomatología prolongada, la hospitalización tardía, la presencia de enfermedades asociadas y un grado ASA alto. Conclusiones. El tratamiento urgente de las hernias externas conlleva una elevada morbimortalidad, por lo que un diagnóstico precoz y la reparación electiva de las hernias no complicadas deberían ser la estrategia terapéutica adecuada en los pacientes adultos (AU)
Objective. The aim of this study was to determine the clinical presentation and outcome of incarcerated external hernias in adults, as well as to identify the factors that might have some influence on outcome. Patients and method. A retrospective study of 230 adult patients who underwent emergency surgical repair of incarcerated external hernias from 1992 to 2001 was performed. The characteristics of clinical presentation, type of anesthesia, surgical procedures, complications and mortality were studied. To determine clinical factors that might have some influence on outcome, an univariate analysis was also performed. Results. There were 77 femoral hernias, 70 inguinal, 43 umbilical and 40 incisional hernias. Seventy-four patients (32.2%) presented after 48 h of symptom onset. Significant associated diseases were found in 135 patients (58.7%). General anesthesia was used in 140 patients (60.9%), spinal anesthesia in 86 patients and local anesthesia in four patients. The most commonly used procedures were anatomic repair and tension-free hernioplasty. Bowel resection was required in 31 patients (13.5%). Overall and major morbidity and mortality were 37.8%, 10% and 3.9%, respectively. Factors that were significantly associated with unfavorable outcome were longer duration of symptoms, late hospitalization, concomitant diseases, and a high ASA class. Conclusions. External hernias produce elevated morbidity and mortality if treatment is undertaken as an emergency. Thus, early diagnosis and elective repair of uncomplicated hernias should be performed in adults (AU)
Subject(s)
Male , Female , Adult , Humans , Hernia/diagnosis , Hernia/surgery , Hernia/mortality , Indicators of Morbidity and Mortality , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Retrospective Studies , Hernia/classification , Hernia/epidemiology , Hernia/pathologyABSTRACT
OBJECTIVE: The aim of this study was to determine the clinical presentation and outcome of incarcerated external hernias in adults, as well as to identify the factors that might have some influence on outcome. PATIENTS AND METHOD: A retrospective study of 230 adult patients who underwent emergency surgical repair of incarcerated external hernias from 1992 to 2001 was performed. The characteristics of clinical presentation, type of anesthesia, surgical procedures, complications and mortality were studied. To determine clinical factors that might have some influence on outcome, an univariate analysis was also performed. RESULTS: There were 77 femoral hernias, 70 inguinal, 43 umbilical and 40 incisional hernias. Seventy-four patients (32.2%) presented after 48 h of symptom onset. Significant associated diseases were found in 135 patients (58.7%). General anesthesia was used in 140 patients (60.9%), spinal anesthesia in 86 patients and local anesthesia in four patients. The most commonly used procedures were anatomic repair and tension-free hernioplasty. Bowel resection was required in 31 patients (13.5%). Overall and major morbidity and mortality were 37.8%, 10% and 3.9%, respectively. Factors that were significantly associated with unfavorable outcome were longer duration of symptoms, late hospitalization, concomitant diseases, and a high ASA class. CONCLUSIONS: External hernias produce elevated morbidity and mortality if treatment is undertaken as an emergency. Thus, early diagnosis and elective repair of uncomplicated hernias should be performed in adults.
Subject(s)
Hernia, Abdominal/diagnosis , Adult , Aged , Aged, 80 and over , Female , Hernia, Abdominal/complications , Hernia, Abdominal/surgery , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
Introducción. El objetivo del trabajo es analizar, mediante la comparación de distintas variables, el comportamiento del adenocarcinoma gástrico en pacientes de 80 años o más respecto a los de menor edad. Métodos. Estudio retrospectivo sobre 212 pacientes con adenocarcinoma gástrico entre enero de 1988 y diciembre de 1998, de los que 27 tenían 80 años o más (grupo A) y 185 menos de 80 (grupo B). Se compararon el sexo, la edad, las enfermedades asociadas, el tiempo de evolución, las manifestaciones clínicas, la localización, el aspecto macroscópico, la intervención, el estadio TNM, la morbimortalidad postoperatoria, la reintervención, la estancia y la supervivencia. Resultados. El porcentaje de complicaciones en el grupo A y B fue del 65 y el 45 por ciento, respectivamente. La mortalidad hospitalaria global fue de 15 pacientes y la postoperatoria de nueve. Al comparar ambos grupos se halló que en el grupo A había mayor presencia de vómitos (p = 0,05), de masa palpable (p = 0,004), operabilidad inferior (p = 0,01), diseminación extragástrica abdominal superior (p = 0,03), peor estadio TNM (p = 0,02), mayor presencia de estadios N1-N2 (p = 0,01), mayor número de complicaciones sistémicas (p = 0,05) y menor supervivencia (p = 0,008). El resto de variables no presentaron diferencias significativas. Conclusiones. Los pacientes octogenarios presentaron tasas superiores de enfermedad localmente avanzada que indujeron peor estadio TNM y menor supervivencia (AU)
