ABSTRACT
Se presentan 2 casos clínicos referentes a pacientes prepúberes con un cuadro clínico caracterizado por la aparición de úlceras vulvares asociadas con síntomas sistémicos y orofaríngeos en los días anteriores a la aparición de dichas úlceras. Se intenta ahondar en la importancia del diagnóstico diferencial entre las diferentes enfermedades infecciosas de transmisión sexual, siendo de vital importancia descartar la posibilidad de abusos sexuales en estas pacientes. La aparición de la úlcera vulvar aguda es rara, a menudo es infradiagnosticada por su baja incidencia y su difícil diagnóstico. Aunque es un cuadro autolimitado, el tratamiento temprano es importante para minimizar la sintomatología que se deriva. El diagnóstico se basa en la clínica y la exclusión de otras causas responsables de la aparición de úlceras vulvares. El tratamiento se fundamenta en la administración de antiinflamatorios y/o antipiréticos. También pueden administrarse anestésicos locales tópicos. La mayoría de las pacientes pueden tratarse de forma ambulatoria pero en ocasiones requieren ingreso para sondaje vesical, debido a la imposibilidad para la micción derivada del dolor que esto ocasiona
We present the cases of two prepubertal girls with a clinical picture characterized by systemic and oropharyngeal symptoms a few days before the appearance of vulvar ulcers. We aim to highlight the importance of performing a differential diagnosis among distinct sexually-transmitted diseases and of excluding the possibility of sexual abuse in these patients. The development of acute vulvar ulcer is rare and this entity is often underdiagnosed because of its low incidence and difficult diagnosis. Although this process is self-limiting, early treatment is important to minimize symptoms. Diagnosis is based on clinical findings and the exclusion of other causes of genital ulcers. Treatment is based on the administration of anti-inflammatory and/or antipyretic agents. Local topical anesthetics can also be used. Most patients can be treated as outpatients. If urination is impossible due to pain, hospital admission may be required for catheterization
Subject(s)
Humans , Female , Child , Adolescent , Vulvar Diseases/diagnosis , Skin Ulcer/diagnosis , Pharyngitis/complications , Diagnosis, Differential , Urination/physiology , Urinary Retention/etiologyABSTRACT
Los tumores primarios múltiples sincrónicos son los que, además de otros criterios, su diagnóstico se hace de forma simultánea. La aparición sincrónica de un carcinoma confinado al endometrio y al ovario es una patología controvertida desde el punto de vista diagnóstico y terapéutico. Dicha patología es rara; los cánceres primarios sincrónicos de endometrio y ovario se encuentran en el 10% de las mujeres con cáncer de ovario y en el 5% de los pacientes con cáncer endometrial. Se presenta un caso de adenocarcinoma endometrioide sincrónico con un cistoadenocarcinoma seroso papilar ovárico que, según la clasificación establecida por Eifel et al2, estaría englobado en el grupo C (constituido por carcinomas de endometrio y ovario de tipos histológicos diferentes). Su etiología es incierta, y en el 45% de las pacientes del grupo C hay invasión miometrial, frente al 10% de las pacientes del grupo A (neoplasias tipo endometrioide idénticas, el tanto en el útero como en el ovario, que constituyen el grupo histológico más frecuente) (AU)
Synchronous multiple primary tumors are those that are diagnosed simultaneously, among other criteria. Synchronous appearance of a carcinoma localized in the endometrium and ovary is controversial from a therapeutic and diagnostic point of view. These entities are rare; synchronous primary cancers of the endometrium and ovary are found in 10% of women with ovarian cancer and in 5% of women with endometrial cancer. We present a case of synchronous endometrioid adenocarcinoma with serous papillary cystadenocarcinoma of the ovary that, according to the classification established by Eifel et al., would be included in group C (composed of carcinomas of the endometrium and ovary of different histological types). The etiology is unclear and, in 45% of patients in group C, there is myometrial invasion, compared with 10% of the patients in group A (concordant endometrioid tumors of the uterus and ovary, which constitute the most frequent histological group) (AU)
Subject(s)
Female , Aged , Humans , Adenocarcinoma/diagnosis , Endometrial Neoplasms/diagnosis , Ovarian Neoplasms/diagnosis , Obesity, Morbid , Metrorrhagia/etiology , Adenocarcinoma/surgery , Hysterectomy/methods , Adnexa Uteri/surgery , Endometrial Neoplasms/surgery , Ovarian Neoplasms/surgeryABSTRACT
OBJECTIVE: To establish the validity of hysteroscopy for predicting cancer in endometrial polyps based on their number, size and hysteroscopic appearance. METHOD: Retrospective observational study of 653 women diagnosed hysteroscopically as having endometrial polyps. After outpatient or surgical hysteroscopic resection or resection following hysterectomy, the diagnosis was confirmed by histological examination. The incidence of cancer in women who had polyps was determined in the light of menopausal status, symptoms, size, number and appearance of the polyps. RESULT: Carcinoma was found in only 3.9% of the women who consulted for menopausal metrorrhagia and were diagnosed as having a polyp. Hysteroscopy had a sensitivity of 36% and a specificity of 98% for a diagnosis of cancerous polyp or atypical hyperplasia. CONCLUSION: The appearance and number of endometrial polyps seen by hysteroscopy may be useful in predicting cancer in the polyps, although resection and histological examination will still be necessary to confirm the diagnosis.
