ABSTRACT
Differentiated thyroid cancer is the most common endocrine malignancy and its incidence appears to be rising rapidly with a good prognosis. However, the involvement of different medical specialties has changed the focus of treatment and triggered a number of controversies. In the absence of controlled trials, the guidelines for treatment are founded on prognostic factors for survival and local control, the effects of the treatments, and comorbidities. Recently, the major advances in the field of genetics and molecular biology have been applied in the treatment of iodine refractory disease, and the use of tracers and recombinant hormones have succeeded in improving adjuvant treatment. Based on this information, we present this review with the aim of updating the knowledge of an ancient disease.
Subject(s)
Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/therapy , Combined Modality Therapy , Humans , Neoplasm InvasivenessABSTRACT
Advanced-stage gastrointestinal tumors are aggressive and frequently invade blood vessels. Advances in endovascular surgery can repair blood vessels that may be infiltrated by a tumor. Currently there are many materials to do this, as the use of prostheses or implants and patches. In Mexico, the bovine pericardium preserved with glutaraldehyde has been used to treat incisional, inguinal, and diaphragmatic hernias and repair vascular defects with good results, low cost, and no allergic reaction from the patient. We report the case of a 47-year-old man, with a history of smoking and alcoholism, diagnosed with pancreatic adenocarcinoma. The tumor, with the use of endoscopic ultrasound, showed direct contact with the portal vein without invading the confluence of the mesenteric vein. During exploratory laparotomy, a tumor attached to the head of the pancreas of 4 cm × 4 cm was found, with tumor invasion of 1 cm × 2 cm on the outer sidewall of the portal vein. We performed pylorus-preserving pancreatoduodenectomy and tumor resection of the portal vein wall with placement of glutaraldehyde-preserved bovine pericardium patch to repair it. The intraoperative and immediate postoperative period arose without complications. The patient was discharged with good result and is currently under surveillance. We report this case to show a successful result using glutaraldehyde-preserved bovine pericardium to close vascular defects after resection of the tumor secondary to vascular invasion.
ABSTRACT
Objetivo: Reportar un caso de hernia de Garengeot. Sede: Centro Médico de Tercer Nivel. Diseño: Reporte de caso. Reporte del caso: Se presenta el caso de una mujer de 82 años de edad, admitida con diagnóstico de oclusión intestinal alta por una probable hernia inguinal complicada, motivo por el que se llevó a laparotomía exploradora encontrando una hernia de Richter y una de Garengeot en el canal femoral izquierdo; se trató con apendicectomía, reducción de la hernia de Richter y cierre del canal femoral con material de sutura no absorbible; la paciente evolucionó de forma satisfactoria y actualmente se encuentra sin complicaciones. Discusión: La presencia del apéndice cecal herniado en el canal femoral se conoce como hernia de Garengeot. Su frecuencia es muy baja, el diagnóstico preoperatorio es complejo y el tratamiento tiene relación con el tiempo de evolución y la coexistencia del proceso inflamatorio. Ante la presencia de apendicitis complicada se recomienda la realización de apendicectomía, con cierre del defecto herniario con sutura sin utilizar materiales protésicos.
ABSTRACT
The surgical oncology remains an essential part in the multidisciplinary management for patients with cancer, even though the current progress in field of radiotherapy, chemotherapy, systemic therapies, including therapies directed to molecular targets. Their role impact in several moments during the management of an oncological patient: prevention, diagnosis, assessment of the spread of the disease, curative treatment, management of the sequels, complications by the treatment and not less important, the palliation. The current state of the surgical oncology as a result of a constant development, inspired by skillful hands with creative and restless minds, have achieved to mark the history of the medicine in an area which currently has a great transcendence and an accelerated growth in a short period of time. Under this argument, we have decided to present an updated overview about the role of the surgical oncology, from the evolution through the history until all their applications in the different areas of the oncology.
Subject(s)
General Surgery/history , Neoplasms/history , Neoplasms/surgery , History, 19th Century , History, 20th Century , History, 21st Century , HumansSubject(s)
Humans , Female , Young Adult , Fibromatosis, Aggressive/pathology , Abdominal Neoplasms/pathology , Postpartum PeriodABSTRACT
BACKGROUND: Hemangiomas are benign endothelial cell-derived tumors that are present in 1-2% of newborns. They are most frequent in females. Eighty per cent are located in the head and neck region. Intramuscular hemangiomas represent 0.8% of all cases. They are characterized by rapid endothelial growth. Treatment is indicated for lesions that have an organic or visceral location or those that present with deformities. METHODS: Six cases of intramuscular hemangioma are presented. They were collected during the period June 2003 to November 2005 from all surgical cases seen at the Department of Cardiovascular Surgery, Hospital General "Dr Manuel Gea Gonzalez," Mexico City, Mexico. Their clinical appearance, treatment, and outcomes are discussed. RESULTS: There were five women and one man with a mean age of 24.6 years (15-44 years). Two hemangiomas were located on the upper extremities and four on the lower extremities. All six patients were treated by surgical resection. Four cavernous hemangiomas were revealed during microscopic examination. At 1-3 years of follow-up, there were no recurrences and the functional and aesthetic results were good. CONCLUSIONS: Intramuscular hemangiomas are rare. Lesions of the extremities are even rarer. Surgical excision in the six cases described here resulted in cure with good functional and cosmetic outcomes.
