[Serous peritoneal papillary tumor of low malignancy potential. Report of a case]. / Tumor papilar peritoneal seroso de bajo potencial maligno. Comunicación de un caso.

Papillary serous carcinoma with low malignant potential, similar to those described in the ovary, can also originate in the peritoneum. Characteristically they show peritoneal spread without involvement of the ovary and, if present, it corresponds to a superficial implant similar to those seen in the rest of the peritoneal cavity. Histologically they correspond to a low malignant potential tumor; they are slow growing and have good prognosis. They are common in young women, usually they present few symptoms and are frequently discovered during other surgical procedures. The treatment is surgical and it can be conservative in cases of women who want to preserve their fertility, without coadjuvant therapy. We report a 34 years old woman with a primary peritoneal serous carcinoma with low malignant potential and discuss its management.

[Prevalence of the 185Ag deletion of the BRCA1 gene in Chilean women with breast neoplasm]. / Prevalencia de la deleción 185AG del gen BRCA1 en mujeres chilenas con cáncer de mama.

BACKGROUND: The most important identified pathogenic factor for breast cancer is the presence of mutations in BRCA1 gene. These are associated with familial breast cancer in up to 80% of cases. The most frequent mutation of BRCA1 gene in Caucasian populations is the exon 2 185AG deletion. AIM: To study the presence of 185AG deletion in Chilean women with sporadic or familial breast cancer. PATIENTS AND METHODS: We studied 15 women with familial breast cancer, in whom at least one close relative was affected, and 40 women with sporadic breast cancer. In genomic DNA obtained from a blood sample, an allele specific polymerase chain reaction was done. This reaction allows the identification of 185AG deletion and uses two pairs of primers. One for the native form that renders a 118 base pairs product and one for the deletion that renders a 170 base pairs product, both with a respective 280 base pairs internal control. RESULTS: The diagnosis of breast cancer was done at 40 +/- 5 and 65 +/- 10 years old in women with familial and sporadic breast cancer, respectively. In none of the samples, the amplification of the 170 base pairs band that corresponds to 185AG deletion, was obtained. In both groups, the product of the amplification was the 118 base pairs band, that corresponds to the native form of BRCA1 gene. The polymerase chain reaction was optimized for a duration of 90 minutes. CONCLUSIONS: 185AG deletion of BRCA1 gene was not detected in this group of Chilean women with sporadic or familial breast cancer.

[Placental site trophoblastic tumor]. / Tumor trofoblástico del sitio placentario.

A clinical case of placental site trophoblastic tumor, is presented in a patient of 27 years old. Diagnosis, clinical behavior and treatment are emphasized in this very infrequent pathology.

[Electrosurgery resection of intraepithelial lesions of lower female genital tract]. / Resección electroquirúrgica de las lesiones intraepiteliales del tracto genital femenino inferior.

Twenty patients bearing lesions caused by human papillomavirus and intraepithelial neoplasia of the lower genital tract and treated with electrosurgical excision of the lesions are presented. The technique used, the benefits of the histopathologic assessment of the specimen, and the changes that this procedure produces in the specimen tissue are analyzed. In general terms, the pre and postoperative diagnosis were concordant and the early and late morbidity was found to be not significative. The efficacy of this therapy in the long term remains to be evaluated.

[Metastatic carcinoma to the ovary of extragenital origin: analysis of 9 cases and review of the concept of Krukenberg's tumor]. / Carcinoma metastásico en el ovario de origen extragenital: análisis de 9 casos y revisión del concepto de tumor de Krükenberg.

Between 1987 to 1992, nine patients with metastatic ovarian tumors of extragenital origin were analyzed. Seven corresponded to Krükenberg tumors, according to the traditional description of carcinoma with signet-ring cells and stroma with sarcomatoid reaction. The primary neoplasia was detected in 8 patients (89%) and corresponded to: gastric cancer (n = 4), colon cancer (n = 2), gallbladder cancer (n = 1) and breast cancer (n = 1). Mean survival in these patients was 11 months (range 4 to 20 months). Irrespective of their histology and origin, all the lesions were found to share similar macroscopic characteristics: bilateral enlarged ovaries, solid and embossed appearance.

[Role of frozen section biopsy in the diagnosis of adnexal neoplasms]. / Rol de la biopsia rápida por congelación en el diagnóstico de las lesiones tumorales anexiales.

Three hundred and five patients undergoing exploratory laparotomy by adnexial tumors in our institution from January 1987 to October 1992 were studied. The results of the frozen sections vs permanent sections were compared. The diagnosis was concordant in 98.7% of the cases. Sensitivity was 96.9% and specificity was 99.6%. These results consagrate frozen sections as an accuracy and efficient intraoperative diagnostic form in the ovary tumoral pathology.

[A re-evaluation laparotomy in ovarian neoplasms]. / Laparotomía de reevaluación en el cáncer de ovario.

"Second look" laparotomy in ovarian cancer demonstrated negative result in 49%, microscopic positive result in 17%, and macroscopic positive result in 34%. The prediction factors were related with, clinical stage, degree of differentiation and the postsurgical residual tumors after the first operation.

[An intraoperative anatomicopathological study of myometrial penetration in endometrial cancer: its usefulness in making decisions on extending the primary surgical treatment]. / Estudio anatomopatológico intraoperatorio de la penetración miometrial en cáncer endometrial: utilidad en la toma de decisiones sobre la extensión del tratamiento quirúrgico primario.

The accuracy of frozen section biopsy was evaluated determining the deep of myometrial invasion in 30 samples of hysterectomies performed because of endometrial cancer. Results were compared with the definitive biopsy. Two sections were performed guided by the site of largest lesion seen when the uterus was sectioned in a frontal plane. The diagnosis of myometrial invasion was well determined in 29 cases with a 96.6% of accuracy. We conclude that frozen section is an exact and low cost method to determine intraoperatively, deep of myometrial invasion. This method helps the surgeon to decide the extent of surgery, specially if lymphadenectomy is necessary, during staging laparotomy.

[Genital intraepithelial lesions in immunosuppressed female patients after renal transplant: cytologic, colposcopic, and histologic study]. / Lesiones intraepiteliales genitales en pacientes inmunosuprimidas postrasplante renal: estudio citologico, colposcopico e histologico.

Twenty seven female patients immunosuppressed after renal transplantation were studied. Cytological, colposcopic and histologic studies of biopsies were used to determine the incidence of neoplastic intraepithelial lesions and those due to infection by human papilloma virus. Intraepithelial neoplasia was found in 7.4% and papilloma virus infection in 60%. Cervix cytology was insensitive (33%) for diagnosis of intraepithelial lesions. Therefore, cytology and colposcopy are recommended for routine follow up of immunosuppressed women.

[Epithelial cancer of the ovary. An analysis of a prospective protocol]. / Cáncer epitelial del ovario. Análisis de un protocolo prospectivo.

We present the results on the treatment of 43 patients with epithelial ovarian cancer excluding borderline tumours. Nine cases were FIGO Stage I, 4 FIGO Stage II, 24 FIGO Stage III and 6 FIGO Stage IV. The protocol consists in cytoreductive surgery followed by chemotherapy for Stages I, III, and IV, mainly using cisplatin + cyclophosphamide (PC) or cisplatin + adriamycin + cyclophosphamide (PAC). We used pelvis and whole abdomen radiotherapy for patients on Stage II. The follow up was between 26 and 76 months. The undifferentiated tumours had bad prognosis in Stage I, instead of receiving chemotherapy. Radiotherapy for patients on Stage II reached satisfactory local regional disease control but with late recurrences. On Stage III, size of residual tumour less than 2 cm on primary surgery was of good prognosis (60% 44 months survival). The addition of adriamycin to PC seems to be of no benefit in long term results. The five year actuarial survival was 44% for FIGO Stage I, 75% for FIGO Stage II, 16% for FIGO Stage III and 0% for FIGO Stage IV. These results don't differ significantly from similar protocols.

[The complications of radical hysterectomy in the treatment of cervix uteri carcinoma]. / Complicaciones de la histerectomía radical en el tratamiento del carcinoma de cuello uterino.

Complications of radical surgery in 60 cases of cervicouterine cancer are presented with the purpose of evaluating the morbi-mortality associated with this treatment. Radical hysterectomy with pelvic lymphadenectomy was the most frequent surgery. Intraoperative complications reached to 13.3%; the most frequent was the vascular venous lesion. Minor postoperative complications reached to 15% and majors to 6.7%. There was no mortality associated with the treatment. Five year survival for this series was 91% for FIGO Stage IB and 86% for FIGO Stage IIA.

[Clinical use of CA-125 in gynecology. Preliminary experience]. / Uso clínìco del CA-125 en ginecología. Experiencia preliminar.

CA-125 levels were measured in 27 normal women, 11 with benign gynecologic pathology and 13 with ovarian cancer in different stages of evolution. The analysis of data was made retrospectively. Considering a level of 65 U/ml as normal, no false positives were found. Patients with benign gynecologic pathology behave as the normal ones with no significative differences in their levels. Levels higher that 65 U/ml were always found in women with ovarian cancer. There were 4 patients with negative levels and clinically or surgically verified disease. Positive levels correlated with histologic type and with surgical staging. In patients with serial levels, decrease in tumoral volume was correlated with decrease in levels. These data suggest that the behaviour of CA-125 in our local population is the same as reported in the literature. It is useful, when is positive, in follow-up, management and prognosis of patients with ovarian cancer. Its negativity is not guarantee of cure and positive levels make evident the presence of the disease. It is a poor diagnostic method because of its low sensitivity.

Estudio clínico epidemiológico del aborto, en mujeres chilenas / Clinico-epidemiological study of abortion, in Chilean women

Se realizó una encuesta a 1.480 mujeres que egresaron con el diagnóstico de aborto durante el año 1983, y se procedió a realizar una descripción epidemiológica de esta población, distintas variables como edad, paridad, estado civil, escolaridad, nivel socioeconómico planificación familiar, antecedentes de abortos, edad de gestación del embarazo y confesión de maniobras obstétricas. Al determinar el perfil epidemiológico de la mujer con mayor riesgo de aborto, nos encontramos que éste no ha variado durante estas últimas dos décadas a pesar de los programas de paternidad responsable, por lo que el aborto sigue constituyendo un problema de Salud Pública, ocupando un lugar destacado entre los problemas maternales de nuestro medio