Sindrome de Poland / Poland syndrome

Se describen dos casos de síndrome de Poland (ausencia unilateral de mama y musculo pectoral). Su frecuencia es escasa en la clínica de mastología. Se describe la actitud diagnóstica y terapéutica en estas pacientes

[A new ovulation inhibitor antiandrogen]. / Un nuevo anovulador antiandrogenico.

PIP: Cyproterone acetate (Androcur), a potent progestagin and antigonadotropin, has been widely used in Europe in treatment of hirsutism, seborrhea, and alopecia. A formulation combining an estrogen, ethinyl estradiol (EE), to neutralize the progestational action and consequent amenorrhea of Androcur is marketed under the name of DIANE. 3 different treatment protocols were tested: 1) continuous administration of Androcur at doses varying from 25-150 mgr with rests every 3 months 2) high dose combination of 50 mgr Androcur and .05 mgr of EE in 21 day cycles and 3) low dose combinations of 2 mgr Androcur and .05 mgr of EE in 21-day cycles (DIANE). 54 patients who received the DIANE combined low dose treatment were compared. 7 of them had previously received the cyproterone acetate in variable doses of 25-150 mgr/day for 3-10 cycles, 16 had previously taken cyproterone acetate in variable doses of 50-150 mgr/day for 3-14 cycles, followed by the high dose combined method for 3-12 cycles and DIANE for 1-7 cycles, and 15 patients had previously received the high dose combined method for 2-22 cycles followed by DIANE for 3-7 cycles. Among the 54 patients there were 10 cases of idiopathic hirsutism, 11 of suprarenal hirsutism, 25 of ovarian hirsutism, 2 of iatrogenic hirsutism, 24 of acne, 37 of seborrhea, and 10 of alopecia. No pregnancies were reported in patients exposed to risk of pregnancy who took a total of 96 cycles of DIANE or 55 cycles of the high dose combination. Continuous dose cyproterone acetate is usually associated with amenorrhea. The high dose combination induces amenorrhea in up to 20% of cases, while with DIANE the principal change is a diminution in the amount of bleeding. Cyproterone acetate alone or associated with androgens is the preferred treatment for androgenic manifestations. The therapeutic regimen should be adapted to the predominance, time of evolution and severity of symptoms. For moderate or serious hirsutism, the treatment should be continuous administration of high doses of cyproterone acetate for 6 months followed by the combined method at high doses according to the type of initial response. When acne and seborrhea predominate, the combined low-dose method is used, because even though the high dose continuous method gives better results, the secondary effects do not justify its use. The high dose continuous method can be chosen if the low dose combined method fails. The high dose combined method is preferred for alopecia, with the low dose combined method used for maintenance.^ieng