ABSTRACT
A 52-year-old woman with a rising carcinoembryonic antigen CEA, no clinical or radiological findings, a negative colonoscopy, and a positron emission tomography (PET) scan that revealed an isolated hypermetabolic lesion in the spleen. The patient underwent splenectomy by laparoscopic surgery. The pathological study confirmed the presence of an isolated metastasis to the spleen. This case reveals the rare occurrence of isolated splenic metastases in the context of colorectal cancer and illustrates the role of PET when a patient shows a rising CEA with negative clinicoradiological studies (AU)
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Subject(s)
Humans , Female , Middle Aged , Adenocarcinoma/secondary , Splenic Neoplasms/secondary , Splenic Neoplasms , Positron-Emission Tomography/methods , Antineoplastic Combined Chemotherapy Protocols , Adenocarcinoma/therapy , Splenic Neoplasms/blood , Splenectomy/methods , Splenectomy , Fluorodeoxyglucose F18 , Carcinoembryonic Antigen/analysis , Carcinoembryonic Antigen/bloodABSTRACT
Introducción: Presentamos nuestra experiencia en el selladoaxilar con fibrina humana autóloga.Material y métodos: Se trata de un ensayo clínico, prospectivoy con asignación aleatoria de tratamiento de dos cohortesde pacientes diagnosticadas de cáncer de mama y tratadascon linfadenectomía axilar, uno sin sellado (control) y otrocon sellado axilar con fibrina humana autóloga (estudio) obtenidaa partir de sangre total de la paciente. La variable principalestudiada ha sido el flujo de drenaje axilar. Como variablessecundarias hemos valorado el dolor, la presencia de signosinflamatorios y/o de infección en la herida y las característicasmacroscópicas del drenaje así como la presencia de seromasaxilares tras la retirada del drenaje.Resultados: La muestra final estuvo compuesta por 36 pacientes(47,4% con sellado de fibrina, 52,6% sin sellado). En eldébito axilar diario se observó una diferencia importante aunquesin significación estadística en el primer día equilibrándose endías posteriores. Sin embargo, sí se observó un descenso significativodel volumen diario en el 4º y 5º días postoperatorio.Conclusiones: Los resultados de este estudio muestran unatendencia a la reducción de la linforrea a partir del tercer díapostoperatorio con la utilización de la fibrina autóloga frente algrupo sin fibrina. Sin embargo, para matizar a nivel estadísticoestos resultados, es necesario incrementar la muestra, por loque consideramos que este estudio es un preliminar(AU)
Introduction: The purpose of this study was to determine ifthe use of human autologous fibrin decreases the incidence ofdrainage in patients with axillary lymphadenectomy operatedfor breast cancer.Material and methods: Prospective clinical trial with twocohorts of patients diagnosed with breast cancer and treatedwith axillary lymphadenectomy, one cohort without seal (controlgroup) and the other one (study group) with autologous fibrinsealant obtained from the patients whole blood. Themain variable was amount of axillary drainage. Secondary variableswere: pain, presence of inflammation and/or infectionsigns, and macroscopic characteristics of the drainage.Results: The final sample was constituted by 36 patients(47.4% with fibrin sealant and 52.6% without it). We observedan important difference in drainage volume the first day, but withoutstatistical significance. The following days the volume inboth groups leveled. However, we observed a significance decreasein the drainge volume in the 4º y 5º postoperative days.Conclusions: Our results indicate a trend towards a decreaseof lymphorrhea in the group with autologous fibrin fromthe third day, as opposed to the group without it. Nevertheless,we deem it necessary to increase the sample size to givefurther statistical evidence. Therefore we consider this a preliminarystudy(AU)
Subject(s)
Humans , Female , Fibrin Tissue Adhesive/therapeutic use , Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Fibrin Tissue Adhesive/administration & dosage , Fibrin Tissue Adhesive/pharmacology , Fibrin Tissue Adhesive/pharmacokinetics , Lymph Node Excision/instrumentation , Lymph Node Excision/statistics & numerical data , Lymph Node Excision/trends , Prospective Studies , ComorbidityABSTRACT
Parotid gland metastases from malignant tumors are extremely rare. A 61-year-old woman was diagnosed with an early breast cancer with no expression of oestrogen and progesterone receptors. Five years later the patient presented a tumour in parotid gland. After total parotidectomy, microscopic analysis of the gland demonstrated an invasive duct carcinoma (IDC) with positive expression of oestrogen receptor. The patient was treated with chemotherapy followed by complementary local radiotherapy. Diagnosis of a metastasic tumour in parotid gland poses a challenge. In our case an immunohistochemical study of oestrogen receptor was fundamental to establish a diagnosis (AU)
Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms/drug therapy , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/drug therapy , Carcinoma, Ductal, Breast/radiotherapy , Carcinoma, Ductal, Breast/surgery , Chemotherapy, Adjuvant , Cyclophosphamide/therapeutic use , Mastectomy, Radical/methods , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Antibiotics, Antineoplastic/therapeutic use , Antimetabolites, Antineoplastic/therapeutic use , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/secondaryABSTRACT
Presentamos un nuevo caso de aparición simultánea de adenocarcinoma de células renales y carcinoma urotelial del uréter ipsilateral. La revisión de la literatura indica que éste es el caso 45 mundial y 8 en publicaciones españolas (AU)
Subject(s)
Middle Aged , Male , Humans , Atrophy , Carcinoma, Transitional Cell , Carcinoma, Renal Cell , Hydronephrosis , Kidney , Ureteral Neoplasms , Neoplasms, Multiple Primary , Kidney NeoplasmsABSTRACT
Se presentan los resultados del primer estudio de consenso auspiciado por la Sociedad Valenciana de Cirugía sobre el tratamiento quirúrgico del cáncer gástrico. Se trata de un esudio tipo Delphi, con la participación de 31 expertos pertenecientes a la mayoría de hospitales de la Comunidad Valenciana. Los temas consensuados han versado sobre los siguientes aspectos: nutrición artificial, métodos de estadificación preoperatoria, tipo de resección y de linfadenectomía, técnicas de reconstrucción, criterios de resecabilidad y temas de organización (AU)
