ABSTRACT
Soft-tissue sarcomas constitute an uncommon and heterogeneous group of tumors of mesenchymal origin. Diagnosis, treatment, and management should be performed by an expert multidisciplinary team. MRI/CT of the primary tumor and biopsy is mandatory before any treatment. Wide surgical resection with tumor-free tissue margin is the mainstay for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not suitable for re-excision. Perioperative chemotherapy should be discussed for high-risk sarcomas of the extremities and trunk-wall. In the case of oligometastatic disease, patients should be considered for local therapies. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. Other drugs have shown activity in second-line therapy and in specific histological subtypes but options are limited and thus, a clinical trial should always be discussed (AU)
Subject(s)
Humans , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/therapy , Sarcoma/therapy , Sarcoma/diagnosis , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Societies, Medical , Biopsy , SpainABSTRACT
Soft-tissue sarcomas constitute an uncommon and heterogeneous group of tumors of mesenchymal origin. Diagnosis, treatment, and management should be performed by an expert multidisciplinary team. MRI/CT of the primary tumor and biopsy is mandatory before any treatment. Wide surgical resection with tumor-free tissue margin is the mainstay for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not suitable for re-excision. Perioperative chemotherapy should be discussed for high-risk sarcomas of the extremities and trunk-wall. In the case of oligometastatic disease, patients should be considered for local therapies. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. Other drugs have shown activity in second-line therapy and in specific histological subtypes but options are limited and thus, a clinical trial should always be discussed.
Subject(s)
Sarcoma/diagnosis , Sarcoma/therapy , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/therapy , Anthracyclines/therapeutic use , Antineoplastic Agents/therapeutic use , Checklist , Chemotherapy, Adjuvant/methods , Dermatofibrosarcoma/therapy , Female , Fibromatosis, Aggressive/genetics , Fibromatosis, Aggressive/therapy , Humans , Magnetic Resonance Imaging , Male , Medical Oncology , Neoadjuvant Therapy/methods , Radiotherapy/methods , Retroperitoneal Neoplasms/therapy , Sarcoma/diagnostic imaging , Sarcoma/pathology , Societies, Medical , Soft Tissue Neoplasms/diagnostic imaging , Soft Tissue Neoplasms/pathology , Solitary Fibrous Tumors/drug therapy , Spain , Tomography, X-Ray Computed , Uterine Neoplasms/therapyABSTRACT
A pesar de los avances en la cirugía del trasplante renal, las complicaciones quirúrgicas continúan siendo una importante causa de morbilidad durante el periodo postrasplante inmediato. El objetivo de este estudio es analizar la incidencia, diagnóstico y tratamiento de dichas complicaciones en población pediátrica sometida a un trasplante renal y comparar los resultados con los de otras series descritas en la literatura. Revisamos de forma retrospectiva los trasplantes renales realizados en nuestro centro en pacientes menores de 18 años en los últimos 10 años. Analizamos el diagnóstico, cronología, tratamiento y evolución de las complicaciones quirúrgicas durante el primer mes postrasplante. En 120 trasplantes revisados se produjeron 35 complicaciones quirúrgicas en 27 pacientes (22,5%). Como consecuencia de estas perdieron el injerto 9 pacientes (7,5%) con una mortalidad asociada nula. La incidencia de complicaciones vasculares y urológicas fue de 8,3$ y 6,6% respectivamente. Entre estas destacan por su morbilidad asociada la trombosis del injerto (4,1%), la estenosis de la arterial renal (1,6%), el pseudoaneurisma arterial (0,8%) y la fístula urinaria (5,0%). Los resultados obtenidos en nuestra serie muestran una incidenica de complicaciones quirúrgicas, pronóstico y supervivencia del injerto asociada a las mismas similares a los publicados en otras series de pacientes pediátricos. El trasplante renal pediátrico presenta una tasa de complicaciones quirúrgicas equiparables al realizado en población adulta, siendo una opción terapéutica segura y eficaz (AU)
Despite advances in renal transplantation surgery, surgical complications still remain an important cause of morbidity in the early postransplant period. The objective of this study is to describe incidence, diagnosis and treatment of these complications in pediatric transplanted population and compare our results to published data. A retrospective review of pediatric transplantations (younger than 18 years old) performed in our institution during the last ten years was designed. We analysed diagnosis, chronology, treatment and prognosis of surgical complications during the first postransplant month. Among 120 transplantations reviewed, 35 surgical complications were described in 27 patients (22,5%). Nine patients (7,5%) lost their graft due these complications, although there was no patient associated mortality. Incidence of vascular and urological complications was 8,3% and 6,6% respectively. The higher morbidity was associated with thrombosis of the allograft (4,1%), renal artery stenosis (1,6%), arterial pseudoaneurysm (0,8%) and urinary leakage (5.0%). Our results show an incidence of surgical complications, prognosis and graft survival related to the complications similar to published data in other series of pediatric patients. Pediatric renal transplantation is a safe and effective therapeutic modality, with an associated surgical complications rate similar to that described in adult transplanted population (AU)
Subject(s)
Humans , Male , Female , Child , Kidney Transplantation , Renal Insufficiency, Chronic/surgery , Transplantation Tolerance/physiology , Graft Rejection/epidemiology , Tissue Survival/physiology , Risk Factors , Postoperative Complications/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Receptor, ErbB-2/analysis , Prostatic Neoplasms/diagnosisABSTRACT
La asociación entre dermatomiositis y cáncer de mama, no se describe habitualmente en la literatura. Describimos el caso de una mujer de 67 años, afecta de cáncer de mama izquierda tras mastectomía simple dos años antes. Recibió tratamiento con quimioterapia (CEF), radioterapia y tamoxifeno adyuvantes. Presentó un cuadro de dermatomiositis severo, con eritema, mialgias y debilidad muscular, sin respuesta a esteroides. Simultáneamente presentó recidiva cutánea de carcinoma de mama (diagnosticada con PAAF y RMN), y posterior exacerbación de la dermatomiositis. Recibió posteriormente quimioterapia por enfermedad metastásica. Creemos que debe ser recomendado el seguimiento de una posible recidiva tumoral tras la presentación de dermatomiositis paraneoplásica. (AU)
Subject(s)
Aged , Female , Humans , Dermatomyositis/complications , Breast Neoplasms/complications , Neoplasm Recurrence, Local/complications , Diabetes Mellitus/complications , Depressive Disorder/complications , Hypercholesterolemia/complicationsSubject(s)
Krukenberg Tumor/secondary , Ovarian Neoplasms/secondary , Stomach Neoplasms/pathology , Adult , Female , HumansSubject(s)
Carcinoma, Small Cell/secondary , Lung Neoplasms/pathology , Aged , Humans , Male , SurvivorsSubject(s)
Echocardiography, Doppler , Takayasu Arteritis/diagnosis , Aorta, Abdominal/physiopathology , Aorta, Abdominal/ultrastructure , Aortography , Child, Preschool , Electrocardiography , Female , Humans , Mesenteric Artery, Superior/physiopathology , Mesenteric Artery, Superior/ultrastructure , Takayasu Arteritis/physiopathologyABSTRACT
A retrospective study of 100 dehydrated children with ages between 0 and 18 months is presented. Ecologic, epidemiologic, clinical and biochemical aspects are revised, as the first part of a series. Relating facts to distribution according with ages and etiology in cases of bacterial diarrhea are similar to other authors. Hypertonic dehydration caused by concentrated nutrition of feeding is prominent, in tight relation with children in low socioeconomically groups. 31% of children had natremia between 150 and 160 mEq/I; and 16% over to 160 mEq/I. Hypocalcemia during rehydration was rarely observed.
