Adenocarcinoma papilar de nasofaringe de bajo grado "thyroid-like". Caso clínico y revisión de la literatura / Low-grade papillary adenocarcinoma of nasopharynx. Case report and review of the literatura

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Importancia de la resonancia magnética en el síndrome del acueducto vestibular dilatado en la infancia / Importance of the magnetic resonance in the enlarged vestibular aqueduct syndrome in children

El síndrome del acueducto vestibular dilatado es la patología de herencia autosómica recesiva en la que se produce una hipoacusia progresiva o fluctuante desde la infancia por detención del desarrollo del oído interno, lo que provoca un aumento del saco endolinfático y una ligera displasia coclear. Presentamos 2 casos clínicos cuya peculiaridad es que ambos son unilaterales, ya que suelen ser bilaterales en el 90%de los casos. Una tomografía computarizada (TC) de cortes finos (1 mm)identifica al acueducto vestibular aumentado, pero una TC normal no excluye este diagnóstico, por lo que se debe realizar una resonancia magnética a todo paciente con hipoacusia neurosensorial unilateral para descartar ésta y otras alteraciones que pueden estar asociadas (AU)

Enlarged vestibular aqueduct syndrome is a clinical condition characterized for an autosomal recessive inheritance and a progressive perceptive deafness linked to a broadening of vestibular great aqueduct and a cochlear dysplasia. We report two clinical cases which peculiarity is that though they are usually bilateral in 90% of the cases, both cases which have been presented are unilateral. The enlarged vestibular aqueduct is detected by a CAT Scan (Computerized axial Tomography) of thin cuts (1 mm), but a normal CAT scan does not exclude this diagnosis. So a MRI (Magnetic Resonance Imaging) is needed in the diagnosis of unilateral neurosensorial hypoacusia to rule out this malformation and others that might be related (AU)

Linfangiomas de cavidad oral en edad pediátrica / Lymphangiomas of the oral cavity in childhood

Los linfangiomas son tumores raros y benignos producidos por el desarrollo anómalo de los vasos linfáticos. Presentamos un caso de linfangioma quístico asintomático localizado en paladar duro; se trata de una localización atípica, puesto que la mayoría de esas lesiones se localizan en la lengua a nivel de cavidad oral. Se realizó una resección con láser de CO2, sin que se evidenciase recidiva tras dos años de seguimiento. Actualmente se acepta adoptar una actitud expectante o el tratamiento con agentes esclerosantes que reduzcan su tamaño o los eliminen (AU)

Lymphangiomas are rare, benign tumors produced by the abnormal development of the lymphatic vessels. We present a case of asymptomatic cystic lymphangioma localized in the hard palate. This is an uncommon location since most of these lesions are found in the tongue at the level of the oral cavity. Resection was performed with CO laser, and there was no evidence of recurrence after two years of follow-up. At the present time, the approaches most widely accepted are expectant treatment or administration of sclerosing agents that reduce the size of the lesions or eliminate them (AU)

Enfermedad de Forestier-Rotes Querol (hiperostosis difusa esquelética idiopática) / Forestier-Rotes Querol disease (diffuseidiopathic skeletal hyperostosis)

Se trata de una enfermedad hiperostótica del aparato locomotor denominada hiperostosis anquilosante senil de la columna vertebral, por osificación del ligamento longitudinal anterior vertebral. Dependiendo del lugar más acusado de osificación de éste, dependerán sus síntomas clínicos predominantes. Presentamos el caso de un paciente que acude por disfagia progresiva como único síntoma a la consulta del centro de salud

This is a hyperostotic disease of the locomotor apparatus called senile ankylosing spinal hyperostosis due to ossification of the anterior vertebral longitudinal ligament. The predominant clinical symptoms will depend on its most affected site of ossification. We present a case of a patient who came to the Health Care Site consultation due to progressive dysphagia as the only symptom

[Serous otitis media and allergy in our health district]. / Otitis media serosa y alergia en nuestra área sanitaria.

UNLABELLED: We studied the role of allergic diseases in patients with otitis media with effusion (OME). MATERIAL AND METHODS: The 40 patients diagnosed with OME in the Otorhinolaryngology Service in 2001 were referred to the Allergy Unit for evaluation. The patients were assessed through anamnesis, prick test and specific IgE determination for the allergens in our area. RESULTS: In 72 % of the patiens allergologic study was negative. One patient had perennial rhinitis with sensitization to house dust mites and another had seasonal rhinitis with sensitization to Gramineae pollen. Five patients showed high total IgE. Two patients had positive skin prick test and specific IgE to Gramineae pollen but were asymptomatic and a further two patients had negative anamnesis and specific IgE to Gramineae and olive pollen, respectively. CONCLUSION: Allergic disease does not cause OME except in some patients with allergic rhinitis.

Otitis media serosa y alergia en nuestra área sanitaria / Serous otitis media and allergy in our health district

Hemos estudiado la incidencia de enfermedades alérgicas en los pacientes con otitis media con derrame (OME). Material y métodos: Los 40 pacientes diagnosticados de otitis media con derrame durante el año 2001 en el Servicio de ORL fueron remitidos a la Unidad de Alergología para su valoración. Esta se realizó mediante anamnesis, prick test IgE específica para los alergenos de nuestra zona. Resultados: en el 72 por ciento de los pacientes el estudio alergológico fue negativo. Un paciente tenía rinitis perenne con sensibilización a ácaros y otro rinitis estacional con sensibilidad a polen de grammíneas. Cinco con igE total alta. En dos pacientes el prick test e IgE específica fueron positivos a polen de gramíneas pero están asintomáticos y otros dos también con anamnesis negativa y exclusivamente IgE específica positiva a polen de gramíneas y olivo respectivamente. Conclusión: La enfermedad alérgica no es causa de OME excepto en algunos enfermos con rinitis alérgica (AU)

We studied the role of allergic diseases in patients with otitis media with effusion (OME). Material and methods. The 40 patients diagnosed with OME in the Otorhinolaryngology Service in 2001 were referred to the Allergy Unit for evaluation. The patients were assessed through anamnesis, prick test and specific IgE determination for the allergens in our area. Results. In 72 % of the patiens allergologic study was negative. One patient had perennial rhinitis with sensitization to house dust mites and another had seasonal rhinitis with sensitization to Gramineae pollen. Five patients showed high total IgE. Two patients had positive skin prick test and specific IgE to Gramineae pollen but were asymptomatic and a further two patients had negative anamnesis and specific IgE to Gramineae and olive pollen, respectively. Conclusion: Allergic disease does not cause OME except in some patients with allergic rhinitis (AU)

Parálisis recurrencial, como signo de alarma de un neurinoma del acústico / Relapsing paralysis as an alarm sign for acoustic neurinoma

Presentamos un caso de un hombre de 54 años con una parálisis recurrencial derecha. La resonancia magnética (RMN) mostró una masa en el ángulo pontocerebeloso derecho. Los síntomas clínicos más frecuentes son alteraciones cocleares (hipoacusia, acúfenos...), vestibulares (vértigo, inestabilidad en la marcha...) y de los nervios trigémino y facial. Una parálisis recurrencial como primera manifestación de un neurinoma del acústico es una patología inusual (AU)

Carcinoma primitivo de úvula. A propósito de un caso / Primitive carcinoma of the uvula. About a case

Presentamos un caso de carcinoma primitivo de úvula que encontramos interesante por su rara presentación en la clínica. Los cáncer primitivos de paladar blando representan menos del 2 por ciento de los tumores malignos de cabeza y cuello.Estas lesiones son más frecuentes en varones en la sexta y séptima década de la vida, y están asociados íntimamente al consumo de alcohol y tabaco.Por la alta incidencia de incompetencia velofaríngea, la cirugía está habitualmente reservada para las lesiones localizadas en úvula, mientras que los tumores más extensos son tratados con radioterapia asociada o no a quimioterapia (AU)

Una forma poco frecuente en la clínica diaria de pseudotumor laríngeo: un laringocele externo / A rare occurrence in daily practice of laryngeal pseudotumor: a external laryngocele

El laringocele externo es una entidad poco frecuente en la clínica diaria. Describimos un caso de un laringocele externo, que se manifestó como una tumoración, que aparecía sólo cuando se realizaba una maniobra de Valsalva. El diagnóstico fue radiológico por TAC. Y se estirpó completamente por medio de una aproximación cervical externa sin la necesidad de realizar ninguna tirotomía (AU)

[Small cell carcinoma of the parotid gland. A case report]. / Carcinoma de células pequeñas de glándula parótida. A propósito de un caso.

A case of small-cell carcinoma (SCC) of the parotid gland in an 82-year-old woman is reported. SCC arising in major salivary glands are extremely rare. By immunohistochemical study, this case was classified as a small-cell carcinoma with neuroendocrine differentiation. These neoplasms seem to have a far better prognosis than those arising from the bronchial tree. Treatment is mainly local and regional surgery with complementary radiotherapy.

[Psoas abscess in Crohn's disease. Preoperative evaluation and surgical attitude]. / Abscesos de psoas en la enfermedad de Crohn. Valoración preoperatoria y actitud quirúrgica.

Three patients with psoas abscess secondary to Crohn's diseases are reported with the aim of discussing the diagnosis and surgical management of these patients. It is concluded that computerized tomography is the method of choice for the diagnosis and follow up of this complication. Surgery should be individualized but in stable patients abscess drainage should be attempted in addition to resection of the intestine involved. Finally, given the great risk of pulmonary thromboembolism in these patients, intensive prophylactic anticoagulant therapy is required.

[Undifferentiated small cell carcinoma (oat-cell type) of the colon. Prognostic and therapeutic implications]. / Carcinomas indiferenciados de células pequeñas (Tipo oat-cell) de colon. Implicaciones pronósticas y terapéuticas.

AIM: This report reviews the clinical and pathologic features of four patients with small-cell anaplastic carcinoma (SCAC) of the colon and describes in detail their histological and immunohistochemical characteristics. METHODS: Four patients with a SCAC of the colon diagnosed by conventional light microscopy, immunohistochemistry and ultrastructure were reviewed; clinical presentation, tumor location and spread, surgical procedure, adjuvant therapy and clinical outcome were recorded. RESULTS: There were two women and two man, with an average age of 55 (range, 40-66) years. Two tumors were located in the sigmoid and two in right colon. Cases 1, 3 and 4 were removed at laparotomy by segmental resection along with lymph nodes. All cases had liver metastases. Pathologic study identified out-cell subtype in all cases and two histopathologic patterns: pure SCAC (cases 2 and 4) and mixed exocrine-SCC differentiation (cases 1 and 3). Three patients were treated with cyclophosphamide, cisplatin and etoposide. Two patients (cases 2 and 4) died of widely metastatic disease; cases 1 and 3 had partial remission lasting 9 and 3 months, respectively. CONCLUSIONS: Due to extremely aggressive behavior of colon SCAC with early metastatic spread, CT scans of the chest-abdomen and radionuclide bone scan should be performed. In the presence of metastatic disease, multiagent chemotherapy with combined etoposide and cisplatin should be instituted.

[Orbit complication of sinusitis. A report of 7 cases]. / Complicaciones orbitarias de las sinusitis. Estudio de siete casos.

Orbital complications of sinusitis were reviewed. Seven cases seen in a 6-year period from 1989 to 1994 were classified following Chandler. The pathogenesis, classification, diagnosis, and treatment of orbital complications, which are rare and steadily decreasing in frequency, are discussed. Because of its possible consequences, this complication should not be overlooked.

[Basaloid squamous cell carcinoma of the larynx: report of a new case]. / Carcinoma basaloide escamoso de laringe: aportación de un nuevo caso.

Basaloid squamous-cell carcinoma of the head and neck is a variant of epidermoid carcinoma which has an affinity for the hypopharynx, base of the tongue, tonsils, and larynx. A case of basaloid carcinoma of the larynx is reported and its clinical features, differential diagnosis, and treatment are reviewed.

[Ogilvie syndrome. Diagnostic and therapeutic attitude]. / Síndrome de Ogilvie. Actitud diagnóstica y terapéutica.

Ogilvie's syndrome (OS) is a clinical condiction with the symptoms, signs and radiological appearances of acute bowell obstruction but without any apparent mechanical cause. Diagnosis and treatment are often delayed and many patients are still inappropriately managed which in turn results in an increase in morbidity and mortality. We have reviewed our experience in eleven patients with OS in order to establish a system for their diagnostic and therapeutic management.

[Acute abdomen in anticoagulated patients. Its assessment and the surgical indications]. / Abdomen agudo en pacientes anticoagulados. Valoración e indicaciones quirúrgicas.

Bleeding complications associated with anticoagulant drugs can development abdominal pain simulating acute surgical conditions of abdomen. We report six cases of intraabdominal spontaneous haemorrhage presenting as an acute abdomen in patients on anticoagulant therapy: two rectus sheath hematomas, a abdominal wall hematoma, a spontaneous hemoperitoneum, a retroperitoneal hematoma and an intramural hematoma of the small bowel. The article conclude that computed tomography examination provided useful information in this complications because can demonstrate the size and location of the mass and its relation to normal intra-abdominal structures. Finally, authors expose the surgical indications of the different bleeding syndromes in this patients.

[Gastric leiomyosarcoma. Considerations for non-radical surgery]. / Leiomiosarcomas gástricos. Consideraciones para una cirugía no radical.

Leiomyosarcomas of the stomach are uncommon tumors and because their rarity there is a lack of understanding of the best approach to their surgical treatment. This is a retrospective review of eleven patients surgically treated with a non-radical method. The median age was 70 years (range, 44 to 83 years) and the most common initial symptoms were abdominal pain (36%), abdominal mass (27%) and weight loss (18%). The most common site of tumor involvement was the middle stomach (63%) and posterior wall (36%) with a median size of 18 cm (range, 8 to 30 cm). Operations included wedge resection of the stomach (55%), subtotal gastrectomy (36%) and biopsy (9%). Neither lymphadenectomy nor extended gastrectomy with en bloc excision were carried out. Follow-up was complete in all patients and the median duration of follow-up was 41 months (range, 8 to 72 months). The overall 5-years survival was 72% and only two patients died because of their tumor. Our results suggest that non-radical surgery in gastric leiomyosarcoma is an appropriate method in the surgical management of these patients.