[Immunogammagraphy with anti-CEA and anti-TAG-72 monoclonal antibodies in the diagnosis of colorectal carcinoma]. / Inmunogammagrafía con anticuerpos monoclonales anti-CEA y anti-TAG-72 en el diagnóstico del carcinoma colorrectal.

BACKGROUND: The purpose of nuclear medicine in the evaluation of colorectal carcinoma is to complete the current diagnostic protocol, by means of monoclonal antibodies (MoAb) against tumoral antigens labelled with radioactive isotopes and performing an immunoscintigraphy. PATIENTS AND METHODS: Immunoscintigraphies have been performed to 143 patients with colorectal carcinoma. Group I: antiCEA MoAb 99mTc-BW 431/26 (72 patients with 74 lesions, 48 primary tumors and 26 recurrences); group II: antiTAT-72 MoAb 111In-CYT-103 (71 patients with 75 lesions, 28 primary tumors and 47 recurrences). All positive images, not corresponding to physiological distribution of MoAb, have been considered as pathological. RESULTS: The sensitivity in the diagnosis of primary tumors in group I was worse than in group II (54.2% vs 66.7%). If rectum tumors were excluded, the sensitivity increased to 80% and 85.7%, respectively. In the suspicion of recurrences, if only lesions confirmed at surgery were considered, the sensitivity was 75% in group I and 89.7% in group II. The immunoscintigraphy has been the only technique able to diagnose recurrences in 4/23 cases from group I and 14/32 from group II. In liver, considering as metastases only hot images, the sensitivity is very low in group I (44.4%) and null in group II. No relationship has been found between tumour markers levels and the immunoscintigraphic result. CONCLUSIONS: Immunoscintigraphy is useful in patients with colorectal carcinoma, especially in the case of recurrences and it is a complementary technique to other diagnostic procedures.

[The therapeutic posture in desmoid tumor]. / Actitud terapéutica ante el tumor desmoide.

BACKGROUND: The desmoid tumor is a histologically benign neoplasm originating in muscular-aponeurotic structures and possesses a high tendency of local recurrence. The aggressive nature of the tumor obliges radical surgery to be performed principally in extra-abdominal tumors. METHODS: Twelve patients were treated from 1983 to 1993. The treatments performed prior to and after histologic diagnosis, the time of evolution when radical treatment was carried out upon diagnosis and the evolution after treatment were evaluated. RESULTS: Of the patients with desmoid tumor 8 were males with a mean age of 29.9 +/- 12.5 years. In eleven cases the presentation was as a tumor and was of pain in only one case. All the patients were surgically treated with a total of 27 interventions being carried out. Three patients also received pharmacologic treatment with tamoxifen, in 2 cases associated to sulindac. In two radiotherapy was used but not as a first line treatment. Following a mean follow up of 38 +/- 17 months no mortality has been registered but 5 patients are not disease free. CONCLUSIONS: The therapeutic attitude to the desmoid tumor should be radical surgery in both the primary tumor and the recurrences with medical treatment being performed in specific situations.