ABSTRACT
El carcinoma coloide (CC) es una variante histológica inusual del adenocarcinoma ductal del páncreas, el cual se caracteriza por la presencia de grandes lagos de mucina extracelular que contiene células neoplásicas y está asociado a una mejor sobrevida a los cinco años, comparada con los adenocarcinomas ductales (DAC) tubulares o no tipo especial (NOS).Presentamos el caso de una paciente mujer de 74 años con una lesión multiquística de tabiques finos en cola de páncreas con diagnóstico clínico radiológico sugestivo de cistoadenoma seroso vs. neoplasia mucinosa. En el acto operatorio se evidenció una lesión de 10 x 6 cm, que infiltraba hilio esplénico y mesocolon transverso. Por otro lado, se identificaron dos nódulos en la pared del fondo gástrico que también fue resecado en conjunto. El estudio anatomopatológico concluyó que la tumoración del páncreas correspondía a un CC asociado incidentalmente a un tumor del estroma gastrointestinal (GIST) de fondo gástrico.(AU)
Colloid carcinoma (CC) is a rare histological type of adenocarcinoma of the pancreatic duct and is characterized by the presence of large lakes of extracellular mucin containing neoplastic cells. Its 5 year prognosis is more favourable than that of ductal, tubular or not otherwise specified (NOS) adenocarcinomas.We present the case of a 74-year-old woman with a thin walled, multicystic lesion in the tail of the pancreas, radiologically suggestive of a serous cystadenoma as opposed to a mucinous neoplasm. Surgery revealed a 10 x 6 cm lesion invading the splenic hilum and transverse mesocolon. Two nodes on the wall of the gastric fundus were also removed. Histopathology showed the pancreatic tumour to be a colloid carcinoma with a synchronous gastrointestinal stromal tumour of the gastric fundus.(AU)
Subject(s)
Humans , Female , Aged , Adenocarcinoma, Mucinous , Pancreatic Neoplasms , Adenocarcinoma, Mucinous/pathology , Stomach/pathology , Carcinoma, Pancreatic Ductal , Inpatients , Physical Examination , Symptom Assessment , Medical History Taking , Pathology , Pathology Department, Hospital , Neoplasms , PathologistsABSTRACT
El hígado ectópico (HE) es una entidad infrecuente, debida a la migración aberrante de las células hepáticas durante la embriogénesis. La incidencia se estima entre el 0,24 y el 0,47%. Puede presentarse en numerosas localizaciones, siendo la vesícula la localización más común. Existen alrededor de 100 casos publicados de HE, de los cuales 28 han desarrollado carcinoma hepatocelular (CHC); mientras que el hígado ortotópico no presenta ninguna alteración; todos provienen de la literatura asiática y caucásica. Reportamos el caso de un paciente de 42 años con lesión sólida de 17×12×12cm, aparentemente dependiente de la pared posterior del cuerpo gástrico, y con desplazamiento de numerosas vísceras, sugiriendo como posibilidad diagnóstica GIST. Mientras que, otras estructuras como el hígado y las vías biliares fueron topográficamente normales. El estudio anatomopatológico concluyó que la tumoración descrita correspondía a un CHC originado en un HE.(AU)
Ectopic liver (EL) is a rare developmental anomaly caused by the migration of hepatic cells to other locations during embryogenesis. Its incidence is thought to be between 0.24 and 0.47% and can occur in various sites, although the gall bladder is the most frequent. Approximately 100 cases of EL have been published, of which 28 developed hepatocellular carcinoma, whilst the orthotopic liver was unaffected. All cases are reported in Asian and Caucasian patients.We report the case of a 42-year-old patient with a solid lesion measuring 17×12×12cm apparently arising from the posterior wall of the stomach, displacing various organs and suggestive of a gastrointestinal stromal tumour (GIST). The liver, biliary tract and other structures were unremarkable. Histopathology revealed a diagnosis of hepatocellular carcinoma in ectopic liver tissue.(AU)
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Inpatients , Physical Examination , Symptom Assessment , Embryonic Development , Liver , alpha-Fetoproteins , Neoplasms , Pathology , Pathology Department, Hospital , Liver DiseasesABSTRACT
BACKGROUND: Desmoid type fibromatosis is a benign neoplastic process non-encapsulated locally invasive and aggressive, which arises from a proliferation of bland-looking fibroblasts and myofibroblasts. The most frequent location of fibromatosis is extraabdominal (60%), abdominal wall (25%) and intra-abdominal (8-15%), rarely can originate in the viscera (0.73%), such as the pancreas, gastroesophageal junction, diaphragm and appendix. The annual incidence of desmoid tumor is estimated at 2 to 5 cases per million. In this article, we report a case of unusual presentation, originated in the cecal appendix. CASE: A 41-year-old female patient with acute pelvic pain, admitted to surgical ward with a clinical and ultrasound diagnosis of probably ovarian pedicle tumor. An explorative laparotomy revealed a solid mass of 15 cm in diameter arising from the cecal appendix, with the anatomopathological study corresponding to a desmoid tumor of the cecal appendix. CONCLUSIONS: The desmoid tumor can arise from several extra and intra-abdominal locations, the latter being the rarest and most aggressive. Accurate preoperative diagnosis is very difficult and almost always patients enter to surgery with suspected diagnosis of intraabdominal tumor of unknown etiology. The risk factors associated to its appearance are not yet characterized. The complete surgical resection of the tumor -with free surgical margins (R0)- is the treatment of choice; however, the risk of recurrence is high even with optimal tumor removal.
Subject(s)
Appendiceal Neoplasms/diagnosis , Fibromatosis, Aggressive/diagnosis , Adult , Female , HumansABSTRACT
RESUMEN Antecedente : La fibromatosis tipo desmoide es un proceso neoplásico benigno no encapsulado localmente invasivo y agresivo, que se origina de la proliferación de fibroblastos y miofibroblastos aparentemente normales. La localización más frecuente de la fibromatosis es extra-abdominal (60%), pared abdominal (25%) e intra-abdominal (8-15%), en raras ocasiones puede originarse en las vísceras (0,73%), como el páncreas, unión gastroesofágica, diafragma y apéndice. La incidencia anual de tumor desmoide se estima de 2 a 5 casos por millón. En el presente artículo, reportamos un caso de presentación inusual, originado en el apéndice cecal. Caso : Paciente de sexo femenino de 41 años con dolor pélvico agudo, que ingresa a sala de operaciones con diagnóstico clínico y ecográfico de probable tumor de ovario a pedículo torcido. En el intraoperatorio se evidenció una tumoración sólida de 15 cm de diámetro que dependía del apéndice cecal, correspondiendo el estudio anatomopatológico a tumor desmoide de apéndice cecal. Conclusiones : El tumor desmoide puede originarse en diversas localizaciones extra e intra-abdominales, siendo esta última la más rara y agresiva. El diagnóstico preoperatorio exacto es muy difícil y casi siempre los pacientes ingresan al quirófano con sospecha diagnostica de tumoración intraabdominal de etiología desconocida. Los factores de riesgos asociados a su aparición aún no se encuentran caracterizados, siendo la resección quirúrgica completa del tumor -con márgenes quirúrgicos libres (R0)- el tratamiento de elección; sin embargo, el riesgo de recurrencia es alto incluso con la remoción óptima del tumor.
ABSTRACT Background : Desmoid type fibromatosis is a benign neoplastic process non-encapsulated locally invasive and aggressive, which arises from a proliferation of bland-looking fibroblasts and myofibroblasts. The most frequent location of fibromatosis is extra- abdominal (60%), abdominal wall (25%) and intra-abdominal (8-15%), rarely can originate in the viscera (0.73%), such as the pancreas, gastroesophageal junction, diaphragm and appendix. The annual incidence of desmoid tumor is estimated at 2 to 5 cases per million. In this article, we report a case of unusual presentation, originated in the cecal appendix. Case : A 41-year-old female patient with acute pelvic pain, admitted to surgical ward with a clinical and ultrasound diagnosis of probably ovarian pedicle tumor. An explorative laparotomy revealed a solid mass of 15 cm in diameter arising from the cecal appendix, with the anatomopathological study corresponding to a desmoid tumor of the cecal appendix. Conclusions : The desmoid tumor can arise from several extra and intra-abdominal locations, the latter being the rarest and most aggressive. Accurate preoperative diagnosis is very difficult and almost always patients enter to surgery with suspected diagnosis of intraabdominal tumor of unknown etiology. The risk factors associated to its appearance are not yet characterized. The complete surgical resection of the tumor -with free surgical margins (R0)- is the treatment of choice; however, the risk of recurrence is high even with optimal tumor removal.
