Resultados de la biopsia selectiva de ganglio centinela combinada con la localización radioguiada de tumores invasivos no palpables de mama. Técnica de SNOLL / No disponible

Objetivo: La biopsia selectiva del ganglio centinela mediante inyección intralesional de un radiocoloide, combinado con la localización radioguiada de tumores no palpables de mama en el mismo acto quirúrgico se denomina técnica de SNOLL. El objetivo de nuestro estudio es mostrar la factibilidad y sencillez para realizar la técnica en un hospital provincial de 2º nivel dotado con Servicio de Medicina Nuclear, comparando nuestros resultados con las publicaciones de referencia. Métodos: Entre enero 2007 y marzo 2008 se incluyeron 20 pacientes consecutivas diagnosticadas de carcinoma no palpable de mama. Se realizó inyección intratumoral de un nanocoloide- Tc99 de albúmina (0,2 ml, 37MBq) guiada por ecografía o estereotaxia seguida de linfogammagrafía e instilación subareolar de colorante azul patente (2 ml). Tras identificación del ganglio centinela se detectó y extirpó la lesión mamaria mediante uso de sonda detectora de rayos gamma. Se verificaron radiológicamente todos los especímenes extirpados. Resultados: Se obtuvo al menos un ganglio centinela mediante marcaje radiactivo en 19 pacientes (95%). En un paciente el ganglio centinela se detectó únicamente mediante colorante. La localización radioguiada y extirpación de la lesión primaria se consiguió en todos los casos. En dos casos (10%), los márgenes se encontraban afectos (< 2 mm) por enfermedad in situ extensa asociada. 4 pacientes presentaron ganglio centinela positivo. Conclusiones: Las conclusiones de nuestra serie se encuadran en las publicadas hasta la fecha, otorgando a la técnica de SNOLL mejores resultados que la localización con guía metálica y confirmando la factibilidad de la misma en cualquier centro con recurso a Medicina Nuclear(AU)

Introduction: The SNOLL technique results of the combination of radioguided occult lesion localization (ROLL) and sentinel node mapping with a single radiotracer injection in the management of non-palpable breast cancer. The aim of this study was to evaluate the feasibility of this technique in a second-level hospital with a nuclear medicine department and compare our results with the reference publications. Methods: From January 2007 to March 2008, lymphoscintigraphy was performed in 20 consecutive patients with non-palpable breast cancer after the intratumoral injection of albumin nanocolloid-Tc99 (0.2 ml, 37 MBq) guided by stereotaxis or ultrasound. Under general anaesthesia, a subareolar injection of blue dye was performed. After sentinel lymph node biopsy, the gamma-ray detection probe was used for radioguided removal of the breast tumor. All the breast lesions were identified on X-ray control of the surgical specimen. Results: Al least one sentinel node was removed in 19 patients (95%). In one patient, the sentinel node was only detected by blue dye. Radioguided surgery of the breast tumor was successfully achieved in all patients. In two cases (10%), in situ carcinoma was present close to the margins of the surgical specimen (< 2 mm) and further re-excision was therefore performed. Axillary dissection was accomplished in 4 patients with sentinel node metastases. Conclusions: The findings of our study are consistent with those published to date, showing the advantage of SNOLL technique over the wire-guided localization of non-palpable breast cancer and confirming its feasibility in any center with a reference nuclear medicine department(AU)

Miofibroblastoma de mama en un paciente varón / Myofibroblastoma of the breast in a male patient

No disponible

[Hepatic alveolar hydatidosis]. / Hidatidosis alveolar hepática.

Alveolar echinococcosis of the liver is a disease caused by the intrahepatic growth of Echinococcus multilocularis larvae. In contrast to hydatidic cyst caused by Echinococcus granulosus, this is a rare disease in Spain. We present a case of alveolar echinococcosis of the liver which presented with jaundice and hepatomegaly. An infiltrative solid tumor was diagnosed by US and CT scan. The patient required left hepatectomy and interventional radiology procedures with satisfactory results. Diagnosis and treatment of this disease are discussed.

[Brucellar hepatic abscess: presentation of a case and review of the literature]. / Absceso hepático brucelar: presentación de un caso y revisión de la literatura.

We present a case of a brucellar liver abscess in a 25-year-old male that was successfully treated by surgery and comment on this unusual form of brucellosis. We detail the complementary exams and how the diagnosis was achieved. We also review the 23 cases reported in the world literature, commenting on them from an etiological, clinical, diagnostic and therapeutic point of view in its two aspects: medical and surgical.