Medulloblastoma during pregnancy: Hormone-mediated association? Report of 2 cases.

OBJECTIVE: To report two rare cases of medulloblastoma in pregnant patients and a review of the literature. MATERIAL AND METHODS: Report of patients diagnosed with medulloblastoma during their pregnancies, who were treated with surgery and adjuvant therapy. We also reviewed other cases reported in the literature and the association made with hormonal receptors. RESULTS: Brain tumors in coincidence with pregnancy are unusual, and the incidence of medulloblastoma in pregnancy is still rarer. We found 8 cases of medulloblastomas diagnosed during pregnancy. Reports suggest that hormonal changes and increases in the levels of growth factors and angiogenic factors during pregnancy influence the rate of growth of brain tumors (not only medulloblastomas but also meningiomas or glial tumors). CONCLUSIONS: The uniqueness of these cases is their rarity. The symptoms are usually masked by the symptoms of pregnancy. At present, there is still little evidence regarding the pathogenesis and treatment of medulloblastoma in pregnancy.

Melanoma cutáneo de la región dorsal. reporte de un caso / Cutaneous melanoma of the dorsal region.a case report

RESUMEN: El melanoma es una neoplasia que se origina de los melanocitos, células derivadas de la cresta neural. En el Ecuador, entre el 2001 y 2005 se diagnosticaron en Quito en promedio: 18 casos anuales de melanoma en hombres y 26 casos en mujeres, con una tasa de incidencia de 2.5 y 3.2 respectivamente, mientras queen Guayaquil, durante el período 2003-2006 fueron reportados 49 casos en total, con una incidencia de 0.9 por cada 100.000 habitantes en hombres y 0.1 en mujeres. Siempre que se pueda es preferible una biopsia escisional, extirpando la lesión entera. La determinación del ganglio centinela junto al nivel de Clark, el espesor de Breslow y la ulceración del tumor, son considerados los factores pronósticos más importantes del melanoma maligno.

SUMMARY: Melanoma is a neoplasm that originates from the melanocytes, cells derived from the neural crest. In Ecuador, between 2001 and 2005 an average of 18 cases in men and 26 cases in women were diagnosed in Quito, with an incidence rate of 2.5 and 3.2 respectively, while in Guayaquil, during the period 2003-2006, 49 cases were reported, with an incidence of 0.9 per 100.000 inhabitants in men and 0.1 in women. The exact etiology is not clear, it is considered a heterogeneous diseasewith multifactorial origin. Whenever possible, an excisional biopsy is preferable, removing the entire lesion. The determination of the sentinel lymph node along with the Clark level, the Breslow thickness and the ulceration of the tumor, are considered the most important prognostic factors of malignant melanoma.