Neuron parvum fluorescens, un Término con Influencia Anglo-Greco-Latina. Propuesta a Terminologia Neuroanatomica y Terminologia Histologica / Neuron Parvum Fluorescens, a Term with Anglo-Greco-Latin Influence. A Proposal to Terminologia Neuroanatomica and Terminologia Histologica

Las terminologías son utilizadas como instrumento lingüístico que permite la transmisión de conocimiento de manera precisa y sin ambigüedades en el ámbito de las ciencias. Los lineamientos de la Federative International Programme for Anatomical Terminology (FIPAT) refieren que la denominación de nombres estructurales debe ser descriptivos e informativos. Este estudio analiza las raíces lingüísticas que componen el término Neuron parvum valde fluorescens vigente en Terminologia Histologica y el término Neuron parvum fluorescens vigente en Terminologia Neuroanatomica. Las células pequeñas intensamente fluorescentes son neuronas que se encuentran en el sistema nervioso autónomo, distribuidas en los ganglios simpáticos. Estas células presentan sinapsis aferentes con terminales nerviosas simpáticas preganglionares y sinapsis eferentes con las dendritas de las neuronas posganglionares. Su función es regular la transmisión ganglionar, actuando como interneuronas con señalización paracrina y endocrina. Además, se caracterizan por ser células fluorescentes, que expresan catecolaminas; serotonina, noradrenalina y dopamina. Se realizó una búsqueda en Terminologia Histologica y Terminologia Neuroanatomica, con una traducción de los términos al español. Además, la búsqueda se complementó en un diccionario etimológico en inglés para los términos correspondientes. Esta investigación encontró diferencia entre la traducción del latín al español del término fluorescens, quien posee un origen etimológico muy diferente a su significado en español. El término Neuron parvum valde fluorescens en Terminologia Histologica y el término Neuron parvum fluorescens en Terminologia Neuroanatomica, identifican a la misma estructura. Se sugiere reemplazar ambos términos por Cateconeuron ganglionare, entregando así una correcta descripción de este tipo de neurona, considerando su ubicación y función. Además, de esta manera ser un término concordante en latín para su incorporación en Terminologia Neuroanatomica y Terminologia Histologica.

SUMMARY: Terminologies are used as a linguistic tool to convey knowledge in a precise and unambiguous manner in science. The guidelines of the Federative International Programme for Anatomical Terminology (FIPAT) state that the names given to structures should be both descriptive and informative. This study analyses the linguistic roots of the term Neuron parvum valde fluorescens in Terminologia Histologica and the term Neuron parvum fluorescens in Terminologia Neuroanatomica. Small intensely fluorescent cells are neurons found in the autonomic nervous system, distributed in the sympathetic ganglia, they have afferent synapses with preganglionic sympathetic nerve terminals and efferent synapses with the dendrites of postganglionic neurons, whose function is to regulate ganglionic transmission, acting as interneurons with paracrine and endocrine signalling. They are also characterized as fluorescent cells, producing the catecholamines: serotonin, noradrenaline and dopamine. A search was carried out in Terminologia Histologica and Terminologia Neuroanatomica, with a translation of the terms into Spanish. This was complemented by a search in an English etymological dictionary for the corresponding terms. This research found a difference between the Latin to English translation of the term fluorescens, which has a very different etymological origin to its English meaning. The term Neuron parvum valde fluorescens in Terminologia Histologica and the term Neuron parvum fluorescens in Terminologia Neuroanatomica identify the same structure. The proposal is to replace both terms with Cateconeuron ganglionare, thus affording an accurate description of this type of neuron, considering its location and function. Moreover, it would also be a concordant term in Latin for its incorporation into the Terminologia Neuroanatomica and Terminologia Histologica.

Características clínicas epidemiológicas de los pacientes con cáncer de pulmón en la provincia Camagüey 2017-2021

Introducción: El cáncer de pulmón es una de las enfermedades más graves y uno de los cánceres con mayor incidencia en las personas, responsable de los mayores índices de mortalidad oncológica a escala mundial. Objetivo: Analizar las características clínicas epidemiológicas de los pacientes con cáncer de pulmón. Métodos: Se realizó un estudio observacional descriptivo retrospectivo, con el objetivo de analizar las características clínicas epidemiológicas de los pacientes con el diagnóstico de cáncer de pulmón atendido en el Hospital Oncológico María Curie durante el quinquenio de enero de 2017 a diciembre de 2021. El universo de estudio incluyó a los 822 pacientes que fueron atendidos en el hospital durante el período antes señalado, con cáncer de pulmón. La muestra a discreción la conformaron 276 pacientes. Resultados: Predominio del cáncer de pulmón en los pacientes de 61 a 80 años de edad, sexo masculino, fumadores pasivos. La variedad cito-histológica con mayor incidencia fue el carcinoma de células pequeñas microcítico; debut de esta enfermedad en pacientes en estadio IV y con tratamiento recibido de radioterapia y quimioterapia en el 100 % de los pacientes. Conclusiones: Es un tumor predominante entre las neoplasias malignas, donde el diagnóstico oportuno permite tratar en estadios tempranos, lo cual favorece la sobrevida en pacientes.

Introduction: Lung cancer is one of the most serious diseases and one of the cancers with the highest incidence in people, responsible for the highest oncological mortality rates worldwide. Objective: To analyze the clinical-epidemiological characteristics of patients with lung cancer. Methods: A retrospective descriptive observational study was carried out, with the objective of analyzing the epidemiological clinical characteristics of patients diagnosed with lung cancer treated at the María Curie Oncological Hospital during the five-year period from January 2017 to December 2021. The universe of study included 822 patients who were treated in the hospital during the aforementioned period with lung cancer. The sample at discretion was made up of 276 patients. Results: Prevalence of lung cancer in patients between 61 and 80 years of age, male, passive smokers. The cyto-histological variety with the highest incidence was small cell microcytic carcinoma; debut of this disease in patients in stage IV and with treatment received with radiotherapy and chemotherapy in 100% of the patients. Conclusions: It is a predominant tumor among malignant neoplasms, where timely diagnosis allows treatment in early stages, which favors survival in patients.

El síndrome de Eaton Lambert: una presentación clínica inusual que suele preceder al diagnóstico oncológico / Eaton lambert syndrome: a rare clinical presentation that usually precedes oncological diagnosis

El síndrome de Eaton Lambert es un trastorno de tipo autoinmune que afecta a la unión neuromuscular. Cursa con debilidad muscular proximal y simétrica y en el 60% de los casos se asocia a una neoplasia subyacente. Dado que esta debilidad es de inicio insidioso, los pacientes suelen consultar inicialmente a su especialista de Medicina Familiar y Comunitaria. Reconocer esta entidad es fundamental para el diagnóstico precoz de la enfermedad oncológica ya que habitualmente precede en meses a los síntomas locales derivados de la enfermedad tumoral. El médico o médica de Atención Primaria tiene un papel fundamental en el adelanto diagnóstico y debe realizar una derivación precoz al medio hospitalario para completar el estudio. Presentamos un caso clínico de síndrome de Eaton Lambert paraneoplásico en el contexto de un carcinoma de pulmón de células pequeñas que trata de ilustrar esta cronología y abordar el proceso diagnóstico y terapéutico.(AU)

Eaton Lambert syndrome is an autoimmune disorder that involves the neuromuscular junction. Clinical course includes proximal muscular weakness and symmetry. In 60% of cases this is associated with underlying neoplasia. Given that this weakness is of insidious onset, patients usually initially consult their family doctor. Recognizing this condition is essential for early diagnosis of oncological disease as it usually occurs a few months prior to local symptoms arising from tumour disease. The family doctor plays a crucial role in early diagnosis and should refer early to hospital to complete the study. We report a case study of paraneoplastic Eaton Lambert syndrome in the context of a small cell lung carcinoma that tries to depict this chronology, in addition to tackling the diagnostic and therapeutic process.(AU)

Carcinoma de células pequeñas extrapulmonar de mama. Comunicación de caso / Extrapulmonary small cell carcinoma of the breast. Case report

RESUMEN El carcinoma de células pequeñas representa 20% de los cánceres de pulmón; raramente ocurre en otros sitios. El carcinoma de células pequeñas extrapulmonar es agresivo, con propensión a la diseminación regional y a distancia. Este tipo de carcinoma es una neoplasia poco frecuente en mama. Aunque la apariencia clínica es inespecífica, a menudo responde bien a la terapia y tiene buen pronóstico de supervivencia. Se presenta el caso de mujer de 50 años con carcinoma de células pequeñas extrapulmonar de mama. El examen físico mostró lesión de 4 x 3 x 3 centímetros confirmada por resonancia magnética de la mama izquierda. El diagnóstico se realizó mediante biopsia que mostró las características células pequeñas, redondas, similares a linfocitos con núcleos hipercromáticos y escaso citoplasma, compatible con carcinoma de células pequeñas de mama. La paciente fue tratada con quimioterapia antes de ser sometida a mastectomía total y resección de los ganglios linfáticos.

ABSTRACT Small cell carcinoma accounts for 20% of lung cancers; it rarely occurs at other sites. Extrapulmonary small cell carcinoma is aggressive, with a propensity for regional and distant spread. This type of carcinoma is a rare breast neoplasm. Although the clinical appearance is nonspecific, it often responds well to therapy and has a good prognosis of survival. We present the case of a 50-year-old woman with extrapulmonary small cell carcinoma of the breast. Physical examination showed a 4 x 3 x 3 centimeters lesion confirmed by magnetic resonance imaging of the left breast. The diagnosis was made by biopsy showing characteristic small, round, lymphocyte-like cells with hyperchromatic nuclei and scant cytoplasm, compatible with small cell carcinoma of the breast. The patient was treated with chemotherapy before undergoing total mastectomy and lymph node resection.

Síndrome miasteniforme de Lambert-Eaton / Lambert-Eaton myasthenic syndrome

Introducción: El síndrome miasteniforme de Lambert-Eaton (LEMS) es una patología paraneoplásica (T-LEMS) o idiopática autoinmunitaria (NT-LEMS) ocasionada por autoanticuerpos contra los canales de calcio dependientes del voltaje presinápticos de la unión neuromuscular. El 60% de los T-LEMS se asocia a carcinoma de pulmón de células pequeñas. Una puntuación Dutch-English LEMS Tumor Association Prediction (DELTA-P) mayor de 3 denota un riesgo elevado de dicha asociación. El diagnóstico precoz fundado en los hallazgos clínicos, estudios neurofisiológicos y dosificación de títulos de anticuerpos en el suero permite iniciar tempranamente el tratamiento sintomático y la búsqueda oncológica. Son escasos los informes de pacientes con LEMS en Latinoamérica. Objetivo: Describir las características de pacientes con LEMS de un centro privado de Buenos Aires, Argentina, y compararlas con las de otras series publicadas. Pacientes y métodos: Se revisaron historias clínicas de 13 pacientes con LEMS con hallazgos clínicos, electromiograma compatible y/o anticuerpos positivos. Se realizó seguimiento hasta descartar o confirmar una neoplasia asociada de acuerdo con los algoritmos recomendados. Resultados: Cuatro pacientes presentaron diagnóstico de T-LEMS, dos de ellos con carcinoma de pulmón de células pequeñas. De los nueve pacientes con NT-LEMS, cinco presentaron una puntuación DELTA-P de 3 y 4. Nueve pacientes presentaron la tríada clínica clásica desde el inicio. Todos los pacientes presentaron en el electromiograma hallazgos compatibles con defecto de placa neuromuscular presináptico. El 70% mejoró sintomáticamente con piridostigmina. Conclusiones: Los hallazgos clínicos, junto con los estudios neurofisiológicos compatibles, resultan suficientes para el diagnóstico de LEMS. No pudo replicarse la relación entre puntuación DELTA-P y riesgo de carcinoma de pulmón de células pequeñas...(AU)

Introduction: Early diagnosis based on clinical findings, neurophysiological studies and serum antibody titres allows early initiation of symptomatic treatment and oncological screening. Reports of patients with LEMS in Latin America are scarce. Aim: This article aims to describe the characteristics of patients with LEMS from a private centre in Buenos Aires, Argentina, and to compare them with those of other series that have been published. Patients and methods: The medical records of 13 patients with LEMS with clinical findings, compatible electromyogram and/or positive antibodies were reviewed. Follow-up was performed until associated neoplasia was ruled out or confirmed according to the recommended algorithms. Results: Four patients were diagnosed with T-LEMS, two of them with small-cell lung carcinoma. Of the nine patients with NT-LEMS, five had a DELTA-P score of 3 and 4. Nine patients presented with the classic clinical triad from the onset of the disease. All patients had electromyogram findings compatible with presynaptic neuromuscular plaque defect. Of the total, 70% improved symptomatically with pyridostigmine. Conclusions: The clinical findings, together with compatible neurophysiological studies, are sufficient for the diagnosis of LEMS. The relationship between the DELTA-P score and the risk of small-cell lung carcinoma could not be replicated. Symptomatic treatment with pyridostigmine represents an effective therapeutic alternative.(AU)

Residential Radon and Small Cell Lung Cancer. Final Results of the Small Cell Study.

INTRODUCTION: Residential radon is considered the second cause of lung cancer and the first in never smokers. Nevertheless, there is little information regarding the association between elevated radon levels and small cell lung cancer (SCLC). We aimed to assess the effect of residential radon exposure on the risk of SCLC in general population through a multicentric case-control study. METHODS: A multicentric hospital-based case-control study was designed including 9 hospitals from Spain and Portugal, mostly including radon-prone areas. Indoor radon was measured using Solid State Nuclear Track Detectors at the Galician Radon Laboratory. RESULTS: A total of 375 cases and 902 controls were included, with 24.5% of cases being women. The median number of years living in the measured dwelling was higher than 25 years for both cases and controls. There was a statistically significant association for those exposed to concentrations higher than the EPA action level of 148Bq/m3, with an Odds Ratio of 2.08 (95%CI: 1.03-4.39) compared to those exposed to concentrations lower than 50Bq/m3. When using a dose-response model with 100Bq/m3 as a reference, it can be observed a linear effect for small cell lung cancer risk. Smokers exposed to higher radon concentrations pose a much higher risk of SCLC compared to smokers exposed to lower indoor radon concentrations. CONCLUSIONS: Radon exposure seems to increase the risk of small cell lung cancer with a linear dose-response pattern. Tobacco consumption may also produce an important effect modification for radon exposure.

Un caso atípico de neoplasia de pulmón / An atypical case of lung neoplasia

Introducción: El cáncer de pulmón se considera el tumor maligno que más muertes produce en el mundo, por encima de otros cánceres y en el 90 por ciento de los casos se diagnostica en estadios avanzados. Objetivos: Describir una forma atípica de presentación de una neoplasia de pulmón. Caso clínico: Paciente masculino de 68 años, fumador de más de 37 años, con antecedentes de insuficiencia cardíaca para lo cual llevó tratamiento con nitrosorbide (10 mg) 1 tableta cada 8 horas y aspirina (125 mg) 1 tableta al día. Refirió dolor en miembro inferior izquierdo, intenso que no se aliviaba durante todo el día y se exacerbaba con los movimientos y esfuerzos físicos. Además, presentó aumento de volumen en la región anterior media del tórax, de aproximadamente 15 cm de longitud, dura, dolorosa, de bordes regulares, superficie lisa. No tuvo tos, disnea, fiebre u otra sintomatología. Conclusiones: El paciente tuvo una forma diferente de presentación de la neoplasia de pulmón. No presentó manifestaciones respiratorias que orientaran hacia la identificación de una causa pulmonar. Es necesaria la identificación del patrón cancerígeno, así como su estadiaje para prescribir el tratamiento y conducta adecuada (AU)

Introduction: Lung cancer is considered the malignant tumor that produces more deaths in the world over other cancers and in 90 percent of cases they are diagnosed in advanced stages. Objectives: To describe an atypical form of presentation of lung neoplasia. Clinical case: A 68-year-old male patient, a smoker over 37 years of age, with a history of heart failure for which he was treated with nitrosorbide (10 mg) 1 tablet every 8 hours and aspirin (125 mg) 1 tablet per day. He reported pain in the lower left limb, which was not relieved throughout the day and was exacerbated by physical movements and efforts. In addition, there was an increase in volume in the middle anterior region of the chest, approximately 15 cm long, hard, painful, with regular edges, smooth surface. He had no cough, dyspnea, fever or other symptoms. Conclusions: The patient had a different form of lung neoplasia presentation. He did not present respiratory manifestations that oriented towards the identification of a pulmonary cause. The identification of the carcinogenic pattern is necessary, as well as its staging to prescribe the appropriate treatment and management(AU)

Tumor desmoplásico de célula pequeña y redonda paratesticular/testicular: reporte de caso y revisión de la literatura / Paratesticular/testicular desmoplastic round small cell malignant tumor: case report and literature review

Resumen El tumor desmoplásico de célula redonda y pequeña (TDCRP) es una patología neoplásica maligna agresiva y poco común. Afecta predominantemente a hombres entre la segunda y tercera década de la vida. Los pacientes que la padecen tienen un pronóstico pobre, con una supervivencia global a 5 años de hasta el 30%. Por lo general se presenta como una masa en la cavidad abdominal, frecuentemente multifocal. Para su tratamiento se recomienda un enfoque multimodal con cirugía, quimioterapia y radioterapia. Poco más de 20 casos de TDCRP a nivel testicular/paratesticular se han reportado en la literatura. A continuación, se presenta un caso ilustrativo en esta localización, se discute el caso y se realiza revisión de la literatura.

Abstract Desmoplastic small round cell tumor (DSRCT) is an aggressive and rare malignant neoplasm. It mainly affects young men in their twenties and thirties. Patients with it have a poor prognosis, with a 5-year survival rate of up to 30%. It generally presents as a mass in the abdominal cavity, often multifocal. A multimodal approach is recommended for its treatment, with surgery, chemotherapy, and radiotherapy. Just over 20 cases of testicular/paratesticular DSRCT have been reported in the literature. Below, we present an illustrative case in this location, we discuss the case and review the literature.

A rare case of penile metastases from small cell prostate cancer.

We present a case of an 83-year-old-male with painless penile nodules several months after he was diagnosed with pure prostatic small cell carcinoma. Penile doppler ultrasound and magnetic resonance imaging demonstrated solid nodules in both corpora cavernosa. Fine-needle aspiration of the nodules with immunohistochemical examination confirmed prostatic small cell carcinoma origin of metastases. Small cell carcinoma of the prostate is a rare disorder accounting for less than 1% of all prostate cancers, the penis being an uncommon site for metastasis. An extremely low number of cases of penile metastases from prostatic small cell carcinoma has been reported to date in the literature.

The prognostic role of PET/CT in small-cell lung cancer. / El papel pronóstico de la PET/TC en el cáncer pulmonar de células pequeñas.

OBJECTIVE: The aim in the present study is to determine the prognostic value of metabolic parameters related to the primary tumors detected in pretreatment Fluorine-18 2-fluoro-2-Deoxy-D-glucose (18F FDG) positron emission tomography/computerized tomography (PET/CT) scans of patients diagnosed with small-cell lung cancer (SCLC). MATERIAL AND METHODS: Enrolled in this retrospective study were 63 patients with a histopathologically confirmed diagnosis of SCLC who underwent an 18F FDG PET/CT scan at baseline. Disease stage, age at diagnosis, gender, albumin level and maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values related to the primary tumor at the baseline PET scan were recorded, and the relationship of these factors with progression-free survival (PFS) and overall survival (OS) was evaluated. RESULTS: The study included a total of 63 patients (10 female, 53 male, mean age of 64.8 and age range of 43-82 years), 22 of which had limited disease (LD) and 41 had extensive disease (ED). The OS and PFS were significantly higher in patients with LD than in patients with ED (15±2.9 vs. 10±0.9 months, p = 0.002 for OS; 10± 0.7 vs 6±0.6 months, p = 0.014 for PFS). However, no statistically significant relationship was identified between gender, albumin level, age and SUVmax, SUVmean, MTV, TLG values related to the primary tumor and PFS or OS. CONCLUSION: The present study found that pretreatment PET parameters were of not predictive value for PFS and OS in patients with SCLC.

Tumor desmoplásico de células pequeñas y redondas. Presentación de caso y revisión de la literatura / Desmoplastic Small Round Cell Tumor. A Case Report and Literature Review

El tumor desmoplásico de células pequeñas y redondas (TDCPR) es una neoplasia maligna rara, con curso clínico agresivo y mortalidad elevada. Se presenta el caso de un hombre de 21 años de edad, quien consultó por dolor abdominal de intensidad moderada, irradiado al flanco derecho, fiebre y pérdida de peso. En tomografía abdominal con medio de contraste se documentó una gran masa intraperitoneal con áreas de necrosis central y extensión a la pelvis, además de lesiones hepáticas de aspecto neoplásico secundario. El diagnóstico se confirmó mediante biopsia percutánea guiada por ultrasonido, que mostró extensa infiltración por tumor maligno, constituido por células con núcleos vesiculosos de cromatina clara, citoplasma eosinófilo e inmunohistoquímica compatible con dicho tumor. En este artículo se hace una confrontación del caso con los hallazgos descritos en otras series publicadas en la literatura y una revisión clínica del tema.

Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm with an aggressive clinical course and high mortality. The case of a 21-year-old man is presented, who consulted for abdominal pain of moderate intensity radiating to the right flank, fever and weight loss. Contrast abdominal tomography was performed, documenting a large intraperitoneal mass with areas of central necrosis and extension to the pelvis, in addition to secondary neoplastic liver lesions. The diagnosis was confirmed by ultrasound-guided percutaneous biopsy, which reported extensive infiltration by malignant tumor, consisting of cells with vesicular nuclei of clear chromatin, eosinophilic cytoplasm and immunohistochemistry compatible with said tumor. This case report is compared with the findings described in other series published in the literature and a clinical review of the subject is made.

Bilateral metastases to the extraocular muscles from small cell lung carcinoma / Metástases bilaterais aos músculos extraoculares de um carcinoma de pequenas células do pulmão

ABSTRACT Bilateral orbital metastases restricted to the extraocular muscles (EOMs) are exceedingly rare. We report a case of bilateral extraocular muscle metastases from a small cell lung carcinoma and provide a review of the relevant literature. A 56-year-old smoker presented with proptosis, motility changes, and a relative afferent pupillary defect of the left eye, with a previous history of a small cell lung carcinoma. An orbital computerized tomography scan revealed a mass restricted to the left medial rectus. An incisional biopsy confirmed metastasis. Visual acuity of the left eye decreased rapidly, and right globe proptosis became evident. Orbital magnetic resonance imaging at two months follow-up showed marked left orbital mass enlargement and a new right lateral rectus mass. The patient was maintained on palliative care and died from metastatic disease-related complications.

RESUMO As metástases orbitárias bilaterais restritas aos mús­culos extraoculares são extremamente raras. Os autores apresentam um caso de metástases bilaterais, localizadas aos musculares extraoculares com base num carcinoma de pequenas células do pulmão e revisão da literatura relevante. Um homem, fumador, de 56 anos recorreu ao serviço de urgência por proptose, alterações de motilidade ocular extrínseca e um defeito pupilar aferente relativo do olho esquerdo, com história pessoal de carcinoma de pequenas células do pulmão. A tomografia computadorizada orbitária revelou uma massa restrita ao reto medial esquerdo. Uma biópsia incisional confirmou o diagnóstico de metástase. A acuidade visual do olho esquerdo diminuiu rapidamente e surgiu uma proptose do globo ocular direito. A ressonância magnética orbitária aos dois meses de seguimento revelou um aumento da massa orbitária esquerda e uma nova massa no reto lateral direito. O paciente foi mantido em cuidados paliativos e faleceu devido a complicações relacionadas com doença metastática.

Asociación de los biomarcadores con el cáncer pulmonar en pacientes de un servicio de neumología / Association of biomarkers with lung cancer in patients of a pneumology service

Se realizó un estudio descriptivo y transversal de 199 pacientes diagnosticados con cáncer de pulmón, atendidos en el Servicio de Neumología del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, de enero del 2014 a diciembre del 2017, con vistas a determinar la asociación de los marcadores tumorales con el proceso neoplásico. En la serie predominaron el sexo masculino y las edades de 50 a 69 años, así como los estadios IIIB y IV de la enfermedad. De igual modo resultó más frecuente la localización en el pulmón derecho y el tipo histológico cáncer de pulmón células no pequeñas, del cual fue más representativo el adenocarcinoma. Por su parte, el CYFRA 21.1 y el CA 72.4 fueron los dos marcadores asociados con los procesos tumorales pulmonares y fueron ratificados como tal.

A descriptive and cross-sectional study of 199 patients diagnosed with lung cancer, assisted in the Pneumology Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba, from January, 2014 to December, 2017, aimed at determining the association of tumoral markers with the neoplastic process. In the series there was a prevalence of the male sex and patients aged 50 to 69, as well as the IIIB and IV stages of the disease. In a same way it was more frequent the localization in the right lung and the histologic type non small cells lung cancer, from which adenocarcinoma was more representative. On the other hand, CYFRA 21.1 and CA 72.4 were the two markers associated with lung tumoral processes and were confirmed as such.

Carcinoma neuroendocrino primario de vagina. Revisión de literatura a propósito de un caso / Primary neuroendocrine carcinoma of the vagina. Literature review on the subject of a case

RESUMEN El carcinoma primario de vagina representa 1 a 2% de los cánceres ginecológicos, siendo la diferenciación histológica neuroendocrina de células pequeñas extremadamente infrecuente, sólo se han reportado 28 casos en la literatura, describiéndose en orden de frecuencia en cérvix, endometrio, ovario, vagina y vulva. Se observa con más frecuencia en mujeres postmenopáusicas. Se presenta el caso de paciente femenino, de 39 años de edad, quien acude a la consulta por presentar secreción genital serohemática, fétida, de 1 mes de evolución, evidenciándose al examen físico lesión exofítica, friable, renitente, de aproximadamente 4 cm de diámetro, en tercio superior y cara posterolateral izquierda de vagina, por lo que se realiza biopsia excisional de dicha lesión, siendo el diagnóstico anatomopatológico carcinoma neuroendocrino de células pequeñas, grado histológico: 3. A propósito de este caso, se realiza una revisión del tema, haciendo hincapié en la importancia de la exploración ginecológica exhaustiva que incluya tomas de citologías y colposcopias periódicas, tomando en cuenta la vagina y así, realizar diagnóstico precoz en vista que el riesgo de carcinoma en dicha zona es infrecuente, mejorando el pronóstico y sobrevida de las pacientes.

ABSTRACT The primary carcinoma of the vagina represents 1 to 2 % of gynecologic cancers, being the histological differentiation neuroendocrine of small cells extremely infrequent, only 28 cases have been reported in the literature, describing in order of frequency: in the cervix, endometrium, ovary, vagina and vulva. It is most commonly seen in postmenopausal women. We present the case of a female patient, 39 years old, who comes to medical consult due to serohematic, fetid, genital discharge of 1 month of evolution, evidencing at physical examination an exophytic lesion, friable, renitent, with a diameter of approximately 4 cm, in the upper third and posterolateral left side of the vagina, for which an excisional biopsy of said lesion is performed, being the anatomopathological diagnosis neuroendocrine carcinoma of small cells, histological grade: 3. A bibliography reviewed was made, emphasizing the importance of exhaustive gynecological exploration with periodic cytology and colposcopy examinations, including the vagina for early diagnosis in view of carcinoma risk in this area is uncommon, improving the prognosis and survival of patients.

Carcinoma de células pequeñas de vejiga, a propósito de un caso / Carcinoma of bladder small cells: with regard to a case

Introducción: El carcinoma de células pequeñas de vejiga es una neoplasia poco frecuente que puede coexistir con un carcinoma urotelial. Ocurre principalmente en el sexo masculino en la séptima y octava décadas de vida. Macroscópicamente se observa como una masa sólida, polipoide y microscópicamente se conforma por células atípicas con núcleos hipercromáticos y una alta tasa mitótica. Caso: Paciente de 56 años, masculino, fumador que refiere que desde hace 6 meses presentó hematuria, con disuria y dificultad para orinar. Se realizó cistoscopía encontrándose lesión tumoral en vejiga por lo que se sometió a cistoprostatectomía radical. Discusión: El carcinoma vesical de células pequeñas es poco frecuente y puede coexistir con el carcinoma urotelial. El estudio anátomo patológico es fundamental para determinar el diagnóstico siendo necesarios marcadores de inmunohistoquímica como sinaptofisina, CD56, cromogranina y enolasa. La cirugía, quimioterapia y radiación se utilizan para dar un tratamiento multidisciplinario de la enfermedad.

Introduction: Small cell carcinoma of the bladder is a rare neoplasm, which can coexist many times with an urothelial carcinoma. It occurs mainly in males in the seventh and eighth decades of life. Macroscopically it is observed as a solid and polypoid mass and microscopically it is conformed by atypical cells with hyperchromatic nuclei and a high mitotic rate. Case: A 56-year-old man, smoker who has hematuria for six months, and dysuria and difficulty to urinate. In a cystocopy a bladder tumor is identified and a radical cistoprostectomy is performed. Discusion: Small cell vesical carcinoma is uncommon and may coexist with urothelial carcinoma. The anatomical pathological study is fundamental to determine the diagnosis, requiring immunohistochemical markers such as synaptophysin, CD56, chromogranin and enolase. Surgery, chemotherapy and radiation are used to provide a multidisciplinary treatment of the disease.

Small Cell Lung Cancer. Methodology and Preliminary Results of the SMALL CELL Study. / Cáncer de pulmón microcítico. Metodología y resultados preliminares del estudio SMALL CELL.

INTRODUCTION: Small cell lung cancer (SCLC) is the most aggressive histologic type of lung cancer, and accounts for approximately 10%-15% of all cases. Few studies have analyzed the effect of residential radon. Our aim is to determine the risk factors of SCLC. METHODS: We designed a multicenter, hospital-based case-control study with the participation of 11 hospitals in 4 autonomous communities. RESULTS: Results of the first 113 cases have been analyzed, 63 of which included residential radon measurements. Median age at diagnosis was 63 years; 11% of cases were younger than 50 years of age; 22% were women; 57% had extended disease; and 95% were smokers or former smokers. Median residential radon concentration was 128Bq/m3. Concentrations higher than 400Bq/m3 were found in 8% of cases. The only remarkable difference by gender was the percentage of never smokers, which was higher in women compared to men (P<.001). Radon concentration was higher in patients with stageIV disease (non-significant difference) and in individuals diagnosed at 63 years of age or older (P=.032). CONCLUSIONS: A high percentage of SCLC cases are diagnosed early and there is a predominance of disseminated disease at diagnosis. Residential radon seems to play an important role on the onset of this disease, with some cases having very high indoor radon concentrations.

Carcinoma de células pequeñas en la unión gastroesofágica / Gastroesophageal junction small cell carcinoma

Resumen Los tumores de células pequeñas extrapulmonares pueden aparecer en múltiples órganos y forman una rara afección clínico-patológica de tumores neuroendocrinos, con gran proliferación epitelial y con comportamiento biológico agresivo. El tubo gastrointestinal es la fuente más común de tumores de células pequeñas extrapulmonares. Nuestro caso clínico describe un paciente con carcinoma de células pequeñas en la unión gastroesofágica, que fue diagnosticado en el contexto de sangrado de tubo digestivo alto. Se excluyó un tumor pulmonar primario; el paciente recibió quimioterapia, quimiorradioterapia y radioterapia cerebral profiláctica, con buena evolución clínica. Nuestro caso se trata de una rara afección clínica, lo que evidencia la importancia de diagnosticar enferemedades poco frecuentes. Existe poca evidencia en la bibliografía de cómo deben tratarse estos pacientes.

Abstract Extrapulmonary small cell carcinomas (EPSCC) can arise in multiple organ sites and form a rare clinicopathological entity of high proliferative epithelial neuroendocrine tumors with aggressive biological behavior. Gastrointestinal is the most common source of EPSCC. We report a case of gastroesophageal junction small cell carcinoma, which was diagnosed in the context of upper gastrointestinal bleeding. A primary small cell lung carcinoma was excluded. Chemotherapy, neoadjuvant chemoradiotherapy and prophylactic cranial radiotherapy were given, with good clinical outcome. Our case of a very rare condition highlights the importance of recognizing atypical pathologic diagnoses. More research needs to be conducted with EPSCC patients in order to better characterize disease pathogenesis, and an optimal disease management.

Is the prognosis of occult N2 disease similar to that of positive positron emission tomography-computed tomography (PET/CT) scan single-station N2 disease in patients with non-small cell lung cancer treated by surgical resection?

OBJECTIVE: A retrospective study, using a prospective database, was conducted on patients treated with surgery in order to analyze the prognosis between two groups: NSCLC (non-small cell lung cancer) patients with occult N2 disease and patients with single station N2 disease observed on pre-operative integrated PET/CT scan. METHODS: A total of 772 patients underwent surgical treatment for lung cancer from January 2007 to December 2014. All of them had an integrated PET/CT scan in the pre-operative work-up and a pulmonary resection plus mediastinal lymphadenectomy were performed in all cases. In the selected cases, no one received induction treatment. All patients from both groups had N2 disease after examination of the histopathology specimen. Clinical and pathological characteristics, disease free survival, and overall survival, were analyzed in both groups. RESULTS: A total of 34 cases presented occult N2 disease, whereas 11 cases showed single station N2 disease on pre-operative PET/CT scan. Mean disease free survival and mean overall survival for occult N2 disease compared to single-station N2 disease on PET/CT scan was 36.0 months (95% CI: 24.9-47.1) and 38.9 months (95% CI: 20.6-57.1), p=.586; and 52.3 months (95% CI: 38.9-65.7) and 38.2 months (95% CI: 21.9-54.5), p=.349, respectively. CONCLUSION: The prognosis of patients with single-station N2 disease on PET/CT scan treated by surgical resection and mediastinal lymphadenectomy as first line treatment was similar to those with occult N2 disease. More studies are needed to support our findings.

Comportamiento del cáncer de pulmón células pequeñas en el hospital Hermanos Ameijeiras / Behavior of small cell lung carcinoma in Hermanos Ameijeiras hospital

Fundamento: el cáncer de pulmón de células pequeñas constituye aproximadamente un 15 por ciento de los carcinomas broncogénicos. Al diagnóstico, entre el 70-80 por ciento de los pacientes suelen presentar la enfermedad diseminada, por lo que la mayoría de los pacientes mueren, aún con el mejor tratamiento disponible.Objetivo: describir el comportamiento del cáncer de pulmón de células pequeñas en los pacientes inscritos en el hospital Hermanos Ameijeiras, Ciudad de La Habana, durante los años 2010 a 2013.Métodos: se realizó un estudio descriptivo, retrospectivo, de los pacientes con diagnóstico de cáncer de pulmón de células pequeñas, atendidos en el servicio de oncología del referido hospital, desde enero de 2010 a diciembre de 2013. El universo de estudio estuvo constituido por 1013 pacientes con diagnóstico de cáncer de pulmón y la muestra por 104 diagnosticados con cáncer de pulmón de células pequeñas.Resultados: la frecuencia del cáncer de pulmón de células pequeñas fue de 10,3 por ciento y el grupo de edades que predominó fue el de 60-69 años, así como en el sexo masculino. El 50 por ciento presentó alguna comorbilidad asociada, siendo la más frecuente la hipertensión arterial, seguido de la diabetes mellitus y cardiopatia isquémica. En cuanto al sitio primario, predominó el pulmón derecho, diagnosticándose la mayoría en etapas IV, siendo el hígado el sitio de metástasis más frecuente, seguido del pulmón contralateral y pleura. El tratamiento más utilizado fue la quimioterapia como modalidad única o con radioterapia, alcanzando una mediana de supervivencia de siete meses.Conclusiones: el cáncer de pulmón de células pequeñas constituye la variante histológica de menor frecuencia, la mayoría de los pacientes presentan enfermedad diseminada al diagnóstico. La quimioterapia mejora la supervivencia, pero solo es curativa en una minoría de pacientes (AU)

Background: small cell lung carcinoma is approximately in a 15 percent of bronchogenic carcinomas. At diagnosis, between 70 and 80 percent of patients often show the disease disseminated, so most of the patients die, even with the best treatment available.Objective: to describe the behavior of small cell lung carcinoma in patients registered in Hermanos Ameijeiras hospital in Havana during the years 2010 to 2013.Methods: a descriptive and retrospective study was carried out in patients diagnosed with small cell lung cancer treated at the oncology department of that hospital from January, 2010 to December, 2013. The universe of study consisted of 1013 patients diagnosed with lung cancer and the sample comprised 104 patients diagnosed with small cell lung carcinoma.Results: the frequency of small cell lung carcinoma was of a 10,3 percent and the predominant age group was 60 to 69 years and in males. The 50 percent showed some associated co-morbidity, being hypertension the most frequent one, followed by diabetes mellitus and ischemic heart disease. As the primary site, the right lung prevailed, diagnosed mostly in stage IV, being the liver the most common site of metastasis, followed by the contralateral lung and pleura. The most used treatment was chemotherapy as a single modality or with radiation therapy, reaching a median survival of 7 months.Conclusions: small-cell lung carcinoma is the less frequent histological variant; most of the patients had the disease disseminated at diagnosis. Chemotherapy improves survival but it is curative in only a minority of patients (AU)

Características clínicas y evolutivas de pacientes con cáncer pulmonar de células pequeñas / Clinical evolutionary features of patients with small-cell lung cancer

Se realizó un estudio observacional descriptivo, longitudinal y retrospectivo de 46 pacientes con cáncer pulmonar de células pequeñas, diagnosticados histopatológicamente y tratados por el Grupo de Atención a Pacientes con Tumores de Pulmón del Hospital Provincial Clínicoquirúrgico Docente "Saturnino Lora Torres" de Santiago de Cuba, desde enero del 2002 hasta diciembre del 2014, con vistas a identificar las características clínicas y evolutivas en ellos, además de evaluar su supervivencia global. La enfermedad predominó en el sexo masculino, sobre todo en las edades de 55 a 74 años, y sus formas de presentación más frecuentes fueron la bronconeumónica y la hiliar infiltrativa pulmonar, detectadas de manera clínica y radiológica, respectivamente. Por otra parte, el diagnóstico histológico se obtuvo principalmente a través de la broncoscopia con biopsia y el esputo citológico, en una etapa limitada, y aunque en la mayoría de los pacientes se pudo aplicar como tratamiento de primera línea la combinación de carboplatino y etopósido, la supervivencia al año fue menor que una tercera parte del total de la serie.

A descriptive, longitudinal and retrospective observational study of 46 patients with small-cell lung cancer, diagnosed histopathologically and treated by the Care Group to patients with lung tumors in "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, was carried out from January, 2002 to December, 2014, aimed at identifying their clinical features and evaluating their global survival. The disease prevailed in the male sex, mainly in the 55 to 74 age group, and its most frequent presentation were the bronchopneumonic and lung infiltrative hilar types, detected in a clinical and radiological way, respectively. On the other hand, the histological diagnostic was obtained mainly through the bronchoscopy with biopsy and the cytological sputum, in a limited stage, and although in most of the patients the carboplatin and etoposide combination could be apply as first line treatment, the survival at a year was less than a third part of the whole series.