Relación entre cistatina C y calcificación coronaria en pacientes con riesgo cardiovascular intermedio / Relationship between cystatin C and coronary artery calcification in patients with intermediate cardiovascular risk

Fundamento y objetivo: La enfermedad cardiovascular es la principal causa de morbimortalidad en los países industrializados. La cuantificación del calcio arterial coronario (CAC) ha demostrado tener un valor pronóstico independiente e incremental con respecto a los factores de riesgo tradicionales para la predicción de mortalidad y episodios cardiovasculares. El objetivo de nuestro estudio fue determinar la posible relación entre el CAC y la cistatina C (CTC). Pacientes y método: Se incluyeron 104 pacientes con dolor torácico estable, libres de enfermedad cardiovascular y nefropatía, con riesgo cardiovascular intermedio, en los que se determinaron el CAC (Agatston) y CTC. Resultados: La CTC se asoció de forma independiente respecto a los factores de riesgo clásicos con el nivel de CAC y con la presencia de enfermedad coronaria. Conclusiones: Los valores de CTC podrían asociarse con el CAC y con el riesgo de enfermedad coronaria. Es necesaria la aparición de nuevos estudios para conocer la importancia de estos marcadores en la práctica clínica habitual (AU)

Background and objective: Cardiovascular disease is the leading cause of morbimortality in industrialized countries. Quantification of coronary artery calcium (CAC) has been shown to have an independent and incremental prognostic value over traditional risk factors for the prediction of mortality and cardiovascular events. The aim of our study was to determine the possible relationship between CAC and cystatin C (CTC). Patients and method: We included 104 patients with stable chest pain, free of cardiovascular disease and nephropathy, with intermediate cardiovascular risk. Both CAC (Agatston) and CTC were determined. Results: CTC was independently associated with the CAC level and the presence of coronary disease. Conclusions: CTC values may be associated with CAC and coronary disease. Further studies are needed to know the importance of these markers in clinical practice (AU)

[Relationship between cystatin C and coronary artery calcification in patients with intermediate cardiovascular risk]. / Relación entre cistatina C y calcificación coronaria en pacientes con riesgo cardiovascular intermedio.

BACKGROUND AND OBJECTIVE: Cardiovascular disease is the leading cause of morbimortality in industrialized countries. Quantification of coronary artery calcium (CAC) has been shown to have an independent and incremental prognostic value over traditional risk factors for the prediction of mortality and cardiovascular events. The aim of our study was to determine the possible relationship between CAC and cystatin C (CTC). PATIENTS AND METHOD: We included 104 patients with stable chest pain, free of cardiovascular disease and nephropathy, with intermediate cardiovascular risk. Both CAC (Agatston) and CTC were determined. RESULTS: CTC was independently associated with the CAC level and the presence of coronary disease. CONCLUSIONS: CTC values may be associated with CAC and coronary disease. Further studies are needed to know the importance of these markers in clinical practice.

Retroperitoneal cystic mature teratoma as the presenting clinical scenario of testicular carcinoma.

OBJECTIVE: To describe a case of retroperitoneal mature teratoma presenting as metastasis of a testicular mixed germ cell tumor in a thirty year old man who had lumbar and abdominal pain and mass sensation in the left hemiabdomen. METHODS: Abdominal ultrasound and thoracic-abdominal-pelvic CT multidetector scan were performed, and then after a Doppler ultrasound study of the testicles. Surgical treatment was performed: orchiectomy and retroperitoneal lesion resection. RESULTS: Imaging studies showed a big cystic lesion in the left retroperitoneal space, 13 × 12 × 11 cm, well defined, with thin septa, displacing the kidney; and a solid-cystic 4 cm left testicular tumor, with multiple septa, solid poles and arterial flows with low resistances. Thoracic extension study did not show any finding. The histopathologic results of the orchiectomy and retroperitoneal resection pieces were, respectively, testicular mixed germ cell tumor (seminoma, with intratubular seminoma foci and teratoma) and mature cystic teratoma. CONCLUSIONS: Germ cell tumors derive from multipotencial cells with a large capacity of differentiation, and the nodal paraaortic chains are a natural way of dissemination of these neoplasms. Because of that, in the presence of a retroperitoneal lesion in a young patient we have to rule out testicular tumor metastasis. The retroperitoneal mature cystic teratoma must be considered as a lesion with malignant potential.

Teratoma quístico maduro retroperitoneal como primera manifestación de carcinoma testicular. Estudio radiológico / Retroperitoneal cystic mature teratoma as the presenting clinical scenario of testicular carcinoma. Radiological study

OBJETIVO: Describir un caso de teratoma maduro retroperitoneal como metástasis de un tumor mixto de células germinales testicular en un paciente de 30 años que debutó con dolor lumbar, abdominal y sensación de masa en hemiabdomen izquierdo.MÉTODOS: Se realizó ecografía abdominal, TC multidetector tóraco-abdomino-pélvico, y ante los hallazgos apreciados ecografía-doppler testicular. Se practicó orquiectomía y resección de la lesión retroperitoneal. RESULTADOS: En las pruebas de imagen se apreció a nivel retroperitoneal izquierdo una gran lesión quística de 13x12x11 cm de diámetro, bien delimitada, con finos septos, que desplazaba el riñón; y una masa testicular de 4 cm, sólido-quística, multiseptada, con polos sólidos y flujos vasculares arteriales de baja resistencia. El estudio de extensión torácico no mostró hallazgos. Los resultados anatomopatológicos de las piezas de orquiectomía y de la lesión retroperitoneal fueron respectivamente: tumor mixto de células germinales (seminoma, con focos de seminoma intratubular y teratoma), y teratoma quístico maduro.CONCLUSIONES: Debido a que los tumores de células germinales derivan de células multipotenciales con gran capacidad de diferenciación y que las cadenas ganglionares paraaórticas constituyen una vía de diseminación natural de estas neoplasias, la presencia de una lesión retroperitoneal en un paciente joven, aún sin signos radiológicos de malignidad (en nuestro caso quística) obliga a descartar metástasis de tumor testicular. El teratoma maduro retroperitoneal postpuberal debe considerarse una lesión con potencial maligno(AU)

OBJECTIVE: To describe a case of retroperitoneal mature teratoma presenting as metastasis of a testicular mixed germ cell tumor in a thirty year old man who had lumbar and abdominal pain and mass sensation in the left hemiabdomen.METHODS: Abdominal ultrasound and thoracic-abdominal-pelvic CT multidetector scan were performed, and then after a Doppler ultrasound study of the testicles. Surgical treatment was performed: orchiectomy and retroperitoneal lesion resection.RESULTS: Imaging studies showed a big cystic lesion in the left retroperitoneal space, 13 x 12 x 11 cm, well defined, with thin septa, displacing the kidney; and a solid-cystic 4 cm left testicular tumor, with multiple septa, solid poles and arterial flows with low resistances. Thoracic extension study did not show any finding. The histopathologic results of the orchiectomy and retroperitoneal resection pieces were, respectively, testicular mixed germ cell tumor (seminoma, with intratubular seminoma foci and teratoma) and mature cystic teratoma.CONCLUSIONS: Germ cell tumors derive from multipotencial cells with a large capacity of differentiation, and the nodal paraaortic chains are a natural way of dissemination of these neoplasms. Because of that, in the presence of a retroperitoneal lesion in a young patient we have to rule out testicular tumor metastasis. The retroperitoneal mature cystic teratoma must be considered as a lesion with malignant potential(AU)