Mixed Adenoneuroendocrine Carcinoma of the Esophagus: A Case Report and Review of the Literature.

The most frequent presentation of esophageal cancer is adenocarcinoma and squamous cell carcinoma. In recent years, the latter has decreased its incidence increasing the adenocarcinoma. Currently, another type of tumor with a much lower incidence has been described, which has a neuroendocrine component along with another exocrine glandular component and has been classified since 2010 as mixed adenoneuroendocrine carcinoma (MANEC). We present the case of a 68-year-old male with a history of dyspepsia and epigastric pain who after performing a gastroscopy, was diagnosed with a malignant neoplasm of the esophagus. The patient underwent a total esophagectomy with reconstruction by tubular gastroplasty with cervical anastomosis. The final result of the piece after immunohistochemistry revealed that the tumor was composed of one component of adenocarcinoma in 60% together with another component compatible with neuroendocrine in 40%. With these findings and according to the World Health Organization classification of 2010 was diagnosed as esophageal MANEC. MANECs are rare tumors, described in other locations of the digestive tract, the esophagus being an infrequent location. Its preoperative diagnosis is difficult, and it is not until the final analysis of the complete piece by means of specific immunohistochemical techniques when its diagnosis can be established. Its treatment is fundamentally surgical, whereas the adjuvant therapeutic schemes with chemotherapy are not well defined at present because of their low incidence.

Leiomiosarcoma primario cutáneo / Primary cutaneos leiomyosarcoma

Los leiomiosarcomas localizados en las partes blandas superficiales son neoplasias muy raras o infrecuentes, tanto en las formas primarias como en el caso de las formas secundarias o metastásicas. Presentamos el caso de un leiomiosarcoma cutáneo primario en una mujer de 42 años de edad y realizamos una revisión de sus características clínicas y diagnóstico, así como de las diferencias pronóstico-evolutivas según las distintas localizaciones de esta afección. Por último, debe señalarse que el tratamiento es fundamentalmente quirúrgico, con escisión con márgenes de seguridad, ya que no existe una respuesta satisfactoria o significativa al tratamiento radio y/o quimioterápico, siendo imprescindible y obligado efectuar un seguimiento periódico de los enfermos debido a la tasa de recurrencia local y la posibilidad de metastatizar según la localización histológica del tumor (AU)

[Experimental acute pancreatitis in the rat. The quantification of pancreatic necrosis after the retrograde ductal injection of sodium taurocholate]. / Pancreatitis aguda experimental en la rata. Cuantificación de la necrosis pancreática tras la inyección retrógrada ductal de taurocolato sódico.

Acute haemorrhagic pancreatitis was induced in rats by injecting 5% sodium taurocholate into the common biliopancreatic duct. The condition was associated with an increase in the serum amylase levels as well as progressive pancreatic necrosis resulting in 100% mortality before 36 hours. This experimental model was documented by quantifying nine different parameters of pancreatic necrosis and giving more information about the induced lesion. The extent of pancreatic necrosis was evaluated at different intervals, 5.77% at 12 hours, 14.9% at 24 hours, and the rats died before 36 hours of pancreatitis induction with an average percentual necrosis of 29.9%. This model seems suitable for more pathogenic as well as therapeutic studies on acute pancreatitis in the rat.

[Somatostatin in the treatment of established and severe acute pancreatitis in the rat]. / Somatostatina en el tratamiento de la pancreatitis aguda establecida y severa en la rata.

The effects of somatostatin (SS) on the treatment of acute pancreatitis were studied in rats. Acute pancreatitis was established by injecting 5% sodium taurocholate in the biliopancreatic duct. Previously, pancreatic necrosis was determined in this experimental model at several intervals without treatment. Treatment was started according different groups: at 12, 16 and 20 hours after induction of acute pancreatitis (IV bolus of 4 ug/kg body weight followed by a 24h continuous infusion of 4 ug/kg body wt/hour). When somatostatin was initiated at 12 or 16h a decrease in serum amylase and lactodehydrogenase was observed, as well as in pancreatic necrosis resulting in 0% mortality after 24h of treatment. When somatostatin was started at 20h there was no changes in the lethal outcome of the disease.

[Bochdalek hernia in adults. Apropos of a case in the right side]. / Hernia de Bochdalek en el adulto. A propósito de un caso en el lado derecho.

Posterolateral diaphragmatic hernia (Bochdalek's hernia) is an infrequent finding in adult patients. Most of them are asymptomatic. Symptomatic cases present with digestive symptoms. Sometimes the clinical picture is related to the associated congenital malformations and not to the hernia itself. It is more common on the left side and in most of the cases it lacks of hernia sac. Simple radiologic study is the clue for the diagnosis. A case of Bochdalek's hernia in a 85 year-old patient is presented.