Cutaneous metastasis from an intracranial glioblastoma multiforme.

A 34-year-old white man with a history of an intracranial glioblastoma multiforme was treated with surgical excision and radiotherapy. Five months later, the patient had a rapidly growing scalp mass develop. This lesion was excised, and the histology revealed a tumor that was similar to the originally resected intracranial glioblastoma. Immunohistochemistry for general neuroepithelial derivation (S-100 protein) and for glial fibrillary acidic protein (GFAP) was positive, whereas mesenchymal, epithelial, and neuronal markers were negative. This immunohistochemistry pattern was identical to the original tumor. Although metastasis of this tumor is not uncommon, metastasis to the skin has never been reported. To our knowledge, this is the first reported case of cutaneous metastasis from glioblastoma in the world literature.

Instrumentos legales en la toma de decisiones medicas en cuadros cronicos terminales / Legal instruments for medical decision-making concerning terminal chronic diseases

La imposibilidad de dar el consentimiento personalmente plantea el que se requiera personas que tomem decisiones por ellos. Una forma alternativa es el uso de instrumentos escritos de validez juridica representados por los testamentos vitales y los poderes legales, llamados genericamente de directivas de futuro.

Bioethics in Ibero-America and the Caribbean

Bioethics has become a field of new challenges for Ibero-America and the Caribbean. A seeming uniformity in the region hides a rich heterogenous society. A brief survey of bioethical developments in different Ibero-American countries is provided as well as the bioethical problems and approaches peculiar to the region. Some of the unique features of bioethics in this region, it is suggested, could infuse new life into the U.S., and European bioethics discussion. Finally, a bibliography of Ibero-American bioethics literature is provided for North American and European readers (AU)