RESUMO
Se presenta el caso clínico de una paciente joven con cáncer de mama y metástasis óseas en tratamiento con bifosfonatos que acude a consulta de Atención Primaria por dolor maxilar. La paciente fue diagnosticada de osteonecrosis secundaria a bifosfonatos. Se exponen asimismo en el artículo los factores de riesgo, fisiopatología, clínica y tratamiento de esta entidad
The clinical case of a young female patient with bone metastases and breast cancer under treatment with bisphosphonates who was evalued in Primary Care due to jaw pain is presented. Bisphosphonate-associated osteonecrosis was diagnosed. We discuss risk factors, pathophysiology, clinical features and management of the disorder
Assuntos
Humanos , Feminino , Adulto , Difosfonatos/efeitos adversos , Osteonecrose/induzido quimicamente , Maxila/patologia , Neoplasias Ósseas/secundário , Neoplasias da Mama/complicações , Fatores de RiscoRESUMO
The present study aims to analyse the survival of 94 patients with squamous cell carcinoma of the oral cavity. They were 86 men and 8 women with a mean age of 61. Seventy four percent were smokers and 70% consumed alcohol regularly. Eighty three percent had unhealthy teeth. A great majority of patients (76) were in the advanced stages (III-IV) and 61% showed neck nodules. The overall survival at 5 years was the following: 70% for patients in stage I, 85% in stage II, 58% stage III and only 17% for the patients in stage IV. The most significant prognostic factor that affected the survival was the N stage. For the patients in N0 and N1 we only found significant differences when the lymph nodes were histologically affected by the tumor.
Assuntos
Carcinoma de Células Escamosas/mortalidade , Neoplasias Bucais/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prevalência , Taxa de SobrevidaRESUMO
Presentamos un estudio sobre 94 casos de carcinoma epidermoide de cavidad oral. La muestra consta de 86 varones, con una edad media de 61 años, siendo fumadores el 74 por ciento y bebedores regulares de alcohol el 70 por ciento. El 83 por ciento presentaba un estado buco-dental malo. La mayoría de los casos eran estadios avanzados III-IV (76 por ciento), con un 61 por ciento de adenopatías clínicamente significativas. La supervivencia a 5 años en estadio I fue del 70 por ciento, estadio II 85 por ciento, estadio III 58 por ciento y estadio IV 17 por ciento. Encontramos que la clasificación que tiene mayor valor pronóstico es la evaluación del estado ganglionar, pero en el caso de N0 y N1 la evaluación clínica es insuficiente, siendo necesario el estudio histológico tras la realización del vaciamiento ganglionar oportuno (AU)
The present study aims to analyse the survival of 94 patients with squamous cell carcinoma of the oral cavity. They were 86 men and 8 women with a mean age of 61. Seventy four percent were smokers and 70% consumed alcohol regularly. Eighty three percent had unhealthy teeth. A great majority of patients (76) were in the advanced stages (III-IV) and 61% showed neck nodules. The overall survival at 5 years was the following: 70% for patients in stage I, 85% in stage II, 58% stage III and only 17% for the patients in stage IV. The most significant prognostic factor that affected the survival was the N stage. For the patients in N0 and N1 we only found significant differences when the lymph nodes were histologically affected by the tumor (AU)
Assuntos
Pessoa de Meia-Idade , Masculino , Feminino , Humanos , Carcinoma de Células Escamosas/mortalidade , Neoplasias Bucais/mortalidade , Taxa de Sobrevida , Prevalência , Estadiamento de NeoplasiasRESUMO
El cáncer de mama es la primera causa de muerte por cáncer en mujeres. El factor epidemiológico más importante de riesgo para desarrollar ésta neoplasia es tener una historia familiar de cáncer de mama. El 5 por ciento al 10 por ciento de casos son heredados en forma autosómica dominante. Los individuos predispuestos heredarían una copia funcional y una inactiva del gen de susceptibilidad, y una mutación somática eliminando el alelo funcional eliminaría su función supresora de tumores. Desafortunadamente, el desarrollo de clínicas de consejo genético no es paralelo al de la investigación molecular. Dada la constante evolución de la genética del cáncer existe una imperiosa necesidad de actualización de los médicos debido al interés creciente de la población en riesgo para examinarse para el cáncer hereditario de mama (AU)
Assuntos
Feminino , Humanos , Síndromes Neoplásicas Hereditárias , Aconselhamento Genético , Genes BRCA1/genética , Neoplasias da Mama/genética , Neoplasias Ovarianas/genéticaRESUMO
A retrospective study was made of 29 patients with cervical metastasis of an unknown primary tumor. Sixteen patients received local treatment with surgery and radiotherapy (group A) and 13 patients were treated with induction chemotherapy, surgery and radiotherapy (group B). All patients responded. Local recurrence occurred in 21.4% of group A and 20% of group B. The frequency of distant metastases was similar (18.8% vs 15.4%). The mean survival time of 68 months in group A was longer than the 40 months of group B, and the a 2-year survival rate was 81% in group A and 67% in group B. The 5-year survival was better in group B (56% vs 40%). The primary tumor was identified twice as often in the patients who received only local treatment (group A 37.5% and group B 15.4%). Detection of the primary tumor was the only factor that significantly influenced patient survival.
