Leiomiosarcoma infiltrante en la lengua / Infiltrating leiomyosarcoma of the tongue

Introducción: La localización de un leiomiosarcoma infiltrante en la lengua es extremadamenterara. Solo se han reportado casos aislados en la literatura.Caso clínico: Hombre de 62 años, fumador, que consulta por una tumoración ulcerada en lalengua de un mes de evolución. Al mes presenta metástasis pulmonares, subcutáneas yóseas. Fallece a los 6 meses con enfermedad diseminada.Discusión: Pensamos que se trató de una metástasis lingual, situación aún más rara que untumor primitivo, con tres casos comunicados en la literatura. El diagnóstico diferencial fueresuelto con técnicas de inmunomarcación(AU)

Introduction: Leiomyosarcoma of the tongue, is extremely rare and poorly documented inthe literature.Case report: We present the case of a 62-year-old male who consult with an ulcerated massin the oral tongue. The lesion had an evolution of one month. Surgical biopsy wasperformed. Six months later the patient died with multiple metastases.Discusion: We thought that was a lingual metastase, situation even rarer that a primitivetumor, with three cases communicated in literature. Definitive diagnosis was facilitated byimmunohistochemical techniques(AU)

A pneumatic dilation strategy in achalasia: prospective outcome and effects on oesophageal motor function in the long term.

BACKGROUND: Long-term follow-up studies of achalasia after pneumatic dilation, mostly retrospective, have shown variable results. AIM: To examine the outcome of achalasia after pneumatic dilation using a prospective follow-up programme. METHODS: One or two dilations (first dilation treatment) in 77 patients to achieve stable (>1 year) remission and patients followed up with yearly clinical and manometric assessments. Endoscopy, pH monitoring and barium swallow were also performed. RESULTS: A total of 69 patients achieved stable remission and were followed up for 5.6 years (3-10.7) [median (IQ range)], whereas six patients underwent cardiomyotomy and two experienced a perforation. Twelve of the 69 patients relapsed after 2.6 years (1.7-5.1): nine of 12 underwent one to two further dilations. Six-year remission rate (by Kaplan-Meyer estimates) was 82% after first dilation treatment and 96% after all dilations. Continuous antisecretory treatment was clinically needed in 16%, oesophagitis present in 7% and reflux pathological in 28% of the patients. Beneficial effects of dilation on oesophageal motility and on diameter of the oesophageal body at barium swallow were maintained during follow-up. CONCLUSIONS: A management strategy including sessions of pneumatic dilation until stable remission and a standardized follow-up is highly successful in the long term. Gastro-oesophageal reflux is clinically relevant in a minority of patients.