Sialometaplasia necrotizante: una entidad simuladora / Necrotizing sialometaplasia: a simulating entity

La sialometaplasia necrotizante es una condición inflamatoria, benigna y autolimitada, simuladora de entidades malignas. Exponemos el caso de un paciente de 24 años de edad, fumador y bulímico, que presenta dos lesiones ulceradas con fondo eritematoso en el paladar duro con resolución espontánea

Necrotizing sialometaplasia is a self-limiting, benign inflammatory condition simulating malignant entities. We expose the case of a 24-year-old smoker and bulimic patient, who presented two ulcerated lesions with an erythematous fundus on the hard palate with spontaneous resolution

Extragingival Pregnancy Pyogenic Granuloma on the Lip.

Pregnancy pyogenic granuloma is considered a benign common growth that usually develops on the gingiva in the second and third trimester of gestation, in response to local irritation, trauma or hormonal factors. Here, the authors report a case of a primigravida who presented an extragingival pyogenic granuloma with a rapid progression in the post-partum. The occurrence on the lower lip in the first few days after delivery was a relatively rarity in the present case which provoked a meaningful state of anxiety and cancerophobia to the female. Complete excision was curative and brought immediate relief of pain and discomfort. This clinical report highlights the possibility of pyogenic granuloma presenting like a rapid-growing mass on the lip and the importance of clinical differential diagnosis of such presentation in this atypical location.

Infrahyoid flap in oropharyngeal reconstruction following carcinoma resection: A study of 6 patients and literature review.

The present study aimed to describe the techniques used and the results obtained with the infrahyoid flap for the reconstruction of medium-sized oropharyngeal defects following resection for advanced squamous cell cancer. During a period of 1 year, six patients with oropharyngeal defects were reconstructed using the infrahyoid flap. The tumor characteristics, location and size of the defect, resective and reconstructive techniques employed and the complications and outcomes of the speech and swallowing functions, as identified in the follow-up visits every 3 months, were evaluated. All flaps were performed simultaneously in association with tumoral excision and ipsilateral supraomohyoid neck dissection. The mean size of the skin paddle was 7.0×3.5 cm. The donor site was primarily sutured. The postoperative course was uneventful and all flaps were viable. One case of marginal skin paddle loss occurred without affecting the survival of the flap. Five patients received postoperative radiotherapy and one patient received concurrent postoperative chemotherapy. During the follow-up period (mean, 63 months), all patients showed excellent oral swallowing. Speech was excellent in five patients and in one patient speech was classified as good. The aesthetic results of the cervical donor site were good. Based on the present case report and the literature review, the infrahyoid flap is a simple and safe procedure for the reconstruction of the oropharynx, with a high success rate, minimal donor site morbidity and good aesthetic and functional results. The infrahyoid flap is a valid surgical option that may be considered in selected oncological patients undergoing reconstruction of medium-size oropharyngeal defects.

Efectividad diagnóstica de la tomografía por emisión de positrones con18fluorodeoxiglucosa asociada a tomografía axial en la discriminación de benignidad o malignidad de las lesiones suprarrenales / Diagnostic efficacy and discriminatory capacity of positron emission tomography combined with axial tomography of adrenal lesions

Introducción: Se analiza la utilidad de la tomografía por emisión de positrones asociada a la tomografía axial computarizada (PET-TAC) en el diagnóstico de benignidad o malignidad de lesiones suprarrenales. Material y métodos: Estudio retrospectivo, entre junio de 2005 y mayo de 2009, de una serie consecutiva de pacientes a los que se les realizó una PET-TAC para el estudio de patología suprarrenal con sospecha de malignidad. Se valoraron la presencia de captaciones focales, su valor estándar de máxima captación (SUV), y la ratio del valor máximo suprarrenal/hepático. Se analizó la sensibilidad, especificidad, valor predictivo positivo y negativo de la prueba, y los valores de captación máxima adrenal y la ratio para los que la rentabilidad diagnóstica fue máxima. Resultados: Se incluyeron 15 pacientes. El diagnóstico final reveló malignidad en ocho y benignidad en siete. Diez pacientes presentaron captación suprarrenal: tres en lesiones benignas y siete en neoplasias, con un valor de captación medio de 6,3 (3,2 en benignas y 9 en malignas). La ratio media suprarrenal/hepático fue de 1,8 (0,9 en lesiones benignas y 2,6 en malignas). Cuando se relaciona la presencia de captación suprarrenal con el diagnóstico final de malignidad, obtuvimos una sensibilidad del 87,5%, especificidad del 57,1%, valor predictivo positivo del 70% y negativo del 80%. Un valor de corte de SUV de 6, o una ratio de captación suprarrenal/hepática de 2, proporciona una sensibilidad de 75%, especificidad de 100%, valor predictivo positivo de 100% y negativo de 77,7%. Conclusiones: La PET-TAC posee una alta capacidad para discriminar entre benignidad o malignidad en la patología adrenal estudiada (AU)

Introduction: The usefulness of 18fluorodeoxyglucose positron emission tomography combined with axial tomography (PET-CT) in diagnosing whether adrenal tumours are benign or malignant is assessed. Material and methods: A retrospective study conducted between June 2005 and May 2009 on a consecutive series of patients on whom a PET-CT scan was performed to study suspected malignant adrenal disease. Focal uptakes were assessed, along with the maximum standard uptake value (SUV), and the ratio of the maximum adrenal/hepatic value. The sensitivity, specificity, positive and negative predictive value of the test, the maximum adrenal uptake values and the ratio for those where the diagnostic yield was maximum. Results: Fifteen patients were included. The final diagnosis showed malignancy in eight and seven were benign. Ten patients had adrenal uptake: three in benign lesions and seven in neoplasias, with a mean uptake value of 6.3 (3.2 in benign lesions and 9.0 in malignant lesions). The mean adrenal/hepatic ratio was 1.8 (0.9 in benign and 2.6 in malignant lesions). When the presence of adrenal uptake is associated with a final diagnosis of malignancy, we obtained a sensitivity of 87.5%, a specificity of 57.1%, and a positive and negative predictive value of 70% and 80%, respectively. An SUV cut-off value of 6, or an adrenal/hepatic uptake ratio of 2, gave a sensitivity of 75%, a specificity of 100%, and a positive and negative predictive value of 100% and 77.7%, respectively. Conclusions: PET-CT has a high ability to discriminate between benign and malignant lesions in the adrenal disease studied (AU)

[Diagnostic efficacy and discriminatory capacity of positron emission tomography combined with axial tomography of adrenal lesions]. / Efectividad diagnóstica de la tomografía por emisión de positrones con (18)fluorodeoxiglucosa asociada a tomografía axial en la discriminación de benignidad o malignidad de las lesiones suprarrenales.

INTRODUCTION: The usefulness of 18fluorodeoxyglucose positron emission tomography combined with axial tomography (PET-CT) in diagnosing whether adrenal tumours are benign or malignant is assessed. MATERIAL AND METHODS: A retrospective study conducted between June 2005 and May 2009 on a consecutive series of patients on whom a PET-CT scan was performed to study suspected malignant adrenal disease. Focal uptakes were assessed, along with the maximum standard uptake value (SUV), and the ratio of the maximum adrenal/hepatic value. The sensitivity, specificity, positive and negative predictive value of the test, the maximum adrenal uptake values and the ratio for those where the diagnostic yield was maximum. RESULTS: Fifteen patients were included. The final diagnosis showed malignancy in eight and seven were benign. Ten patients had adrenal uptake: three in benign lesions and seven in neoplasias, with a mean uptake value of 6.3 (3.2 in benign lesions and 9.0 in malignant lesions). The mean adrenal/hepatic ratio was 1.8 (0.9 in benign and 2.6 in malignant lesions). When the presence of adrenal uptake is associated with a final diagnosis of malignancy, we obtained a sensitivity of 87.5%, a specificity of 57.1%, and a positive and negative predictive value of 70% and 80%, respectively. An SUV cut-off value of 6, or an adrenal/hepatic uptake ratio of 2, gave a sensitivity of 75%, a specificity of 100%, and a positive and negative predictive value of 100% and 77.7%, respectively. CONCLUSIONS: PET-CT has a high ability to discriminate between benign and malignant lesions in the adrenal disease studied.