Metastatic lesion of a choroidal melanoma located in the head of pancreas.

Metastases in pancreas are uncommon, ranging from 2 to 5 % of pancreatic malignancies. Choroidal melanoma is rare, and less than 1% spread to the pancreas. It can cause obstructive jaundice if it affects the pancreatic head region. Advanced disease is associated with poor prognosis, however immunotherapy with PD-1 inhibitors (nivolumab or pembrolizumab), alone or in combination with anti-CTLA-4 antibodies (ipilimumab), has shown an increase in survival.

Lesión metastásica en cabeza pancreática secundaria a melanoma de coroides / Metastatic pancreatic head lesion secondary to choroidal melanoma

Las metástasis pancreáticas constituyen sólo el 2-5% de los tumores malignos de éste órgano. El melanoma coroideo es una neoplasia poco común, que en <1% de las ocasiones metastatiza en páncreas, pudiendo ocasionar ictericia obstructiva si afecta a la región de la cabeza pancreática. Las metástasis en este tipo de tumores conllevan mal pronóstico, no obstante la inmunoterapia con inhibidores de PD-1 (nivolumab y pembrolizumab) con o sin anticuerpos anti CTLA-4 (ipilimumab) ha demostrado un aumento de la supervivencia (AU)

Pronóstico y supervivencia de pacientes diagnosticados de liposarcoma retroperitoneal bien diferenciado y desdiferenciado / Prognosis and survival of patients diagnosed with well-differentiated and dedifferentiated retroperitoneal liposarcoma

Objetivos: El objetivo principal es determinar la supervivencia global y la supervivencia libre de enfermedad de pacientes intervenidos de liposarcoma retroperitoneal, comparándolos en función de los subtipos histológicos bien diferenciado y desdiferenciado. Los objetivos secundarios son analizar descriptivamente las características clínicas de estos pacientes e identificar otras variables independientes que puedan modificar significativamente estos perfiles de supervivencia.MétodosSe realiza un estudio observacional y analítico mediante una cohorte histórica retrospectiva, seguida prospectivamente. Los criterios de inclusión fueron: cirugía de liposarcoma de localización retroperitoneal, subtipos histológicos bien diferenciado y desdiferenciado, entre enero de 2002 y mayo de 2019. Se incluyeron un total de 32 pacientes. Se utilizó el estimador de Kaplan-Meier para resumir los datos y la prueba log-rank para el análisis comparativo.ResultadosLa supervivencia global a los 5 años fue del 59%. No se encontraron diferencias entre los pacientes con subtipo bien diferenciado con respecto al desdiferenciado (p=0,834). La supervivencia libre de enfermedad a los 2 años fue del 59% en los bien diferenciados y del 26% en los desdiferenciados, siendo estas diferencias estadísticamente significativas (p=0,005). Ninguna de las otras variables estudiadas modificó significativamente estos perfiles de supervivencia.ConclusionesLa supervivencia libre de enfermedad de los liposarcomas retroperitoneales desdiferenciados es significativamente menor que en los bien diferenciados, pero no puede afirmarse que haya diferencias en la supervivencia global (AU)

Objectives: The main objective is to establish the overall survival and disease-free survival profiles regarding the patients with retroperitoneal liposarcoma, making a comparison based on the well-differentiated and dedifferentiated histological subtypes. The secondary objectives are to descriptively analyze the clinical characteristics of said patients and to identify and analyze other independent variables that might modify these survival profiles significantly.MethodsAn observational and analytical study was performed using a retrospective historical cohort that was followed prospectively. The inclusion criteria consisted of: the procedure of liposarcoma located in the retroperitoneum, the well-differentiated and dedifferentiated histological subtypes, between January 2002 and May 2019. As a result, 32 patients took part in this study's sample. Kaplan–Meier estimator was used to summarize the results and log-rank test was used in the comparative analysis.ResultsThe overall survival at 5 years was around 59%. No differences were found between the patients with a well-differentiated subtype compared to the dedifferentiated ones (p=0.834). The disease-free survival at 2 years was 59% regarding the well-differentiated and 26% regarding the dedifferentiated, with these differences being statistically significant (p=0.005). None of the other studied variables modified these survival profiles significantly.ConclusionsDedifferentiated retroperitoneal liposarcomas show less disease-free survival than well-differentiated liposarcomas. However, regarding overall survival no differences can be claimed (AU)

Total en bloc spondylectomy for the L5 metastasis of a carcinoid tumor: illustrative case.

BACKGROUND: Total en bloc spondylectomy (TES) was designed to achieve oncological complete tumor resection in a vertebral compartment. Because of the special anatomy of the lumbosacral junction, TES procedure at the L5 level is a challenge, and it has been explained in few reports in the literature. Performing TES in the lower lumbar region, as normal, is accomplished by using a combined approach. OBSERVATIONS: The authors presented the case of a 20-year-old man with an isolated spinal metastasis at the L5 level of carcinoid tumor of jejunum, limited to the vertebral body. Due to good long-term prognosis, after multidisciplinary evaluation the authors decided to treat the patient with TES through a combined posteroanterior approach, with posterior instrumentation and anterior reconstruction. Nine years after surgery, the patient was asymptomatic, with no sign of local recurrence. LESSONS: TES is a feasible technique to provide long-term survival in a select subgroup of patients, reducing the risk of local recurrence. The authors presented some anatomical and biomechanical factors that must be considered at the lumbosacral region. Despite the high rates of complication associated with TES, most patients benefit from local control provided by the technique.

Prognosis and survival of patients diagnosed with well-differentiated and dedifferentiated retroperitoneal liposarcoma.

OBJECTIVES: The main objective is to establish the overall survival and disease-free survival profiles regarding the patients with retroperitoneal liposarcoma, making a comparison based on the well-differentiated and dedifferentiated histological subtypes. The secondary objectives are to descriptively analyze the clinical characteristics of said patients and to identify and analyze other independent variables that might modify these survival profiles significantly. METHODS: An observational and analytical study was performed using a retrospective historical cohort that was followed prospectively. The inclusion criteria consisted of: the procedure of liposarcoma located in the retroperitoneum, the well-differentiated and dedifferentiated histological subtypes, between January of 2002 and May of 2019. As a result, 32 patients took part in this study's sample. Kaplan-Meier estimator was used to summarise the results and log-rank test was used in the comparative analysis. RESULTS: The overall survival at 5 years was around 59%. No differences were found between the patients with a well-differentiated subtype compared to the dedifferentiated ones (p = 0.834). The disease-free survival at 2 years was 59% regarding the well-differentiated and 26% regarding the dedifferentiated, with these differences being statistically significant (p = 0.005). None of the other studied variables modified these survival profiles significantly. CONCLUSIONS: Dedifferentiated retroperitoneal liposarcomas show less disease-free survival than well-differentiated liposarcomas. However, regarding overall survival no differences can be claimed.

Prognosis and survival of patients diagnosed with well-differentiated and dedifferentiated retroperitoneal liposarcoma. / Pronóstico y supervivencia de pacientes diagnosticados de liposarcoma retroperitoneal bien diferenciado y desdiferenciado.

OBJECTIVES: The main objective is to establish the overall survival and disease-free survival profiles regarding the patients with retroperitoneal liposarcoma, making a comparison based on the well-differentiated and dedifferentiated histological subtypes. The secondary objectives are to descriptively analyze the clinical characteristics of said patients and to identify and analyze other independent variables that might modify these survival profiles significantly. METHODS: An observational and analytical study was performed using a retrospective historical cohort that was followed prospectively. The inclusion criteria consisted of: the procedure of liposarcoma located in the retroperitoneum, the well-differentiated and dedifferentiated histological subtypes, between January 2002 and May 2019. As a result, 32 patients took part in this study's sample. Kaplan-Meier estimator was used to summarize the results and log-rank test was used in the comparative analysis. RESULTS: The overall survival at 5 years was around 59%. No differences were found between the patients with a well-differentiated subtype compared to the dedifferentiated ones (p=0.834). The disease-free survival at 2 years was 59% regarding the well-differentiated and 26% regarding the dedifferentiated, with these differences being statistically significant (p=0.005). None of the other studied variables modified these survival profiles significantly. CONCLUSIONS: Dedifferentiated retroperitoneal liposarcomas show less disease-free survival than well-differentiated liposarcomas. However, regarding overall survival no differences can be claimed.