RESUMO
BACKGROUND: Basal cell carcinomas are rare in non-sun-exposed skin, and are even rarer in the perianal region. Alertness to the unusual occurrence of this tumor at perianal site, with understanding of its clinical course, can prevent delay in its diagnosis and morbid aggressiveness in the management of the disease. PRESENTATION OF CASE: A 93 year old female, referred to our hospital because of a three month bleeding ulcerative lesion, with a diameter approximately of 4.5×3.2cm, located in the perianal region. DISCUSSION: Tumors of the anus and perianal are infrequent neoplasms of the digestive tract. There are many diseases that can be confused with this diagnosis and it is commonly delayed because the tumor is rarely thought of in this particular cutaneous topography. Suspicion and early diagnosis, give the opportunity for a timely and appropriate treatment and also prevent tumor extension. CONCLUSION: Treatment modalities include early wide local excision to clear margins, ensuring further local recurrence and distant metastasis. The use of local V-Y advancement fasciocutaneous flaps may be another valid option for the reconstruction of perianal skin defects, with less morbidity than other flaps described in the literature.
RESUMO
El colgajo del recto abdominal miocutáneo vertical, es un excelente colgajo que rellena el gran defecto en la pelvis luego de una resección abdominoperineal isquioanal, siendo libre de tensión y reduciendo significativamente la incidencia de complicaciones de la herida perineal y la estancia hospitalaria, con el cual se puede reconstruir la pared posterior de la vagina. Se reporta aquí el primer caso en Costa Rica de una resección abdominoperineal isquioanal, con reconstrucción de pared posterior de vagina con colgajo del recto abdominal miocutáneo vertical, practicada con éxito en una paciente de 62 años, con un adenocarcinoma rectal localmente avanzado con infiltración de pared posterior de vagina.
Vertical rectus abdominis myocutaneous flap, is an excellent flap that fills the large defect in the pelvis after an adominoperineal ischioanal resection; it is free from tension, significantly reduces the incidence of perineal wound complications and hospital stay and can be used to reconstruct the posterior wall of the vagina. We report the first case of Costa Rica abdominoperineal ischioanal resection with reconstruction of posterior vaginal wall with vertical rectus abdominis myocutaneous flap, successfully practiced in a patient of 62 years with locally advanced rectal adenocarcinoma infiltrating posterior wall of the vagina.
Assuntos
Humanos , Feminino , Idoso , Costa Rica , Histerectomia , Neoplasias Retais , Reto do Abdome , VaginaRESUMO
La microcirugía endoscópica transanal (TEM, por sus siglas en inglés) es una técnica que se ha desarrollado desde los años 80 y tiene múltiples indicaciones. La cirugía transanal mínimamente invasiva (TAMIS, por sus siglas en inglés) se ha introducido como un enfoque alternativo al TEM, con las mismas indicaciones y algunas ventajas. Se reporta aquí el primer caso en Costa Rica de TAMIS, practicada exitosamente en un paciente de 85 años con una tumoración rectal de 4 cm de diámetro.
Transanal Endoscopic Microsurgery (TEM, for its acronym in English) is a technique developed in the 80s, which has many uses. Transanal Minimally Invasive Surgery (TAMIS, for its acronym in English) has been introduced as an alternative approach to TEM, with the same indications and some advantages. The case of an 85-yearold male with a 4 cm in diameter rectal tumor successfully resected by TAMIS is herein reported, which is the first case treated in this manner in Costa Rica.
