Metastasis of Lung Cancer in the Pancreas, Diagnosis Using Endoscopic Ultrasound: A Case Report / Metástasis de cáncer pulmonar en el páncreas, diagnóstico por ultrasonografía endoscópica: reporte de caso

Abstract Only 2% of malignant tumor lesions in the pancreas represented metastatic lesions. Endoscopic biliopancreatic ultrasonography, with the possibility of guided biopsy, is one of the main diagnostic methods currently available for lesions in the pancreas. A case of a male patient with a history of small cell carcinoma of the lung with findings of a tumor lesion in the pancreas corresponding to metastasis was described.

Resumen Tan solo el 2% de las lesiones tumorales malignas en el páncreas representan lesiones metastásicas. La ultrasonografía endoscópica biliopancreática, con posibilidad de biopsia guiada, es uno de los principales métodos diagnósticos disponibles actualmente para las lesiones en el páncreas. Se describe el caso de un paciente masculino con antecedente de carcinoma de células pequeñas de pulmón con hallazgos de lesión tumoral en el páncreas correspondiente a metástasis.

Early-onset Colorectal Cancer: A Study in a Colombian Population / Cáncer colorrectal de inicio temprano: un estudio en una población colombiana

Abstract Introduction: Colorectal cancer (CRC) is the third most common cancer in terms of incidence and the second cause of death secondary to cancer. Early-onset CRC accounts for about 10% of cases and carries a higher mortality than that seen in older patients. We analyze the association between age and the clinical, endoscopic, and histopathological characteristics of CRC at the time of diagnosis in a Latin American population. Methods: A cross-sectional study was conducted using the database of the Gastroenterology Service of Clínica Foscal and Clínica Foscal Internacional in Bucaramanga, Colombia. Results: Between July 2016 and June 2021, 521 cases of de novo adenocarcinoma-type CRC were diagnosed, of which 77 patients (14.7%) were under 50. In patients with early-onset CRC, the prevalence of CRC was higher in women. Family history of CRC was more common in patients younger than 50 years. Hereditary syndromes, particularly familial adenomatous polyposis and hereditary non-polyposis CRC, were also more frequent in the youth. Histopathologically, mucinous adenocarcinoma and signet ring cell adenocarcinoma were more common in young patients. Conclusions: The study showed an approach to the characteristics of early-onset CRC in a Latin American population. Increasing the prevention, control, and early detection of CRC in young people is necessary to improve diagnosis and treatment.

Resumen Introducción: El cáncer colorrectal es el tercer cáncer más común en incidencia y la segunda causa de muerte secundaria al cáncer. El cáncer colorrectal de inicio temprano representa alrededor del 10% de los casos y conlleva una mortalidad más alta que la observada en pacientes de mayor edad. Se analiza la asociación entre la edad y las características clínicas, endoscópicas e histopatológicas del cáncer colorrectal al momento del diagnóstico en una población latinoamericana. Metodología: Se realizó un estudio de corte transversal utilizando la base de datos del Servicio de Gastroenterología de la Clínica Foscal y Clínica Foscal Internacional en Bucaramanga, Colombia. Resultados: Entre julio 2016 a junio 2021 se diagnosticaron 521 casos de cáncer colorrectal tipo adenocarcinoma de novo, de los cuales 77 pacientes (14,7%) tenían menos de 50 años. En pacientes con cáncer colorrectal de aparición temprana, la prevalencia de cáncer colorrectal fue mayor en mujeres. Los antecedentes familiares de carcinoma colorrectal fueron más frecuentes en pacientes menores de 50 años. La presencia de síndromes hereditarios, especialmente poliposis adenomatosa familiar y cáncer colorrectal no poliposo hereditario, también fueron más frecuentes en la población juvenil. Histopatológicamente, el adenocarcinoma mucinoso y el adenocarcinoma de células en anillo de sello fueron más frecuentes en pacientes jóvenes. Conclusiones: El estudio mostró una aproximación a las características del cáncer colorrectal de aparición temprana en una población latinoamericana. Es necesario incrementar la prevención, control y detección temprana del cáncer colorrectal en jóvenes para mejorar el diagnóstico y tratamiento.

Clinical characteristics of early-onset gastric cancer. A study in a Colombian population.

Gastric cancer is a multifactorial disease with important genetic and environmental factors. It is the fifth most common cancer in incidence, and the fourth cause of death secondary to cancer. The incidence of early-onset gastric cancer is increasing worldwide, but clinical information on these patients has not been well established. We analyzed the association between age and clinical, endoscopic, and histopathological characteristics of gastric cancer at the time of diagnosis in a Latin American population. A retrospective and descriptive cross-sectional study was carried out using the database of the Gastroenterology Service of the Clínica Foscal and Clínica Foscal Internacional in Bucaramanga, Colombia. Between January 2016 and December 2019, 259 de novo gastric cancer cases were diagnosed, of which 36 patients (13.9%) were 40 years old or younger. In patients with early-onset gastric, the prevalence of gastric cancer diagnosis was lower in men. A family history of gastric cancer or any other neoplasm was not associated with a higher prevalence of gastric neoplasms. In young patients, vomiting and ascites were more common, the preferred anatomical location was the body of the stomach, and the Borrmann IV classification and the diffuse-type histology were more likely. Our study showed an approximation of the characteristics of early-onset gastric cancer in a Latin American population, where we observed that early-onset gastric cancer has different demographic, anatomical, and histological features than late-onset gastric cancer.

Clinical characteristics of early-onset gastric cancer. A study in a Colombian population

Gastric cancer is a multifactorial disease with important genetic and environmental factors. It is the fifth most common cancer in incidence, and the fourth cause of death secondary to cancer. The incidence of early-onset gastric cancer is increasing worldwide, but clinical information on these patients has not been well established. We analyzed the association between age and clinical, endoscopic, and histopathological characteristics of gastric cancer at the time of diagnosis in a Latin American population. A retrospective and descriptive cross-sectional study was carried out using the database of the Gastroenterology Service of the Clínica Foscal and Clínica Foscal Internacional in Bucaramanga, Colombia. Between January 2016 and December 2019, 259 de novo gastric cancer cases were diagnosed, of which 36 patients (13.9%) were 40 years old or younger. In patients with early-onset gastric, the prevalence of gastric cancer diagnosis was lower in men. A family history of gastric cancer or any other neoplasm was not associated with a higher prevalence of gastric neoplasms. In young patients, vomiting and ascites were more common, the preferred anatomical location was the body of the stomach, and the Borrmann IV classification and the diffuse-type histology were more likely. Our study showed an approximation of the characteristics of early-onset gastric cancer in a Latin American population, where we observed that early-onset gastric cancer has different demographic, anatomical, and histological features than late-onset gastric cancer.

El cáncer gástrico es una enfermedad multifactorial con importantes factores genéticos y ambientales. Es el quinto cáncer más común en incidencia y la cuarta causa de muerte secundaria al cáncer. La incidencia del cáncer gástrico de inicio temprano está aumentando en todo el mundo, pero la información clínica sobre estos pacientes no está bien establecida. Analizamos la asociación entre la edad y las características clínicas, endoscópicas e histopatológicas del cáncer gástrico al momento del diagnóstico en una población latinoamericana. Se realizó un estudio retrospectivo y descriptivo de corte transversal utilizando la base de datos del Servicio de Gastroenterología de la Clínica Foscal y Clínica Foscal Internacional en Bucaramanga, Colombia. Entre enero de 2016 y diciembre de 2019 se diagnosticaron 259 casos de cáncer gástrico de novo, de los cuales 36 pacientes (13,9%) tenían 40 años o menos. En pacientes con enfermedad gástrica de inicio temprano, la prevalencia del diagnóstico de cáncer gástrico fue menor en los hombres. El antecedente familiar de cáncer gástrico o cualquier otra neoplasia no se asoció con una mayor prevalencia de neoplasias gástricas. En pacientes jóvenes fueron más frecuentes los vómitos y la ascitis, la localización anatómica preferida fue el cuerpo del estómago, siendo más probable la clasificación de Borrmann IV y la histología de tipo difuso. Nuestro estudio mostró una aproximación a las características del cáncer gástrico de inicio temprano en una población latinoamericana, donde observamos que el cáncer gástrico de inicio temprano tiene diferentes características demográficas, anatómicas e histológicas que el cáncer gástrico de inicio tardío.

Tofacitinib in the treatment of moderate to severe ulcerative colitis in Colombia: Real world experience. / Tofacitinib en el tratamiento de la colitis ulcerosa moderada a grave en Colombia: experiencia en mundo real.

INTRODUCTION: There are no studies on efficacy of tofacitinib for ulcerative colitis (UC) in Latin America. The aim of this study was to describe the efficacy and safety, in the real world, of patients with moderate-severe UC treated with tofacitinib in our setting. MATERIALS AND METHODS: Multicenter descriptive observational study, in patients with UC who received treatment with tofacitinib in induction phase for 8 weeks and then, maintenance therapy, between June 2019 and June 2022. RESULTS: Thirty-four adult patients, 50% female, mean age 38.1 (range 22-72) years. 76.5% pancolitis, and 20.6% left colitis. 79.4% failure to tumor necrosis factor inhibitors (anti-TNFs), and 35.3% to vedolizumab. 14.7% naïve to biologic therapy. 23.5% had previous extraintestinal manifestations. During induction, 58.8% of patients achieved clinical, biochemical and endoscopic remission. During maintenance, 76.9% of patients at 26 weeks and 66.6% at 52 weeks presented clinical remission. Eight patients presented adverse events, none of them cardiovascular or thromboembolic. 44.1% were steroid-dependent, and 23.5% required steroids as rescue therapy. 38.3% required an increase in tofacitinib to 10mg every 12h during maintenance. In 17.6% tofacitinib was discontinued due to lack of efficacy. We included three pediatric-aged female patients, mean age 15.3 (range 14-17) years, 2/3 with pancolitis and 1/3 with left colitis, all with prior exposure to biologic therapy, who had clinical, biologic and endoscopic remission at induction. CONCLUSIONS: In this first Latin American study with tofacitinib in UC, efficacy and safety are demonstrated in the treatment of our patients with moderate to severe activity.

Drenaje endoscópico transgástrico de pseudoquiste pancreático en paciente pediátrico / Transgastric endoscopic drainage of pancreatic pseudocyst in a pediatric patient

Resumen Un pseudoquiste pancreático es una acumulación de líquido casi siempre estéril, rico en enzimas digestivas y jugo pancreático encapsulado en una pared de tejido fibroso y de granulación sin revestimiento epitelial, generalmente de forma ovalada o redondeada. Los pseudoquistes se pueden desarrollar por complicaciones en el páncreas que generan obstrucción o ruptura de un conducto pancreático. Se presenta el caso de un paciente masculino de 9 años con diagnóstico de pseudoquiste pancreático con crecimiento progresivo, debido a trauma abdominal cerrado. Se realizó un manejo multidisciplinario para determinar el tratamiento. Por las características del pseudoquiste, se definió realizar un drenaje endoscópico transgástrico. El procedimiento llevado a cabo es descrito en el presente texto. El paciente evolucionó satisfactoriamente.

Abstract A pancreatic pseudocyst is an accumulation of fluid that is almost always sterile and is rich in digestive enzymes and pancreatic juice that is encapsulated in a wall of fibrous tissue and granulation tissue without an epithelial lining. They are generally oval or rounded. Pseudocysts can develop from complications in the pancreas that lead to obstruction or rupture of a pancreatic duct. We present the case of a 9-year-old male patient diagnosed with a pancreatic pseudocyst with progressive growth due to closed abdominal trauma. Multidisciplinary management determined treatment. Due to the characteristics of the pseudocyst, transgastric endoscopic drainage was used, and the procedure was carried out as described herein. The patient evolved satisfactorily.

Pancreatitis crónica calcificante en un paciente con enolismo y tabaquismo pesado / Chronic calcifying pancreatitis in a patient with enolism and heavy smoking

Hombre de 62 años con enolismo crónico y tabaquismo pesado activo, síntomas de 3 meses de evolución consistente principalmente en deposiciones diarreicas amarillentas, flotantes, fétidas, 12 diarias, que no mejoran con el ayuno, lo despiertan en la noche, con meteorismo y dolor abdominal, perdida de 12 kg de peso y edemas periféricos. La tomografía de abdomen confirmo la sospecha de pancreatitis crónica e insuficiencia exocrina como causal de la diarrea crónica y esteatorrea (1). La pérdida de peso y malnutrición son hallazgos frecuentes, para el manejo se requiere de enzimas pancreáticas a más de 40.000 U con cada comida(2). El alcoholismo y el tabaquismo activo aceleran y contribuyen al progreso de calcificación (3)(4) y en esta fase hasta el 90 % de los pacientes presentaran diabetes mellitus(5).