RESUMO
The article discusses the importance of accurately distinguishing HER2-low from HER2-negative breast cancer, as novel ADCs have demonstrated activity in a large population of patients with HER2-low-expressing BC. While current guidelines recommend a dichotomous classification of HER2 as either positive or negative, the emergence of the HER2-low concept calls for standardization of HER2 testing in breast cancer, using currently available assays to better discriminate HER2 levels. This review covers the evolution and latest updates of the ASCO/CAP guidelines relevant to this important biomarker in breast cancer, including still-evolving concepts such as HER2 low, HER2 heterogeneity, and HER2 evolution. Our group presents the latest Mexican recommendations for HER2 status evaluation in breast cancer, considering the ASCO/CAP guidelines and introducing the HER2-low concept. In the era of personalized medicine, accurate HER2 status assessment remains one of the most important biomarkers in breast cancer, and the commitment of Mexican pathologists to theragnostic biomarker quality is crucial for providing the most efficient care in oncology.
RESUMO
Resumen OBJETIVO: Describir las características clínicas e histopatológicas de los casos de teratoma maduro con transformación maligna, su tratamiento y supervivencia. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y observacional efectuado entre enero de 2014 y diciembre de 2018 en un servicio de oncología ginecológica. Parámetros de estudio: etapa patológica del tumor, concentraciones de Ca 125, supervivencia y tratamiento. El tamaño de la muestra no permitió aplicar pruebas estadísticas. RESULTADOS: Se estudiaron 147 pacientes con diagnóstico de teratoma maduro, de éstos 4 experimentaron transformación maligna a carcinoma epidermoide y se descartaron 18 por información incompleta. El estudio histopatológico transoperatorio identificó malignidad en 3 de los 4 tumores de ovario. No se practicaron cirugías conservadoras de la fertilidad porque en ninguno de los casos fue necesaria. En 3 de los 4 teratomas maduros con transformación maligna se indicó esquema de quimioterapia coadyuvante. Todas las pacientes permanecen vivas y sin recaída hasta el momento. CONCLUSIONES: El estudio histopatológico transoperatorio es indispensable en todas las lesiones de ovario, incluso las de aspecto quístico. El tratamiento quirúrgico cuidadoso de los tumores malignos de ovario evita su ruptura y cambio en el pronóstico y tratamiento de las pacientes. El tratamiento quirúrgico y médico de una neoplasia poco frecuente, como el teratoma maduro con transformación maligna, mejora la supervivencia y evita subtratamientos o sobretratamientos.
Abstract OBJECTIVE: Describe the clinical and histopathological characteristics of cases of mature teratoma with malignant transformation, its treatment and survival. MATERIALS AND METHODS: Retrospective, cross-sectional and observational study conducted between January 2014 and December 2018 in a gynecological oncology service. Study parameters: pathological stage of the tumor, concentrations of Ca 125, survival and treatment. The sample size did not allow statistical tests to be applied. RESULTS: 147 patients with a diagnosis of mature teratoma were studied of these 4 underwent malignant transformation to squamous cell carcinoma and 18 were ruled out due to incomplete information. The transoperative histopathological study identified 3 of the 4 ovarian tumors as malignant. Fertility conservative surgeries were not performed because in none of the cases was it necessary. In 3 of the 4 mature teratomas with malignant transformation, adjuvant chemotherapy scheme was indicated. All patients remain alive and have no relapse so far. CONCLUSIONS: The histopathological transoperatory study is absolutely necessary for an ovarian tumor, even in cystic ovarian tumors. Carefully management of ovarian tumors is very important, we should prevent a rupture of the malignant tumor because this changes the surgical stage and the prognosis. The surgical and medical treatment of infrequent tumor-like mature teratoma with malignant transformation improves survival and avoid sub treatments or overtreatment.
RESUMO
We present the clinicopathlogical features of an ovarian mature cystic teratoma with a fully developed gastric wall containing an extensive peptic ulcer. Complete gastric wall, was the only teratomatous tissue present. There are only two previous reported cases of gastric mucosa with a peptic ulcer in an ovarian teratoma.
