Tumor Odontogénico Epitelial Calcificante maxilar superior: reporte de un caso / Calcifying Epithelial Odontogenic Tumor in upper maxillary: a case report

RESUMEN: El Tumor Odontogénico Epitelial Calcificante (TOEC), también denominado Tumor de Pindborg, se define como una neoplasia benigna, caracterizada por la proliferación epitelial; presenta secreción de una proteína tipo amiloide con tendencia a la calcificación. Representa menos del 1% de los tumores odontogénicos. Reportamos un caso en paciente de 75 años con un TOEC en la región maxilar izquierda en relación a una pieza dentaria incluida. El caso no mostró sintomatología específica, sólo una expansión de corticales vestibular y palatina. El diagnóstico se confirmó histológicamente mediante biopsia incisional y extirpación quirúrgica de la lesión, mostrando una histomorfología clásica para este tipo de lesiones. Reportamos este caso para resaltar la edad de presentación inusual, especialmente su localización e ilustrar su abordaje terapéutico y seguimiento.

ABSTRACT: The Calcifying Epithelial Odontogenic Tumor (CEOT), also called Pindborg Tumor, is defined as a benign neoplasm, characterized by epithelial proliferation; secretion of an amyloid-like protein is present with a tendency to calcification. It represents less than 1% of odontogenic tumors. We report a case of a 75-year-old patient with a TOEC in the left maxillary region in relation to an included tooth. The case did not show specific symptomatology, only an expansion of vestibular and palatal corticals. The diagnosis was confirmed histologically by incisional biopsy and surgical removal of the lesion, showing a classic histomorphology for this type of lesions. We report this case to highlight the unusual age of presentation, especially its location and to illustrate its therapeutic approach and follow-up.

Caracterização de colágenos tipos I e III no estroma do carcinoma de células escamosas cutâneo em cães / Characterization of types I and III collagen in the stroma of cutaneous squamous cell carcinoma in dogs

O carcinoma de células escamosas (CCE) é uma neoplasia epitelial maligna que acomete cães e diversas outras espécies, incluindo a humana. O CCE afeta vários sítios anatômicos e pode desenvolver metástase. O objetivo deste estudo foi a caracterização das fibras de colágenos tipos I e III no estroma do CCE cutâneo de cães. Para este trabalho, utilizaram-se 44 amostras de pele incluídas em parafina e que tiveram prévio diagnóstico de CCE. As amostras foram processadas histologicamente e coradas com hematoxilina/eosina para confirmação do diagnóstico e classificação do grau de diferenciação tumoral e com a coloração histoquímica de picrosirius para observação dos colágenos tipos I e III. O colágeno tipo III mostrou maior expressão nos CCEs cutâneos bem diferenciados. O papel do colágeno do tipo III nas neoplasias não está bem esclarecido, e outros fatores além do grau de diferenciação celular podem estar envolvidos em sua expressão e determinar sua importância na biologia tumoral.(AU)

Squamous cell carcinoma (SCC) is a malignant epithelial tumor that affects dogs and several other species, including humans. The SCC occurs in various anatomical sites and can develop metastasis. The aim of this study was to characterize types I and III collagen fibers in the stroma of cutaneous SCC in dogs. For this work 44 paraffin-embedded samples with previous diagnostic of SCC were used. Samples were processed and evaluated histologically with hematoxylin/eosin to confirm the diagnosis and classification of cell differentiation degree and with Picrosirius for observation of types I and III collagen. Type III collagen expression was higher in well-differentiated SCC. The role of type III collagen in cancer is not very clear and factors other than cell differentiation degree may be involved in its expression and determine its importance in tumor biology.(AU)

Caracterização de colágenos tipos I e III no estroma do carcinoma de células escamosas cutâneo em cães / Characterization of types I and III collagen in the stroma of cutaneous squamous cell carcinoma in dogs

O carcinoma de células escamosas (CCE) é uma neoplasia epitelial maligna que acomete cães e diversas outras espécies, incluindo a humana. O CCE afeta vários sítios anatômicos e pode desenvolver metástase. O objetivo deste estudo foi a caracterização das fibras de colágenos tipos I e III no estroma do CCE cutâneo de cães. Para este trabalho, utilizaram-se 44 amostras de pele incluídas em parafina e que tiveram prévio diagnóstico de CCE. As amostras foram processadas histologicamente e coradas com hematoxilina/eosina para confirmação do diagnóstico e classificação do grau de diferenciação tumoral e com a coloração histoquímica de picrosirius para observação dos colágenos tipos I e III. O colágeno tipo III mostrou maior expressão nos CCEs cutâneos bem diferenciados. O papel do colágeno do tipo III nas neoplasias não está bem esclarecido, e outros fatores além do grau de diferenciação celular podem estar envolvidos em sua expressão e determinar sua importância na biologia tumoral.

Squamous cell carcinoma (SCC) is a malignant epithelial tumor that affects dogs and several other species, including humans. The SCC occurs in various anatomical sites and can develop metastasis. The aim of this study was to characterize types I and III collagen fibers in the stroma of cutaneous SCC in dogs. For this work 44 paraffin-embedded samples with previous diagnostic of SCC were used. Samples were processed and evaluated histologically with hematoxylin/eosin to confirm the diagnosis and classification of cell differentiation degree and with Picrosirius for observation of types I and III collagen. Type III collagen expression was higher in well-differentiated SCC. The role of type III collagen in cancer is not very clear and factors other than cell differentiation degree may be involved in its expression and determine its importance in tumor biology.

Tumor de Frantz: neoplasia sólida pseudopapilar de páncreas / Frantz tumor: a pancreatic pseudopapillary solid neoplasia

Nosotros reportamos un caso de neoplasia sólida pseudopapilar de páncreas en una mujer de 35 años. Ella refirió haber iniciado desde hace tres meses una enfermedad progresiva caracterizada por dolor epigástrico y baja de peso. En el examen físico solo mostró dolor moderado a la palpación profunda de mesogastrio, no se palpó alguna masa abdominal. Los exámenes auxiliares mostraron hemoglobina 13.3gr; leucocitos, plaquetas, perfil de coagulación, bioquímica, electrolitos, albúmina, globulinas, bilirrubinas, transaminasas y fosfatasa alcalina fueron normales. Examen de orina: leucocitos 14-16 por campo, urocultivo: negativo, Ca 19.9: 21.2 (0-37). Arco V (anticuerpos IgG E. granulosus):, 17.3 (nivel dudoso), Inmunoblot quiste hidatídico: negativo. La ecografía abdominal mostro entre cuerpo y cola de páncreas una imagen hipoecogénica de aspecto sólido. En la tomografía abdominal se detectó en el cuerpo del páncreas la presencia de dos nódulos hipodensos con densidad promedio de 25 U.H. y que medían 50 y 22 mm de diámetro. Las imágenes por resonancia magnetica nuclear determinaron en el cuerpo del páncreas un quiste bilobulado de 45 y 25 mm de diámetro, con isointensidad en T1, hiperintensidad en T2, sin cambios tras la saturación grasa, con realce periférico por el contraste. Intervenida quirúrgicamente, se encontró una tumoración quística en el cuerpo del páncreas; sin signos de infiltración a otros órganos. Se realizó pancreatectomía distal y esplenectomía. La tumoración era ovalada y medía 60x46x35 mm, encapsulada, de consistencia irregular, que al corte dejaba fluir material de aspecto necrótico. El estudio histológico demostró el típico patrón pseudopapilar con estroma perivascular hialinizado; en los estudios de inmunohistoquimica se observo inmunoreactividad positiva a ciclina D1 y al receptor de progesterona; también hubo positividad para vimentina, enolasa neuronoespecífica y CD-56...

We report a case of solid and papillary epithelial neoplasm of the pancreas in a 35-year-old female. She presented with epigastric pain and weight loss, these symptoms developed 3 months before. Physical examination revealed mild pain on deep palpation of mesogastrium, without palpable abdominal mass; rest of the examination was normal. The laboratory data showed hemoglobin 13.3gr/dl; WBC, platelets, blood coagulation test, blood biochemistry, electrolytes, liver function test were normals. Urine test: 14-16 leukocytes per field, urocultive negative, Ca 19.9: 21.2 (0-37). Her serology for hydatic cyst (arc V and inmunoblot) was negative. Abdominal ultrasound showed between body and tail of the pancreas a solid hypoechoic image. In abdominal CT was detected in the body of the pancreas the presence of two hypodense lesions with average density of 25 UH and mediate 50 and 22 mm in diameter. The nuclear magnetic resonance imaging identified the body of the pancreas, bilobed cyst of 45 and 25 mm in diameter, with isointensity in T1, hyperintensity in T2, unchanged after fat saturation, with peripheral contrast enhancement. Operation findings showed a cystic tumor in the body of pancreas without signs of infiltration to other organs. Therefore, distal pancreatectomy and splenectomy were carried out. The tumor was 60x46x35 mm and a half oval, encapsulated, irregular consistency, which the court left necrotic-looking material flow. The study showed the pattern typical hyalinized perivascular pseudopapillary with stroma, in immunohistochemical studies positive imunoreactivity was observed in cyclin D1 and progesterone receptor, also were positive for vimentin, enolase neuronoespecífica and CD-56. The proliferation index assessed by Ki-67 was less than 1% in tumor cells...

Lesiones premalignas y malignas de cérvix en adolescentes y mujeres jóvenes. Clínica Maternidad Rafael Calvo, Cartagena / Cervical malignant and premalignant lesions in adolescents and young women. Clínica Maternidad Rafael Calvo, Cartagena

Objetivo: Determinar la frecuencia de lesiones premalignas y malignas de cérvix en adolescentes y mujeres jóvenes. Métodos: Estudio descriptivo transversal de 136 historias clínicas de pacientes entre 14 y 24 años remitidas al Servicio de Patología Cervical de Clínica Maternidad Rafael Calvo. Se evaluaron citología, colposcopia y estudio histopatológico. Resultados: La edad media fue de 21,0 (DE 2,4) años, la de inicio de vida sexual de 16,0 (DE 1,9) y la del primer embarazo 15,0 (DE 6,1) años. El 51,4% informaron dos o más compañeros sexuales. Treinta y seis (26,4%) eran adolescentes y 100 (73,6%) adultas jóvenes de 20 a 24 años. El 48,5% de toda la población tuvo citología anormal. Se observaron hallazgos colposcópicos de lesiones premalignas en 48 pacientes (35,3%): 12 adolescentes y 36 adultas. Se realizaron 50 biopsias: 39 (78,0%) resultaron con lesiones de bajo grado, nueve (18,0%) lesiones de alto grado y una (2%) con cáncer de cérvix infiltrante. No se observó diferencia estadísticamente significativa entre la frecuencia de LIE de bajo o alto grado entre adolescentes y adultas jóvenes. En las pacientes con lesiones de alto grado y cáncer se observó una mayor frecuencia de inicio de vida sexual antes de 16 años y más de un compañero sexual. Conclusión. Se observó una mayor frecuencia de lesiones premalignas y malignas que las descritas en otros estudios. Nuevas evaluaciones deben inferir las causas que influyen en el incremento en la presencia de LIE a edades tempranas. [Romero IM, Ceballos C, Monterrosa A. Lesiones premalignas y malignas de cérvix en adolescentes y mujeres jóvenes. Clínica Materniada Rafael Calvo, Cartagena. MedUNAB 2009; 12:14-18].

Objetive: to establish frequency of cervical premalignant lesions and cancer in adolescents and young women. Methods: This is a descriptive cross-sectional study of 136 patients between 14 and 24 years old who were referred to Cervical Pathology Unit, Clínica Maternidad Rafael Calvo, Cartagena, Colombia. Results of cytology, colposcopy and biopsies were evaluated. Results: Mean age was 21,0 (SD 2,4) years; initiation of intercourse were a mean age of 16,0 (SD 1,9), and mean age of first pregnancy was 15,0 (SD 6,1) years. Fifty one percent of patients had two or more sexual partners. Thirty six (26,4%) were adolescents and 100 (73,6%) were young adult (20¿24 years old). Abnormal cytology was found in 48,5% of patients. There were 48 patients (35,3%) with premalignant lesions on colposcopy: 12 adolescents and 36 adults. Fifty biopsies were performed: 39 (78,0%) resulted with low grade lesions, 9 (18,0%) with high grade lesions, and one (2,0%) infiltrating carcinoma. Differences between frequencies of premalignant lesions in adolescents and young women were not statiscally significant. Patients with high grade lesions and cervical cancer initiated intercourse at 16 years old or less and they had more than one sexual partner. Conclusion: It was observed a higher frequency of premalignant and malignant lesions in this study than other reports. Additional studies should look for causes of increasing presentation of these lesions at earlier ages. [Romero IM, Ceballos C, Monterrosa A. Cervical malignant and premalignant lesions in adolescents and young women. Clínica Maternidad Rafael Calvo, Cartagena. MedUNAB 2009; 12:14-18].