La cápsula endoscópica para el diagnóstico del melanoma intestinal / Cholecystogastric fistula diagnosed by endoscopic ultrasonography

Melanoma is a cancer that frequently metastasises to the small bowel, but most cases are asymptomatic and are diagnosed postmortem. Therefore, CT and PET CT cannot detect all lesions and conventional endoscopic study only detects 10-20% of lesions. In this study, we present the case of a 68-year-old patient with a history of cutaneous melanoma and a diagnosis of intestinal melanoma. Thanks to capsule endoscopy, two lesions compatible with cutaneous melanoma metastasis to the small bowel were detected, allowing a much more effective surgical planning. Capsule endoscopy is an innovative technique that improves preoperative diagnosis, as it is able to detect bowel segments that cannot be inspected by conventional endoscopy. It also has a better resolution than conventional CT, improving sensitivity in the detection of lesions.(AU)

SEOM-GETNE clinical guidelines for the diagnosis and treatment of gastroenteropancreatic and bronchial neuroendocrine neoplasms (NENs) (2022)

'Neuroendocrine neoplasms (NENs) are a heterogeneous family of tumors of challenging diagnosis and clinical management. Their incidence and prevalence continue to rise mainly due to an improvement on diagnostic techniques and awareness. Earlier detection, along with steadfast improvements in therapy, has led to better prognosis over time for advanced gastrointestinal and pancreatic neuroendocrine tumors. The aim of this guideline is to update evidence-based recommendations for the diagnosis and treatment of gastroenteropancreatic and lung NENs. Diagnostic procedures, histological classification, and therapeutic options, including surgery, liver-directed therapy, peptide receptor radionuclide therapy, and systemic hormonal, cytotoxic or targeted therapy, are reviewed and discussed, and treatment algorithms to guide therapeutic decisions are provided (AU)

Primary hepatic neuroendocrine carcinoma with subsequent cerebral and spinal metastases

A 72-year-old man was referred to us for evaluation of asymptomatic masses in the liver that had been detected on ultrasonography performed during a physical screening. The level of neuron-specific enolase was elevated (56.97 ng/mL; normal level, 15.7-17.0 ng/mL). Other tumor markers were normal, including alpha fetoprotein, carcinoembryonic antigen and cancer antigen 199. No tumor was found through chest CT scan, gastroscopy and colonoscopy. Abdominal MR demonstrated multiple masses with irregular central necrosis, which appeared as marked hyperintensity on T2WI. Most lesions showed rim-like enhancement at portal venous phase. Pathological examination of tissue obtained by means of percutaneous biopsy indicated that the tumor was composed of small cells which were arranged in nests and trabeculae, the nuclei were round with little cytoplasm, and nuclear division was present (hematoxylin-eosin stain (AU)

The effects of aerobic exercise on the intestinal tumors and flora of the ApcMin/+ mouse

IntroductionIntestinal tumor is one of the most common tumors that seriously threaten the health of residents all over the world. Studies suggest that the imbalance of intestinal flora is associated with tumorgenesis; meanwhile, long-term regular aerobic exercise can improve the occurrence and development of tumors. However, moderate aerobic exercise affecting the development of intestinal tumors and their related flora has not been explored. Thus, the purpose of our study is to explore the effects of aerobic exercise on intestinal tumor growth and flora changes in ApcMin/+ mice, and try to answer whether there is a correlation between them after exercise intervention.MethodsIn this study, 18 required ApcMin/+ mice were randomly divided into Model group (n = 6), Exercise group (n = 6), and Aspirin group (positive control, n = 6), while C57BL/6 J wild-type mice were used as the blank control group. Each group is given corresponding intervention. Weight monitoring, tumor counts, hematoxylin–eosin staining, TdT-mediated dUTP nick-end labeling (TUNEL) fluorescence assay, immunohistochemistry (IHC), fecal sampling and grouping, and bacterial 16S rDNA gene analysis were completed after 12 weeks’ intervention for each group of mice.ResultsAs a result, we were able to show significant improvements in mice’ body weight changing rates (Exercise group 8.6% higher than Model control group), tumor numbers (Exercise group 4.33 ± 0.94 vs. Model control group 7.33 ± 2.49.

Adenocarcinoma sobre quiste de duplicación yeyunal / Adenocarcinoma over a jejunal duplication cyst

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Uso de la fluorescencia con verde de indocianina (ICG) en la identificación de un linfoma intestinal / Use of flourescent imaging with indocyanine green (ICG) for the identification of intestinal lymphoma

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Metastasis of lobular breast carcinoma in the bowel / Metástasis de carcinoma lobular de mama en el intestino

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Metástasis de carcinoma pulmonar pleomórfico como causa de abdomen agudo / Small Bowel Perforation Due to Metastatic Pleomorphic Lung Cancer

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Hemangioma intestinal como causa de anemia crónica / No disponible

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Linfoma de Hodgkin en enfermedad inflamatoria intestinal tratado con tiopurinas. Presentación de un caso y revisión de la literatura / Hodgkin's lymphoma associated with inflammatory bowel disease treated with thiopurines. A case report and review of the literature

El riesgo asociado de desarrollar una enfermedad linfoproliferativa en la enfermedad inflamatoria intestinal (EII) es un tema controvertido desde hace décadas y se discute si el riesgo se asocia a la inflamación crónica de la EII per se o a los tratamientos de la misma, especialmente los fármacos tiopurínicos (azatioprina y mercaptopurina) y los agentes anti-TNF-alfa. Presentamos un caso excepcional de un varón de 35 años diagnosticado de enfermedad de Crohn con 17 años y en tratamiento con azatioprina, que presentó años después, un linfoma de Hodgkin intestinal

The risk of developing a lymphoproliferative disease associated with inflammatory bowel disease (IBD) has been a controversial issue for decades; it is debatable whether the risk is associated with the chronic inflammation of IBD per se or its treatment, especially with thiopurine drugs (azathioprine and mercaptopurine) and anti-TNF-alfa agents. We present an unusual case of a 35-year-old man who had been diagnosed with Crohn's disease at age 17 and treated with azathioprine, presenting years later with an intestinal Hodgkin's lymphoma

Melanoma mucoso intestinal: una rara causa de obstrucción / Melanoma of the intestinal mucosa: A rare cause of obstruction

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Hemorragia digestiva aguda en paciente con neurofibromatosis tipo 1 afecto de múltiples GIST y ganglioneuromatosis intestinal / Acute gastrointestinal bleeding, multiple GIST and intestinal ganglioneuromatosis in a patient with neurofibromatosis

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Pólipos elastofibromatosos del tracto gastrointestinal: reporte de tres casos y revisión de la literatura / Elastofibromatous polyps of the gastrointestinal tract: report of three cases and review of the literature

Introducción: Los pólipos elastofibromatosos gastrointestinales son lesiones benignas infrecuentes. Fueron descritos por primera vez en el estómago en 1985, por Enjoji y desde entonces, se han descrito casos aislados, sin reportes de ellos en la literatura hispana. Se presentan como lesiones polipoideas únicas, asintomáticas, ubicadas con mayor frecuencia en el intestino grueso. Su diagnóstico se realiza mediante biopsia, y dentro del diagnóstico diferencial se incluye la amiloidosis. Objetivo: Caracterizar una nueva serie clínico-patológica de casos de pólipos elastofibromatosos gastrointestinales y realizar una revisión bibliográfica de los casos publicados. Pacientes y métodos: Se realizó un estudio retrospectivo de los casos de pólipos fibroelastomatosos, diagnosticados entre los años 2016 y 2017 en el Hospital Clínico Universidad Católica de Chile. Se revisaron los datos demográficos, láminas histológicas teñidas con hematoxilina-eosina y tinciones histoquímicas de Verhoeff - van Gieson, y rojo Congo. Además, se realizó una búsqueda bibliográfica de los casos comunicados previamente en la literatura. Resultados: Se encontraron 3 casos de pólipos fibroelastóticos gastrointestinales, todos ubicados en el intestino grueso. En la revisión bibliográfica, se encontraron 41 casos, la mayor parte de ellos ubicados en el intestino grueso (34 casos, 77%), en segundo lugar, en el estómago (6 casos, 14%) y menos frecuentemente en el intestino delgado (4 casos, 9%). Conclusiones: Los hallazgos son similares a los descritos en la literatura. Por ser lesiones infrecuentes, se requiere un exhaustivo examen anatomopatológico con técnicas histoquímicas complementarias para descartar condiciones sistémicas que tienen otra repercusión clínica, como la amiloidosis

Introduction: Gastrointestinal elastofibromatous polyps are rare benign lesions. In 1985, Enjoji described elastofibromatous change of the stomach but since only isolated cases have been reported, with none in Spanish language journals. They present as single, usually asymptomatic, polypoid lesions, most frequently in the large intestine. Biopsy is essential for diagnosis and the main differential diagnosis is amyloidosis. Objective: To report the clinicopathological characteristics of a new series of gastrointestinal elastofibromatous polyps and review the pertinent literature. Patients and methods: A retrospective study of cases of elastofibromatous polyps diagnosed between 2016 and 2017 in the Hospital Clínico de la Universidad Católica de Chile. Demographic data and histological slides stained with H&E, Verhoeff - van Gieson histochemical staining and Congo-red, were reviewed as well as previously reported cases. Results: 3 cases of gastrointestinal elastofibromatous polyps were found, all located in the large intestine. The location of 41 previously reported cases was: 34 (77%) in the large intestine; 6 (14%) in the stomach and 4 (9%) in the small intestine. Conclusions: Our findings concord with previously reported cases. As they are rare lesions, careful histopathological examination, complemented with histochemical studies, is necessary for a correct differential diagnosis, ruling out other possibilities, such as amyloidosis, with different clinical implications

Negative video capsule enteroscopy - what's the next step? / Enteroscopia de videocápsula negativa: ¿cuál es el próximo paso?

Video capsule endoscopy (VCE) is a reliable noninvasive method for examination of small-bowel mucosa. However, it has some limitations. The aim of this article was to review the approach in patients with negative VCE. It is clear that a negative VCE should be interpreted based on the indication. In suspected small bowel bleeding (SSBB), patients with ongoing/recurrent overt bleeding, or occult bleeders who experience significant declines in hemoglobin after a negative VCE should proceed small bowel study; on the other hand, patients with occult SSBB and only mild-moderate anemia should be managed with supportive care. In inflammatory bowel disease, a normal VCE has a very high sensitivity and negative predictive value. In small bowel tumor suspicion there is a high risk of false negative results, so another imaging modality should be considered. In polyposis syndromes, if VCE is negative, patients should continue screening within 2-3 years

La videocápsula endoscópica (VCE) es un método fiable no invasivo para la exploración de la mucosa del intestino delgado. Sin embargo, presenta algunas limitaciones. El objetivo de este artículo fue revisar el abordaje de algunos pacientes con VCE negativa. Está claro que una VCE negativa debe interpretarse en función de la indicación. En la sospecha de hemorragia del intestino delgado (SSBB, por sus siglas en inglés), los pacientes con hemorragia manifiesta persistente/recurrente o sangradores ocultos que sufren descensos considerables de la hemoglobina después de una VCE negativa deben continuar con un estudio del intestino delgado; además, los pacientes con SSBB oculta y solo anemia de leve a moderada deben ser tratados con tratamiento de apoyo. En la enfermedad inflamatoria intestinal, una VCE normal presenta una sensibilidad muy alta y un valor pronóstico negativo. Cuando se sospecha de tumor de intestino delgado, se corre un elevado riesgo de resultados falsos negativos, por lo que se debe considerar otra modalidad de prueba de diagnóstico por la imagen. En los síndromes de poliposis, si la VCE es negativa, se debe volver a realizar la prueba en los pacientes dentro de 2-3 años