Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis.

Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

[Duodenopancreatectomy in the elderly. Evaluation of results]. / Duodenopancreatectomía en ancianos. Evaluación de resultados.

INTRODUCTION: With the increase in life expectancy, more and more resectable periampullary tumours are being diagnosed in the geriatric population. Despite the decrease in post-operative mortality, there continues to be a debate on the risk-benefit of cephalic duodenopancreatectomy (CPD) in the elderly. OBJECTIVE: To analyse the morbidity and mortality of CPD in patients over 70 years-old. DESIGN: Prospective observational study. PATIENTS: A total of 54 duodenopancreatectomies were performed between January 2005 and December 2010. Two groups of patients were compared: Group 1 (patients>70 years-old, n: 24), and Group 2 (patients<70 years-old, n: 30). The morbidity and mortality, transfusion, reinterventions, mean hospital stay, and survival were analysed. RESULTS: The>70 years group included more ASA 2 and 3 patients (P=.010), and had a higher number of previous medical problems per patient (P=.037). The post-operative mortality was higher in the older age group, although the difference was not significant (8.3 vs 3.3%). There were also no significant differences in post-operative morbidity (45.8 v. 46.6%), reintervention rate (16.6 vs 13.3%), length of hospital stay (18 vs 13%), and survival at 6 and 12 months (84 and 72% vs 90 and 86%). CONCLUSIONS: Age, in itself, does not seem to be a contraindication for CPD, but the elderly do have a higher risk of complications due to the physiological changes associated with ageing. The disparity of results demonstrates the need for more population studies at national level that may give an overall view of morbidity and mortality in CPD.

Cardiac papillary fibroelastoma in left ventricular apex.

Papillary fibroelastoma (PF) is a rare benign heart tumor and represents less than 10% of primary cardiac tumors. It mainly affects the cardiac valves and is often discovered during open heart surgery or autopsy. We present a case of a patient who was detected with a left ventricular apex tumor during the evaluation of the transient ischemic attack. The patient underwent surgery, and subsequently, macroscopic and microscopic examination confirmed the diagnosis of PF.

La endoscopia como técnica diagnóstica y terapéutica alternativa de la teniasis / Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis

A pesar de su baja incidencia en países desarrollados, la teniasis gastrointestinal debería sospecharse ante todo paciente con clínica de dolor abdominal, diarrea, anemia y/o malabsorción de origen desconocido, más aún si ha estado en áreas endémicas o con malas condiciones alimentarias-higiénicas. El diagnóstico tradicional es la identificación del parásito en las heces, existiendo además métodos serológicos o inmunológicos más recientes. Se revisa a raíz de un caso diagnosticado por gastroscopia, los casos reportados en la literatura que han sido diagnosticados por endoscopia y finalmente discutiremos acerca de la endoscopia como método diagnóstico, así como la eficacia y seguridad que proporcionaría el tratamiento endoscópico dado el potencial riesgo de neurocisticercosis (AU)

Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis (AU)

Primary monophasic synovial sarcoma of the duodenum confirmed by cytogenetic analysis with demonstration of t(X;18): a case report.

Synovial sarcoma (SS) is an uncommon malignant neoplasm of the soft tissues. It mainly affects the periarticular tissues of the extremities in young adults, but has been described at nearly all sites; nevertheless, the gastrointestinal tract is an exceptional location. We report a case of a primary synovial sarcoma of the duodenum in a 69-year-old woman. Histological study showed a monophasic pattern. The tumor cells demonstrated diffuse vimentin and Bcl-2 expression, partial EMA expression and focal AE1/3 positivity. The differential diagnosis includes gastrointestinal stromal tumors. Cytogenetic analysis confirmed the diagnosis, with detection of the X;18 translocation. The patient presented postoperative complications and died one month following the intervention.

Duodenopancreatectomía en ancianos. Evaluación de resultados / Duodenopancreatectomy in the elderly. Evaluation of results

Introducción Con el aumento de la esperanza de vida, cada vez se diagnostican más tumores periampulares resecables en la población geriátrica. A pesar de la disminución de la mortalidad postoperatoria, el debate sobre la relación riesgo-beneficio de la duodenopancreatectomía cefálica (DPC) en ancianos sigue vigente.Objetivo Analizar la morbimortalidad de la DPC en los pacientes mayores de 70 años. Diseño Estudio prospectivo observacional. Pacientes Entre enero de 2005 y diciembre 2010, se realizaron 54 duodenopancreatectomías. Se compararon 2 grupos de pacientes: grupo 1 (pacientes>70 años, n: 24), y grupo 2 (pacientes<70 años, n: 30). Se analizó la morbimortalidad, transfusión, reintervenciones, estancia media y supervivencia. Resultados El grupo>70 años incluyó más pacientes ASA 2 y 3 (p=0,010), y presentaron mayor número de antecedentes personales por paciente (p=0,037). La mortalidad postoperatoria fue superior en el grupo de más edad, aunque sin diferencias significativas (8,3 vs. 3,3%). La morbilidad postoperatoria (45,8 vs. 46,6%), la tasa de reintervenciones (16,6 vs. 13,3%), la estancia hospitalaria (18 vs. 13 días), y la supervivencia a 6 y 12 meses, tampoco presentaron diferencias significativas (84 y 72% vs. 90 y 86%).Conclusiones La edad no parece ser una contraindicación por sí misma para la DPC, si bien los ancianos presentan mayor riesgo de complicaciones debido a los cambios fisiológicos relacionados con el envejecimiento. La disparidad de resultados evidencia la necesidad de disponer de estudios poblacionales de ámbito nacional que aporten una visión global de la morbimortalidad en la DPC (AU)

Introduction With the increase in life expectancy, more and more resectable periampullary tumours are being diagnosed in the geriatric population. Despite the decrease in post-operative mortality, there continues to be a debate on the risk-benefit of cephalic duodenopancreatectomy (CPD) in the elderly. Objective To analyse the morbidity and mortality of CPD in patients over 70 years-old. Design Prospective observational study. Patients A total of 54 duodenopancreatectomies were performed between January 2005 and December 2010. Two groups of patients were compared: Group 1 (patients>70 years-old, n: 24), and Group 2 (patients<70 years-old, n: 30). The morbidity and mortality, transfusion, reinterventions, mean hospital stay, and survival were analysed. Results The>70 years group included more ASA 2 and 3 patients (P=.010), and had a higher number of previous medical problems per patient (P=.037). The post-operative mortality was higher in the older age group, although the difference was not significant (8.3 vs 3.3%). There were also no significant differences in post-operative morbidity (45.8 v. 46.6%), reintervention rate (16.6 vs 13.3%), length of hospital stay (18 vs 13%), and survival at 6 and 12 months (84 and 72% vs 90 and 86%).Conclusions Age, in itself, does not seem to be a contraindication for CPD, but the elderly do have a higher risk of complications due to the physiological changes associated with ageing. The disparity of results demonstrates the need for more population studies at national level that may give an overall view of morbidity and mortality in CPD (AU)

Hamartoma de mama con carcinoma intraductal / Intraductal carcinoma arising in a breast hamartoma

El hamartoma de mama es una entidad benigna y poco común que afecta preferentemente a mujeres a partir de la pubertad. Se caracteriza por un crecimiento lento y su transformación maligna se considera un hallazgo incidental. Presentamos el caso de una mujer de 48 años con una tumoración en mama derecha. Histológicamente mostró elementos epiteliales propios de la mama dispuestos al azar, rodeados por un tejido fibroadiposo, y un foco de carcinoma intraductal. Las imágenes mamográficas fueron de hamartoma típico sin signos de malignidad. A los ocho meses de la intervención no existen signos de recidiva

Breast hamartomas are uncommon benign lesions found in all age groups after puberty. They present clinically as a slow-growing mass and its malignant transformation is usually a coincidental finding. We report the case of a 48 year-old woman with a mass in her right breast. Histological study showed epithelial elements of normal breast tissue randomly dispersed among a fibrofatty stroma, and a microscopic focus of intraductal carcinoma . Mammography showed the typical hamartoma features without any suspicious signs of malignancy. The patient remains alive and well eight months after surgery