[Hepatocellular carcinoma: is spontaneous regression possible?]. / Carcinoma hepatocelular: es posible la regresión espontánea?

We present the case of a patient with liver cirrhosis secondary to hepatitis C who developed a large (6 cms) hepatocellular carcinoma, diagnosed by raised alphafetoprotein (AFP) levels (> 10000 ng/ml) and imaging techniques (ultrasonography and abdominal CT with and without contrast). During follow-up there was normalization of the AFP levels and disappearance of the lesion on U.S. and CT. Spontaneous regression is exceptional in hepatocellular carcinoma. We describe the characteristics of our case and of the 10 patients described in the literature.

[The prognostic value of the endoscopic signs in the recurrence of peptic ulcer hemorrhage]. / Valor pronóstico de los signos endoscópicos en la recidiva de la hemorragia por ulcus péptico.

The endoscopic signs of hemorrhage in bleeding peptic ulcers are considered as prognostic factors for rebleeding and mortality. The value of these signs has been examined in several studies of patients with known high risk factors. In this survey, we studied the prognostic value of the endoscopic signs of hemorrhage in bleeding peptic ulcer in a group of patients without clinical risk factors such as age > 60 years, concomitant malignancy or respiratory and heart disease. Endoscopic findings were examined in fifty patients without rebleeding (group I) and twenty five with rebleeding (group II). Endoscopic findings results were spurting arterial bleeding in 9.3% of the cases, oozing hemorrhage in 17.3% of the cases, visible vessel in 9.3% of the cases, and adherent clot in 82.3% of the cases. In 9.3% of the cases endoscopic findings were negative. No statistical differences were found in the endoscopic signs among the two groups. The visible vessel and the spurting arterial bleeding cases presented in more than 50% of the rebleeding, (visible vessel and spurting arterial 57.1%). Oozing hemorrhage and the adherent clot were present in 30% of the cases. The endoscopic signs of bleeding can assist in choosing the group of patients with prospective high risk of rebleeding and possible candidates for the new treatment of endoscopic hemostatic therapy.

[Adenosquamous carcinoma of the pancreas: diagnosis with ultrasonography-guided percutaneous needle biopsy]. / Carcinoma adenoescamoso de páncreas: diagnóstico por punción citológica percutánea bajo control ecográfico.

Pancreatic adenosquamous carcinoma is an unusual histologic subtype of nonendocrine cancer of the pancreas. Diagnosis is usually made after surgery or necropsy. We report a case of adenosquamous cell carcinoma of the pancreas diagnosed by ultrasonically guided fine-needle aspiration biopsy.

[Digestive hemorrhage caused by gastric varices: usefulness of the techniques of endoscopic sclerosis]. / Hemorragia digestiva por varices gástricas: utilidad de las técnicas de esclerosis endoscópica.

Upper gastrointestinal hemorrhage secondary to gastric varices still has a high death rate. Fourteen patients were admitted to our unit with bleeding gastric varices from November 1989 to August 1991. Endoscopic injection sclerotherapy obtained control of the bleeding in 92.3%; however, recurrences occurred in 33% of these cases in the first 24-48 hours, with a death rate of 50% during the second stage of the upper gastrointestinal hemorrhage. Total mortality rate was 21.4%. Of the fourteen patients, nine exhibited junctional varices, while five hand fundic varices. In ten of the fourteen patients, gastric varices developed during esophageal sclerotherapy. While hospitalized, it was observed that patients with gastric varices in the fundus had more recurrences and mortality, than those located next to the cardio-esophageal junction. Sclerosis of the varices only obtained temporary control of the bleeding with greater frequency of recurrences and mortality.