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1.
Chirurgia (Bucur) ; 108(5): 611-5, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24157103

RESUMEN

AIM: Given the context that rectal tumours respond to a certain degree to radiotherapy, a necessity arises for estimating a tumour's capacity to react to radiation from the very moment of diagnostic biopsy. MATERIAL AND METHODS: We have histologically and immunohistochemically analysed tissues coming from 52 patients with rectal adenocarcinomas. RESULTS: Of the studied parameters, the ones presenting significant variation under radiotherapy in terms of statistics(p 0.05) were: colloid type (p=0.001), EGFR in the tumour(p=0.00045), EGFR in the normal epithelium (p=0.0017),VEGF in the tumour (p=0.0132) and VEGF in the tumour stroma (p=0.030). CONCLUSIONS: Our study follows the same trends as the medical literature we have consulted regarding the variation of EGFR and VEGF with radiotherapy, and the distinct note of our study relies in the observation that normal stroma in case of rectal tumors also reacts to radiotherapy, sometimes more aggressively than the tumor itself, especially in which concerns the nerve and muscle fibers.


Asunto(s)
Adenocarcinoma/patología , Adenocarcinoma/radioterapia , Biomarcadores de Tumor/metabolismo , Receptores ErbB/metabolismo , Neoplasias del Recto/patología , Neoplasias del Recto/radioterapia , Factor A de Crecimiento Endotelial Vascular/metabolismo , Adenocarcinoma/metabolismo , Biopsia , Femenino , Humanos , Inmunohistoquímica , Masculino , Células Oxífilas/patología , Valor Predictivo de las Pruebas , Pronóstico , Radioterapia Adyuvante , Neoplasias del Recto/metabolismo , Estudios Retrospectivos , Sensibilidad y Especificidad
2.
Chirurgia (Bucur) ; 105(1): 93-6, 2010.
Artículo en Ro | MEDLINE | ID: mdl-20405687

RESUMEN

The term "synchronous tumors" is reserved for simultaneous evolution of two or more tumors with distinct sites, in which the possibility that one tumor is a metastasis of the other has been excluded. In medical practice, the involvement of two different cavitary organs of the gastrointestinal tract is very rare. We present two clinical cases of synchronous tumors: one of a malignant degeneration of a colonic polyp, associated to a jejunal tumor; the other of a patient with a gastric adenocarcinoma, who also had a bulky rectal villous tumor. We tried to find out the etiology of the tumors and the frequency of these associations, mentioned in medical literature. Immunohistochemistry investigations, genetic analysis and familial screening must complete an individualized medical approach in which the surgical technique must be adequate for each case.


Asunto(s)
Adenocarcinoma Mucinoso/cirugía , Neoplasias del Colon/cirugía , Pólipos del Colon/cirugía , Neoplasias Primarias Múltiples/cirugía , Neoplasias Gástricas/cirugía , Adenocarcinoma/cirugía , Adenocarcinoma Mucinoso/patología , Adulto , Anciano , Colon Descendente/cirugía , Neoplasias del Colon/patología , Pólipos del Colon/patología , Colonoscopía , Diagnóstico Diferencial , Procedimientos Quirúrgicos del Sistema Digestivo , Neoplasias Duodenales/cirugía , Gastroscopía , Humanos , Neoplasias del Yeyuno/cirugía , Masculino , Neoplasias Primarias Múltiples/patología , Neoplasias Gástricas/patología , Resultado del Tratamiento
3.
Chirurgia (Bucur) ; 105(1): 123-5, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20405693

RESUMEN

We hereby aim to account on a case of actinomycotic infection occurred in a female patient with an intrauterine contraceptive device (IUCD). The infection occurred as a pseudo-tumour which raised differential diagnosis issues with a malignant tumour. The diagnosis has been eventually established following the pathologic examination of paraffin-embedded tissues. Although the infection's gateway was the uterus, the subsequent invasion of the parietal, urinary bladder and lateral rectal walls did not seem to affect the fallopian tubes or the ovaries.


Asunto(s)
Actinomicosis/diagnóstico , Dispositivos Intrauterinos/efectos adversos , Infección Pélvica/diagnóstico , Recto del Abdomen , Enfermedades Uterinas/diagnóstico , Actinomicosis/tratamiento farmacológico , Actinomicosis/microbiología , Actinomicosis/cirugía , Adulto , Ampicilina/uso terapéutico , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Femenino , Humanos , Laparotomía , Infección Pélvica/tratamiento farmacológico , Infección Pélvica/microbiología , Infección Pélvica/cirugía , Neoplasias Pélvicas/diagnóstico , Recto del Abdomen/microbiología , Recto del Abdomen/cirugía , Resultado del Tratamiento , Enfermedades Uterinas/tratamiento farmacológico , Enfermedades Uterinas/microbiología , Enfermedades Uterinas/cirugía
4.
Chirurgia (Bucur) ; 104(2): 213-7, 2009.
Artículo en Ro | MEDLINE | ID: mdl-19499666

RESUMEN

The gastric plasmacytoma represents a rarely encountered, so that, the diagnosis criteria, the medical attitude and the evolution of this disease are less coded. It is known the fact that this tumours, extramedullary plasmacytomas with gastric localization, develop in soft submucous tissue, therefore it's very difficult or even impossible preoperative diagnosis through an upper endoscopy including biopsy. We present the case of a 54 years old patient, with no significant pathological personal record, that was admitted in our Clinic for having melenic dark stools which have repeated within a 6 months period prior to this hospitalisation. Repeated gastric mucosal samples taken in another medical unit shown normal aspects, contrary to all imaging testing (e.g. ultrasonography, upper endoscopy and barium swallow) which revealed a tumor mass of considerable extent at the level of the gastric corpus. First-line therapy was gastric resection followed by radiotherapy, because it is well known that the tumour is highly radiosensitive. The patient's postoperative course was satisfactory, showing no signs or recurrence 6 months after surgery at upper endoscopy and CT-scan.


Asunto(s)
Plasmacitoma/diagnóstico , Plasmacitoma/cirugía , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugía , Diagnóstico Diferencial , Gastrectomía/métodos , Humanos , Masculino , Melena/etiología , Persona de Mediana Edad , Plasmacitoma/complicaciones , Plasmacitoma/radioterapia , Radioterapia Adyuvante , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/radioterapia , Resultado del Tratamiento
5.
Chirurgia (Bucur) ; 104(6): 705-14, 2009.
Artículo en Ro | MEDLINE | ID: mdl-20187469

RESUMEN

Crohn's disease is an inflammatory bowel disease, a chronic condition with recurrent relapses, difficult to diagnose and requiring a complex medical and surgical treatment. Analyzing 11 patients admitted in the surgical Clinique between 2003 and 2008 with Crohn's disease diagnostic, the authors study at the 7 patients operated the reason of the surgical interventions represented by the complications of the inflammatory disease--intestinal obstruction 2 cases, peritonitic syndrome in 3 cases, malignization 1 case, enterovesical fistulae--1 case. Intraoperatory the differential diagnosis between an inflammatory or tumoral etiology of the lesions was very difficult, and the surgical indication was in almost all cases for enteral resection. Postoperative evolution was in most cases with complications (5 cases)--unique anastomotic fistulae 2 cases, or recurrent fistulae in 3 cases, late bowel obstruction--2 cases. Studying the literature, it can be concluded that the surgical treatment is only one stage of the complex treatment that must be individualized for each case and applied only to the complications of the disease.


Asunto(s)
Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/cirugía , Obstrucción Intestinal/cirugía , Intestino Delgado/patología , Intestino Delgado/cirugía , Peritonitis/cirugía , Adulto , Anciano , Colectomía/métodos , Neoplasias del Colon/etiología , Pólipos del Colon/etiología , Enfermedad de Crohn/complicaciones , Diagnóstico Diferencial , Femenino , Humanos , Íleon/cirugía , Fístula Intestinal/cirugía , Obstrucción Intestinal/etiología , Masculino , Persona de Mediana Edad , Peritonitis/etiología , Estudios Retrospectivos , Resultado del Tratamiento
6.
Chirurgia (Bucur) ; 104(5): 641-4, 2009.
Artículo en Ro | MEDLINE | ID: mdl-19943569

RESUMEN

Malignant melanomas of the gastrointestinal tract and particulary of the stomach are very rare intra-operative findings. The majority of such melanomas are metastatic from a cutaneous primary. We present the clinical case of a 69-years-old woman with malignant melanoma of the left pectoral region resected in 1988, presented with epigastric pain, weight loss and anaemia. Endoscopy and CT-scan suggested the diagnosis of malignant tumor of the large curvature of the stomach. Explorative laparotomy revealed a large ulcerated tumor of the fornix, with spleno-pancreatic invasion. We also found several pigmented satellite nodules. The surgical solution consisted in a total gastrectomy and distal spleno-pancreatectomy. Histology revealed the tumor and the satellite nodules to be composed of nests of epithelioid cells with melanin pigment. After 3 months, the evolution was favorable. There are some articles in medical literature which present cases of primary gastric melanomas. According to these scientific criterias from the literature, we discussed the nature of this melanoma - a primary or a metastatic one.


Asunto(s)
Melanoma/secundario , Neoplasias Cutáneas/patología , Neoplasias Gástricas/secundario , Anciano , Femenino , Gastrectomía , Neoplasias Gastrointestinales/secundario , Humanos , Melanoma/cirugía , Pancreatectomía , Neoplasias Cutáneas/cirugía , Esplenectomía , Neoplasias Gástricas/cirugía , Resultado del Tratamiento
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