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1.
J Surg Oncol ; 124(4): 483-491, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34028818

RESUMEN

BACKGROUND: The American College of Surgeon (ACS) Surgical Risk Calculator is an online tool that helps surgeons estimate the risk of postoperative complications for numerous surgical procedures across several surgical specialties. METHODS: We evaluated the predictive performance of the calculator in 385 cancer patients undergoing breast surgery. Calculator-predicted complication rates were compared with observed complication rates; calculator performance was evaluated using calibration and discrimination analyses. RESULTS: The mean calculator-predicted rates for any complication (4.1%) and serious complication (3.2%) were significantly lower than the observed rates (11.2% and 5.2%, respectively). The area under the curve was 0.617 for any complication and 0.682 for serious complications. p Values for the Hosmer-Lemeshow test were significant (<.05) for both outcomes. Brier scores were 0.102 for any complication and 0.048 for serious complication. CONCLUSIONS: The ACS risk calculator is not an ideal tool for predicting individual risk of complications following breast surgery in a Mexican cohort. The most valuable use of the calculator may reside in its role as an aid for patient-led surgery planning. The possibility of introducing breast surgery-specific data could improve the performance of the calculator. Furthermore, a disease-specific calculator could provide more accurate predictions and include complications more frequently found in breast cancer surgery.


Asunto(s)
Neoplasias de la Mama/cirugía , Mastectomía/efectos adversos , Complicaciones Posoperatorias/diagnóstico , Mejoramiento de la Calidad , Medición de Riesgo/normas , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Femenino , Estudios de Seguimiento , Humanos , Complicaciones Posoperatorias/etiología , Pronóstico , Estudios Prospectivos , Factores de Riesgo
2.
Cir Esp ; 93(9): e127-32, 2015 Nov.
Artículo en Inglés, Español | MEDLINE | ID: mdl-26166401

RESUMEN

Malignant paragangliomas are rare, but may occur especially in patients with familial forms of the disease. We present the case of a 23 year old woman diagnosed with bilateral carotid paraganglioma with distant and local metastases, associated to a family history of paraganglioma and we present a literature review.


Asunto(s)
Paraganglioma , Tumor del Cuerpo Carotídeo/diagnóstico , Femenino , Humanos , Paraganglioma/diagnóstico
3.
Cureus ; 16(5): e61467, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38953073

RESUMEN

We present a case report of a giant solitary fibrous tumor (SFT) with a review of the literature and discuss its biological features and diagnosis. A 43-year-old man presented to our emergency department with abdominal pain and distension with an evolution of two days. Contrast-enhanced computed tomography (CT) showed a large, well-circumscribed semisolid mass (12 cm x 10 cm x 12 cm) localized in the pancreatic head. The histological diagnosis obtained by endoscopic ultrasound-guided trans-duodenal tumor biopsy with fine-needle aspiration showed proliferating short spindle-shaped cells, suggesting a mesenchymal neoplasia of low grade. We proceeded to a Whipple surgical technique. The histopathological study of the resected tumor confirmed proliferating spindle-shaped cells in the tissue, and one mitotic figure was observed in 10 high-power fields (HPFs). Immunostaining was positive for CD34 and STAT-6. The histological diagnosis was a malignant pancreatic SFT. In the six months posterior to the surgical procedure, the patient has been free of recurrent disease. Preoperative diagnosis is difficult and requires comprehensive evidence including clinical, immunohistochemistry, and histological features. Since there are currently no recognized best practices, we advise total surgical excision and careful clinical monitoring.

4.
Cureus ; 16(6): e62097, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38989373

RESUMEN

Hepatocellular adenomas are rare and benign primary neoplasms of phenotypically mature hepatocytes. Our understanding of this pathology has greatly improved due to advances in molecular and anatomic knowledge. This article provides an in-depth review of hepatic adenomas (HCA) while presenting the case of a 20-year-old patient with a giant inflammatory hepatocellular adenoma with an atypical presentation, in whom surgical intervention was performed via right hepatectomy. In the post-surgical course, the patient had an in-hospital stay of three days with no complications. During outpatient monitoring via laboratory tests and imaging at eight months, the patient did not present any trace of recurrence.

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