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1.
Rev. argent. coloproctología ; 35(1): 45-48, mar. 2024. ilus
Article in Spanish | LILACS | ID: biblio-1551689

ABSTRACT

El tumor neuroectodérmico maligno del tracto gastrointestinal es una neoplasia rara con pocos casos reportados en la literatura, especialmente en América Latina. Descrito por primera vez en 2003, se trata de una entidad sin tratamiento estandarizado y de pobre pronóstico. Se presenta el caso de una paciente de 22 años de edad que acude a la consulta por dolor abdominal, anemia y masa abdominal palpable. Luego de estudios pertinentes se decide la conducta resectiva y el posterior tratamiento oncológico. (AU)


Malignant gastrointestinal neuroectodermal tumor (GNET), formerly known as clear cell sarcoma of the gastrointestinal tract, is an extremely rare tumor of mesenchymal origin, which presents great microscopic and molecular similarity to clear cell sarcoma found in other parts of the body, such as tendons and aponeurosis. It is characterized by its rapid evolution, high recurrence rate and frequent diagnosis as metastatic disease.1,2 (AU)


Subject(s)
Humans , Female , Young Adult , Sarcoma, Clear Cell/pathology , Neuroectodermal Tumors/pathology , Gastrointestinal Neoplasms/diagnosis , Digestive System Surgical Procedures/methods , Immunohistochemistry , S100 Proteins/analysis , Gastrointestinal Neoplasms/surgery , Ileum/surgery
2.
In. Rodríguez Temesio, Gustavo Orlando; Olivera Pertusso, Eduardo Andrés; Berriel, Edgardo; Bentancor De Paula, Marisel Lilian; Cantileno Desevo, Pablo Gustavo; Chinelli Ramos, Javier; Guarnieri, Damián; Lapi, Silvana; Hernández Negrin, Rodrigo; Laguzzi Rosas, María Cecilia. Actualizaciones en clínica quirúrgica. Montevideo, Oficina del Libro-FEFMUR, 2024. p.111-116.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1553194
4.
J. coloproctol. (Rio J., Impr.) ; 43(3): 227-234, July-sept. 2023. tab, ilus
Article in English | LILACS | ID: biblio-1521140

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic condition that affects the digestive tract and can lead to inflammation and damage to the intestinal lining. IBD patients with cancer encounter difficulties since cancer treatment weakens their immune systems. A multidisciplinary strategy that strikes a balance between the requirement to manage IBD symptoms and the potential effects of treatment on cancer is necessary for effective care of IBD in cancer patients. To reduce inflammation and avoid problems, IBD in cancer patients is often managed by closely monitoring IBD symptoms in conjunction with the necessary medication and surgical intervention. Anti-inflammatory medications, immunomodulators, and biologic therapies may be used for medical care, and surgical options may include resection of the diseased intestine or removal of the entire colon. The current study provides a paradigm for shared decision-making involving the patient, gastroenterologist, and oncologist while considering recent findings on the safety of IBD medicines, cancer, and recurrent cancer risk in individuals with IBD. We hope to summarize the pertinent research in this review and offer useful advice. (AU)


Subject(s)
Humans , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/therapy , Uterine Cervical Neoplasms , Urologic Neoplasms , Gastrointestinal Neoplasms , Methotrexate , Risk Factors , Tumor Necrosis Factor Inhibitors , Mercaptopurine
5.
Rev. colomb. cir ; 38(3): 536-540, Mayo 8, 2023. fig
Article in Spanish | LILACS | ID: biblio-1438586

ABSTRACT

Introducción. El tumor miofibroblástico inflamatorio es una enfermedad proliferativa rara, de etiología incierta, caracterizada por la proliferación de miofibroblastos epitelioides o fusionados mezclados con células inflamatorias, predominantemente mononucleares. En general se considera una lesión benigna, aunque en algunos casos esta neoplasia ha mostrado un comportamiento agresivo en cuanto a recidiva local y metástasis. El tratamiento definitivo es la resección quirúrgica completa. Caso clínico. Paciente de 67 años con dos meses de evolución de fiebre y masa abdominal, en quien se realizó una tomografía computarizada de abdomen que identificó una lesión de aspecto infiltrativo tumoral, comprometiendo la grasa retroperitoneal en la transcavidad de los epiplones. Por vía percutánea se tomó una biopsia que informó un pseudotumor inflamatorio retroperitoneal. Fue llevado a cirugía radical abdominal, con patología quirúrgica final que describió un tumor miofibroblástico inflamatorio de compromiso multifocal, adherido a la serosa del estómago e intestino delgado, sin compromiso muscular. Discusión. El tumor inflamatorio miofibroblástico es una entidad rara, de etiología por esclarecer y difícil diagnóstico. Presentamos el caso clínico de un paciente con tumor inflamatorio miofibroblástico gastrointestinal.Conclusión. Se describe el caso clínico de un paciente con un tumor inflamatorio miofibroblástico gastrointestinal, de presentación rara en nuestro medio. Es importante la comparación con casos similares para poder hacer conclusiones útiles en la práctica clínica


Introduction. Inflammatory myofibroblastic tumor is a rare proliferative disease of uncertain etiology, characterized by the proliferation of epithelioid or fused myofibroblasts mixed with predominantly mononuclear inflammatory cells. In general, it is considered a benign lesion, although in some cases this neoplasm has shown aggressive behavior in terms of local recurrence and metastasis. The definitive treatment is complete surgical resection. Clinical case. A 67-year-old patient with a two-month history of fever and an abdominal mass underwent a computed tomography scan of the abdomen that identified an infiltrative tumor, compromising the retroperitoneum fat in the lesser cavity. A biopsy was taken percutaneously, which reported a retroperitoneal inflammatory pseudotumor. He was taken to radical abdominal surgery, with final surgical pathology describing an inflammatory myofibroblastic tumor with multifocal involvement attached to the serosa of the stomach and small intestine without muscle involvement. Discussion. Inflammatory myofibroblastic tumor is a rare entity, of unknown etiology and difficult to diagnose. We present a clinical case of gastrointestinal myofibroblastic inflammatory tumor to better understand this entity.Conclusion. The clinical case of a patient with a gastrointestinal myofibroblastic inflammatory tumor, a rare presentation in our environment, is described. Comparison with similar cases is important to draw useful conclusions in clinical practice


Subject(s)
Humans , Fibroblasts , Gastrointestinal Neoplasms , Case Reports , Gastrointestinal Tract , Myofibroblasts
6.
Rev. colomb. cir ; 38(2): 363-368, 20230303. fig
Article in Spanish | LILACS | ID: biblio-1425217

ABSTRACT

Introducción. El angiosarcoma es una neoplasia vascular originada a nivel del endotelio, de baja frecuencia, conocido por su agresividad y crecimiento acelerado. Alcanza solo el 1 al 2 % del total de los sarcomas. La presentación gastrointestinal es infrecuente y su incidencia es poco conocida debido al escaso reporte de casos en la literatura. Suele identificarse en etapas avanzadas debido a la dificultad del diagnóstico histopatológico por sus características morfológicas, siendo necesario aplicar tinciones especiales o estudio inmunohistoquímico. Caso clínico. Por su interés y singularidad, presentamos el caso de un paciente masculino de 54 años, quien consultó con hemorragia digestiva profusa, anemización y requerimiento de terapia transfusional. Resultados. Durante el proceso diagnóstico, en la endoscopia encontraron diversas lesiones multifocales que se extendían por gran parte del tracto gastrointestinal. El estudio histopatológico mostró angiosarcoma gastrointestinal. Discusión. El angiosarcoma del tracto gastrointestinal es extremadamente infrecuente, de difícil diagnóstico y bajas posibilidades de manejo curativo, con opciones terapéuticas limitadas, lo que configura un mal pronóstico a corto plazo


Introduction. Angiosarcoma is a vascular neoplasm originating from endothelial cells, known for its aggressiveness, accelerated growth and reduced frequency. Reach only 1 to 2% of total sarcomas. Gastrointestinal presentation is extremely rare, the true incidence is poorly known, due to the limited reports of this entity in the literature. It is usually identified in advanced stages in view of the difficulty of the histopathological diagnosis, attributable to its morphological characteristics, being necessary to apply special stains or immunohistochemical study. Case report. Due to their interest and uniqueness, we present the case of a 54-year-old male patient, who presented with a profuse gastrointestinal bleeding, anemia, and requirement for transfusion therapy. Results. The endoscopy detected several multifocal lesions that extended most of the gastrointestinal tract. The histopathological study showed gastrointestinal angiosarcoma. Discussion. Angiosarcoma of the gastrointestinal tract is extremely uncommon, difficult to diagnose and has low possibilities of curative management, with limited therapeutic options, which configures a poor prognosis in the short term


Subject(s)
Humans , Gastrointestinal Neoplasms , Hemangiosarcoma , Sarcoma , Lymphatic Vessel Tumors , Gastrointestinal Hemorrhage , Neoplasms, Vascular Tissue
7.
Nursing (Ed. bras., Impr.) ; 26(296): 9268-9279, jan.2023. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1437513

ABSTRACT

Objetivo: Avaliar a nutrição de pacientes cirúrgicos com neoplasia no trato gastrointestinal em uso de suplemento alimentar. Método: Trata-se de uma revisão sistemática de literatura realizada nas bases de dados Google Scholar, PubMed, Scielo e Web of Science, no período de maio a junho de 2021, sem recorte temporal ou restrição de idioma, através dos descritores: "enteral nutrition e immunenutrition", "cancerpatients e gastriccancerpatients", "preoperative, perioperative e postoperative". Resultados: Foram selecionados 8 estudos, destes, a maioria identificou benefícios na utilização da suplementação em razão da diminuição de células TNF-a, do cortisol e da transferrina, diminuindo o tempo de internação e melhora no estado funcional dos participantes suplementados. Conclusão: Os achados foram positivos, no entanto, houve algumas limitações como a heterogeneidade em abordagens terapêuticas e perda de pacientes durante o estudo, apesar de apresentarem baixo risco de viés, ainda há a necessidade de mais estudos.(AU)


Objective: To evaluate the nutrition of surgical patients with neoplasia in the gastrointestinal tract using food supplements. Method: This is a systematic literature review carried out in Google Scholar, PubMed, Scielo and Web of Science databases, from May to June 2021, without time frame or language restriction, using the descriptors: "enteral nutrition and immunenutrition", "cancerpatients and gastriccancerpatients", "preoperative, perioperative and postoperative". Results: Eight studies were selected, most of which identified benefits in the use of supplementation due to the decrease in TNF-a cells, cortisol and transferrin, reducing the length of hospital stay and improving the functional status of supplemented participants. Conclusion: The findings were positive, however, there were some limitations such as heterogeneity in therapeutic approaches and loss of patients during the study, despite having a low risk of bias, there is still a need for further studies(AU)


Objetivo: Evaluar la nutrición de pacientes quirúrgicos con neoplasia en el tracto gastrointestinal utilizando suplementos alimenticios. Método: Se trata de una revisión sistemática de la literatura realizada en las bases de datos Google Scholar, PubMed, Scielo y Web of Science, de mayo a junio de 2021, sin franja horaria ni restricción de idioma, utilizando los descriptores: "nutrición enteral e inmunonutrición", "pacientes oncológicos y pacientes con cáncer gástrico", "preoperatorio, perioperatorio y postoperatorio". Resultados: Se seleccionaron ocho estudios, la mayoría de los cuales identificaron beneficios en el uso de la suplementación por la disminución de células TNF-a, cortisol y transferrina, reduciendo la estancia hospitalaria y mejorando el estado funcional de los participantes suplementados. Conclusión: Los hallazgos fueron positivos, sin embargo, hubo algunas limitaciones como la heterogeneidad en los enfoques terapéuticos y la pérdida de pacientes durante el estudio, a pesar de tener un bajo riesgo de sesgo, aún existe la necesidad de realizar más estudios(AU)


Subject(s)
Nutrition Assessment , Dietary Supplements , Surgical Oncology , Gastrointestinal Neoplasms
8.
Nursing (Ed. bras., Impr.) ; 26(296): 9268-9279, jan-2023. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1412708

ABSTRACT

Objetivo: Avaliar a nutrição de pacientes cirúrgicos com neoplasia no trato gastrointestinal em uso de suplemento alimentar. Método: Trata-se de uma revisão sistemática de literatura realizada nas bases de dados Google Scholar, PubMed, Scielo e Web of Science, no período de maio a junho de 2021, sem recorte temporal ou restrição de idioma, através dos descritores: "enteral nutrition e immunenutrition", "cancerpatients e gastriccancerpatients", "preoperative, perioperative e postoperative". Resultados: Foram selecionados 8 estudos, destes, a maioria identificou benefícios na utilização da suplementação em razão da diminuição de células TNF-a, do cortisol e da transferrina, diminuindo o tempo de internação e melhora no estado funcional dos participantes suplementados. Conclusão: Os achados foram positivos, no entanto, houve algumas limitações como a heterogeneidade em abordagens terapêuticas e perda de pacientes durante o estudo, apesar de apresentarem baixo risco de viés, ainda há a necessidade de mais estudos.(AU)


Objective: To evaluate the nutrition of surgical patients with neoplasia in the gastrointestinal tract using food supplements. Method: This is a systematic literature review carried out in Google Scholar, PubMed, Scielo and Web of Science databases, from May to June 2021, without time frame or language restriction, using the descriptors: "enteral nutrition and immunenutrition", "cancerpatients and gastriccancerpatients", "preoperative, perioperative and postoperative". Results: Eight studies were selected, most of which identified benefits in the use of supplementation due to the decrease in TNF-a cells, cortisol and transferrin, reducing the length of hospital stay and improving the functional status of supplemented participants. Conclusion: The findings were positive, however, there were some limitations such as heterogeneity in therapeutic approaches and loss of patients during the study, despite having a low risk of bias, there is still a need for further studies.(AU)


Objetivo: Evaluar la nutrición de pacientes quirúrgicos con neoplasia en el tracto gastrointestinal utilizando suplementos alimenticios. Método: Se trata de una revisión sistemática de la literatura realizada en las bases de datos Google Scholar, PubMed, Scielo y Web of Science, de mayo a junio de 2021, sin franja horaria ni restricción de idioma, utilizando los descriptores: "nutrición enteral e inmunonutrición", "pacientes oncológicos y pacientes con cáncer gástrico", "preoperatorio, perioperatorio y postoperatorio". Resultados: Se seleccionaron ocho estudios, la mayoría de los cuales identificaron beneficios en el uso de la suplementación por la disminución de células TNF-a, cortisol y transferrina, reduciendo la estancia hospitalaria y mejorando el estado funcional de los participantes suplementados. Conclusión: Los hallazgos fueron positivos, sin embargo, hubo algunas limitaciones como la heterogeneidad en los enfoques terapéuticos y la pérdida de pacientes durante el estudio, a pesar de tener un bajo riesgo de sesgo, aún existe la necesidad de realizar más estudios.(AU)


Subject(s)
Nutrition Assessment , Dietary Supplements , Surgical Oncology , Gastrointestinal Neoplasms
9.
Chinese Medical Journal ; (24): 974-985, 2023.
Article in English | WPRIM | ID: wpr-980853

ABSTRACT

BACKGROUND@#Progressive lipid loss of adipose tissue is a major feature of cancer-associated cachexia. In addition to systemic immune/inflammatory effects in response to tumor progression, tumor-secreted cachectic ligands also play essential roles in tumor-induced lipid loss. However, the mechanisms of tumor-adipose tissue interaction in lipid homeostasis are not fully understood.@*METHODS@#The yki -gut tumors were induced in fruit flies. Lipid metabolic assays were performed to investigate the lipolysis level of different types of insulin-like growth factor binding protein-3 (IGFBP-3) treated cells. Immunoblotting was used to display phenotypes of tumor cells and adipocytes. Quantitative polymerase chain reaction (qPCR) analysis was carried out to examine the gene expression levels such as Acc1 , Acly , and Fasn et al .@*RESULTS@#In this study, it was revealed that tumor-derived IGFBP-3 was an important ligand directly causing lipid loss in matured adipocytes. IGFBP-3, which is highly expressed in cachectic tumor cells, antagonized insulin/IGF-like signaling (IIS) and impaired the balance between lipolysis and lipogenesis in 3T3-L1 adipocytes. Conditioned medium from cachectic tumor cells, such as Capan-1 and C26 cells, contained excessive IGFBP-3 that potently induced lipolysis in adipocytes. Notably, neutralization of IGFBP-3 by neutralizing antibody in the conditioned medium of cachectic tumor cells significantly alleviated the lipolytic effect and restored lipid storage in adipocytes. Furthermore, cachectic tumor cells were resistant to IGFBP-3 inhibition of IIS, ensuring their escape from IGFBP-3-associated growth suppression. Finally, cachectic tumor-derived ImpL2, the IGFBP-3 homolog, also impaired lipid homeostasis of host cells in an established cancer-cachexia model in Drosophila . Most importantly, IGFBP-3 was highly expressed in cancer tissues in pancreatic and colorectal cancer patients, especially higher in the sera of cachectic cancer patients than non-cachexia cancer patients.@*CONCLUSION@#Our study demonstrates that tumor-derived IGFBP-3 plays a critical role in cachexia-associated lipid loss and could be a biomarker for diagnosis of cachexia in cancer patients.


Subject(s)
Humans , Insulin-Like Growth Factor Binding Protein 3/metabolism , Culture Media, Conditioned/pharmacology , Cachexia/pathology , Gastrointestinal Neoplasms , Somatomedins/metabolism , Insulins/metabolism , Lipids
10.
Chinese Journal of Pathology ; (12): 586-591, 2023.
Article in Chinese | WPRIM | ID: wpr-985737

ABSTRACT

Objective: To investigate the clinical and pathological features of primary gastric (gastrointestinal)-type mucoglandular lesions of the endometrium. Methods: Eight cases of primary gastric (gastrointestinal)-type mucoglandular lesions of endometrium diagnosed between 2014 to 2022 were retrieved from pathology archives of the Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai, China. The clinical history, pathological sections and follow-ups were analyzed. Results: The eight patients ranged in age from 35 to 67 years, with an average age of 55.5 years. Seven patients were examined for high-risk human papillary virus (HPV) before operation. Only one of them was positive for high-risk HPV52. No cervical mucinous lesions were found in any of the patients. Two cases were invasive gastric (gastrointestinal)-type adenocarcinoma, 2 cases were benign gastric (gastrointestinal)-type mucinous metaplasia, and the other 4 cases were atypical gastric (gastrointestinal)-type mucinous gland hyperplasia. Microscopically, tumor cells showed mucous epithelium with gastrointestinal differentiation. Immunophenotyping showed that MUC6 was diffusely or focally positive in 5 cases, CK20 and CDX2 were positive in 3 cases. And p16 was negative or focally positive in 5 cases and strongly positive in 1 case. ER was expressed in both benign and atypical lesions, and weakly positive or negative in the invasive adenocarcinoma. p53 showed mutant expression in one case and wild-type expression in the rest. HPV in situ hybridization was negative. Conclusions: Primary gastric (gastrointestinal)-type mucoglandular lesions of the endometrium show various forms of gastrointestinal differentiation, which are high-risk HPV independent. Morphology combined with immunohistochemistry is helpful for the diagnosis, which can only be made on exclusion of cervical gastrointestinal glandular lesion, gastrointestinal metastatic carcinoma and the mucinous subtype of endometrioid carcinoma.


Subject(s)
Female , Humans , Middle Aged , Adult , Aged , Uterine Cervical Neoplasms/pathology , Papillomavirus Infections , China , Adenocarcinoma/pathology , Endometrium/pathology , Gastrointestinal Neoplasms/pathology , Biomarkers, Tumor/analysis
11.
Article in Chinese | WPRIM | ID: wpr-986806

ABSTRACT

Modern clinical oncology has made great achievements over the last century. However, peritoneal metastasis from gastrointestinal cancer, as one of three most common metastasis modalities, was not re-recognized until the end of the last century, and a normative diagnosis and treatment system has been gradually beginning to be formed until today. This comment is to review the development history, reflect on the lessons and experiences in clinical practice, analyze the difficulties on redefinition, deep understanding and clinical management, and pain points on theory construction, technique practice and discipline construction, in the field of gastrointestinal cancer peritoneal metastasis. We suggested a solution to the difficulties and pain points by realizing the fact of burden of peritoneal metastasis, reinforcing technical training, and promoting collaborative researches, aiming to provide reference for the steady development of peritoneal surface oncology.


Subject(s)
Humans , Peritoneal Neoplasms/secondary , Gastrointestinal Neoplasms , China , Pain
12.
Chinese Journal of Pathology ; (12): 791-796, 2023.
Article in Chinese | WPRIM | ID: wpr-1012309

ABSTRACT

Objective: To investigate the clinicopathological characteristics of malignant gastrointestinal neuroectodermal tumors (GNET), and to describe their clinical, histological, immunophenotypic, ultrastructural, and molecular features, diagnosis and differential diagnosis. Methods: Three cases of malignant GNET were collected at Xijing Hospital of the Fourth Military Medical University, from 2013 to 2022. All patients underwent surgical resection of the tumor. Histological, immunohistochemical (IHC), ultrastructural and molecular genetic analyses were performed, and the patients were followed up for six months, three years and five years. Results: There were two males and one female patients. The tumors were located in the ileum, descending colon, and rectum, respectively. Grossly, the tumors were solid, firm, and poorly circumscribed, measured in size from 2 to 4 cm in greatest dimension, and had a greyish-white cut surface. These tumors were histologically characterized by a sheet-like or nested population of oval to spindled cells or epithelioid cells with weakly eosinophilic or clear cytoplasm, small nucleoli and scattered mitoses. Electron microscopy showed neuroendocrine differentiation, and no evidence of melanogenesis. IHC staining showed that the tumor cells were diffusely positive for S-100 protein, SOX10, CD56, synaptophysin and vimentin. They were negative for melanocytic markers, HMB45 and Melan A. All three cases showed split EWSR1 signals consistent with a chromosomal translocation involving EWSR1. Next-generation sequencing in one case confirmed the presence of EWSR1-ATF1 fusion. These patients were followed up for 6 months, 3 years and 5 years, respectively, and all of them developed possible lung or liver metastases, and one of them died of multiple pulmonary metastases. Conclusion: Malignant GNET has distinctive morphological, IHC, and molecular genetic features and it should be differentiated from other malignancies of the gastrointestinal tract, especially clear cell sarcoma and melanoma.


Subject(s)
Male , Humans , Female , Biomarkers, Tumor/analysis , Gastrointestinal Neoplasms/pathology , S100 Proteins/analysis , Melanoma
13.
Article in English | WPRIM | ID: wpr-1009907

ABSTRACT

Long non-coding RNAs (lncRNAs) are strongly related to the occurrence and development of digestive tract cancer in human. Firstly, lncRNAs target and regulate the expression of downstream cancer genes to affect the growth, metastasis, apoptosis, metabolism and immune escape of cancer cells. Secondly, lncRNAs are considered to be important regulating factors for lipid metabolism in cancer, which is related to signaling pathways of adipogenesis and involved in the occurrence and development of digestive tract cancer. Finally, lncRNAs have application value in the diagnosis and treatment of digestive tract cancer. For example, lncRNAMALAT1 has been reported as a target for diagnosis and treatment of hepatocellular carcinoma. This article reviews current progress on the regulatory role of lncRNAs in digestive tract cancer, to provide references for the research and clinical application in the prevention and treatment of digestive tract cancer.


Subject(s)
Humans , RNA, Long Noncoding/genetics , Gastrointestinal Neoplasms/genetics , Apoptosis , Liver Neoplasms
14.
Article in English | WPRIM | ID: wpr-982041

ABSTRACT

The application of artificial neural network algorithm in pathological diagnosis of gastrointestinal malignant tumors has become a research hotspot. In the previous studies, the algorithm research mainly focused on the model development based on convolutional neural networks, while only a few studies used the combination of convolutional neural networks and recurrent neural networks. The research contents included classical histopathological diagnosis and molecular typing of malignant tumors, and the prediction of patient prognosis by utilizing artificial neural networks. This article reviews the research progress on artificial neural network algorithm in the pathological diagnosis and prognosis prediction of digestive tract malignant tumors.


Subject(s)
Humans , Neural Networks, Computer , Algorithms , Prognosis , Gastrointestinal Neoplasms/diagnosis
15.
Rev. Bras. Cancerol. (Online) ; 69(2)abr.-jun. 2023.
Article in English | SES-SP, LILACS | ID: biblio-1512145

ABSTRACT

Introduction: Gastrointestinal stromal tumors (GIST), although relatively rare, account for 80% of mesenchymal tumors of the digestive tract. They manifest in any part of the alimentary tract and are derived from Cajal cells. They may occur sporadically or be associated with familial syndromes such as neurofibromatosis type I. The clinical picture is variable, and they are often diagnosed incidentally. The diagnosis requires imaging tests associated with histopathological and immunohistochemical analysis. The best strategy for treatment is surgical resection and cases should be analyzed individually to verify additional advantages with the association of systemic therapy. This study aims to present an unusual case of GIST associated with neurofibromatosis type I in a patient with incidental diagnosis after semi-intestinal occlusion secondary to an episode of pancreatitis, in addition to performing a literature review on the subject. Case report: A 49-year-old woman with a history of severe pancreatitis presented with intestinal obstruction approximately 8 months after this episode. Abdominal computed tomography revealed a heterogeneous formation in the mesogastric region, measuring 6.6 x 5.1 x 5.3 cm. She underwent surgical resection and histopathological and immunohistochemical studies confirmed the diagnosis of GIST. Six months after diagnosis, the patient is in good general condition and is on systemic therapy. Conclusion: GIST are rare tumors, but their diagnosis should come to mind in patients with neurofibromatosis type 1 with abdominal masses


Introdução: Os tumores do estroma gastrointestinal (GIST), embora relativamente raros, correspondem a 80% dos tumores mesenquimais do trato digestivo. Manifestam-se em qualquer parte do trato alimentar e são derivados das células de Cajal. Podem ocorrer de forma esporádica ou associados a síndromes familiares como a neurofibromatose tipo I. O quadro clínico é variável, sendo frequentemente diagnosticados de forma incidental. O diagnóstico requer realização de exames de imagem associados à análise histopatológica e imuno-histoquímica. A melhor estratégia para o tratamento é a ressecção cirúrgica e os casos devem ser analisados individualmente para verificar vantagens adicionais com a associação da terapia sistêmica. O objetivo deste trabalho é apresentar um caso incomum de GIST associado à neurofibromatose tipo I em uma paciente com diagnóstico incidental após semioclusão intestinal secundárias a episódio de pancreatite, além de realizar revisão de literatura sobre o assunto. Relato do caso: Mulher, 49 anos de idade,com passado de pancreatite grave,apresentou quadro de oclusão intestinal cerca de oito meses após esse episódio. A tomografia computadorizada de abdome revelou formação heterogênea em região mesogástrica, medindo 6,6 x 5,1 x 5,3 cm. Foi submetida à ressecção cirúrgica, e os estudos histopatológico e imuno-histoquímico corroboraram o diagnóstico de GIST. Seis meses após o diagnóstico, a paciente encontra-se em bom estado geral e em uso de terapia sistêmica. Conclusão: Os GIST são tumores raros, porémseu diagnóstico deve ser lembrado em pacientes com neurofibromatose tipo 1 apresentando massas abdominais


Introducción: Los tumores del estroma gastrointestinal (GIST), aunque relativamente raros, representan el 80% de los tumores mesenquimales del tubo digestivo. Se manifiestan en cualquier parte del tubo digestivo y se derivan de las células de Cajal. Pueden presentarse de forma esporádica o asociarse a síndromes familiares como la neurofibromatosis tipo I. El cuadro clínico es variable y con frecuencia su diagnóstico es incidental. El diagnóstico requiere pruebas de imagen asociadas al análisis histopatológico e inmunohistoquímico. La mejor estrategia de tratamiento es la resección quirúrgica y los casos deben analizarse individualmente para verificar ventajas adicionales con la asociación de terapia sistémica. El objetivo de este trabajo es presentar un caso inusual de GIST asociado a neurofibromatosis tipo I en un paciente con diagnóstico incidental tras una semioclusión intestinal secundaria a un episodio de pancreatitis, además de revisar la literatura sobre el tema. Informe del caso: Mujer de 49 años, con antecedente de pancreatitis severa, presentó oclusión intestinal aproximadamente ocho meses después de este episodio. La tomografía computarizada de abdomen reveló una formación heterogénea en la región mesogástrica, que medía 6,6 x 5,1 x 5,3 cm. Se le realizó resección quirúrgica y los estudios histopatológicos e inmunohistoquímicos corroboraron el diagnóstico de GIST. Seis meses después del diagnóstico, la paciente se encuentra en buen estado general y en tratamiento sistémico. Conclusión: Los GIST son tumores raros, pero su diagnóstico debe considerarse en pacientes con neurofibromatosis tipo 1 que presentan masas abdominales


Subject(s)
Humans , Female , Middle Aged , Neurofibromatosis 1 , Gastrointestinal Stromal Tumors , Gastrointestinal Neoplasms
16.
Rev. argent. cir ; 114(3): 275-278, set. 2022. graf
Article in Spanish | LILACS | ID: biblio-1422938

ABSTRACT

RESUMEN El tumor estromal gastrointestinal representa el 3% de las neoplasias gastrointestinales; es el tumor mesenquimático más frecuente. Afecta a hombres mayores de 50 años. El 80% son benignos, la mayoría afectan el estómago e intestino delgado. La incidencia de localización extragastrointestinal es desconocida. Paciente masculino de 56 años, tabaquista, obeso, con hipertensión arterial (HTA) y diabético (DBT), anticoagulado, consulta por dolor en fosa ilíaca derecha, posterior a esfuerzo físico. Se realiza tomografía computarizada (TC) donde se visualiza lesión de aspecto expansivo intraperitoneal que muestra realce periférico. Se decide conducta quirúrgica. Se halla un tumor mesentérico. En su presentación, estos tumores hasta en un 60% suelen ser asintomáticos por lo que resultan solo un hallazgo imagenológico; es indispensable, pues, su sospecha clínica y fundamentalmente el aporte de la inmunohistoquímica para la definición de la patología. El CD 117 es el principal marcador. Su tratamiento de preferencia es siempre quirúrgico, acompañado de tratamientos quimioterápicos.


ABSTRACT Gastrointestinal stromal tumors (GISTs) account for < 3% of gastrointestinal neoplasms and are the most common mesenchymal tumors. They are more common in men > 50 years. They are benign in 80% of the cases and usually occur in the stomach and small intestine. The incidence of extragastrointestinal GISTs is unknown. A 56-year-old male patient sought medical care for abdominal pain in the right iliac fossa that appeared after exercising. The patient was a current smoker, obese, had a history of hypertension (HTN) and diabetes (DBT) and was receiving anticoagulants. A computed tomography (CT) scan showed an expansive mass within the peritoneum with peripheral enhancement. Surgical management was decided. During the procedure, a tumor was found in the mesentery. Up to 60% of these tumors are usually asymptomatic and are incidentally found in imaging tests; therefore, clinical suspicion and, most importantly immunohistochemistry, are essential for the diagnosis. CD117 is the main marker. Surgery is the treatment of choice for GISTs and chemotherapy is also indicated.


Subject(s)
Humans , Male , Middle Aged , Gastrointestinal Stromal Tumors/surgery , Gastrointestinal Neoplasms/surgery , Ileostomy , Gastrointestinal Stromal Tumors/pathology , Gastrointestinal Stromal Tumors/diagnostic imaging , Laparotomy
17.
Rev. chil. enferm. respir ; 38(2): 117-122, jun. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1407768

ABSTRACT

Resumen Objetivos: Presentar caso clínico y revisión de la literatura sobre asociación de tumores poco frecuentes compatibles con diagnóstico de tríada de Carney. Paciente y Métodos: Revisión de ficha clínica de paciente de sexo femenino de 39 años de edad con antecedentes de asma, quien acude a servicio de urgencias por síntomas respiratorios. En estudio con imágenes se evidencia masa pulmonar en lóbulo superior derecho probablemente hamartoma y masa en la bifurcación carotídea izquierda compatible con posible paraganglioma. Se completó el estudio con endoscopia digestiva alta sin evidencia de tumor gástrico y PET-CT (tomografía de emisión de positrones-tomografía computarizada) que descartó otras lesiones. Resultados: La paciente fue sometida a resección quirúrgica de ambos tumores (pulmonar y carotídeo). En estudio histopatológico diferido, se plantean los diagnósticos de paraganglioma carotideo y hamartoma pulmonar, el cual, luego de una segunda revisión histopatológica, es corregido a condroma pulmonar. Discusión: La tríada de Carney se compone por la asociación de al menos 2 de 3 tumores: tumor estromal gastrointestinal (GIST), paraganglioma extra-adrenal y condroma pulmonar. Su expresión es variable, coexistiendo en forma completa en solo el 22% de los casos. Conclusión: Los pacientes con sospecha de tríada de Carney deben recibir evaluación multidisciplinaria, estudio completo en búsqueda de tumores asociados y seguimiento a largo plazo por posibles recurrencias o metástasis.


Objective: To present a clinical case and review of the literature on the infrequent association of pulmonary and extra thoracic tumors compatible with Carney's triad. Patient and Methods: Review of clinical records of a 39 years-old female patient with history of asthma who presented in the emergency department with respiratory symptoms. An imaging study showed a pulmonary mass in the right upper lobe with the aspect of hamartoma and a mass in the left carotid artery bifurcation compatible with a possible paraganglioma. Upper gastrointestinal endoscopy showed no evidence of gastric tumor and a PET-CT (Positron Emission Tomography - Computed Tomography) excluded other lesions. Results: Patient underwent surgical resection of both tumors (pulmonary and carotid). Diagnosis of carotid paraganglioma and pulmonary hamartoma were stated by histopathology. However, lung tumor after a second pathological analysis was confirmed to be a pulmonary chondroma. Discussion: Carney's triad is defined by the association of at least 2 of 3 tumors: Gastrointestinal Stromal Tumor (GIST), extraadrenal paraganglioma and pulmonary chondroma. Its expression is variable, coexisting completely in only 22% of cases. Conclusion: Patients with suspected Carney's triad should receive a multidisciplinary assessment, a complete study searching associated tumors and long-term follow-up for recurrences or metastases.


Subject(s)
Humans , Female , Adult , Paraganglioma/diagnostic imaging , Carotid Arteries/diagnostic imaging , Chondroma/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Neoplasms, Multiple Primary , Paraganglioma/surgery , Radiography, Thoracic , Carotid Arteries/surgery , Chondroma/surgery , Gastrointestinal Stromal Tumors/surgery , Gastrointestinal Stromal Tumors/diagnostic imaging , Positron Emission Tomography Computed Tomography , Gastrointestinal Neoplasms/surgery , Gastrointestinal Neoplasms/diagnostic imaging , Lung Neoplasms/surgery
18.
Rev. argent. cir ; 114(2): 167-171, jun. 2022. graf
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1387600

ABSTRACT

RESUMEN Los tumores GIST son un motivo de consulta cada vez más frecuente en las entrevistas de cirugía gastroenterológica. Suelen ser derivados como hallazgos incidentales o por presentar síntomas derivados de su crecimiento. Se presenta el caso clínico de una paciente que requirió internación de urgencia por síndrome anémico agudo. Se comenta su algoritmo diagnóstico y su resolución quirúrgica. Asimismo se comentan los estándares de diagnóstico y tratamiento actuales con especial foco en la estrategia quirúrgica, la cual debe ser individualizada según cada caso.


ABSTRACT Gastrointestinal stromal tumors (GISTs) are becoming an increasingly common reason for consultation in gastroenterology surgery interviews. Patients are usually referred for surgery due to an incidental finding or symptoms associated with tumor growth. We report the case of a female patient who required urgent hospitalization due to acute anemic syndrome. The diagnostic algorithm and surgical approach are described. The current standards of diagnosis and treatment are also discussed, with special focus on the surgical strategy, which must be tailored to each case.


Subject(s)
Humans , Female , Middle Aged , Gastrointestinal Stromal Tumors/surgery , Gastrointestinal Neoplasms/surgery , Endoscopy, Digestive System , Gastrointestinal Stromal Tumors/pathology , Gastrointestinal Stromal Tumors/diagnostic imaging , Gastrointestinal Neoplasms/diagnostic imaging , Laparotomy
19.
Rev. colomb. cir ; 37(3): 401-407, junio 14, 2022. tab, fig
Article in Spanish | LILACS | ID: biblio-1378694

ABSTRACT

Introducción. A nivel mundial los tumores gastrointestinales tienen un impacto importante en la mortalidad y se asocian a diferentes factores, entre ellos regionales y sociodemográficos. El objetivo de este estudio fue describir la variación en el tiempo del cáncer gastrointestinal en una población del centro occidente de Colombia, dada su alta incidencia y desenlace frecuentemente fatal.Métodos. Se realizó un estudio retrospectivo observacional con muestreo no probabilístico en un tiempo de seis años. Se seleccionaron pacientes diagnosticados con algún tipo de neoplasia del tracto digestivo, en un hospital de tercer nivel del centro occidente de Colombia. Resultados. Se evaluaron un total de 1152 pacientes. Los tumores del tracto digestivo superior (esófago, unión esófago-gástrica y estómago) fueron los más frecuentes (44 %), seguidos de los tumores del tracto digestivo medio e inferior (intestino delgado, colon, recto y ano; 31 %) y de los tumores hepato-bilio-pancreáticos (25 %). La edad media de presentación fue 64,6 años, con una mayor frecuencia en el sexo masculino (51,6 %). El adenocarcinoma fue el tipo histológico más común.Conclusión. Los resultados de este estudio muestran que los tumores gastrointestinales son una neoplasia frecuente en nuestro país, siendo los tumores gástricos los que se presentan con mayor prevalencia, seguidos de los tumores colorrectales y las neoplasias biliopancreáticas, las cuales se mantiene en el tiempo.


Introduction. Worldwide, gastrointestinal tumors have a significant impact on mortality and are associated with different factors, including regional and sociodemographics. The objective of this study was to describe the variation over time of gastrointestinal cancer in a population from Central-Western Colombia, given its high incidence and frequently fatal outcome. Methods. An observational retrospective study with non-probabilistic sampling was carried out over a period of six years. Patients diagnosed with some type of neoplasm of the digestive tract were selected in a tertiary care hospital in the Central-Western Colombia. Results. A total of 1152 patients were evaluated. Tumors of the upper digestive tract (esophagus, esophagogastric junction, and stomach) were the most frequent (44%), followed by tumors of the middle and lower digestive tract (small intestine, colon, rectum and anus; 31%), and hepatobiliary-pancreatic tumors (25%). The mean age of presentation was 64.6 years with a higher frequency in males (51.6%). Adenocarcinoma was the most common histological type.Conclusion. The results of this study show that gastrointestinal tumors are a frequent neoplasm in our country, with gastric tumors being the most prevalent, followed by colorectal tumors and biliopancreatic neoplasms, which are maintained over time.


Subject(s)
Humans , Mortality , Gastrointestinal Neoplasms , Stomach , Incidence , Colon , Neoplasms
20.
Vive (El Alto) ; 5(13): 35-42, abr. 2022.
Article in Spanish | LILACS | ID: biblio-1410327

ABSTRACT

La patología tumoral apendicular tiene una incidencia inferior al 0,5% de todos los tumores gastrointestinales, al ser una afección poco frecuente se detalla un análisis de los datos clínicos, imagenológicos y del manejo de la patología. Se presenta el caso de una paciente femenina de 25 años que consulta por dolor abdominal localizado en fosa ilíaca derecha de larga data. Al examen físico impresiona abdomen doloroso a la palpación superficial y profunda en fosa ilíaca derecha, ausencia de signos de irritación peritoneal. En los exámenes complementarios; la tomografía simple y contrastada de abdomen y pelvis evidencia imagen tubular, hipodensa que comienza desde la base del ciego con un calibre aproximado de 29 mm, en relación con mucocele apendicular. Se decide manejo quirúrgico, realizando hemicolectomía derecha por vía laparoscópica, sin ninguna complicación. El reporte histopatológico de la muestra enviada concluye neoplasia mucinosa apendicular de bajo grado. La paciente mostró una evolución postquirúrgica satisfactoria, siendo dada de alta, al día siguiente de su intervención quirúrgica.


Appendicular tumor pathology has an incidence of less than 0.5% of all gastrointestinal tumors, being a rare condition, an analysis of the clinical and imaging data and the management of the pathology is detailed. We present the case of a 25-year-old female patient who consulted for long-standing abdominal pain located in the right iliac fossa. Physical examination revealed a painful abdomen on superficial and deep palpation in the right iliac fossa, with no signs of peritoneal irritation. In the complementary examinations; the simple and contrasted tomography of abdomen and pelvis evidences a tubular image, hypodense that begins from the base of the cecum with an approximate caliber of 29 mm, in relation to appendicular mucocele. Surgical management was decided, performing laparoscopic right hemicolectomy, without any complications. The histopathological report of the sample sent concluded low grade appendicular mucinous neoplasia. The patient showed a satisfactory postoperative evolution and was discharged the day after surgery.


A patologia do tumor apendicular tem uma incidência de menos de 0,5% de todos os tumores gastrointestinais. Por ser uma condição rara, uma análise dos dados clínicos e de imagem e o manejo da patologia é detalhada. Apresentamos o caso de uma paciente feminina de 25 anos de idade que se consultou por dores abdominais de longa data localizada na fossa ilíaca direita. O exame físico revelou um abdômen doloroso à palpação superficial e profunda na fossa ilíaca direita, sem sinais de irritação peritoneal. Nos exames complementares, a tomografia simples e contrastada do abdômen e da pélvis mostrou uma imagem tubular hipodensa, começando na base do ceco com um calibre aproximado de 29 mm, em relação à mucocele apendicular. O gerenciamento cirúrgico foi decidido, realizando uma hemicolectomia laparoscópica direita, sem nenhuma complicação. O relatório histopatológico da amostra enviada concluiu uma neoplasia da mucosa apendiceal de baixo grau. O paciente apresentou uma evolução pós-operatória satisfatória e teve alta no dia seguinte à cirurgia.


Subject(s)
Gastrointestinal Neoplasms , Surgical Procedures, Operative
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