Sentinel node biopsy for melanoma. Analysis of our experience (125 patients).

INTRODUCTION: The objective of this study is to analyze our experience in the use of sentinel node biopsy (SNB) in melanoma and identify the predictive factors of positive SNB and multiple drainage. MATERIAL AND METHODS: Retrospective study of patients who underwent SNB for melanoma between August of 2000 and February of 2013. RESULTS: SNB was performed in 125 patients with a median of age of 55,6 (±15) years. The anatomic distribution was: 44 (35,2%) in legs, 24 (19,2%) in arms, 53 (42,4%) trunk and 3 (2,4%) in head and neck. The median Breslow index was 1,81 (0,45-5). Between 1 and 6 nodes were isolated. The drainage was unique in 98 (78,4%) and multiple in 27 (21,6%). The trunk was the localization of 25 (92,6%) nodes with multiple drainage. The definitive result of sentinel node (SN) was positive in 18 cases (7,1%). Breslow thickness (p=0,01) was statistically significant predictor of a positive SNB. CONCLUSIONS: The SNB allows patients to be selected for lymphadenectomy. Melanoma of the trunk was the principle location of multiple drainage. The only predictive factor of positive SNB was Breslow thickness.

[Acute abdomen due to perforated appendicular mucocele]. / Abdomen agudo por mucocele apendicular perforado.

Primary neoplasms of the appendix are present in approximately 0.2% to 0.3% of appendectomy specimens. Generally affect middle-age adults and elderly people. Approximately 30% to 50% of appendiceal neoplasms manifest with acute appendicitis by luminal obstruction. The definitive diagnosis is histological. We must avoid simple laparoscopic appendectomy and adopt an open procedure with a laparotomy appendectomy for a bening process. Right hemicolectomy is indicated when a malignant condition is suspected Follow-up is recommended in this pathology due to the risk of associated malignant neoplasms. We report a case of perforated appendiceal mucocele in a 84-year-old man presented as an acute abdomen.

[Leiomyomatosis peritonealis disseminata]. / Leiomiomatosis peritoneal difusa.

Leiomyomatosis peritonealis disseminata (LPD) is a rare, benign proliferative process characterized by multiple smooth muscle nodules throughout the peritoneum. Predominantly affects women in their reproductive years. The cause of LPD is unknown although it may be associated with high estrogen state. The clinical appearance mimics a peritoneal carcinomatosis and the radiologic findings are unspecific. So, the definitive diagnosis is histological. Treatment must be individualized depending on age, hormonal status and symptomatology. To date, less than 140 cases have been reported. We report a case of LPD in a 50-year-old woman presented as an intestinal obstruction.