ABSTRACT
BACKGROUND: The prognostic benefit of health care service provision and delivery policies for patients with malignant melanoma (MM) is not yet clear. OBJECTIVE: To analyze the role of health care provision determinants in the initial prognosis of MM. METHODS: A multicenter cross-sectional study was conducted at 14 public hospitals and recruited 3550 patients with MM between 2000 and 2009. The study variables were analyzed using univariate and multivariate models to identify their role in the variations observed. RESULTS: In a 10-year period, the number of patients with MM increased by 78.54%, with primary in situ MM (Tis) or MMs with a Breslow thickness <1 mm (T1) representing 51.72% of the total number of MMs in 2000, increasing to 62.23% by the end of the study period (P = .005). Among the variables that explained the variation in MM frequency the year of diagnosis after 2004 (univariate odds ratio [OR], 1.43 [P < .001]; multivariate OR, 1.36 [P = .005]) and diagnosis in centers with specific fast-track referral systems (univariate OR, 1.24 [P = .01]; multivariate OR, 1.59 [P = .025]) were shown to explain the increasing frequency of Tis-T1 MM. LIMITATIONS: The primary potential limitation of this study is its retrospective nature. CONCLUSION: Health care provision policies and interventions aimed at improving accessibility to specialized care appear to explain the increasing frequency of Tis-T1 MM.
Subject(s)
Health Services Accessibility , Melanoma/epidemiology , Skin Neoplasms/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma in Situ/epidemiology , Carcinoma in Situ/pathology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Melanoma/pathology , Middle Aged , Primary Prevention , Prognosis , Retrospective Studies , Skin Neoplasms/pathology , Spain/epidemiology , Young AdultSubject(s)
Leg Ulcer/drug therapy , Sulfonamides/therapeutic use , Uremia/drug therapy , Vascular Calcification/drug therapy , Wound Healing/drug effects , Aged , Bosentan , Endothelin Receptor Antagonists/therapeutic use , Female , Humans , Leg Ulcer/etiology , Leg Ulcer/pathology , Uremia/complications , Uremia/pathology , Vascular Calcification/complications , Vascular Calcification/pathologyABSTRACT
El carcinoma basocelular es el tumor cutáneo más frecuente en el área de cabeza y cuello; la exposición crónica al sol es el factor de riesgo más importante para este tumor. Suele manifestarse clínicamente con síntomas anodinos en estadios iniciales, lo que contribuye a que su diagnóstico sea difícil y tardío. Tiene un comportamiento localmente invasivo, especialmente a nivel del pabellón auricular. Este es el único caso descrito en el conducto auditivo externo no relacionado con la exposición al sol, con características clínicas y terapéuticas que lo hacen peculiar.
Basal cell carcinoma is the most frequent skin tumor in the head and neck area, and chronic sun exposure is the most important risk factor. It usually manifests clinically with anodyne symptoms in the early stages, which contributes to its difficult late diagnosis. It is locally invasive, especially at the level of the pinna. It is the only case described in the external auditory canal not related to sun exposure; it presents clinical and therapeutic characteristics that make it peculiar.
Subject(s)
Ultraviolet RaysSubject(s)
Hypopharyngeal Neoplasms/pathology , Pyriform Sinus/pathology , Sarcoma, Ewing/pathology , Aged , Biopsy , Cetuximab/therapeutic use , Combined Modality Therapy , Comorbidity , Fatal Outcome , Humans , Hypopharyngeal Neoplasms/drug therapy , Hypopharyngeal Neoplasms/radiotherapy , Male , Pyriform Sinus/surgery , Sarcoma, Ewing/drug therapy , Sarcoma, Ewing/radiotherapyABSTRACT
INTRODUCCIÓN: Las metástasis en glándula parótida proceden en la mayoría de los casos de tumores primarios malignos cutáneos de cara y cuero cabelludo. Menos del 20% de las metástasis surgen de tumores infraclaviculares, de hecho el carcinoma de células pequeñas pulmonar constituye el 1.7% de los tumores malignos parotídeos. Descripción: Paciente de 65 años en el que que debutó un oat cell pulmonar mediante una tumoración parotídea dolorosa y parálisis facial. DISCUSIÓN: El 50% de las metástasis parotídeas, suelen ser la primera manifestación de un tumor primario previamente desconocido. CONCLUSIONES: Es importante realizar una PAAF ante una tumoración parotídea de comportamiento maligno, como el carcinoma de células pequeñas, para descartar la naturaleza metastásica
INTRODUCTION: Parotid gland metastases are originated from primary malignant cutaneous tumors of the face and scalp in most cases. In less than 20% of metastases, they arise from primary tumors below the clavicle; in fact, small cell lung carcinoma metastases constitute 1.7% of malignant parotid tumors. Description: We present the case of a 52- year old who made debut with a oat cell lung cancer by means of a painful tumor parotid and facial paralysis. DISCUSSION: Parotid gland metastases are the first manifestation in the 50% of the cases of a previously unknown primary tumor. CONCLUSIONS: It's important to performing a FNAC (fine needle aspiration cytology) before a parotid tumor of malignant behavior, such as small cell cancer, to rule out the metastatic nature
Subject(s)
Humans , Male , Middle Aged , Parotid Neoplasms/complications , Parotid Neoplasms/diagnostic imaging , Carcinoma, Small Cell/pathology , Lung Neoplasms/pathology , Neoplasm Metastasis/pathology , Parotid Neoplasms/pathology , Magnetic Resonance Spectroscopy , Lymphadenopathy/diagnostic imaging , Lymphadenopathy/pathology , Biopsy, Fine-NeedleABSTRACT
Laryngeal angiolipoma is a benign and rare tumor at this level. It is a type of unique lipoma, which is located in aritenoepiglottic retraction, epiglottis, and postcricoid region, and it is usually diagnosed after surgical exeresis. It is usually silent until it reaches a large size, causing dysphagia as the most common symptom; so it should be part of the differential diagnosis of odynophagia. We present a case in a male patient of supraglottic angiolipoma as an unusual cause of odynophagia
El angiolipoma laríngeo es un tumor benigno e infrecuente a este nivel. Es un tipo de lipoma único, que se localiza en el repliegue aritenoepiglótico, la epiglotis y la región poscricoidea, y suele diagnosticarse tras su exéresis quirúrgica. Suele ser silente hasta que alcanza gran tamaño, ocasionado odinofagia como síntoma más frecuente; de ahí que deba formar parte del diagnóstico diferencial de la odinofagia. Presentamos un caso en un paciente varón de angiolipoma supraglótico, como causa inusual de odinofagia
Subject(s)
Angiolipoma , Larynx , LipomaABSTRACT
The solid fibrous solitary tumour of the oral cavity is an extremely rare entity. It is also of complicated diagnosis because of its extensive morphologic diversity (especially when there is a small amount of biopsied tissue) and because of its similarity to many mesenchymal injuries, mostly with hemangiopericytoma. The prognosis is reserved because of the few cases reported, mainly depending on tumour location and size.
Subject(s)
Neoplasms, Second Primary/pathology , Palatal Neoplasms/pathology , Solitary Fibrous Tumors/pathology , Uvula/pathology , Aged, 80 and over , Antigens, CD34/analysis , Biomarkers, Tumor/analysis , Female , Humans , Neoplasm Proteins/analysis , Neoplasms, Second Primary/chemistry , Neoplasms, Second Primary/surgery , Palatal Neoplasms/chemistry , Palatal Neoplasms/surgery , Papilloma/surgery , Proto-Oncogene Proteins c-bcl-2/analysis , Solitary Fibrous Tumors/chemistry , Solitary Fibrous Tumors/surgery , Uvula/chemistry , Uvula/surgery , Vimentin/analysisABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Sarcoma, Ewing/pathology , Bone Neoplasms/pathology , Hypopharyngeal Neoplasms/pathology , Biopsy , Pyriform Sinus/pathology , Fatal OutcomeSubject(s)
Amyloidosis , Nasopharyngeal Diseases , Adult , Amyloidosis/diagnosis , Humans , Male , Nasopharyngeal Diseases/diagnosisABSTRACT
Introducción: El tabaco y el alcohol son los dos principales factores etiológicos del cáncer laríngeo, y el VPH es un coadyuvante de los anteriores. La positividad del p16 y, por tanto, la detección del VPH, se localiza preferentemente en la orofaringe. En los pacientes con carcinoma orofaríngeo uniformemente tratados con quimio-radioterapia, la presencia del VPH es un indicador pronóstico favorable con respecto a la recurrencia y la supervivencia global. El objetivo consiste en extrapolar estos resultados al cáncer de laringe, tras ver similitudes del mismo con el VPH. Método: Se estudian varias variables clinicopatológicas: edad, tabaquismo, alcoholismo, histología, estadios de la afección y localización en 95 pacientes con cáncer de laringe. Estas variables se correlacionaron con la tinción inmunohistoquímica de p16. Resultados: El VPH es positivo en el 20% de cáncer laríngeo, sobre todo en los estadios III y IV, y a nivel supraglótico y transglótico, pero no pueden obtenerse resultados significativos, pues el test exacto de F para ambas variables, estadio y localización, es 0,482 y 1,073. Conclusiones: El VPH está presente en el 20% del cáncer epidermoide laríngeo, sin mostrar preferencia a nivel de localización ni estadio, en pacientes fumadores, susceptibles de aplicar protocolos de preservación de órgano...
Introduction: Tobacco and alcohol are the two major etiological factors for laryngeal cancer, and HPV is an adjunct of both of them. P16 positivity and therefore HPV detection is preferably located at the oropharynx. In patients with oropharyngeal carcinoma uniformly treated with chemo-radiotherapy, the presence of HPV is a favourable prognostic indicator regarding recurrence and overall survival. Our aim is to extrapolate these results to cancer of the larynx after seeing similarities with HPV. Method: We study several clinical and pathological variables: age, smoker, drinker, histology, staging and localization, in 95 patients with laryngeal cancer. These variables were correlated with immunohistochemical staining of p16. Results: HPV is positive in 20% of epidermoid laryngeal carcinoma. There are no statistically significant differences regarding level (supraglottic or transglottic level) or stages (III and IV). F exact test for both variables, stage and location, are 0,482 and 1,073 respectively. Conclusions: HPV is present in 20% of squamous laryngeal cancer. It shows no preference to level, location or stage in smokers susceptible of being applied organ preservation protocols...
Subject(s)
Humans , Papillomavirus Infections , Immunohistochemistry , Head and Neck NeoplasmsABSTRACT
La lepra lepromatosa es una enfermedad infecciosa transmisible, casi erradicada en la actualidad, y crónica, que puede simular un cáncer. Las lesiones más precoces y frecuentes se localizan en piel, cavidades nasal y oral. Su diagnóstico y tratamiento oportuno evitan lesiones irreversibles
The leprosy lepromatosa is an infectious transmissible disease, almost eradicated at present, and chronicle that can simulate a cancer. The most early and frequent injuries are located in skin, nasal and oral cavity. Its diagnosis and early treatment avoids irreversible injuries
Subject(s)
Humans , Mouth/injuries , Hand, Foot and Mouth Disease , Leprosy , Leprosy, Lepromatous , Leprosy/surgery , Leprosy/diagnosis , Leprosy/epidemiologyABSTRACT
Los schwannomas de la cadena cervical del simpático (SC) son tumores benignos e infrecuentes, que se presentan como una masa cervical unilateral de lento crecimiento, y cuyo diagnóstico preoperatorio definitivo suele ser difícil. A pesar de las pruebas disponibles (TAC, RM, eco y angiografía), solo se obtiene en el momento de la cirugía. El tratamiento de elección es la cirugía, y rara vez se produce recidiva o malignización, aunque sí puede variar hastapresentarse el síndrome de Horner
Schwannomas of the sympatic cervical chain are infrequent and benign tumors, presented as unilateral cervical mass of slow growth, and whose definitive preoperative diagnosis usually is difficult, in spite of the available tests (CAT, MR, ecography and angiography), obtaining it at the moment of the surgery. Surgical extirpation constitutes the election treatment, being rare the tumor recidive and the malignization, not so the Horner syndrome
Subject(s)
Humans , Autonomic Nervous System Diseases , Otorhinolaryngologic Neoplasms , Neurilemmoma , Paraganglioma , Sympathetic Nervous SystemABSTRACT
El pseudosarcoma de laringe es un tumor poco frecuente, sobre el cual hay gran controversia a causa de su histogénesis y comportamiento biológico, de ahí la variada nomenclatura que ha recibido. Es un tumor maligno, considerado de buen pronóstico por su evolución favorable tras tratamiento, su alta supervivencia y buena calidad de vida. Se expone un caso, en el que aparece la radioterapia como factor de riesgo
The pseudosarcoma of larynx is an infrequent tumor, who presents a great controversy in its histogenesis and biological behaviour, which explains the varied nomenclature that it has received. It is a malignant tumor, considered of good prognosis because of its favourable evolution after treatment, its high survival and good life quality. We expose a case in which the radiotherapy seems to be risk factor
Subject(s)
Humans , Carcinoma , Carcinoma/diagnosis , Larynx , Larynx/pathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Amyloidosis/surgery , Nasopharyngeal Diseases/surgery , Otoscopy , Nasal Obstruction/etiologyABSTRACT
El tumor fibroso solitario de la cavidad oral es una entidad extremadamente infrecuente y difícil de diagnosticar por su amplia diversidad morfológica, especialmente cuando se trata de biopsias de pequeño tamaño por su similitud con numerosas lesiones mesenquimales como el hemangiopericitoma. Su pronóstico es reservado por los pocos casos reportados, debiéndo basarse en la localización y tamaño del tumor (AU)
The solid fibrous solitary tumour of the oral cavity is an extremely rare entity. It is also of complicated diagnosis because of its extensive morphologic diversity (especially when there is a small amount of biopsied tissue) and because of its similarity to many mesenchymal injuries, mostly with hemangiopericytoma. The prognosis is reserved because of the few cases reported, mainly depending on tumour location and size (AU)
Subject(s)
Humans , Female , Aged, 80 and over , Palatal Neoplasms/pathology , Solitary Fibrous Tumors/pathology , Uvula/pathology , Neoplasms, Second Primary/pathology , Biomarkers/analysis , Proto-Oncogene Proteins c-bcl-2/analysis , PrognosisABSTRACT
Introducción: Los linfomas MALT que afectan al riñónson muy raros; siendo la primera descripción la de Pelstringy colaboradores en 1991. Pacientes y métodos: Presentamosun caso de un varón de 71 años al que se le practicó unanefrectomía radical por laparoscopia. En el estudio delriñón se observaron un carcinoma renal, tipo de células claras,y un linfoma B, tipo MALT. Conclusiones: La presenciasimultánea en el riñón de un carcinoma renal y un linfomaMALT es extremadamente rara. Los linfomas MALTque surgen en el riñón podrían estar relacionados con unaenfermedad autoinmune, como el síndrome de Sjögren, ocon la inflamación crónica, como las pielonefritis (AU)
Introduction: Mucosa-associated lymphoid tissue(MALT) lymphoma involving the kidney is extremely rare;and was first reported in 1991 by Pelstring et al. Patientsand methods: We report a case of 71 year-old man underwenta radical nephrectomy by laparos copy. Pathologicalstudy of the kidney revealed a renal cell carcinoma, clearcell type, and a B-cell lymphoma, MALT type. Conclusions:The simultaneous occurrence in the kidney of a renalcarcinoma and MALT lymphoma is extremely rare. MALTlymphoma arising from the kidney could be associated withautoinmune disease such as a Sjögren syndrome or withchronic inflammation, such as pyelonephritis (AU)
Subject(s)
Humans , Male , Aged , Kidney Neoplasms/diagnosis , Lymphoma, B-Cell, Marginal Zone/diagnosis , Carcinoma, Renal Cell/diagnosis , Neoplasms, Multiple Primary/diagnosis , Kidney Neoplasms/surgery , Lymphoma, B-Cell, Marginal Zone/surgery , Carcinoma, Renal Cell/surgery , Neoplasms, Multiple Primary/surgery , NephrectomyABSTRACT
Introducción: El sarcoma del estroma endometrial(SEE) es un tumor infrecuente que contabiliza menos del10% de los sarcomas uterinos. Pacientes y métodos: Presentamosel caso de una mujer de 44 años con masas uterinasdetectadas mediante ecografía a la que se realizó unahisterectomía con conservación de anejos. Resultados:Microscópicamente, uno de dichos nódulos estaba constituidopor una densa proliferación maligna de células estromalesdel endometrio y focos de células espumosas. Elestudio inmunohistoquímico mostró positividad paravimentina, CD10, receptores hormonales y negatividad paraactina y desmina. Discusión y conclusiones: El CD10 es unmarcador inmunohistoquímico del estroma endometrialnormal y de los tumores del estroma endometrial, y es útilpara el diagnóstico diferencial entre el SEE y el leiomiomacelular o el leiomiosarcoma uterino. Revisamos la nuevaclasificación de la Organización Mundial de la Salud delSEE y sus opciones terapéuticas
Introduction: Endometrial stromal sarcoma (ESS) is anuncommon neoplasm which accounts for less than 10% ofall uterine sarcomas. Patients and methods: We report acase of a 44 year-old woman with uterine masses revealedby ultrasonography, who had undergone hysterectomywithout adnexectomy. Results: Microscopically the neoplasmwas composed of malignant stromal elements andfoci of foamy cells. The immunohistochemical study showedimmunorreactivity for vimentin, CD10, estrogen receptorand progesterone receptor but it was negative for actinand desmin. Discussion and conclusions: CD10 is animmunohistochemical marker of normal endometrial stromaand of endometrial stromal neoplasms. This marker isuseful in the differential diagnosis of ESS versus uterinecellular leiomyoma or uterine leiomyosarcoma. The newWorld Health Organization classification of ESS and themore recent treatments are reviewed