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2.
Rev. esp. investig. quir ; 22(2): 67-70, 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-184388

RESUMO

Los carcinoides de células caliciformes del apéndice cecal son una patología infrecuente con características propias dentro de los tumores neuroendocrinos apendiculares. Presentamos tres casos de esta entidad, dos diagnosticados en un cuadro clínico de abdomen agudo y otro como hallazgo incidental en una colectomía derecha por un adenocarcinoma de colon. La media de edad fue de 46,6 años, el 100% fueron mujeres. Los tres casos se trataron con una colectomía derecha laparoscópica. En el seguimiento, una paciente presentó una metástasis del adenocarcinoma de colon en el hígado y otra una carcinomatosis peritoneal, siendo ambas reintervenidas. Dos pacientes están vivas en el momento actual con un seguimiento de 26 meses de media y una falleció a los 16 meses por progresión de su enfermedad. Realizamos una revisión de la clínica, diagnóstico, clasificación y tratamiento de este in-usual tipo de neoplasia


The goblet cells carcinoid of the cecal appendix is an uncommon disease with own characteristics within the appendicular neuroen-docrine tumors. We present three cases of this entity, two diagnosed in a clinical picture of acute abdomen and another as incidental finding in a right colectomy for colon adenocarcinoma. The average age was 46.6 years, 100% were women. All three cases were treated with a laparoscopic right colectomy. In follow-up, a patient presented a metastasis of adenocarcinoma of colon in liver and other a peritoneal carcinomatosis, being both operated. Two patients are alive at the present time with a follow-up of 26 months on average and one died at 16 months due to progression of their disease. We carry out a review of the clinic, diagnosis, classification and treatment of this unusual type of malignancy


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/cirurgia , Neoplasias do Apêndice/diagnóstico , Neoplasias do Apêndice/cirurgia , Estudos Retrospectivos , Apendicectomia
4.
Clin. transl. oncol. (Print) ; 20(5): 670-677, mayo 2018. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-173545

RESUMO

Background. Pulmonary carcinoids are being staged along the lines of lung cancer American Joint Committee on Cancer (AJCC) staging system. The current study evaluated the prognostic value of a modified staging system for patients with pulmonary carcinoid. Patients and methods. Surveillance, Epidemiology and End Results (SEER) database (2004-2014) was searched through SEER*Stat program. Through recursive partitioning analysis and subsequent decision tree formation, suggested stages were constructed. Overall survival analyses were performed through Kaplan-Meier analysis. The cancer-specific Cox regression hazard (adjusted for age, gender, race, sub-site and surgery) was calculated and pairwise comparisons of hazard ratios were conducted. Results. A total of 6395 pulmonary carcinoid patients were recruited in the period from 2004–2014. Pairwise hazard ratio comparisons among different AJCC 8th stages were conducted and all comparisons were non-significant except for stage IIB vs. stage IIIA and stage IIIA vs. stage IIIB. Pairwise hazard ratio comparisons among different modified staging system stages were conducted and all comparisons were significant except for stage III vs. stage IV. C-statistic (using death from pulmonary carcinoid as the dependent variable) for AJCC 8th staging system was: 0.794 (SE 0.013; 95% CI 0.769-0.818); for AJCC 7th staging system was: 0.789 (SE 0.013; 95% CI 0.764-0.815), while c-statistic for the modified staging system was: 0.802 (SE 0.012; 95% CI 0.778-0.827). Conclusion. The proposed modified staging system provided a simpler yet prognostically more relevant classification of pulmonary carcinoids compared to AJCC staging systems (both 7th and 8th editions)


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Tumor Carcinoide/patologia , Neoplasias Pulmonares/patologia , Estadiamento de Neoplasias/métodos , Prognóstico , Tumor Carcinoide/mortalidade , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/mortalidade , Modelos de Riscos Proporcionais , Programa de SEER
5.
Rev. esp. patol ; 51(1): 14-17, ene.-mar. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-169852

RESUMO

El adenocarcinoma de colon primario sincrónico con un tumor neuroendocrino bien diferenciado ileal es raro y se detecta accidentalmente en autopsias o en el estudio anatomopatológico de piezas resecadas, solo ocasionalmente en la colonoscopia y excepcionalmente en el acto quirúrgico. En este artículo describimos un adenocarcinoma de ciego asociado a un tumor neuroendocrino bien diferenciado de íleon, no detectado en la colonoscopia, con metástasis ganglionares no asociadas a metástasis del adenocarcinoma. En la revisión de la literatura, la asociación de tumores primarios no carcinoides con carcinoides del tracto gastrointestinal puede representar hasta más de un 50% de forma no sincrónica, siendo la incidencia muy rara, entre 1 y 8%, en tumores sincrónicos. Parece claro que el tumor neuroendocrino bien diferenciado es un factor predisponente para desarrollar un segundo tumor primario (AU)


Synchronous colonic adenocarcinoma and well-differentiated ileal neuroendocrine tumour are infrequent and are usually incidental findings on autopsies or resected surgical specimens. Only rarely are they detected on colonoscopies or during surgery. We present a case of a synchronous caecal adenocarcinoma and well-differentiated ileal neuroendocrine tumour, undetected during colonoscopy, with carcinoid metastasis in one regional lymph node not associated with adenocarcinoma metastasis. A review of the literature shows that the association of non-synchronous second primary malignancies in patients with gastrointestinal carcinoid tumours is reported in more than 50% of cases; however, synchronous tumours are found in only 1-8%. It would appear that well-differentiated ileal neuroendocrine tumour could be a predisposing factor for the development of a second malignancy (AU)


Assuntos
Humanos , Masculino , Idoso , Tumores Neuroendócrinos/patologia , Neoplasias do Íleo/patologia , Neoplasias do Colo/patologia , Neoplasias do Ceco/patologia , Adenocarcinoma/patologia , Neoplasias Primárias Múltiplas/patologia , Tumor Carcinoide/patologia , Segunda Neoplasia Primária/patologia
7.
Clin. transl. oncol. (Print) ; 19(9): 1168-1172, sept. 2017. tab
Artigo em Inglês | IBECS | ID: ibc-165220

RESUMO

Purpose. Neuroendocrine tumors (NETs) are, after lymphomas, the most frequent gastrointestinal tumors in children, mainly located in the appendix. Best management remains unclear, given the absence of pediatric guidelines. We present the first Spanish series of pediatric patients with NETs. Patients and methods. Retrospective study of all pediatric patients (<18 years) with NET treated in four oncology reference institutions in Spain between 1994 and 2015. Results. Seventeen patients were included. All patients presented with acute abdomen. TNM stage was T1a (82%) and T1b (12%). Extension study was heterogenous, with only 4 patients undergoing an OctreoScan. Four patients met criteria for second surgery (affected surgical margins or mesoappendix invasion), but it was only performed in two. Despite the diverse management, none of the patients relapsed during follow-up. Conclusions. The disparity in diagnostic tests, second surgery criteria and follow-up shown in this study highlights the need for specific pediatric guidelines (AU)


No disponible


Assuntos
Humanos , Criança , Tumores Neuroendócrinos/cirurgia , Neoplasias do Apêndice/complicações , Neoplasias do Apêndice/epidemiologia , Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico , Tumores Neuroendócrinos , Estudos Retrospectivos , Apêndice/patologia , Prognóstico , Octreotida/administração & dosagem , Octreotida/análise , Fatores de Risco
10.
Cir. Esp. (Ed. impr.) ; 95(6): 335-341, jun. 2017. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-165080

RESUMO

Introducción: La microcirugía endoscópica transanal (TEM) se diseña como una alternativa menos agresiva en el tratamiento de lesiones rectales (principalmente adenomas y adenocarcinomas). Sin embargo, su uso se ha ampliado a otras lesiones rectales para intentar disminuir la morbilidad añadida a técnicas más invasivas. El objetivo de este estudio es mostrar nuestra experiencia en el uso de la TEM en el tratamiento de otras lesiones rectales, diferentes de adenomas y adenocarcinomas. Métodos: Estudio retrospectivo descriptivo en el que se incluyen pacientes intervenidos mediante TEM para el tratamiento de lesiones rectales (diferentes a adenomas o adenocarcinomas) desde junio de 2008 hasta diciembre de 2016. Resultados: Entre los 138 pacientes operados mediante TEM en nuestro servicio, 10 fueron tratados por lesiones diferentes a adenomas o adenocarcinomas. Las lesiones rectales fueron 3tumores neuroendocrinos primarios, una metástasis de tumor neuroendocrino, una estenosis rectal, un pólipo cloacogénico, un endometrioma, un tumor retrorrectal, un absceso presacro y una lesión sin filiar en tabique rectovaginal. El tiempo operatorio medio fue de 72 min y la estancia postoperatoria de 4,2 días. Solo un paciente necesitó reintervención por rectorragia. Conclusiones: La aplicación del TEM para el tratamiento de lesiones rectales diferentes a adenomas o adenocarcinomas puede ser una herramienta útil que potencialmente ayude a disminuir la morbilidad asociada a otros tipos de técnicas quirúrgicas más invasivas (AU)


Introduction: Transanal endoscopic microsurgery (TEM) was developed as a less aggressive alternative treatment for rectal lesions (mainly adenomas and adenocarcinomas). However, its use for other rectal lesions has become more frequent, trying to reduce the morbidity associated with more invasive techniques. The aim of this study is to describe our experience in the use of TEM in other rectal lesions. Methods: Retrospective and descriptive study including patients operated with TEM (from June 2008 to December 2016) for the treatment of rectal lesions different from adenomas or adenocarcinomas. Results: Among the 138 patients treated by TEM in our department, 10 patients were operated on for rectal lesions other than adenomas or adenocarcinomas. Rectal lesions were 3neuroendocrine tumours, a neuroendocrine tumour metastasis, a rectal stenosis, a cloacogenic polyp, an endometrioma, a retrorrectal tumour, a presacral abscess and a lesion in the rectovaginal septum. Mean operative time was 72min and postoperative stay was 4.2 days. Only one patient needed a reoperation, due to rectal bleeding. Conclusions: TEM could be a useful tool for the treatment of rectal lesions different from adenomas or adenocarcinomas, potentially decreasing the morbidity associated with more aggressive surgical techniques (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Microcirurgia Endoscópica Transanal/métodos , Neoplasias do Ânus/cirurgia , Estudos Retrospectivos , Tumores Neuroendócrinos/cirurgia , Tumor Carcinoide/cirurgia , Obstrução Intestinal/cirurgia
11.
Clin. transl. oncol. (Print) ; 19(5): 579-586, mayo 2017. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-162191

RESUMO

Background. Pulmonary carcinoid (PC) tumours are classified as either typical (TC) or atypical (AC) according to mitotic index (MI) and presence of necrosis. The aim of this study was to analyse the diagnostic and prognostic values of the Ki-67 index in PC. Methods/patients. Between January 2001 and March 2015, we evaluated 94 consecutive patients with a confirmed diagnosis of TC (n = 75) or AC (n = 19) at our institution. Diagnostic histology was centrally reviewed by a local expert neuroendocrine pathologist, with assessment of Ki-67, MI, and necrosis. Results. Median patient follow-up was 35 months. Eighty-four patients who underwent curative surgical resection were included in the survival analysis for identification of prognostic factors. Ki-67 index showed high diagnostic accuracy to predict histological subtype when assessed by receiver operator characteristic curves with an area under the curve of 0.923 (95% CI 0.852-0.995, p < 0.001). Multivariate analysis showed that MI, Ki-67 index, and the presence or absence of necrosis were independent prognostic factors for relapse-free survival. Combination of MI, Ki-67, and necrosis led to the classification of patients into four different prognostic groups (very low, low, intermediate, and high risks of relapse). Conclusions. The current study proposes the incorporation of Ki-67 index in the prognostic classification of PC tumours. Due to the limited number of patients and length of follow-up, the current model needs validation by larger cohort studies. Nevertheless, our results suggest that Ki-67 index and MI have continuous effect on prognosis. Prognostic models incorporating multiple cutoffs of Ki-67 and MI might better predict outcome and inform clinical decisions (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Antígeno Ki-67/análise , Tumores Neuroendócrinos/classificação , Tumores Neuroendócrinos/diagnóstico , Prognóstico , Tumor Carcinoide/diagnóstico , Estudos de Coortes , Imuno-Histoquímica/métodos , Imuno-Histoquímica
20.
Clin. transl. oncol. (Print) ; 18(1): 65-72, ene. 2016. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-148053

RESUMO

Objective. The aim of the this study was to analyze the status of sex-determining region Y-related high-mobility group box 4 (SOX4) expression in varied human cancers and its correlation with overall survival in patients with human cancers. Methods. To observe initially the expression status of SOX4 in twenty kinds of human cancers at protein database (The Human Protein Atlas). We systematically and carefully searched the studies from electronic databases and seriously identified according to eligibility criteria. The correlation between SOX4 expression and overall survival in human cancers was evaluated through Review Manager. Results. We found that SOX4 expression was significantly positive in most types of human cancer tissues, and the positive rate of SOX4 expression was about 78 % in overall cancer tissues. Furthermore, a total of 10 studies which included 1348 cancer patients were included in the final analysis. Meta-analysis showed that SOX4 overexpression was correlated with a poor overall survival and the pooled hazard ratio (HR), and corresponding 95 % confidence interval (CI) was 1.67 (95 % CI 1.01-2.78). From subgroup analyses, we present evidence that SOX4 overexpression was an unfavorable prognostic factor for colorectal cancer patients’ recurrence-free survival and gastric cancer patients’ overall survival, and the pooled HRs (95 % CI) were 1.73 (95 % CI 1.04-2.88) and 3.74 (95 % CI 1.04-13.45), respectively. Conclusions. In summary, SOX4 is a potential prognostic biomarker in human cancers (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Fatores de Transcrição SOX/administração & dosagem , Fatores de Transcrição SOX/metabolismo , Neoplasias/genética , Neoplasias/metabolismo , Bases de Dados como Assunto , Neoplasias do Colo do Útero/diagnóstico , Neoplasias Hepáticas/patologia , Tumor Carcinoide/complicações , Neoplasias Colorretais/metabolismo , Fatores de Transcrição SOX , Fatores de Transcrição SOX/provisão & distribução , Neoplasias/tratamento farmacológico , Neoplasias/radioterapia , Bases de Dados como Assunto , Neoplasias do Colo do Útero/complicações , Neoplasias Hepáticas/metabolismo , Tumor Carcinoide/diagnóstico , Neoplasias Colorretais/diagnóstico
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