RESUMEN
In this article, we review de state of the art on the management of renal cell carcinoma (RCC) and provide recommendations on diagnosis and treatment. Recent advances in molecular biology have allowed the subclassification of renal tumours into different histologic variants and may help to identify future prognostic and predictive factors. For patients with localized disease, surgery is the treatment of choice with nephron-sparing surgery recommended when feasible. No adjuvant therapy has demonstrated a clear benefit in overall survival. Considering the whole population of patients with advanced disease, the combination of axitinib with either pembrolizumab or avelumab increase response rate and progression-free survival, compared to sunitinib, but a longer overall survival has only been demonstrated so far with the pembrolizumab combo. For patients with IMDC intermediate and poor prognosis, nephrectomy should not be considered mandatory. In this subpopulation, the combination of ipilimumab and nivolumab has also demonstrated a superior response rate and overall survival vs. sunitinib. In patients progressing to one or two antiangiogenic tyrosine-kinase inhibitors, both nivolumab and cabozantinib in monotherapy have shown benefit in overall survival compared to everolimus. Although no clear sequence can be recommended, medical oncologists and patients should be aware of the recent advances and new strategies that improve survival and quality of life in patients with metastatic RCC.
Asunto(s)
Ensayos Clínicos como Asunto/normas , Neoplasias Renales/terapia , Guías de Práctica Clínica como Asunto/normas , Humanos , Oncología Médica , Sociedades MédicasRESUMEN
Approximately, 7 % of all breast cancers (BC) and 11-15 % of ovarian cancers (OC) are associated with inherited predisposition, mainly related to germline mutations in high penetrance BRCA1/2 genes. Clinical criteria for genetic testing are based on personal and family history to estimate a minimum 10 % detection rate. Selection criteria are evolving according to new advances in this field and the clinical utility of genetic testing. Multiplex panel testing carries its own challenges and we recommend inclusion of genes with clinical utility. We recommend screening with annual mammography from age 30 and breast MRI from age 25 for BRCA1 and BRCA2 mutation carriers. Bilateral salpingo-oophorectomy should be offered to women with a BRCA1 or BRCA2 mutation, between 35 and 40 years and after completion of childbearing, or individualise based on the earliest age of ovarian cancer diagnosed in the family. Bilateral risk-reducing mastectomy is an option for healthy BRCA1 and BRCA2 mutation carriers, as well as contralateral mastectomy for young patients with a prior BC diagnosis. BRCA genetic testing in patients with BC and OC may influence their locoregional and systemic treatment.
Asunto(s)
Neoplasias de la Mama/prevención & control , Genes BRCA1 , Genes BRCA2 , Predisposición Genética a la Enfermedad , Neoplasias Ováricas/prevención & control , Guías de Práctica Clínica como Asunto/normas , Adulto , Anciano , Neoplasias de la Mama/genética , Femenino , Humanos , Oncología Médica , Persona de Mediana Edad , Mutación/genética , Neoplasias Ováricas/genética , Sociedades MédicasRESUMEN
Genetic mutations have been identified as the cause of inherited cancer risk in some colon cancer; these mutations are estimated to account for only 5-6 % of colorectal cancer (CRC) cases overall. Up to 25-30 % of patients have a family history of CRC that suggests a hereditary component, common exposures among family members, or a combination of both. Cancers in people with a hereditary predisposition typically occur at an earlier age than in sporadic cases. A predisposition to CRC may include a predisposition to other cancers, such as endometrial cancer. We describe genetics, current diagnosis and management of CRC hereditary syndromes pointing to a multidisciplinary approach to achieve the best results in patients and family outcomes (AU)
No disponible
Asunto(s)
Humanos , Masculino , Femenino , /normas , Neoplasias Colorrectales/terapia , Poliposis Adenomatosa del Colon/congénito , Poliposis Adenomatosa del Colon/genética , Neoplasias/metabolismo , Biopsia/métodos , Placebos/administración & dosificación , Placebos/metabolismo , Reacción en Cadena de la Polimerasa/métodos , Neoplasias del Colon/tratamiento farmacológico , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/radioterapia , Poliposis Adenomatosa del Colon/metabolismo , Poliposis Adenomatosa del Colon/patología , Neoplasias/complicaciones , Biopsia/instrumentación , Placebos/provisión & distribución , Reacción en Cadena de la PolimerasaRESUMEN
Approximately, 7 % of all breast cancers (BC) and 11-15 % of ovarian cancers (OC) are associated with inherited predisposition, mainly related to germline mutations in high penetrance BRCA1/2 genes. Clinical criteria for genetic testing are based on personal and family history to estimate a minimum 10 % detection rate. Selection criteria are evolving according to new advances in this field and the clinical utility of genetic testing. Multiplex panel testing carries its own challenges and we recommend inclusion of genes with clinical utility. We recommend screening with annual mammography from age 30 and breast MRI from age 25 for BRCA1 and BRCA2 mutation carriers. Bilateral salpingo-oophorectomy should be offered to women with a BRCA1 or BRCA2 mutation, between 35 and 40 years and after completion of childbearing, or individualise based on the earliest age of ovarian cancer diagnosed in the family. Bilateral risk-reducing mastectomy is an option for healthy BRCA1 and BRCA2 mutation carriers, as well as contralateral mastectomy for young patients with a prior BC diagnosis. BRCA genetic testing in patients with BC and OC may influence their locoregional and systemic treatment
No disponible
Asunto(s)
Humanos , Síndrome de Cáncer de Mama y Ovario Hereditario/genética , Genes BRCA1 , Genes BRCA2 , Pruebas Genéticas/métodos , Enfermedades Genéticas Congénitas , Detección Precoz del Cáncer/métodos , Salpingooforectomía/métodos , Factores de RiesgoRESUMEN
Genetic mutations have been identified as the cause of inherited cancer risk in some colon cancer; these mutations are estimated to account for only 5-6 % of colorectal cancer (CRC) cases overall. Up to 25-30 % of patients have a family history of CRC that suggests a hereditary component, common exposures among family members, or a combination of both. Cancers in people with a hereditary predisposition typically occur at an earlier age than in sporadic cases. A predisposition to CRC may include a predisposition to other cancers, such as endometrial cancer. We describe genetics, current diagnosis and management of CRC hereditary syndromes pointing to a multidisciplinary approach to achieve the best results in patients and family outcomes.
Asunto(s)
Neoplasias Colorrectales Hereditarias sin Poliposis/diagnóstico , Neoplasias Colorrectales Hereditarias sin Poliposis/prevención & control , Predisposición Genética a la Enfermedad , Guías de Práctica Clínica como Asunto/normas , Adolescente , Adulto , Niño , Preescolar , Neoplasias Colorrectales Hereditarias sin Poliposis/genética , Detección Precoz del Cáncer , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Purpose. This study aims to asses a cancer fast-track programme (CFP) to shorten the time since a patient with suspicion of cancer is referred by the primary care (PC) physician to the specialized medical team. Methods. Guidelines for main suspected tumours were designed to help PC physicians to detect and rapidly refer cases to the CFP oncology coordinator, who sent them to the appropriate department to accelerate diagnosis, staging and therapy. All patients analysed in this report were referred from June 2009 to July 2012. Results. A total of 897 suspected cancer cases were submitted and finally 705 were studied. In 205 (29 %) a cancer diagnosis was confirmed within 23 days (median). Therapy was initiated within 46 days after referral (median). Early diagnoses with a potential curative approach were made in 166 (82 %). Conclusions. This CFP decreased the waiting time for cancer diagnosis, by improving communication between PC physician and specialized care teams. Most patients included in this program could get therapy with curative intent (AU)
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Neoplasias/diagnóstico , Neoplasias/terapia , Detección Precoz del Cáncer/instrumentación , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer , Planes y Programas de Salud/organización & administración , Planes y Programas de Salud/normas , Diagnóstico Precoz , Detección Precoz del Cáncer/economía , Detección Precoz del Cáncer/normas , Detección Precoz del Cáncer/tendenciasRESUMEN
PURPOSE: This study aims to asses a cancer fast-track programme (CFP) to shorten the time since a patient with suspicion of cancer is referred by the primary care (PC) physician to the specialized medical team. METHODS: Guidelines for main suspected tumours were designed to help PC physicians to detect and rapidly refer cases to the CFP oncology coordinator, who sent them to the appropriate department to accelerate diagnosis, staging and therapy. All patients analysed in this report were referred from June 2009 to July 2012. RESULTS: A total of 897 suspected cancer cases were submitted and finally 705 were studied. In 205 (29 %) a cancer diagnosis was confirmed within 23 days (median). Therapy was initiated within 46 days after referral (median). Early diagnoses with a potential curative approach were made in 166 (82 %). CONCLUSIONS: This CFP decreased the waiting time for cancer diagnosis, by improving communication between PC physician and specialized care teams. Most patients included in this program could get therapy with curative intent.
Asunto(s)
Implementación de Plan de Salud , Neoplasias/diagnóstico , Neoplasias/terapia , Guías de Práctica Clínica como Asunto , Atención Primaria de Salud , Evaluación de Programas y Proyectos de Salud , Administración del Tiempo/organización & administración , Atención a la Salud/métodos , Atención a la Salud/organización & administración , Humanos , Comunicación Interdisciplinaria , Planificación de Atención al Paciente/organización & administración , Planificación de Atención al Paciente/normas , Derivación y Consulta , Listas de EsperaRESUMEN
PURPOSE: T cells are dominant in the immune regulation of malignant pleural effusion (MPE). However, it is unclear about the role of IL-17+ T cells, particularly for IL-17+CD8+ Tc17 cells in antitumor immunity. This retrospective study is aimed at evaluating the prognostic significance of IL-17+ T cells in patients with MPE. METHODS: The frequency of IL-17+CD4+ Th17 and IL-17+CD8+ Tc17 cells in peripheral blood (PB), pleural fluids (PF), and tumor tissues in 24 patients undergoing thoracoscopy was determined by flow cytometry, immunohistochemistry, and ELISA. The association among the different measures was analyzed by Spearman's correlation tests. RESULTS: The percentages of PF Th17 and Tc17 cells were significantly higher than those in the PB of MPE patients and healthy controls (p < 0.01). Analysis of Th17 and Tc17 cells in the tumor tissues indicated that the percentages of Th17 and Tc17 cells in the invading tumor edge were significantly higher than those in the non-tumor tissues and intra-tumor regions (p < 0.05). More importantly, the percentages of IL-17+ T cells were associated with prolonged survival of patients with MPE. CONCLUSIONS: Both Th17 and Tc17 cells were involved in the tumor immunity against MPE. Increased frequency of Tc17 cells may serve as a biomarker for the prognosis of patients with MPE (AU)
No disponible
Asunto(s)
Humanos , Femenino , Neoplasias de la Mama/diagnóstico , Factor Estimulante de Colonias de Granulocitos , Factor Estimulante de Colonias de Granulocitos/metabolismo , Antraciclinas/metabolismo , Antraciclinas/uso terapéutico , Taxoides/uso terapéutico , Estudios Retrospectivos , Quimioterapia Adyuvante/métodos , Receptores de Factor Estimulante de Colonias de Granulocitos y Macrófagos/metabolismo , Signos y Síntomas/análisisRESUMEN
BACKGROUND: BRCA1-associated breast cancers have been associated to a triple-negative phenotype. The prevalence of BRCA1 germline mutations in young onset TNBC based on informativeness of family history has not been reported. PATIENTS AND METHODS: From January 2008 to May 2009 were collected blood and tumor samples from patients with TNBC younger than 50 years and without a family history of breast and ovarian cancer in first- and second-degree relatives. Analysis of BRCA1 germline mutations was made. Age at diagnosis and informativeness of family history (presence of female in first- and second-degree relatives alive until age 45) was collected in all cases. Immunohistochemistry of basal-like features was performed centrally in all available tumors. RESULTS: Seven pathogenic mutations were detected in 92 patients (7.6 %), two of them in patients younger than 35 years (28.6 %) (Fisher's exact test, p = 0.631). Three non-classified variants were detected (3.2 %). Family history was informative in two patients with a pathogenic mutation (28.6 %) and not informative in five (71.4 %) (Fisher's exact test, p = 0.121). Of the seven patients with a pathogenic mutation, four had a basal-like phenotype. CONCLUSION: Patients with apparently sporadic TNBC younger than 50 years and a non-informative family history are candidates for germline genetic testing of BRCA1 (AU)
No disponible
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Anciano , Genes BRCA1 , Mutación de Línea Germinal , Cromatografía Líquida de Alta Presión , Análisis Mutacional de ADN , Predisposición Genética a la Enfermedad , Inmunohistoquímica , Estudios RetrospectivosRESUMEN
PURPOSE: To evaluate the impact on survival of the relative dose intensity (RDI) achieved in patients with early breast cancer receiving anthracycline plus taxane-based chemotherapy in the adjuvant setting. PATIENTS AND METHODS: Patients with early breast cancer diagnosed from January 1999 through December 2006 were included. Dose intensity was evaluated according to the number of delayed cycles and days and the percentage of RDI. RESULTS: A total of 231 breast cancer patients were included. Granulocyte colony-stimulating factor (G-CSF) was given to 39 % of patients. Few patients delayed chemotherapy administration ≥2 cycles (6 %) and ≥15 days (2 %), and the majority of them received ≥85 % of the RDI (98 %). Overall survival was statistically lower at 5 years in patients who received <85 % of RDI in comparison with those who received ≥85 % of RDI (80 vs. 97 %; p = 0.026). CONCLUSIONS: With a wide use of G-CSF in patients treated with adjuvant anthracyclines plus taxane-based schedules, 98 % of patients received a RDI ≥85 %. A significant although inconsistent impairment of survival was found in those patients with lower RDI.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Quimioterapia Adyuvante/métodos , Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Antraciclinas/administración & dosificación , Neoplasias de la Mama/mortalidad , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Embarazo , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Taxoides/administración & dosificaciónRESUMEN
BACKGROUND: BRCA1-associated breast cancers have been associated to a triple-negative phenotype. The prevalence of BRCA1 germline mutations in young onset TNBC based on informativeness of family history has not been reported. PATIENTS AND METHODS: From January 2008 to May 2009 were collected blood and tumor samples from patients with TNBC younger than 50 years and without a family history of breast and ovarian cancer in first- and second-degree relatives. Analysis of BRCA1 germline mutations was made. Age at diagnosis and informativeness of family history (presence of female in first- and second-degree relatives alive until age 45) was collected in all cases. Immunohistochemistry of basal-like features was performed centrally in all available tumors. RESULTS: Seven pathogenic mutations were detected in 92 patients (7.6 %), two of them in patients younger than 35 years (28.6 %) (Fisher's exact test, p = 0.631). Three non-classified variants were detected (3.2 %). Family history was informative in two patients with a pathogenic mutation (28.6 %) and not informative in five (71.4 %) (Fisher's exact test, p = 0.121). Of the seven patients with a pathogenic mutation, four had a basal-like phenotype. CONCLUSION: Patients with apparently sporadic TNBC younger than 50 years and a non-informative family history are candidates for germline genetic testing of BRCA1.
Asunto(s)
Genes BRCA1 , Mutación de Línea Germinal , Neoplasias de la Mama Triple Negativas/genética , Adulto , Edad de Inicio , Cromatografía Líquida de Alta Presión , Análisis Mutacional de ADN , Femenino , Predisposición Genética a la Enfermedad , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Estudios Retrospectivos , Neoplasias de la Mama Triple Negativas/metabolismoRESUMEN
BACKGROUND: Levels of bone turnover markers (BTM) might be correlated with outcome in terms of skeletal-related events (SRE), disease progression, and death in patients with bladder cancer (BC) and renal cell carcinoma (RCC) with bone metastases (BM). We try to evaluate this possible correlation in patients who receive treatment with zoledronic acid (ZOL). METHODS: This observational, prospective, and multicenter study analysed BTM and clinical outcome in these patients. Serum levels of bone alkaline phosphatase (BALP), procollagen type I amino-terminal propeptide (PINP), and beta-isomer of carboxy-terminal telopeptide of type I collagen (ß-CTX) were analysed. RESULTS: Patients with RCC who died or progressed had higher baseline ß-CTX levels and those who experienced SRE during follow-up showed high baseline BALP levels. In BC, a poor rate of survival was related with high baseline ß-CTX and BALP levels, and new SRE with increased PINP levels. Cox univariate analysis showed that ß-CTX levels were associated with higher mortality and disease progression in RCC and higher mortality in BC. Bone alkaline phosphatase was associated with increased risk of premature SRE appearance in RCC and death in BC. CONCLUSION: Beta-isomer of carboxy-terminal telopeptide of type I collagen and BALP can be considered a complementary tool for prediction of clinical outcomes in patients with BC and RCC with BM treated with ZOL.
Asunto(s)
Neoplasias Óseas/tratamiento farmacológico , Remodelación Ósea , Carcinoma de Células Renales/metabolismo , Difosfonatos/uso terapéutico , Imidazoles/uso terapéutico , Neoplasias Renales/metabolismo , Neoplasias de la Vejiga Urinaria/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Fosfatasa Alcalina/sangre , Biomarcadores de Tumor/sangre , Conservadores de la Densidad Ósea/uso terapéutico , Neoplasias Óseas/mortalidad , Neoplasias Óseas/secundario , Huesos/enzimología , Huesos/metabolismo , Carcinoma de Células Renales/mortalidad , Colágeno Tipo I/sangre , Progresión de la Enfermedad , Femenino , Humanos , Neoplasias Renales/mortalidad , Masculino , Persona de Mediana Edad , Fragmentos de Péptidos/sangre , Procolágeno/sangre , Estudios Prospectivos , Resultado del Tratamiento , Vejiga Urinaria/metabolismo , Neoplasias de la Vejiga Urinaria/mortalidad , Ácido ZoledrónicoRESUMEN
OBJECTIVE: Randomised clinical trials with a control arm of non-screened patients are nowadays ethically impossible. The aim of this study was to establish the impact of mammography screening on a non-selected population. PATIENTS AND METHODS: Between January 1993 and December 2002, 3662 patients were included, 2313 in the screened group and 1349 in the unscreened group. RESULTS: 55.3% of the screened patients were diagnosed in stage I vs. 26.1% in the non-screened group. The proportion of stage III-IV was 4.6% and 19.8% for the screened and unscreened groups respectively (p<0.001). 48.8% in the screening group were submitted to mastectomy vs. 66.4% of the unscreened patients (p<0.001). Overall survival was superior for the prevalent cases in the screening group, with a relative risk of 0.49, and was not significant for the incident cases. CONCLUSIONS: Diagnosis of breast cancer in the mammography screening programme of the Region of Valencia significantly increases conservative surgery rates and suggests an improvement in survival in prevalent cases. The increased rate of early stages in these patients could be the main reason of this benefit (AU)
No disponible
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Anciano , Neoplasias de la Mama/epidemiología , Carcinoma/epidemiología , Neoplasias de la Mama , Carcinoma Ductal de Mama/epidemiología , Carcinoma Ductal de Mama , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer , Mamografía/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Carcinoma , Factores de Confusión Epidemiológicos , Estrógenos , Estimación de Kaplan-Meier , Mastectomía/métodos , Mastectomía/estadística & datos numéricos , Estadificación de Neoplasias , Estudios Retrospectivos , Factores de Riesgo , España/epidemiologíaRESUMEN
This is a phase II institutional exploratory trial of biweekly irinotecan and cetuximab administration regimen in metastatic colorectal cancer patients progressing to at least one previous chemotherapy line. A total of 40 patients were treated between November 2005 and November 2007 with irinotecan 180 mg m-2 and cetuximab 500 mg m-2 q2w (every 2 weeks), in every 21-day cycles, until unacceptable toxicity or progressive disease. An overall response rate of 22.5% was obtained (two complete and seven partial responses). The disease control rate was 60%. The time to progression was 3.4 months and the overall survival was 8 months. The toxicity compared very favourably to weekly cetuximab combination schedules. Grade 3/4 adverse effects were observed in 12 patients. Overall, our results turn up very similar both in terms of toxicity and efficacy to those obtained by weekly and biweekly administration regimens.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Colorrectales/tratamiento farmacológico , Adulto , Anciano , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Camptotecina/administración & dosificación , Camptotecina/análogos & derivados , Cetuximab , Neoplasias Colorrectales/patología , Esquema de Medicación , Femenino , Humanos , Irinotecán , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Estudios ProspectivosAsunto(s)
Humanos , Femenino , Neoplasias de la Mama/clasificación , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/metabolismo , Biología Molecular/métodos , Biología Molecular/tendencias , Neoplasias Basocelulares/clasificación , Neoplasias Basocelulares/diagnóstico , Inmunohistoquímica/métodos , Inmunohistoquímica/tendencias , Inmunohistoquímica , Carcinoma/complicaciones , Carcinoma/diagnóstico , Queratinas , Pronóstico , Valor Predictivo de las PruebasRESUMEN
Parotid gland metastases from malignant tumors are extremely rare. A 61-year-old woman was diagnosed with an early breast cancer with no expression of oestrogen and progesterone receptors. Five years later the patient presented a tumour in parotid gland. After total parotidectomy, microscopic analysis of the gland demonstrated an invasive duct carcinoma (IDC) with positive expression of oestrogen receptor. The patient was treated with chemotherapy followed by complementary local radiotherapy. Diagnosis of a metastasic tumour in parotid gland poses a challenge. In our case an immunohistochemical study of oestrogen receptor was fundamental to establish a diagnosis.
Asunto(s)
Neoplasias de la Mama , Carcinoma Ductal de Mama , Neoplasias de la Parótida/secundario , Anastrozol , Antibióticos Antineoplásicos/administración & dosificación , Antibióticos Antineoplásicos/uso terapéutico , Antimetabolitos Antineoplásicos/administración & dosificación , Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos Alquilantes/administración & dosificación , Antineoplásicos Alquilantes/uso terapéutico , Antineoplásicos Hormonales/administración & dosificación , Antineoplásicos Hormonales/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/cirugía , Capecitabina , Carcinoma Ductal de Mama/tratamiento farmacológico , Carcinoma Ductal de Mama/patología , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/secundario , Carcinoma Ductal de Mama/cirugía , Quimioterapia Adyuvante , Terapia Combinada , Ciclofosfamida/administración & dosificación , Ciclofosfamida/uso terapéutico , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapéutico , Doxorrubicina/administración & dosificación , Doxorrubicina/uso terapéutico , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/análogos & derivados , Fluorouracilo/uso terapéutico , Humanos , Inmunohistoquímica , Mastectomía Radical , Persona de Mediana Edad , Nitrilos/administración & dosificación , Nitrilos/uso terapéutico , Glándula Parótida/patología , Glándula Parótida/cirugía , Neoplasias de la Parótida/diagnóstico , Neoplasias de la Parótida/tratamiento farmacológico , Neoplasias de la Parótida/patología , Neoplasias de la Parótida/radioterapia , Neoplasias de la Parótida/cirugía , Receptores de Estrógenos/análisis , Factores de Tiempo , Resultado del Tratamiento , Triazoles/administración & dosificaciónRESUMEN
Parotid gland metastases from malignant tumors are extremely rare. A 61-year-old woman was diagnosed with an early breast cancer with no expression of oestrogen and progesterone receptors. Five years later the patient presented a tumour in parotid gland. After total parotidectomy, microscopic analysis of the gland demonstrated an invasive duct carcinoma (IDC) with positive expression of oestrogen receptor. The patient was treated with chemotherapy followed by complementary local radiotherapy. Diagnosis of a metastasic tumour in parotid gland poses a challenge. In our case an immunohistochemical study of oestrogen receptor was fundamental to establish a diagnosis (AU)