Tumor miofibroblástico inflamatorio tras cáncer de mama. Un reto en el diagnóstico diferencial. Revisión de la literatura / Myofibroblastic tumour after breast cancer. A challenge in differential diagnosis. Literature review

Introducción El tumor miofibroblástico inflamatorio (TMI) es un tumor mesenquimal benigno, con potencial de transformación maligna. Puede aparecer en múltiples órganos (pulmón, intestino…), siendo la mama una ubicación excepcional. Hallazgos clínicos: Se presenta el caso de una paciente de 53 años que tiene como antecedente un carcinoma de mama derecha, tipo ductal infiltrante G2, luminal A. Fue tratada con cirugía, radioterapia y quimioterapia, consiguiéndose curación. Transcurridos nueve años, reinició estudio por aparición de una tumoración sospechosa de 3 cm en la misma mama. Diagnósticos principales, intervenciones terapéuticas y resultados: Se realizó una biopsia con aguja gruesa. El estudio anatomopatológico no fue concluyente, por lo que se decidió realizar una exéresis de la lesión. Los resultados del análisis anatomopatológico fueron: tumor miofibroblástico inflamatorio. La paciente no precisó tratamiento adyuvante posterior y se encuentra libre de enfermedad actualmente. Conclusión: El TMI es una entidad poco frecuente, con pocos casos publicados hasta la fecha. Representa un reto diagnóstico, tanto a nivel radiológico como anatomopatológico. A pesar de ser una neoplasia con comportamiento benigno, está indicado realizar una exéresis amplia y completa de la lesión, ya que en algunos casos se ha descrito su recurrencia, y de forma excepcional se han descrito casos de metastatización. El conocimiento de su existencia y comportamiento es clave a la hora orientar el diagnóstico y tratamiento.(AU)

Introduction: Inflammatory myofibroblastic tumour (IMT) is a benign mesenchymal tumour, with potential for malignant transformation. It can appear in multiple organs (lung, intestine…), the breast being an exceptional location. Clinical findings: We present the case of a 53-year-old female patient with a history of right breast ductal infiltrating carcinoma, G2, Luminal A. She was treated with surgery, radiotherapy, and chemotherapy, achieving complete response. Nine years later, she was re-examined due to the appearance of a new suspicious tumour in the same breast, which measured three centimetres. Main diagnosis, therapeutic intervention, and outcomes: A core needle biopsy was performed. The anatomopathological study was inconclusive, so it was decided to perform total excision of the lesion. The results of the anatomopathological analysis were: Inflammatory Myofibroblastic Tumour. The patient did not require further adjuvant treatment and is disease free at present. Conclusions: IMT is a rare entity, with few cases published to date. It represents a diagnostic challenge, both radiologically and anatomopathologically. Although it is a tumour with benign behaviour, wide and complete excision of the lesion is indicated, as its recurrence has been described in some cases, as well as some exceptional cases of metastatisation. Knowledge of its existence and behaviour is a key factor in guiding diagnosis and treatment.(AU)

[Nutritional value of the diet in healthy pregnant women. Results of a nutrition survey of pregnant women]. / Valor nutricional de la dieta en embarazadas sanas. Resultados de una encuesta dietética en gestantes.

GOAL: The purpose of the present paper is to describe the level of nutritional adequacy of the regular diet of pregnant women belonging to our health-care area. SCOPE: Health-care area of Valme Hospital, Seville. DESIGN: Randomized transversal descriptive study. SUBJECTS: Forty-nine pregnant women during their first trimester. INTERVENTIONS: The daily intake was assessed by means of a 24-hour reminder sheet and a weekly consumption survey. The data obtained were compared with the recommended daily intake of nutrients and with the recommended daily allowances for various foods. At the same time, an anthropometric and basic analysis were also carried out. RESULTS: The calorie intake was as recommended (2,208 +/- 475 kcal/day). The diet contained excessive amounts of proteins (88 +/- 21 g/day) and fat (97 +/- 27 g/day), with a predominance of monounsaturated fats (46.9 +/- 5.5%) over saturated (36.6 +/- 7.2%) or polyunsaturated fats (15.1 +/- 7%), (p < 0.0005). Nonetheless, the diet was short on carbohydrates (44%), fibre (18 +/- 4.9 g/day), calcium (948 +/- 353 mg/day), iron (13.4 +/- 3.1 mg/day) and vitamin B6 (1.1 +/- 0.8 mg/day) (p < 0.0005), and extremely short on folic acid (172 +/- 101 micrograms/day), (p < 0.0005). In the assessment of the diet in terms of daily allowances, this was sufficient in fruit (2.3 +/- 1.8/day), but short on dairy products (1.9 +/- 1.1/day) and extremely short on vegetables (1 +/- 0.4/day), (p < 0.0005). Only 2% of the subjects fulfilled with the recommended daily intake for key vitamins and minerals. The prevalence of obesity (BMI > 30 kg/m2) was 18.4%. CONCLUSIONS: The normal diet of pregnant women in our health-care area is short on calcium, iron, folic acid and dietary fibre, although with an excess of animal protein and fat.