Lesiones y neoplasias del tracto genital femenino relacionadas con la infección por el virus del papiloma humano. Impacto previsible de la vacunación profiláctica / No disponible

“El descubrimiento de que el cáncer de cérvix es la rara consecuencia de una infecciónfrecuente ha sido tan impactante para la salud pública como la demostración de la asociaciónexistente entre el tabaco y el cáncer de pulmón.”Si bien la infección por virus del papiloma humano (VPH) desaparece espontáneamente lamayoría de las veces, desde el año 1999 sabemos que es el factor etiológico causante del cáncerde cérvix; posteriormente se ha demostrado su asociación no sólo con las lesiones precursorasde este tumor sino también con otras neoplasias y sus precursores de vulva, vagina, ano,pene y orofaringe. Asimismo está demostrado que determinados tipos de VPH son los causantesde procesos no neoplásicos como los condilomas genitales y la papilomatosis respiratoriarecurrente. En la presente revisión se analizan todos estos procesos, el papel etiopatogénico delos diferentes tipos de VPH, su incidencia, impacto sanitario y mortalidad, así como los procedimientosdiagnósticos y terapéuticos que conllevan.Mientras las lesiones neoplásicas se asocian fundamentalmente a la presencia de los llamadosVPH de alto riesgo basándose en su potencial carcinogenético (tipos más frecuentes:16 y 18), las lesiones no neoplásicas lo hacen a los VPH de bajo riesgo (tipos 6 y 11).La reciente aprobación de una vacuna tetravalente eficaz frente a estos cuatro tipos devirus (6, 11, 16 y 18) hace previsible un importante impacto a medio plazo sobre la incidenciay, por tanto, sobre la mortalidad asociada a ellos

“The discovery that cervical cancer is a rare consequence of a common infection is as momentous for public health as the demonstration of the association between cigarette smoking and lung cancer”. Most of the times the human papillomavirus (HPV) infection is cleared spontaneously,but since 1999 we know that it is the etiological factor for the cervical uterine cancer.Its association with cervical intraepithelial lesions and with other neoplasms and itsprecursors: vulvar, vaginal, penis, anal and nasopharyngeal carcinomas, has been demonstratedlater. The relationship between HPV and other non-cancerous conditions as anogenitalwarts and recurrent respiratory papillomatosis has also been demonstrated. In the presentarticle we review the burden, management and mortality of all these conditions andthe etiological role of different types of HPV.The cancerous conditions usually are associated with High Risk HPV Genotypes in relationto their carcinogenetic potential (the most frequent are 16 y 18) whereas the noncancerous ones are associated with low risk HPV (6, 11).The tetravalent HPV vaccine with proved efficacy against HPV types 6, 11, 16 and 18,has been approved recently with an important expected impact on its morbidity and mortality (AU)

Angiosarcoma in the small intestine. Apropos of a particular case.

Presentation of a case of small intestine primary angiosarcoma in a 70-year-old male. There is question of an extremely rare tumor in the gastrointestinal tract. Its symptomatology is similar to that of other tumors in the small intestine. An immunohistochemical study is usually essential for its anatomopathological diagnosis. The diagnosis is generally arrived at in its advanced stages, and that makes for a bad prognosis. The bibliography has been revised from this case on.

[Granular cell tumor: an infrequent cause of dysphonia in childhood]. / Tumor de células granulares: una causa poco frecuente de disfonía en la infancia.

Granular cell tumors (GCT) are rare and usually benign tumors whose histogenesis is debated. The skin, subcutaneous tissues, and mucosae of the head and neck are areas of predilection for GCT. Laryngeal involvement is uncommon, but may create diagnostic and therapeutic problems when it occurs. Laryngeal GCT are decidedly uncommon in children, only 17 cases having been reported in the literature. A case of GCT of the larynx in an 11-year-old girl is reported. The presenting symptom was hoarseness. The macroscopic tumor and hoarseness disappeared after chemotherapy (EVAIA) for Ewing sarcoma of the knee.