RESUMEN
A 10-year-old boy was evaluated for intermittent colicky abdominal pain, general malaise, and asthenia. Imaging revealed a solid liver lesion. Subsequent biopsy and extension studies diagnosed the lesion as undifferentiated embryonal sarcoma of the liver, classified as PRETEXT II, group III according to the postoperative staging system of the Intergroup Study for Soft Tissue Sarcomas. He underwent neoadjuvant chemotherapy using alternating cycles of ifosfamide, doxorubicin, vincristine, D-actinomycin, and cyclophosphamide. This was followed by surgical intervention and two additional adjuvant chemotherapy cycles, resulting in a complete disease response. The patient remains in follow-up and shows no signs of relapse 28 months post-diagnosis. Undifferentiated embryonal sarcoma of the liver is a rare and often misdiagnosed condition that can be mistaken for a benign disease. Its prognosis hinges on timely and accurate diagnosis, which is essential for effectively treating patients with this aggressive pathology with a high mortality risk. Notably, there is no standard treatment approach. In our case, we implemented therapeutic strategies from various literature reports, yielding a promising outcome and positive patient progression.
RESUMEN
Malignant germ cell tumors (MGCTs) localized in the uterus are rare in prepubertal girls. They typically occur in postmenopausal women and are characterized by the presence of a pelvic mass and transvaginal bleeding. In this case, the authors describe the clinical features, radiologic findings, histopathologic description, and treatment received by an infant with a primary yolk sac tumor of the uterine wall. Currently, treatment for uterine GCTs is based on guidelines for GCTs. Surgery and bleomycin, etoposide, cisplatin (pBEP) chemotherapy are effective for uterine yolk sac tumors. After 46 months of clinical follow-up, which included abdominopelvic ultrasound and tumor marker assessments, our patient is free of disease, suggesting a favorable outcome.
RESUMEN
OBJETIVO: Evaluar las características de los pacientes sometidos a angioplastía en miembros inferiores, así como establecer posibles asociaciones entre los factores que lleven a complicaciones de la misma. MATERIALES Y MÉTODO: Estudio descriptivo, observacional, retrospectivo de corte transversal durante 18 meses en el que se evaluaron aquellos pacientes con enfermedad arterial periférica sometidos a angioplastía de miembros inferiores, sus características demográficas, clínicas, quirúrgicas y las complicaciones postoperatorias. RESULTADOS: Se evaluaron 158 registros de pacientes con edades entre 30 y 95 años. El 65,2% (n = 103) de los procedimientos se realizaron de forma electiva, los vasos intervenidos con mayor frecuencia fueron la arteria femoral superficial (64%), el tipo de intervención endovascular más frecuente fue la combinación de balón + balón medicado (32,9%), el tratamiento farmacológico postoperatorio más usado fue la combinación de ácido acetilsalicílico (ASA) y clopidogrel (86,1%). Se presentaron 21 casos de complicaciones, la más frecuente fue la amputación menor (52%). Se encontró mayor riesgo de amputación menor cuando el procedimiento quirúrgico es realizado de forma urgente (p = 0,012; OR [IC 95%]: 4,8 [1,4-16,5]). DISCUSIÓN: La complicación posangioplastía con diferencia estadísticamente significativa fue la amputación menor cuando el procedimiento se realizó de manera urgente, esta asociación pudo estar relacionada con el estado clínico del paciente en el momento del ingreso y no con el procedimiento quirúrgico. CONCLUSIÓN: La angioplastía realizada de urgencias fue un procedimiento tan seguro como cuando se realiza de forma programada, dado por la misma proporción de sangrado o disección arterial.
AIM: Evaluate the characteristics of patients undergoing angioplasty in the lower limbs, as well as to establish possible associations between the factors leading to complications. MATERIALS AND METHODS: Observational descriptive, cross-sectional and retrospective study conducted during 18 months in which patients with peripheral arterial disease undergoing angioplasty of the lower limb were included, as well their demographic, clinical, and surgical characteristics and the postoperative complications. RESULTS: 158 records of patients between 30 and 95 years were evaluated. 65.2% (n = 103) of the procedures were performed not urgently, the most frequently intervened vessels were the superficial femoral artery (64%), the most frequent type of endovascular intervention was the combination of balloon + medicated ball (32.9%), the most used postoperative pharmacological treatment was the combination of acetylsalicylic acid (ASA) and clopidogrel (86.1%). There were 21 cases of complications, the most frequent complication was minor amputation (52%). A higher risk of minor amputation was found when the surgical procedure was performed urgently (p = 0.012, OR [95% CI]: 4.8 [1.4-16.5]). DISCUSION: The post-angioplasty complication with statistically significant difference was minor amputation when the procedure was performed urgently, this association was related to the clinical status of the patient at the time of admission and not to the surgical procedure. CONCLUSION: Angioplasty performed urgently is as safe as elective procedures, given by the same proportion of bleeding or arterial dissection.
