Primer caso en México y América Latina de linfoma anaplásico de células gigantes en paciente con implantes mamarios / First case report in Mexico and Latin America of anaplastic large cell limphoma in a patient with mammary implants

El Linfoma Anaplásico de Células Gigantes (LACG) asociado a implantes mamarios es una patología poco frecuente. Desde el primer caso publicado en la década de los noventa, en los últimos años hemos observado un mayor número de casos recogidos en la literatura. Si bien se tiene información de aproximadamente 90 casos publicados en el mundo, algunos autores mencionan la posibilidad de que existan más de 100 o 200 casos, por lo que su presencia ha suscitado mucha controversia, si bien en general se sigue considerando una patología infrecuente. Hasta donde hemos podido conocer, presentamos el primer caso de LACG documentado por un cirujano plástico en México y América Latina, en una mujer de 43 años de edad portadora de implantes mamarios, con historia de asimetría mamaria unilateral por seroma tardío, y en la que tras 2 punciones sin mejoría de la sintomatología se realizó retirada del implante y capsulectomía, confirmando en líquido periprotésico la presencia del LACG (AU)

Anaplastic Large Cell Lymphoma (ALCL) associated to breast implants is a rare condition. Since the first case report in the nineties, we have seen lately an increase of the total of reported cases. In the literature, we can find around 90 cases and some authors mentioned the possibility of 100 or 200 cases around the world. Anyway it keeps on been and infrequent pathology. To our knowledge, we present the first case reported by a plastic surgeon in Mexico and Latin America in a 43-year female with history of breast augmentation, and unilateral asymmetry due late seroma. After 2 punctures without success, removal of breast implant and capsulectomy was scheduled. Diagnostic of ALCL was confirmed in the periprosthetic fluid (AU)

Reunión de consenso para recomendaciones sobre la gama de productos Restylane Skinboosters(R) / Advisory board recommendations on the products Restylane(R) Skinboosters

Con motivo del 10º aniversario de Restylane Skinboosters(R) se llevó a cabo una reunión de consenso entre un grupo de médicos españoles con el objetivo de aumentar el estándar de seguridad, mejorar y dar coherencia a los tratamientos, favorecer la buena praxis, posibilitar mejores resultados y aumentar la seguridad con esta gama de productos. Se realizó una revisión exhaustiva de los estudios clínicos publicados que demuestran cómo Restylane Skinboosters(R) mejora la calidad de la piel, disminuyendo la rugosidad, aumentando la firmeza e hidratación a largo plazo y reduciendo las cicatrices de acné, así como estimulando la creación de colágeno tipo I. Por último, los participantes pusieron en común su experiencia clínica para realizar un resumen de las indicaciones y los protocolos más empleados con esta gama de tratamientos (AU)

Related to the 10th anniversary of Restylane Skinboosters(TM) an advisory board was carried out. It gathered a group of Spanish physicians with the aim of increasing the safety standards, improve treatments, encourage good practice, increase safety and enable better results using this product range. An exhaustive review of published clinical studies demonstrates that Restylane Skinboosters(TM) improve firmness and quality of the skin, reduce roughness, provide long-term hydration and reduce acne scars. It also stimulates creation of collagen type I. Finally, doctors summarized main indications and the most appropriate protocols with these products based on their clinical experience (AU)

Infección diseminada por micobacterias no tuberculosas en paciente con síndrome hiper-IgE / Disseminated non-tuberculous mycobacterial infection in a patient with hyper-IgE syndrome

No disponible

Tratamiento con láser CO2 de las lesiones glóticas leucoplásicas premalignas / Treatment with endoscopic CO2 laser for the pre-malignant glottic epithelial lesions

Las lesiones premalignas de laringe pueden llegar a desarrollar un carcinoma invasivo. No existe una clasificación ni una terapia homologada universalmente. En el presente artículo presentamos nuestra experiencia en el manejo de lesiones premalignas leucoplásicas glóticas a través de la cirugía con láser CO2 y realizamos una revisión de distintos estudios. Durante el plazo de 10 años tratamos 69 pacientes, efectuando una de 2 técnicas: escisión de la mucosa leucoplásica o vaporización de la lesión. Para optar por una u otra se consideró: Extensión de la lesión; aspecto macroscópico; compromiso de comisura anterior, experiencia del cirujano. Los resultados histológicos fueron: Queratosis 53,6 por ciento y displasia leve 23,2 por ciento ambas tratadas equivalentemente con vaporización o exéresis; displasia moderada 14,5 por ciento, displasia severa 8,7 por ciento tratadas mayoritariamente con exéresis. No se observaron importantes complicaciones per-operatorias ni a largo plazo. Observamos 7 recidivas (10 por ciento) las cuales no evolucionaron a carcinomas invasivos, logrando finalmente controlar las lesiones. En tanto 9 pacientes (13 por ciento) presentaron malignización: 3 queratosis, 1 displasia leve, 3 displasia moderada y 2 displasia severa, de los cuales sólo en 1 paciente (1,5 por ciento) se recurrió a una cirugía radical de rescate. La pesquisa precoz de estas lesiones y el establecimiento de un tratamiento oportuno reduce las posibilidades de desarrollar carcinomas invasivos. El tratamiento con láser CO2 es una técnica adecuada para abordar estas lesiones, ofreciéndonos seguridad y buenos resultados oncológicos (AU)

Pre-malignant lesions of the larynx can degenerative into invasive carcinoma. There is not an universally accepted classification and treatment. We present our experience in the treatment with endoscopic CO2 laser for the pre-malignant glottic epithelial lesions. At the same time we carry out a review of the literature published. During a period of ten years we have treated 69 patients with one of these techniques: resection of the epithelial lesion or vaporization. The election of the technique depends on the size of the lesion, the macroscopic aspect, anterior commissures involvement and the surgeons experience. The histological findings were: 53.6% keratosis and 23.2% mid dysplasia both of them treated with vaporization and resection; 14.5% moderate dysplasia and 8.7% severe treated with resection of the lesion. There were no important complications during the operation. Recurrence occurred in 7 patients (10%) but after treatment all of them were free of disease during the follow-up period, they didn't progress to carcinomatosis. 9 patients (13%) had a malignant evolution: 3 keratosis, 1 mild dysplasia, 3 moderate dysplasia and 2 severe dysplasia. Only one case (1.5%) underwent total laryngectomy. The early diagnosis and an appropriate treatment reduced the possibilities of malignant transformation. The therapy with CO2 laser is the treatment of choice in this kind of lesions (AU)

[Treatment with CO2 laser of premalignant glottic epithelial lesions]. / Tratamiento con láser CO2 de las lesiones glóticas leucoplásicas premalignas.

Pre-malignant lesions of the larynx can degenerative into invasive carcinoma. There is not an universally accepted classification and treatment. We present our experience in the treatment with endoscopic CO2 laser for the pre-malignant glottic epithelial lesions. At the same time we carry out a review of the literature published. During a period of ten years we have treated 69 patients with one of these techniques: resection of the epithelial lesion or vaporization. The election of the technique depends on the size of the lesion, the macroscopic aspect, anterior commissures involvement and the surgeons experience. The histological findings were: 53.6% keratosis and 23.2% mid dysplasia both of them treated with vaporization and resection; 14.5% moderate dysplasia and 8.7% severe treated with resection of the lesion. There were no important complications during the operation. Recurrence occurred in 7 patients (10%) but after treatment all of them were free of disease during the follow-up period, they didn't progress to carcinomatosis. 9 patients (13%) had a malignant evolution: 3 keratosis, 1 mild dysplasia, 3 moderate dysplasia and 2 severe dysplasia. Only one case (1.5%) underwent total laryngectomy. The early diagnosis and an appropriate treatment reduced the possibilities of malignant transformation. The therapy with CO2 laser is the treatment of choice in this kind of lesions.

Innovative new concepts in augmentative breast surgery. Part II: systematic and drawing.

This paper presents a simple protocol to define the anatomic parameters for creating aesthetic augmented breasts using round silicone implants. This study completes our previous publication on augmentative breast surgery. We discuss the need for correct submuscular dissection and explain how to obtain the correct positioning of the inframammary fold via measurements. We also explain how we use radiological images to show the continuity of the submuscular dissection in the inferior border so that we can create a new submammary fold and thus preserve the central position of the nipple-areola complex.

Systematic procedure for ultrasonically assisted lipoplasty.

It is well known that liposuction is the extraction of fat tissue from localized areas through small incisions with the use of a cannula and a vacuum pump. Since we began liposuction 18 years ago in our Department of Plastic and Reconstructive Surgery at the Clinica RUBER of Madrid, more than 1,300 patients have been treated with this procedure. During this time, instruments and techniques have been dramatically improved: there have been changes in methods (from the dry method to the wet and super-wet ones), in instruments (from the large caliber cannulae to the small caliber ones), and in application (from the deep aspiration plane to the superficial one) [1-5]. We presently have completely developed a systematic procedure for conventional liposuction (CL) which produces excellent results and provides a foreseen evolution in all patients, and that we have combined with the new ultrasonically assisted lipoplasty (UAL) to get very satisfactory results.

[Postoperative gastritis due to alkaline reflux. Our results]. / Gastritis postquirúrgica por reflujo alcalino. Nuestros resultados.

We present the results of a retrospective study carried out on 23 patients with alkaline gastric reflux (AGR) verified through endoscopy, biopsies and Tc99m HIDA, which were operated on in our department with Y of Roux, Braun, Henley as the correction techniques of this pathology. The criteria of surgical indications were evaluated in these patients as also the results obtained in reference to residual symptoms and changes in the histologic and gammagraphic patterns.

[Systemic mastocytosis]. / Mastocitosis sistémica.

We record a case of systemic mastocytosis in a 70 year old male whose clinical picture started with abdominal symptomatology (pain and diarrhea) and syncopal episodes, who was found to have hepatosplenomegaly and skin, bone and bone-marrow involvement. Papulo-erythematous lesions appeared over the scar tissue of a previous colyscectomy. Scratching of these lesions produced urtication. Histologically an infiltration of mastocytes was found, being compatible with the diagnosis of systemic mastocytosis with Köebner's phenomenon. We review the most remarkable characteristics of systemic mastocytosis.

[Angiodysplasia of the colon. Apropos of 2 cases]. / Angiodisplasia de colon. A propósito de dos observaciones.

Angiodysplasia of the colon is a vascular lesion which involves the arterioles, venules and small venous vessels; usually it is a lesion of the aged and presents with rectorrhagia, melena or chronic anemia due to chronic blood loss. We present two cases of angiodysplasia of the colon in two female patients in the eighth decade of their lives, treated in the Servicio de Cirugía del Hospital Universitario Virgen Macarena de Sevilla. We emphasize the value of the angiographic study for the diagnosis of this lesion, and also the usefulness of isotopic study with labeled erythrocytes for the localization. The treatment of choice is surgical resection of the affected area. It was performed in both patients. One of them died.