Sellar and suprasellar mixed germ cell tumor mimicking a pituitary adenoma.

Germ cell tumors (GCT) are a heterogeneous group of lesions whose origin is not well established. Several cases of primary intrasellar germinomas have been reported, however non-germinomatous GCT have rarely been described. We report the case of a young adult male patient with a mixed GCT that presented with a sellar tumor with suprasellar extension. The patient seeked medical attention because of seizures and magnetic resonance imaging evidenced a tumor of the sellar region. Hyperprolactinemia was also present and dopamine agonist therapy was started. As there was a rapid tumor growth and the patient had concomitant central diabetes insipidus and elevated testosterone levels, a GCT was suspected and confirmed by elevated serum concentration of ß-human chorionic gonadotrophin. Patient underwent surgical resection of the tumor and histopathological examination confirmed the diagnosis of a mixed GCT. Chemotherapy was initiated, followed by conventional radiotherapy. In conclusion, although pituitary adenomas respond for the vast majority of sellar tumors, concomitant symptoms such as central diabetes insipidus and rapid tumor growth should raise the suspicion of a diverse diagnosis. The present report intend not only to show a rare case of sellar and suprasellar mixed GCT but also to remind clinicians that if laboratory findings do not fit into patient's diagnosis (such as high testosterone levels in our patient), then the diagnosis should be reviewed.

[Mixed carcinoid-adenocarcinoma in transverse colon]. / Tumor mixto carcinoide-adenocarcinoma de colon transverso.

The following case is a 69-year-old woman with a presumptive diagnosis of adenocarcinoma in transverse colon, which was diagnosed by pathology as a mixed carcinoid-adenocarcinoma tumor after surgery. We have found very few cases published of this type of tumor in the colon (around 20) but not cases in the transverse colon. We discuss in the following report the diagnosis, the therapeutic conduct and its results. We point out with particular consideration that, due to the lack of information related to the functional behaviour and clinical characteristics of these mixed tumors, more studies, analysis, follow-up and descriptions are necessary to perform future diagnosis and therapeutic procedures.

Malignant mixed Mullerian tumor of the uterine cervix with neuroendocrine differentiation.

Malignant mixed Mullerian tumors (MMMTs) are rare neoplasms. We report the clinical, pathologic, and immunohistochemical features of an MMMT primary of uterine cervix. This lesion was composed of a poorly differentiated epithelial component (cytokeratin positive) and a spindle cell component (vimentin positive) with heterologous (myoblastic) differentiation (focal 1A4 positive). There were also cells with neuroendocrine features that expressed S-100 and chromogranin A. Along with a brief review of this amazing neoplasm, some histogenetic concepts relevant to this case are discussed. To our knowledge this is the first report of a malignant mixed Mullerian tumor of the uterine cervix with neuroendocrine differentiation.

Retinoblastoma / Retinoblastoma

Estudio realizado en el Instituto Nacional de Oftalmologia sobre los casos de retìnoblastoma en los ultimo diez años para conocer su frecuencia, distribuciòn por sexo, edad y estudio clìico en el que llegan a la consulta especializada. Se encontro un alto porcentaje de casos avanzados y terminales. Es importante recalcar que por ser un tumor altamente maligno el diagnòstico precoz conlleva un pronòstico màs alentador gracias a los avances en el tratamiento radio y quimioteràpico