Fibromatosis agresiva de cabeza y cuello en la edad pediátrica. Un caso clínico y revisión de la literatura / Aggressive fibromatosis of the head and neck in pediatric age. A case report and review of the literature

Introducción. El tumor desmoide es una neoplasia mesenquimal benigna rara en la edad pediátrica, originada principalmente en el tejido conectivo de músculos y aponeurosis. Con frecuencia, es mal diagnosticada como fibromas, procesos reactivos o fibrosarcomas de bajo grado. Se caracteriza por un crecimiento lento, localmente agresiva y con una alta tasa de recurrencia sin capacidad de metastatizar. Material y método. Niña de 7 años con tumoración para mandibular derecha de un año de evolución. Se caracterizaba por un crecimiento lento e indoloro, trismus y latero-desviación mandibular a la izquierda durante la apertura oral. Las pruebas de imagen mostraban tumor departes blandas en región maseterina con una reacción perióstica en el cuerpo mandibular. La biopsia informó de tumor desmoide. Resultados. Se realizó abordaje de Risdon para la exéresis tumoral más Split de cortical externa de cuerpo mandibular sin poder preservarla rama marginal del VII par craneal (PC). La anatomía patológica informó de fibromatosis agresiva sin afectación ósea. Actualmente presenta parálisis marginal y está libre de enfermedad. Conclusiones. Los tumores desmoides de cabeza y cuello son difíciles de tratar debido a la proximidad o implicación de estructuras vitales, su naturaleza infiltrativa y la tendencia a la recurrencia local. La cirugía primaria con márgenes quirúrgicos negativos es el tratamiento de elección. Sin embargo, en muchos casos esto implica cirugías (..) (AU)

Background. Desmoid tumor is a rare benign mesenchymal neoplasmin children primarily originated in the muscle connective tissue, fascial sheaths, and musculoaponeurotic structures. It is often misdiagnosed as fibroids, reactive processes or low-grade fibro sarcomas. It is characterized by slow growth, locally aggressive nature, high recurrence rate without metastasize capacity. Material and methods. 7 year old girl with right (..) (AU)

[Aggressive fibromatosis of the head and neck in pediatric age. A case report and review of the literature]. / Fibromatosis agresiva de cabeza y cuello en la edad pediátrica. Un caso clínico y revisión de la literatura.

BACKGROUND: Desmoid tumor is a rare benign mesenchymal neoplasm in children primarily originated in the muscle connective tissue, fascial sheaths, and musculoaponeurotic structures. It is often misdiagnosed as fibroids, reactive processes or low-grade fibrosarcomas. It is characterized by slow growth, locally aggressive nature, high recurrence rate without metastasize capacity. MATERIAL AND METHODS: 7 year old girl with right paramandibular tumor, a year of evolution. It was characterized by slow and painless growth, trismus and mandibular latero-deviation to the left during mouth opening. Imaging tests showed soft parts tumor in masseteric region with a periosteal reaction in the mandibular body. The biopsy reported a desmoid tumor. RESULTS: Risdon approach was performed for tumor resection and external cortical Split mandibular body, without preserving the marginal branch of CP VII. The pathology reports of aggressive fibromatosis without bone involvement. It currently presents marginal paralysis and free-disease. CONCLUSIONS: Desmoid tumors of head and neck are difficult to treat because of the proximity or involvement in vital structures, infiltrative nature and tendency to local recurrence. Primary surgery with negative surgical margins is the treatment of choice. However, in many cases this involves disfiguring surgery. Therefore, in these cases and in those surgical margins affections, the use of chemotherapy/non-cytotoxic drugs can be an alternative. Because they are low incidence tumors prospective multicenter studies are needed to clarify the role of adjuvant treatment in this tumor.

Maxillofacial metastasis of genitourinary origin. A report of 3 cases and review of the literature.

INTRODUCTION: The maxillofacial region can harbour a wide range of primary tumours, as well as secondary tumours spreading from distant sites. Rare, though nevertheless important among the latter are genitourinary tumours, such as clear cell renal carcinoma and cervical cancer. Diagnosis of the maxillofacial metastasis sometimes precedes that of the original site, though in other cases the metastasis may arise many years after treatment of the primary tumour. CASE REPORT: We present three cases of maxillofacial metastasis of genitourinary tumours, two clear cell renal adenocarcinoma and squamous cell carcinoma of the uterine cervix. The patients were referred our hospital service for diagnosis and treatment, after having been initially evaluated for buccodental symptoms. DISCUSSION: The appearance of a maxillofacial tumour, initially with the aspect of a primary tumour, may sometimes be the consequence of haematogenous dissemination from another site, such as these surprising cases originating in the genitourinary area. If disseminated metastatic disease is suspected, an extensive oncological screening should be done to evaluate the best therapeutic option in each patient.

Leiomiosarcoma intraóseo mandibular / Mandibular intraosseous leiomyosarcoma

Los leiomiosarcomas son neoplasias malignas mesenquimalesderivadas del músculo liso. Los leiomiosarcomas intraóseos mandibularesprimarios son muy raros. Se cree que proceden de la musculatura lisa dela pared de los vasos sanguíneos. Pueden presentarse a cualquier edad, sinninguna predilección y afectan preferentemente a hombres, con una relaciónhombre-mujer de 2:1. La excisión quirúrgica completa está asociadacon una menor recidiva y mayor supervivencia. La radioterapia es efectivaen el tratamiento de la enfermedad microscópica residual. Presentamosel caso de un leiomiosarcoma intraóseo mandibular(AU)

Leiomyosarcomas are malignant mesenchymalneoplasms of smooth muscle differentiation. Leiomyosarcomasoccurring in the jawbones are exceedingly rare, andare believed to arise from the musculature of the tunica ofblood vessels. Intraoral cases may present at any age withno predilection for any age group. They occur predominantlyin males, with a male to female ratio of approximately 2:1.Complete surgical excision is associated with low recurrenceand longer survival. Radiotherapy is effective in the treatmentof microscopic disease(AU)

Análisis y puesta en marcha de un modelo de alta resolución en cirugía maxilofacial / Analysis and launching of a high-resolution model in maxillofacial surgery

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Reingeniería de empresa en el hospital. Aplicación en el Hospital Civil de Málaga - C.H. Carlos Haya / Company re-engineering in the hospital. Application in the Civil Hospital of Málaga - C.H. Carlos Haya

Se presenta en este trabajo un análisis de la reestructuración de un centro hospitalario, el Hospital Civil del Complejo Hospitalario Carlos Haya de Málaga, abarcando el período 1996-2000, en el que se ha utilizado el concepto y el método de la reingeniería de empresas aplicándola a un medio hospitalario. El método utilizado ha sido descriptivo aunque sin embargo para la realización del cambio se han utilizado modelos prospectivos en los que han participado los autores (AU)

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[Miniplates in the treatment of mandibular fractures]. / Miniplacas en el tratamiento de fracturas de mandíbula.

We present in this paper the treatment of mandibule fractures with miniplates of titanium. The miniplates have provided stable fixation and compared with other techniques improved in all concepts. The complication rates have been very low: there were not infections. The stability of fixation avoid to block with elastic training. Therefore, meticulous techniques is mandatory with particular emphasis in passive fitling of the plates.