Tos e infiltrados pulmonares. Un final inesperado / Pulmonary infiltrates and cough. An unexpected end

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[Unusual cervical cyst. Adenocarcinoma ex-pleomorphic adenoma of a minor salivary gland]. / Quiste cervical inusual. adenocarcinoma ex-adenoma pleomorfo de glándula salival menor.

Cysts with an origin in a malignant tumour of the cervical region are rare. It is even more uncommon that the malignant tumour has its origin in a minor salivary gland as it is the malignant transformation of a pleomorphic adenoma. Some considerations are made regarding its localization, histopathology, diagnosis and therapeuthic attitude, as well as some advices to take into account in order to arrive to the diagnosis and correct treatment in similar cases to the one shown.

Quiste cervical inusual. Adenocarcinoma ex-adenoma pleomorfo de glándula salival menor / Unusual cervical cyst. Adenocarcinoma ex-pleomorphic adenoma of a minor salivary gland

Los quistes con origen en un tumor maligno de la región cervical son poco frecuentes. Es aún más raro que el tumor maligno se origine en una glándula salival menor y sea la transformación maligna de un adenoma pleomorfo. Se hacen algunas consideraciones sobre su localización, histopatología, diagnóstico y actitud terapéutica, así como algunos consejos a tener en cuenta para llegar al diagnóstico y tratamiento correcto en casos similares al presentado

Cysts with an origin in a malignant tumour of the cervical region are rare. It is even more uncommon that the malignant tumour has its origin in a minor salivary gland as it is the malignant transformation of a pleomorphic adenoma. Some considerations are made regarding its localization, histopathology, diagnosis and therapeuthic attitude, as well as some advices to take into account in order to arrive to the diagnosis and correct treatment in similar cases to the one shown

Amplificación del gen del receptor del factor de crecimiento epidérmico y expresión de la E-cadherina en los carcinomas de cabeza y cuello / Epidermal growth factor receptor gene amplification and e-cadherin expression in head and neck carcinomas

Introducción: La molécula de adhesión E-cadherina tiene un papel fundamental en el mantenimiento de la morfología y diferenciación epiteliales normales. Se ha sugerido que la dispersión e invasividad de las células cancerosas inducida por la activación del receptor del factor de crecimiento epidérmico (EGFR) podrían deberse a su acción sobre la E-cadherina. El objetivo de este estudio es determinar si la activación por amplificación del EGFR se relaciona con la expresión de la E-cadherina en los carcinomas epidermoides de cabeza y cuello. Material y métodos: Se estudian 50 pacientes con carcinoma epidermoide de cabeza y cuello. La determinación de la amplificación del EGFR se realizó mediante PCR semicuantitativa. La expresión de la E-cadherina se estudió con técnicas de inmunohistoquímica. Resultados: Se halló amplificación del EGFR en 9 casos (18 por ciento). La expresión de la E-cadherina en las muestras tumorales mostró, en general, una disminución con relación al epitelio normal adyacente. No se observó relación entre la amplificación del EGFR y la expresión de la Ecadherina. Conclusión: La amplificación del EGFR no tuvo influencia en la expresión de la E-cadherina, sugiriendo que se trata de mecanismos complementarios en la disminución de la adhesión celular en los carcinomas epidermoides de cabeza y cuello (AU)

INTRODUCTION: The E-cadherin adhesion molecule is fundamentally involved in the maintenance of normal epithelial morphology and differentiation. The scattering and invasion of cancer cells induced by epidermal growth factor receptor (EGFR) activation has been suggested to be probably by affecting E-cadherin function. The aim of this study is to confirm whether EGFR amplification is related to E-cadherin expression in head and neck squamous cell carcinomas. MATERIAL AND METHODS: Fifty patients with head and neck squamous cell carcinoma were studied. EGFR amplification was analyzed by semiquantitative PCR. E-cadherin expressión was determined by immunohistochemistry. RESULTS: EGFR amplification was found in 9 cases (18%). E-cadherin expression was generally weaker in tumors than in adjacent normal epithelium. No relationship was found between EGFR amplification and E-cadherin expression. CONCLUSION: EGFR amplification did not affect the level of E-cadherin expression, suggesting a complementary role of both of these molecules in reduction of cellular adhesion in head and neck squamous cell carcinomas (AU)

Cómo puede evaluar el patólogo si la exéresis del meso-recto y del carcinoma rectal ha sido adecuada / No disponible

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[Epidermal growth factor receptor gene amplification and E-cadherin expression in head and neck carcinomas]. / Amplificación del gen del receptor del factor de crecimiento epidérmico y expresión de la E-cadherina en los carcinomas de cabeza y cuello.

INTRODUCTION: The E-cadherin adhesion molecule is fundamentally involved in the maintenance of normal epithelial morphology and differentiation. The scattering and invasion of cancer cells induced by epidermal growth factor receptor (EGFR) activation has been suggested to be probably by affecting E-cadherin function. The aim of this study is to confirm whether EGFR amplification is related to E-cadherin expression in head and neck squamous cell carcinomas. MATERIAL AND METHODS: Fifty patients with head and neck squamous cell carcinoma were studied. EGFR amplification was analyzed by semiquantitative PCR. E-cadherin expressión was determined by immunohistochemistry. RESULTS: EGFR amplification was found in 9 cases (18%). E-cadherin expression was generally weaker in tumors than in adjacent normal epithelium. No relationship was found between EGFR amplification and E-cadherin expression. CONCLUSION: EGFR amplification did not affect the level of E-cadherin expression, suggesting a complementary role of both of these molecules in reduction of cellular adhesion in head and neck squamous cell carcinomas.

[Genetic alterations in sinonasal adenocarcinoma in wood workers studies with comparative genomic hybridization]. / Alteraciones genéticas en adenocarcinomas nasosinusales de trabajadores de la madera mediante hibridación genómica comparativa.

Eleven wood-workers with sinonasal adenocarcinoma were analyzed by comparative genomic hybridization. This technique serves as a screening test for regions of copy number changes in tumor genomes. We have applied the technique to map DNA gains and losses in 9 cases of formalin-fixed, paraffin-embedded tumors and 2 cases of frozen tumors. Gains were found most frequently than losses. Whole arm chromosomic gains were detected in high frequencies at 8q, 7q, 12q and 18p and losses at 18q, 8p, 10q, 5q, 14q and 17p. The segment most frequently amplified was 18p11.1-q11 (45%), even though others like 7q21-22 (18%) were related with lower survival rates. This analysis allows us to know for the first time the chromosomic aberrations that occur and may play an important role in sinonasal adenocarcinoma. In the future, comparative genomic hybridization could be used in the woodworkers with long exposition to wood dust to detect initial genetic aberrations and obtain an early treatment and diagnosis of the disease.

Alteraciones genéticas en adenocarcinomas nasosinusales de trabajadores de la madera mediante hibridación genómica comparativa / Genetical disorders in sinonasal adenocarcinomas in wood-workers by comparative genomic hybridization

Se estudian 11 pacientes trabajadores de la madera que desarrollaron adenocarcinomas nasosinusales. Se utilizó la hibridación genómica comparativa como método de análisis en el conjunto del contenido genómico en 9 tumores parafinados y 2 tumores congelados.Encontramos alteraciones en todos los casos predominando las ganancias cromosómicas frente a las pérdidas. Las ganancias más frecuentes de brazos cromosómicos se observan en 8q, 7q, 12q y 18p y las pérdidas o deleciones en 18q, 8p, 10q, 5q, 14q y 17p. El mayor número de amplificaciones se encontró en 18p11.1-q11 (45 por ciento), aunque otras como 7q21-22 (18 por ciento) se relacionaron con menor supervivencia. Por primera vez, este análisis permite conocer las alteraciones cromosómicas ocurridas en los adenocarcinomas nasosinusales y es un primer paso en el diseño de un modelo de progresión. En un futuro, la hibridación genómica comparativa podría ser utilizada en trabajadores expuestos al polvo de madera para detectar las alteraciones genéticas iniciales y contribuir al diagnóstico y tratamiento precoz de la enfermedad. (AU)

Eleven wood-workers with sinonasal adenocarcinoma were analyzed by comparative genomic hybridization. This technique serves as a screening test for regions of copy number changes in tumor genomes. We have applied the technique to map DNA gains and losses in 9 cases of formalin-fixed, paraffin-embedded tumors and 2 cases of frozen tumors. Gains were found most frequently than losses. Whole arm chromosomic gains were detected in high frequencies at 8q, 7q, 12q and 18p and losses at 18q, 8p, 10q, 5q, 14q and 17p. The segment most frequently amplified was 18p11.1-q11 (45%), even though others like 7q21-22 (18%) were related with lower survival rates. This analysis allows us to know for the first time the chromosomic aberrations that occur and may play an important role in sinonasal adenocarcinoma. In the future, comparative genomic hybridization could be used in the woodworkers with long exposition to wood dust to detect initial genetic aberrations and obtain an early treatment and diagnosis of the disease (AU)

Significado pronóstico de la expresión de las moléculas de adhesión e-cadherina, cd44s y cd44v6 en los carcinomas epidermoides supraglóticos / Pronostic significance of the expression of adhesion molecules e-cadherin, cd44s and cd44v6 in supraglottic squamous cell carcinomas

Objetivo: Determinar el valor pronóstico de la expresión de las moléculas de adhesión E-cadherina, CD44s y CD44v6 en los carcinomas epidermoides supraglóticos. Material y métodos: La determinación de la expresión de las moléculas a estudio se realizó mediante inmunohistoquímica en muestras incluidas en parafina de 101 pacientes. Resultados: La expresión de las tres moléculas se hallaba reducida en los carcinomas en comparación con el epitelio normal. Los casos con recidiva presentaron una expresión de la E-cadherina y de la CD44s significativamente menor que los casos sin recidiva. La disminución de la expresión de cualquiera de las tres moléculas se relacionó con una peor supervivencia, aunque las diferencias no fueron significativas. En el estudio multivariante sólo el estadio ganglionar (N) fue un factor pronóstico independiente. Conclusiones: Aunque la disminución de la expresión de las moléculas E-cadherina, CD44s y CD44v6 parece indicar un peor pronóstico en los carcinomas epidermoides supraglóticos, su utilidad es inferior a la de los indicadores clásicos (AU)

OBJECTIVE: To establish the prognostic significance of the expression of adhesion molecules E-cadherin, CD44s and CD44v6 in squamous cell carcinomas of the supraglottic larynx. MATERIAL AND METHODS: The expression of the studied molecules was determined by immunohistochemistry in paraffin-embedded tissue specimens from 101 patients. RESULTS: The expression of the three molecules was reduced in carcinomas compared to normal epithelium. The cases with recurrence showed an E-cadherin and CD44s expression significantly lower than those cases without recurrence. Reduced expression of any of the three molecules correlated with a decrease in survival, although the differences were not significant. In multivariate analysis only nodal stage (N) was an independent prognostic factor. CONCLUSIONS: Although reduced expression of E-cadherin, CD44s and CD44v6 seems to be related to a poor prognosis in supraglottic squamous cell carcinomas, these changes do not offer a useful adjunct to current prognostic indicators (AU)

[Chronic granulomatous endophthalmitis. Clinical-pathological correlation]. / Endoftalmitis crónica granulomatosa. Correlación clínico-patológica.

CASE REPORT: The authors present the case of a patient with a painful eye secondary to a non-perforating traumatism sustained in the past which, at the time of the injury, had caused a post-traumatic cataract, corneal lesions and a secondary glaucoma. The structural damage of the ocular content, associated with a well preserved size and external shape, made the diagnosis more difficult, requiring additional diagnostic methods. The pathological findings are also presented. DISCUSSION: The authors present the available diagnostic methods for those cases with chronic inflammation in which direct examination of the ocular content is not feasible, and it is mandatory to exclude vital threatening pathologies.

Endoftalmitis crónica granulomatosa. Correlación clínico-patológica / Chronic granulomatous endophthalmitis. Clinical-pathological correlation

Caso clínico: Paciente afectado por un traumatismo no perforante antiguo en su ojo izquierdo que provoca una catarata traumática, lesiones corneales y glaucoma secundario y que presenta años después una evolución tórpida y dolorosa. La desestructuración del contenido ocular con conservación del tamaño y forma del globo obliga a efectuar un diagnóstico mediante medios auxiliares, presentándose los hallazgos anatomopatológicos. Discusión: Presentamos las posibilidades diagnósticas que existen en casos de inflamaciones crónicas en las cuales no sea posible el examen directo del interior del ojo a fin de descartar patología de importancia vital (AU)

[Prognostic significance of the expression of adhesion molecules E-cadherin, Cd44s and CD44V6 in supraglottic squamous carcinoma]. / Significado pronóstico de la expresión de las moléculas de adhesión E-cadherina, CD44s y CD44V6 en los carcinomas epidermoides supraglóticos.

OBJECTIVE: To establish the prognostic significance of the expression of adhesion molecules E-cadherin, CD44s and CD44v6 in squamous cell carcinomas of the supraglottic larynx. MATERIAL AND METHODS: The expression of the studied molecules was determined by immunohistochemistry in paraffin-embedded tissue specimens from 101 patients. RESULTS: The expression of the three molecules was reduced in carcinomas compared to normal epithelium. The cases with recurrence showed an E-cadherin and CD44s expression significantly lower than those cases without recurrence. Reduced expression of any of the three molecules correlated with a decrease in survival, although the differences were not significant. In multivariate analysis only nodal stage (N) was an independent prognostic factor. CONCLUSIONS: Although reduced expression of E-cadherin, CD44s and CD44v6 seems to be related to a poor prognosis in supraglottic squamous cell carcinomas, these changes do not offer a useful adjunct to current prognostic indicators.

[Fetus-in-fetu in male adult. Report of an exceptional case and review of the literature]. / Fetus-in-fetu en varón adulto. Descripción de un caso excepcional y revisión de la literatura.

The name fetus-in-fetu designates the presence of a tumoral mass containing a homunculus. Fewer than 70 cases have been reported in the literature since its first description about 1800. This entity usually presents in childhood and it is exceptional in adult life. There is an interesting debate regarding its origin and mainly its relationship with teratomas and the normal process of twin formation. We report here a case seen and treated at our institution with a review of the literature and some hypothesis on its development.

[Small cell-sarcomatoid carcinoma of the urinary bladder]. / Carcinoma de célula pequeña-sarcomatoide de vejiga urinaria.

OBJECTIVES: Oat cell carcinoma of the urinary bladder is extremely uncommon. To date, 87 cases have been reported in the literature. Histologically, these tumors are similar to oat cell carcinoma of the lung and in slightly more than half of the cases the tumor is associated with another carcinomatous component: urothelial, squamous carcinoma, adenocarcinoma or, more rarely, sarcomatoid carcinoma. A case of sarcomatoid small cell carcinoma is described herein. METHODS/RESULTS: We report a case of sarcomatoid small cell carcinoma of the urinary bladder in a 79-year-old female patient. The tumor was in the advanced stages and was unamenable to resection. The patient was treated with multi-drug systemic chemotherapy, but she died five months after diagnosis. Light microscopy disclosed a carcinomatous component similar to oat cell carcinoma of the lung that stained with epithelial and neuroendocrine markers. The sarcomatoid component was histologically nondescript and showed extensive immunoreactivity to mesenchymal and epithelial markers. CONCLUSIONS: Sarcomatoid small cell carcinoma of the bladder is rare. To our knowledge, only five cases have been previously reported. It is aggressive, metastasizes early and has a poor diagnosis. Surgical resection with adjuvant multidrug systemic chemotherapy is currently the best available treatment.

[Internal jugular thrombophlebitis: complications of the cervical oncological surgery. A case report]. / Tromboflebitis de la yugular interna: complicación de la cirugía oncológica cervical. Presentación de un caso.

Internal jugular vein thrombophlebitis is an infrequent complications, associated in the past to pharyngeal and amygdaline infections but related today to the use of catheters and intravenous drugs. The present paper reports the case of a patient who underwent total laryngectomy and functional neck dissection, developing recurrent neumonias and sepsis in the postoperative period which were secondary to an homolateral jugular thrombophlebitis. A physical exploration with no findings and the poor resolution of CT scan and ultrasound due to postsurgical alterations, lead to a late diagnosis and fatal evolution, in spite of the medical and surgical treatment.

[Primary leiomyosarcoma of the liver]. / Leiomiosarcoma primario de hígado.

We report a case of primary hepatic leiomyosarcoma in a 70 years old woman presenting with hepatomegaly, right upper quadrant pain and impairement of general status. A left hemihepatectomy was undertaken revealing a single tumor of 7 cm in diameter in the left hepatic lobe. An immunohistochemycal study was performed indicating the smooth muscle nature of the tumor. The patient died 6 months later without evidence of active tumoral disease. This is the 28th report on primary leiomyosarcoma of the liver in the world literature.

[Effect of overexpression of P53 protein in colorectal carcinoma on short-term prognosis]. / Influencia en el pronóstico a corto plazo de la sobreexpresión de la proteína P53 en carcinomas colorrectales.

BACKGROUND AND METHODS: p53 protein expression was studied immunohistochemically in 73 colorectal adenocarcinomas, using monoclonal antibody D07 in alcohol fixed, paraffin embedded tissue. RESULTS: Immunoreactivity was found in 49% of specimens, detected in the nuclei of the cancer cells. There was no significant correlation between the expression of p53 and the clinicopathological parameters age, sex, tumor size and site, lymphatic invasion, and lymph node metastasis. However, the p53 overexpression correlated with stage of disease, histologic grade, vascular invasion and with the presence of villous or tubular adenomas in the resected specimens. The p53 positive tumors showed a higher rate of recurrence than the p53 negative tumors; however, the difference was not statistically significant. The short-term survival rate (follow-up 7-48 months, median 30 months) was 90% for 20 patients with p53 negative tumors, and 65% for the patients with p53 positive tumors; a significant difference in the survival between the two groups of patients was found. CONCLUSIONS: These results suggest that in colorectal carcinoma, immunohistochemical detection of p53 protein can be used along with other established indicators to asses prognostic outcome, specially to identify patients with a poor short-term prognosis.

[Well-differentiated liposarcoma of the spermatic cord with dedifferentiation]. / Liposarcoma bien diferenciado de cordón espermático con desdiferenciación.

We report a case of well-differentiated liposarcoma with dedifferentiation of spermatic cord in a 73-year-old-man. Treatment was by orchiectomy without retroperitoneal lymph node dissection or adjuvant therapy. The patient has survived 10 months with no evidence of recurrence. Liposarcoma localized to the spermatic cord is rare; less than 70 cases have been previously reported. The literature is reviewed with special emphasis on the clinical significance of the dedifferentiation phenomenon.