ETV6-NTRK3-positive parotid mammary analogue secretory carcinoma: a case report.

INTRODUCTION: Mammary analogue secretory carcinoma (MASC) is a recent discovered entity of salivary glands tumors, reported for first time in 2010. The presence of a translocation encodes the ETS variant transcription factor 6-neurotrophic tyrosine receptor kinase (ETV6-NTRK3) gene fusion differences MASC from other tumors. CASE PRESENTATION: A 68-year-old male showed a non-painful right parotid enlargement, came from dermatology service, and followed by some facial squamous cell carcinomas. A computed tomography (CT) scan showed a 1.7×1.6 cm right parotid enlargement in superficial lobe. The patient underwent a right superficial parotidectomy. The final pathology confirmed the presence of ETV6-NTRK3-positive MASC. Complete right deep parotidectomy and functional cervical emptying were performed. DISCUSSIONS AND CONCLUSIONS: It is necessary to establish an appropriated differential diagnosis between salivary gland tumors. MASC is a low-grade malignancy cancer that sometimes can evolve to a high-grade tumor that might produce local and distance dissemination. Most times, these tumors are only treated by surgical resection and evaluating by a multidisciplinary team the need of more treatments. In our case, the patient showed a primary parotid tumor, removed surgically with free edges, and being identified as MASC. We decided to underwent neck dissection and discovered a second MASC focus on cervical salivary gland; however, there was no nodal dissemination. The patient remains disease-free after 14 months from last surgery. It is important to keep studying genetic therapy targets to ETV6-NTRK3 to obtain a new therapy line to treat those cases that require.

Tumores que recuerdan a las células de los cordones sexuales (UTROSCT): exposición de un caso clínico y revisión de la literatura / Uterine tumors resembling ovarian sex cord tumors (UTROSCT): case report and review of the literature

Los tumores uterinos que recuerdan a las células de los cordones sexuales son una entidad clínica rara, clasifica-dos en tipo I (tumores del estroma endometrial con elementos de las células que recuerdan a las células de los cordones sexuales del ovario) y tipo II (tumores uterinos que recuerdan a las células de los cordones sexuales del ovario). Lo más frecuente es el hallazgo casual en una pieza quirúrgica y en el contexto de una metrorragia perimenopáusica. Aunque los tumores uterinos que recuerdan a las células de los cordones sexuales son tumores de baja malignidad y de escasa recurrencia, no hay consenso sobre la radicalidad del tratamiento. Se presenta un caso clínico de un hallazgo anatomopatológico tras una histerectomía compatible con tumores uterinos que recuerdan a las células de los cordones sexuales en el contexto de un útero miomatoso en una paciente de 46 años con historia de hipermenorreas y dolor pélvico

Uterine tumors resembling the sex cord cells are a rare clinical entity, classified as type I (Endometrial stromal tumor with sex-cord-like elements [ESTSCLE]) and type II (Uterine tumors resembling ovarian sex cord tumors [UTROSCT]). Most often it found incidentally in a surgical specimen and in the context of a perimenopausal ute-rine bleeding. Although uterine tumors resembling the sex cord cells are generally low-grade tumors and low recurrence, there is no clinical consensus on how much should be radical treatment. A case of a pathological finding occurs after abdominal hysterectomy compatible with uterine tumors resembling the sex cord cells in the context of a fibroid uterus in a 46-year woman with a history of hipermenorreas and pelvic pain

Edema palpebral como manifestación inicial de granulomatosis de Wegener / Eyelid oedema as an initial manifestation of Wegener's granulomatosis

No disponible

Application of quality tools in the management of a gynecologic surgery program: impact on outcomes / Impacto en los resultados en salud de incorporar herramientas de calidad a la gestión del programa quirúrgico en ginecología

Objective: To study the outcomes of various types of hysterectomy over a 12-year period (2002-2015) in the Department of Obstetrics and Gynecology at a public tertiary care hospital in Las Palmas de Gran Canaria. Design: Retrospective cohort study. Study population: Patients scheduled to undergo abdominal hysterectomy, vaginal hysterectomy, or laparoscopic hysterectomy for both benign and malignant disease. Outcome measures: Primary diagnosis, mean hospital stay, surgery-related variables, and perioperative complications (organ injury, infections, venous thromboembolism, hemorrhage, reintervention). Results: The rate of minimally invasive hysterectomy procedures (laparoscopic or vaginal) increased from 27% to 45% (p < 0.0001). The overall complication rate decreased from 38.2% to 14.5% (p < 0.0001). On the whole, surgery-related infectious morbidity decreased from 19.9% to 4% (p < 0.0001). The frequency of major hemorrhages requiring blood transfusion decreased significantly from 15.5% to 4.7% (p < 0.0001). Mean hospital stay decreased for both abdominal and vaginal hysterectomies (from 8.4 to 5 days and from 6 to 3.4 days respectively, p < 0.0001). Conclusions: The rate of postoperative complications decreased significantly over the 12-year study period. Today, hysterectomy is a safer procedure than 15 years ago (AU)

Objetivo: evaluar la evolución experimentada en 10 años de los resultados en el procedimiento de histerectomía para un mismo servicio, el servicio de obstetricia y ginecología del Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, centro sanitario público de tercer nivel. La hipótesis de estudio es que los cambios introducidos en la práctica quirúrgica y cuidados de los pacientes han sido determinantes para conseguir mejorar los resultados en salud. Diseño: estudio de cohortes retrospectivo. Población: pacientes a las que se les realizó histerectomía en nuestro centro por alguna de las tres vías de abordaje (laparotómica, vaginal y laparoscópica) en procesos oncológicos y no oncológicos. Variables estudiadas: diagnóstico que motivó la intervención, complicaciones quirúrgicas atribuidas a la realización de la histerectomía (infección, lesión de órgano, hemorragia, reintervención, etc.), estancia media del ingreso. Resultados: el número de histerectomías realizadas por abordaje menos invasivos (vaginal o laparoscópica) se incrementó del 27% al 45% (p < 0,0001). La tasa global de complicaciones asociada al programa de histerectomías disminuyó de 38,2% a 14,5% p < 0,0001. La incidencia de morbilidad infecciosa evolucionó de un 19,9% a un 4% p < 0,0001; la incidencia de hemorragia que precisó transfusión pasó de un 15,5% a un 4,7% p < 0,0001. La estancia media asociada al procedimiento disminuye de 8,4 a 5 días para las histerectomías abdominales y de 6 a 3,4 días para las histerectomías por vía vaginal p < 0,0001. Conclusiones: realizar una histerectomía hoy en nuestro centro es más seguro que hace 10 años. La tasa global de complicaciones asociadas al procedimiento de histerectomía disminuyó en nuestro servicio de forma notable en la última década (AU)

Alterations in the expression of p53, KLF4, and p21 in neuroendocrine lung tumors.

CONTEXT: Neuroendocrine lung neoplasms are a heterogeneous group of tumors with different clinical behavior and prognosis. OBJECTIVES: To evaluate the expression of p53, KLF4, and p21 in neuroendocrine lung neoplasms and to analyze the influence that expression has on the prognosis of those tumors. DESIGN: All neuroendocrine lung neoplasms (N = 109) resected in our institution were reviewed, with the collection of histologic slides and paraffin blocks of 47 typical carcinoids (43%), 9 atypical carcinoids (8%), 35 large cell neuroendocrine carcinomas (32%), and 18 small cell lung carcinomas (17%), as well as 10 tumorlets (100%). Four tissue microarrays were performed. Follow-up was assessed in all cases (119 of 119; 100%). RESULTS: p53 protein immunostaining results were negative in both the tumorlets and typical carcinoids and were overexpressed in 11% (1 of 9) of the atypical carcinoids and in 68% (36 of 53) of the carcinomas. KLF4 results were positive in all tumorlets (10 of 10; 100%), 32% (15 of 47) of the typical carcinoids, 44% (4 of 9) of the atypical carcinoids, and 62% (33 of 53) of the carcinomas. p21 expression did not differ among the groups. The lack of KLF4 and p21 expression was associated with an accumulation of aggressive features in typical carcinoids (P = .04 and P = .004, respectively, Fisher exact test). CONCLUSIONS: p53, KLF4, and p21 showed altered expression patterns in pulmonary neuroendocrine neoplasms. Lack of KLF4 and p21 expression was associated with accumulation of aggressive features in typical carcinoids.

Epstein-Barr virus-associated adenocarcinomas and squamous-cell lung carcinomas.

The association of Epstein-Barr virus with pulmonary neoplasms has been restricted to lymphoepithelioma-like carcinomas in Asian patients. We have selected 19 pulmonary adenocarcinomas and squamous-cell carcinomas from 1545 pulmonary neoplasms diagnosed from 1996 to 2007 in an occidental population. All of them showed a low-power appearance confusing between an epithelial and a lymphoid neoplasm, with a dense lymphocytic infiltrate intermingled with neoplastic cells giving an image akin to lymphoepithelial complexes. Five carcinomas presented typical features of Lymphoepithelioma-like lung carcinomas; but six cases could be classified as squamous-cell carcinomas and eight as adenocarcinomas. A semiquantitative polymerase chain reaction method, Early RNA genes 1 and 2 in situ hybridization as well as Latent membrane protein immunostaining for Epstein-Barr virus DNA, RNA and protein detection methods were used in every case. None of Lymphoepithelioma-like carcinomas showed positivity for Epstein-Barr virus in any used method. Otherwise four squamous-cell carcinomas and eight adenocarcinomas (12 cases) demonstrated viral sequences in polymerase chain reaction and/or in situ hybridization analysis in neoplastic cells. Moreover two adenocarcinomas also displayed human herpesvirus 6 DNA sequences coamplification in molecular analysis. Protein immunostaining was focally positive in only three cases. We performed the same analysis in 70 more cases of conventional pulmonary squamous-cell carcinomas and adenocarcinomas that gave negative results. In conclusion, a subset of pulmonary squamous-cell carcinomas and adenocarcinomas show Epstein-Barr DNA and/or RNA sequences in neoplastic cells. This finding expands the spectra of epithelial cell common tumours Epstein-Barr virus associated.