Decidualización peritoneal y embolización de arterias uterinas en la hemorragia puerperal tras cesárea / Peritoneal deciduosis and uterine artery embolization in puerperal hemorrhage after cesarean section

La decidualización peritoneal es una metaplasia de células peritoneales, que aparece en la gestación por acción de la progesterona. Anatomopatológicamente, son lesiones altamente vascularizadas, por lo que es preciso el diagnóstico definitivo mediante técnicas inmunohistoquímicas para diferenciarlo de tumores malignos. La embolización arterial selectiva es una técnica conservadora para el tratamiento de las hemorragias posparto con mínimos efectos secundarios, que permite la conservación de la fertilidad. Presentamos el hallazgo de una decidualización peritoneal severa durante la realización de una cesárea en una paciente que posteriormente precisó embolización de arterias uterinas por hemorragia puerperal (AU)

Deciduosis peritonei consists of the presence of decidua in the peritoneal surface and develops during pregnancy due to the effect of progesterone. The typical lesions are highly vascularized and immunohistochemical studies are required to exclude a diagnosis of malignancy. Selective arterial embolization is a conservative procedure to treat postpartum hemorrhages with minimal side effects and allows fertility to be preserved. We present a case of severe deciduosis peritonei identified during a cesarean section in a patient who subsequently required embolization of the uterine arteries due to a postpartum hemorrhage (AU)

Breast metastases as the first sign of recurrence of a cutaneous melanoma.

Malignant melanoma is the most rapidly increasing cancer in the world. Metastatic disease occurs in 20% of patients, and prognosis in these cases is poor. We report the case of a woman who presented breast metastasis as the first sign of recurrence of a melanoma.

Breast metastases as the first sign of recurrenceof a cutaneous melanoma

Malignant melanoma is the most rapidly increasingcancer in the world. Metastatic disease occurs in20% of patients, and prognosis in these cases ispoor. We report the case of a woman who presentedbreast metastasis as the first sign of recurrence of amelanoma

CCND1- and ERBB2-gene deregulation and PTEN mutation analyses in invasive lobular carcinoma of the breast.

Because of the relatively low incidence of lobular breast carcinoma, there are very few studies on the molecular characteristics of this breast cancer. In an attempt to improve its characterization, we investigated in a large collection of invasive lobular carcinomas (ILCs) the status of markers known to be involved in the better-studied invasive ductal carcinomas (IDC). In the current study we disposed of 80 well-characterized ILC cases. Gene amplification of cyclin D1 (CCND1) and c-erbB2-encoding gene (ERBB2) and expression of their gene products were studied by differential polymerase chain reaction (PCR) and immunohistochemistry, respectively. A comprehensive point mutation study of the phosphatase and tensin homolog tumor suppressor gene (PTEN) was pursued by single strand conformation polymorphism (SSCP)/sequencing analysis. The CCND1 gene was rarely amplified in ILC in spite of showing overexpression of the protein in 41% of tumors. Hence, unlike IDC, increase in gene dosage did not account for the protein excess. PTEN mutations were detected in ILC (truncating mutations) in around 2% of the tumors. Unlike IDC, ILC did not display ERBB2 overexpression and expression of the transcription factor E2F1 correlated inversely with tumor grade. The observed discrepancy in the pattern of the human oncogenes CCND1 and ERBB2, which are involved in the process of carcinogenesis of ductal tumors, appears to suggest a different molecular basis for development and progression of ILC.