Impact of preoperative levels of hemoglobin and albumin on the survival of pancreatic carcinoma.

INTRODUCTION: Pancreatic cancer presents the worst survival rates of all neoplasms. Surgical resection is the only potentially curative treatment, but is associated with high complication rates and outcome is bad even in those resected cases. Therefore, candidates amenable for resection must be carefully selected. Identification of prognostic factors preoperatively may help to improve the treatment of these patients, focusing on individually management based on the expected response. PATIENTS AND METHODS: We perform a retrospective study of 59 patients with histological diagnosis of pancreatic carcinoma between 1999 and 2003, looking for possible prognostic factors. RESULTS: We analyze 59 patients, 32 males and 27 females with a mean age of 63.8 years. All the patients were operated, performing palliative surgery in 32% and tumoral resection in 68%, including pancreaticoduodenectomies in 51% and distal pancreatectomy in 17%. Median global survival was 14 months (Range 1-110).We observed that preoperative levels of hemoglobin under 12 g/dl (p = 0.0006) and serum albumina under 2.8 g/dl (p = 0.021) are associated with worse survival. CONCLUSION: Preoperative levels of hemoglobin and serum albumina may be prognostic indicators in pancreatic cancer.

Impacto de los niveles preoperatorios de hemoglobina y albúmina en la supervivencia del carcinoma de páncreas / No disponible

Introducción: El cáncer de páncreas presenta la peor tasa de supervivencia de todas las neoplasias. La resección quirúrgica es el único tratamiento potencialmente curativo, pero está grabado con una alta tasa de complicaciones y el pronóstico continúa siendo malo en aquellos casos resecados, por lo que es necesario seleccionar bien a los candidatos. Por ello, la identificación de factores pronósticos de forma preoperatoria podría contribuir a mejorar el tratamiento de estos pacientes orientando hacia pautas más personalizadas en función de la respuesta esperable. Material y métodos: Realizamos un estudio retrospectivo de 59 pacientes con diagnóstico histológico de carcinoma de páncreas entre 1999 y 2003, para identificar posibles factores pronósticos. Resultados: De los 59 pacientes, 32 eran varones y 27 mujeres, con una edad media de 63,8 años. Todos los pacientes fueron operados, realizándose cirugía paliativa en el 32% y resección tumoral en el 68%, incluyendo duodenopancreatectomías cefálicas en el 51% y pancreatectomías distales en el 17%. La mediana de supervivencia global fue de 14 meses (intervalo 1-110). Observamos que los niveles preoperatorios de hemoglobina inferiores a 12 g/dl (p = 0,0006) y de albúmina sérica por debajo de 2,8 g/dl (p = 0,021) se asocian a menor supervivencia global. Conclusión: Los niveles preoperatorios de hemoglobina y albúmina pueden ser indicadores pronósticos en el cáncer de páncreas(AU)

Introduction: Pancreatic cancer presents the worst survival rates of all neoplasms. Surgical resection is the only potentially curative treatment, but is associated with high complication rates and outcome is bad even in those resected cases. Therefore, candidates amenable for resection must be carefully selected. Identification of prognostic factors preoperatively may help to improve the treatment of these patients, focusing on individually management based on the expected response. Patients and methods: We perform a retrospective study of 59 patients with histological diagnosis of pancreatic carcinoma between 1999 and 2003, looking for possible prognostic factors. Results: We analyze 59 patients, 32 males and 27 females with a mean age of 63,8 years. All the patients were operated, performing palliative surgery in 32% and tumoral resection in 68%, including pancreaticoduodenectomies in 51% and distal pancreatectomy in 17%. Median global survival was 14 months (Range 1-110). We observed that preoperative levels of hemoglobin under 12 g/dl (p = 0,0006) and serum albumina under 2,8 g/dl (p = 0,021) are associated with worse survival. Conclusion: Preoperative levels of hemoglobin and serum albumina may be prognostic indicators in pancreatic cancer(AU)

Enfermedad de Castleman de localizacion cervical / Cervical Castleman’s disease

La enfermedad de Castleman se caracteriza por la presencia demasas de tejido linfático; existen dos variedades la hialino vascular 91%(localizada) y plasmática 9% (multicéntrica).Presentamos un varón de 30 años con tumoración latero cervical izquierdaindolora. Se realizó una exéresis total de la lesión.La histología es Enfermedad Castleman variante hialino vascular.La enfermedad de Castleman se presenta fundamentalmente en el tejidolinfático mediastínico. La localización cervical es muy rara. Se debe realizarun estudio de extensión para descartar la forma multicentrica de la enfermedad.En la forma localizada la extirpación de la lesión implica la curaciónde la enfermedad(AU)

Castleman´s Disease is characterized by the presence oflymphatic tissue masses. There are two forms the hyaline vascular91% (unifocal) and the plasmatic 9% (multifocal).We present a 30 year old man with a left laterocervical painlessmass. Total resection of the tumour was performed.The histological result was Castleman´s disease hyaline vascularform. Castleman´s disease presents mainly in the lymphatic tissueof the mediastinum. Cervical location is very rare. Peripherymetastasis work up must be done to rule out the multifocal form ofthe disease. Surgical excision is curative for the unifocal form(AU)

Inflamación y perforación de divertículo solitario de ciego. Presentación de 5 casos y revisión de la literatura / Inflammation and perforation of a solitary diverticulum of the cecum. A report of 5 cases and literature review

El divertículo solitario de ciego es una entidad benigna pocofrecuente en el mundo occidental, pero con alta prevalencia enpoblación asiática. Habitualmente son asintomáticos y sólo se manifiestancuando se complican con inflamación, perforación o hemorragia.Son una causa poco frecuente de abdomen agudo, manifestándoseclínicamente de forma idéntica a una apendicitisaguda con dolor en fosa iliaca derecha, fiebre y leucocitosis. A pesarde la información que aportan ecografía y TC, sigue siendo difícilobtener un diagnóstico preoperatorio de certeza, realizándoseeste habitualmente durante el acto quirúrgico, aunque en ocasioneses también difícil diferenciarlo intraoperatoriamente de unaneoplasia, estando indicado en esos casos la resección quirúrgicaamplia.Presentamos 5 casos de inflamación y perforación de divertículosolitario de ciego y revisamos la literatura

Solitary diverticulum of the cecum is a benign condition uncommonin the Western world, and with a higher incidence inAsian population. They are usually asymptomatic, and manifestclinically only with complications such as inflammation, perforation,or bleeding. They are a rare cause of acute abdominal pain,clinically similar to acute appendicitis, with tenderness in the rightlower quadrant, fever, and leukocytosis. In spite of the informationprovided by ultrasonography or CT scans, a correct preoperativediagnosis is still difficult to reach, and is usually arrived at inthe operating theater; differentiation from a neoplasm may bealso sometimes complicated, and a wide surgical resection is usuallyrequired for such cases.We report on 5 cases of inflammation and perforation of asolitary cecal diverticulum, and perform a literature review

Mammary hamartoma.

INTRODUCTION: Mammary hamartomas are rare benign breast lumps. They are usually painless, wellcircumscribed, mobile and with no adherence to skin or muscle, composed of varying amounts of fat, glandular and fibrous tissue. Mammary hamartoma has been classically considered as an underdiagnosed pathology, but with the increasing use of diagnostic procedures in breast tumours, the number of hamartomas has increased in the last years. Because there is no distinct pathological feature, a correlation with the clinical findings and image techniques is necessary in order to achieve a correct diagnosis of the pathology. MATERIALS AND METHODS: The clinicopathological features of 8 mammary hamartomas are reported here. RESULTS: The patients are ranged in age from 34 to 67 years. The initial manifestation was in all cases a well-circumscribed, soft, palpable breast lump. Mammography was performed in all patients. Other diagnostic procedures used in the diagnosis were Ultrasound, Fine Needle Aspiration Cytology and Needle Core Biopsy. Treatment was tumorectomy. We describe a case of recurrence after excision of the lump in a more aggressive histological form and one patient who presented the coexistence of a mammary hamartoma and an invasive ductal carcinoma. CONCLUSION: Mammary hamartoma is an uncommon breast tumour. It is necessary the correlation between pathology and clinical and radiological findings. We express our management plan for these lesions.

Malignant mixed Mullerian tumors.

Malignant mixed Mullerian tumours (MMMTs) are rare neoplasms, highly aggressive and with an extremely poor prognosis, usually arising in elderly postmenopausal women and presenting at an advanced stage. MMMTs derive from the mullerian mesodermus that differentiates in epithelial and stromal elements, both malignant elements. The clinic pathological features of 3 uterine MMMTs are reported here. The patients ranged in age from 25 to 69 years. The initial manifestations were mainly bloody discharge, abdominal pain and increase of the volume of the uterus. Treatment in 2 patients was hysterectomy with double ooforectomy, and resection of the pelvic mass was the treatment in the third case. Adjuvant radio chemotherapy was administrated in 2 of the 3 cases. Follow-up revealed recurrent pelvic tumour in 1 patient at 59 months, and breast metastases at 20 months in the second one. Because of the high incidence of recurrence and poor prognosis of these tumours, they should be studied and managed by a multidisciplinary team composed by surgeons, oncologists, radiotherapists and pathologists.

Mammary hamartoma

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Introduction. Mammary hamartomas are rare benignbreast lumps. They are usually painless, wellcircumscribed,mobile and with no adherence toskin or muscle, composed of varying amounts offat, glandular and fibrous tissue. Mammary hamartomahas been classically considered as an underdiagnosedpathology, but with the increasing use ofdiagnostic procedures in breast tumours, the numberof hamartomas has increased in the last years.Because there is no distinct pathological feature, acorrelation with the clinical findings and imagetechniques is necessary in order to achieve a correctdiagnosis of the pathology.Materials and methods. The clinicopathologicalfeatures of 8 mammary hamartomas are reportedhere.Results. The patients are ranged in age from 34 to67 years. The initial manifestation was in all cases awell-circumscribed, soft, palpable breast lump.Mammography was performed in all patients. Otherdiagnostic procedures used in the diagnosis wereUltrasound, Fine Needle Aspiration Cytology andNeedle Core Biopsy. Treatment was tumourectomy.We describe a case of recurrence after excision ofthe lump in a more aggressive histological formand one patient who presented the coexistence of amammary hamartoma and an invasive ductal carcinoma.Conclusion. Mammary hamartoma is an uncommonbreast tumour. It is necessary the correlationbetween pathology and clinical and radiologicalfindings. We express our management plan forthese lesions

Malignant mixed mullerian tumors

No disponible

Malignant mixed mullerian tumours (MMMTs) arerare neoplasms, highly aggressive and with an extremelypoor prognosis, usually arising in elderlypostmenopausal women and presenting at an advancedstage. MMMTs derive from the mullerianmesodermus that differentiates in epithelial andstromal elements, both malignant elements.The clinic pathological features of 3 uterine MMMTsare reported here. The patients ranged in age from25 to 69 years. The initial manifestations weremainly bloody discharge, abdominal pain and increaseof the volume of the uterus. Treatment in 2patients was hysterectomy with double ooforectomy,and resection of the pelvic mass was the treatmentin the third case. Adjuvant radio chemotherapywas administrated in 2 of the 3 cases. Follow-uprevealed recurrent pelvic tumour in 1 patient at 59months, and breast metastases at 20 months in thesecond one.Because of the high incidence of recurrence andpoor prognosis of these tumours, they should bestudied and managed by a multidisciplinary teamcomposed by surgeons, oncologists, radiotherapistsand pathologists

Inflammation and perforation of a solitary diverticulum of the cecum. A report of 5 cases and literature review.

Solitary diverticulum of the cecum is a benign condition uncommon in the Western world, and with a higher incidence in Asian population. They are usually asymptomatic, and manifest clinically only with complications such as inflammation, perforation, or bleeding. They are a rare cause of acute abdominal pain, clinically similar to acute appendicitis, with tenderness in the right lower quadrant, fever, and leukocytosis. In spite of the information provided by ultrasonography or CT scans, a correct preoperative diagnosis is still difficult to reach, and is usually arrived at in the operating theater; differentiation from a neoplasm may be also sometimes complicated, and a wide surgical resection is usually required for such cases. We report on 5 cases of inflammation and perforation of a solitary cecal diverticulum, and perform a literature review.