[Massive hypertrophy of the mammary gland. Report of 6 cases]. / Hipertrofia masiva de la glándula mamaria. Presentación de seis casos.

In the period of January of 1985 to January of 1995, 6 cases of massive hypertrophy of the mammary gland were diagnosed from 60,000 patients seen in the External Consultation of the Service of Gynecological Oncology. The age oscillated between 11 and 27 years old, with an average of 20.8 years. One case was unilateral and the 5 remaining, bilateral; 3 coexisted with pregnancy. The treatment consisted of reductive mammoplasty. This pathology is a rare entity, with not very well defined etiology in which apparently there are involved hormonals receptors and an unusual sensibility to hormones although they are at normal serum levels.

Activity satellite association and polymorphism of Ag stained nucleolus organizer regions (Ag+ NORs) in lymphocytes from women with cervical uterine cancer.

Thirty five female patients with different stages of neoplastic lesions: cervical intraepithelial neoplasia (CIN) or dysplasia (CIN I and CIN II), in situ carcinoma (CIS), and adenocarcinoma, and 27 healthy women (controls) were studied to determine the activity, satellite association, and polymorphism of Ag stained nucleolus organizer regions (Ag+ NORs) in acrocentric chromosomes in metaphases obtained from peripheral blood lymphocytes. For each person, 25 to 50 metaphases stained with ammoniacal silver technique were scored. The average number of Ag+ NORs was higher in women with adenocarcinoma (7.66 +/- 0.72) than in controls (6.65 +/- 0.74). Non-associated chromosomes showing Ag+ NORs were found more frequently in patients (5.85 +/- 0.88) than in controls (4.81 +/- 0.67). Patients aged 30-39 and 60 or more had an increase of Ag+ NORs (7.99 +/- 1.04, and 7.81 +/- 0.71) with respect to their controls (6.36 +/- 0.052 and 6.17 +/- 0.88), but the frequency of satellite association showed lower values in 50-59 year-old patients (0.75 +/- 0.08) than in controls (1.02 +/- 0.19). The most frequent association in patients was the large type (patients = 38.96%, controls = 30.49%). The partial association showed higher values (6.49%) than controls (2.44%). Otherwise, the spherical association was more frequent for controls (37.80%) than for patients (28.57%). All these differences were statistically significant (p < 0.05). The frequency of Ag+ NORs and the type of polymorphism of satellite association could be related to the neoplastic process, while the frequency of satellite association and of polymorphism of Ag+ NORs seems to be irrelevant.

[Carcinoma of fallopian tubes. Presentation of 2 cases]. / Carcinoma de trompa de Falopio. Presentación de dos casos.

The carcinoma of the Fallopian tube is at the present time, one of the most rare gynecologic tumors, representing approximately less than 1% in world literature, being in our experience of 0.15%. We presented two cases of adenocarcinoma of the Fallopian tube, seen in a lapse of 25 years, not diagnosed preoperatorily with the clinical trial of abnormal bleeding, negative biopsy of endometrium and adnexal mass. As it is written in the literature, the diagnosis is rarely established previous to the operation and it usually corresponded to an adenocarcinoma. The classification of the FIGO for the stage is used. In relation to the survival follow-up: the stages I and II present 60% approximately of survival to the five years and it is suggested radiotherapy additional to the surgery; however, according to some authors this doesn't improve the survival.

[Nongynecological surgical procedures performed by an oncological gynecology service]. / Procedimientos quirúrgicos no ginecológicos, realizados por un servicio de ginecología oncológica.

From March, 1987 to July 1990, 1,568 surgical procedures, were done at Oncological Gynecology Service; 206 of them (13.1%) were considered as "non-gynecological" surgical procedures; 182 (88.3%) were secondary to a malignity diagnosis, being the most frequent one ovarian carcinoma (54.4%). As to benign lesions, 11.7% caused "non gynecological" surgery, most frequent were severe pelvic adhesions, 41.6%, and severe endometriosis, 25%. "Non-gynecological" surgical procedure carried out most frequently was pelvic lymphadenectomy. Morbidity was 3.8%, and mortality, 0.48% due to acute myocardial infarction. The acceptance for oncologic gynecologist is justified in this series, based on survival and morbi-mortality, which permits the participation in a multidisciplinary team.

[Radical hysterectomy with pelvic lymphadenectomy for the treatment of invasive IB and IIA cervical cancer: review of 153 cases]. / Histerectomía radical con linfadenectomía pélvica para el tratamiento de cáncer cervical invasor IB y IIA: revisión de 153 casos.

One hundred and fifty three patients with carcinoma of the cervix, stages IB and IIA, were treated with radical hysterectomy and pelvic lymphadenectomy, during the period from October 1978 to December, 1989; 85.6% were at stages IB and 14.4% at IIA. The most frequent histological type was the epidermoid one in 91.5%. Average age was 48 years; 94 patients out of 107 (87.8%) were followed up during five years at least. Total survival at five years, was 75.7%; with positive lymphatic nodes, 50% and with negative nodes, 77.2%. In 17.6% of the cases post-operative radiotherapy was required. Late morbidity was most frequent as vesical dysfunction (17.6%); there were vesicovaginal fistulae (1.3%); and operative mortality was 0.6%). The present study confirms that this type of surgery is justified, as to survival and morbi-mortality, and it allows a histopathological evaluation that shows risk factors, as to recurrence.

[Usefulness of endometrial curettage during cervical conization]. / Utilidad del legrado endometrial durante la conización cervical.

In order to determine the value of uterine curettage at the time of cervical conization, as well as morbidity for it, 318 patients were studied. The patients were sent because of abnormal Papanicolaous's test. The established diagnostic procedures were cervical biopsy directed by Schiller's test and/or colposcopy and cervical cone. In 151 cases cervical cone was done without endometrial curettage, and in 167 endometrial curettage was used simultaneously to cervical conization. The results show that curettage plus cervical conization had a morbidity of 9.6%, statistically significant (p less than 0.05) as compared with cervical conization (4%). Furthermore, there was an RR 2.7 times of greater risk with the first procedure, morbidity increased and it did not contribute to a more complete diagnosis.