RESUMO
BACKGROUND: Since the introduction of sentinel lymph node biopsy, its use as a standard of care for patients with clinically node-negative cutaneous melanoma remains controversial. Our experience of sentinel lymph node biopsy for melanoma is presented and evaluated. MATERIAL AND METHODS: A cohort study was conducted on 69 patients with a primary cutaneous melanoma and with no clinical evidence of metastasis, who had sentinel lymph node biopsy from October-2005 to December-2013. Sentinel lymph node biopsy was identified using preoperative lymphoscintigraphy and subsequent intraoperative detection with gamma probe. RESULTS: The sentinel lymph node biopsy identification rate was 98.5%. The sentinel lymph node biopsy was positive for metastases in 23 patients (33.8%). Postoperative complications after sentinel lymph node biopsy were observed in 4.4% compared to 38% of complications in patients who had complete lymphadenectomy. CONCLUSION: The sentinel lymph node biopsy in melanoma offers useful information about the lymphatic dissemination of melanoma and allows an approximation to the regional staging, sparing the secondary effects of lymphadenectomy. More studies with larger number of patients and long term follow-up will be necessary to confirm the validity of sentinel lymph node biopsy in melanoma patients, and especially of lymphadenectomy in patients with positive sentinel lymph node biopsy.
Assuntos
Metástase Linfática/diagnóstico por imagem , Melanoma/secundário , Biópsia de Linfonodo Sentinela/estatística & dados numéricos , Neoplasias Cutâneas/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Reações Falso-Negativas , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Excisão de Linfonodo , Melanoma/diagnóstico por imagem , Melanoma/tratamento farmacológico , Melanoma/cirurgia , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia , Estadiamento de Neoplasias/métodos , Complicações Pós-Operatórias/epidemiologia , Cintilografia , Estudos Retrospectivos , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/cirurgia , Úlcera Cutânea/etiologia , Espanha/epidemiologia , Análise de SobrevidaAssuntos
Doenças do Colo/cirurgia , Colonoscopia/efeitos adversos , Perfuração Intestinal/cirurgia , Laparoscopia , Complicações Pós-Operatórias/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças do Colo/etiologia , Feminino , Humanos , Perfuração Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
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Assuntos
Humanos , Colonoscopia/efeitos adversos , Laparoscopia , Doença Iatrogênica , Estudos RetrospectivosRESUMO
Retrorectal cystic hamartomas (tailgut cysts) are rare congenital lesions thought to arise from remnants of the embryonic postanal gut. They predominantly occur as asymptomatic retrorectal multicystic masses in women. The treatment of choice is by complete surgical excision. The most important complications of these cysts are infection with a secondary fistula and malignant degeneration. The differential diagnosis includes a wide variety of conditions that occur in the retrorectal space. In this article, 3 cases showing different surgical technical aspects of treatment are presented. In addition, the aetiopathogenic features and histopathological appearance, clinical presentation and complications, imaging features and differential diagnosis of tailgut cysts are described.
Assuntos
Cistos , Hamartoma , Doenças Retais , Adulto , Cistos/diagnóstico , Cistos/diagnóstico por imagem , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Seguimentos , Hamartoma/diagnóstico , Hamartoma/diagnóstico por imagem , Hamartoma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doenças Retais/diagnóstico , Doenças Retais/diagnóstico por imagem , Doenças Retais/cirurgia , Região Sacrococcígea , Fatores de Tempo , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Los hamartomas quísticos retrorrectales (tailgut cysts) son tumores congénitos poco frecuentes derivados de remanentes embrionarios postanales del intestino. La mayoría de los hamartomas quísticos son multiquísticos y aparecen como masas asintomáticas en mujeres de mediana edad. El tratamiento de elección es la extirpación completa. Las complicaciones más frecuentes son la infección y el desarrollo de fístulas cutáneas y la degeneración maligna. El diagnóstico diferencial incluye una extensa variedad de patologías que pueden existir en el espacio retrorrectal. En este artículo presentamos 3 pacientes con hamartomas quísticos y realizamos una revisión de su etiopatogenia, las manifestaciones clínicas, las técnicas de diagnóstico, sus complicaciones y los diagnósticos diferenciales. Asimismo, se discuten las diferentes técnicas quirúrgicas posibles para su abordaje quirúrgico (AU)
Retrorectal cystic hamartomas (tailgut cysts) are rare congenital lesions thought to arise from remnants of the embryonic postanal gut. They predominantly occur as asymptomatic retrorectal multicystic masses in women. The treatment of choice is by complete surgical excision. The most important complications of these cysts are infection with a secondary fistula and malignant degeneration. The differential diagnosis includes a wide variety of conditions that occur in the retrorectal space. In this article, 3 cases showing different surgical technical aspects of treatment are presented. In addition, the aetiopathogenic features and histopathological appearance, clinical presentation and complications, imaging features and differential diagnosis of tailgut cysts are described (AU)
