Value of the identification of microsatellite instability in colorectal cancer

OBJECTIVE: Recent studies defend a possible prognostic and therapeutic value of the identification of microsatellite instability (MSI) in colorectal cancer. This work tries to assess the impact that the identification of MSI tumours can have in clinical practice. MATERIAL AND METHODS: We recovered tumour samples from 92 of the 143 patients operated on for colorectal cancer in our institution between 1995 and 2000. Five MSI markers (BAT 25, BAT 26, D2S123, D5S346 and D17S250) were studied on them. The rate and clinicopathologic characteristics of MSI tumours were investigated along with their impact on the global and disease-free survival as compared with microsatellite stable (MSS) tumours. RESULTS: All 5 microsatellite markers' status were established in 73 patients (79.3% of the samples). Among them, 7 tumours showed instability in just one marker (low microsatellite instability [MSI-L]) whereas 5 tumours had mutations in 2 or more markers (high microsatellite instability [MSI-H]), for a total 15.4% rate of MSI tumours. All MSI-H tumours were located in the right colon. We could not fi nd any impact from MSI detection on global or disease-free survival. CONCLUSIONS: MSI determination did not identify groups of patients with a different prognosis. Moreover, with such low incidence its determination can only be justified in those cases that fulfill Bethesda's criteria to identify families with Lynch's syndrome (AU)

Tumor de mama de origen parasitario / Tumour of the breast from parasite origin

Paciente de 18 años de edad, natural de Guinea, que acudea la consulta presentando una gran tumoración en la mama izquierdaque ocupa los dos cuadrantes externos. Se realizanmamografías, ecografía y resonancia magnética, mostrandoun gran granuloma de 12 centímetros, sin observar calcificacionesy localizando una larva adulta en el interior del mismo.Se practica una punción aspiración con aguja fina (PAAF)de la tumoración, observando filarias del tipo Loa Loa. Trasrecibir tratamiento con Dietilcarbamazina e Ivermectin es intervenidarealizando una tumorectomía amplia, quedando lapaciente asintomática

An eighteen years old patient, from Guinea, who comes toour clinic with a large tumour in the left breast that includesthe two external quadrants. A mammography, an ecographand a magnetic nuclear resonance are made showing a largegranuloma of 12 centimetres, without calcifications andwatching the adult larva on the inside of granuloma.A PAAF is practised on the tumour, watching the parasite(Loa Loa filaria). After receiving treatment with Dietilcarbamazinaand Ivermectin, the patient undergoes a large lumpectomy,the patient is now asymptomatic