Presentación de caso del tumor maligno vaginal en edad pediátrica / A Case Report about a Malignant Vaginal Tumor during Childhood

La presentación de caso es de un adenocarcinoma de células claras de vagina, diagnosticado en el Laboratorio Nacional de Asmara, Eritrea, en diciembre de 2008. Este padecimiento es una neoplasia extremadamente rara, que representa del 1 al 2 porciento de los cánceres ginecológicos. Se trata de una niña de cuatro años de edad, atendida en el Hospital de Adikey del territorio eritreano, en la consulta de ginecología, por presentar sangramiento vaginal. Al realizar el examen físico se encontró una tumoración que ocupaba toda la vagina; se le realizó exéresis quirúrgica de la lesión y en estudio anatomopatológico se confirmó un adenocarcinoma de células claras, los cuales son considerados tumores infrecuentes y deben incluirse en el diagnóstico diferencial de otros tumores vaginales descritos en infantes, con un comportamiento agresivo, recomendándose un tratamiento quirúrgico radical (AU)

A case of a vaginal clear cell adenocarcinoma, diagnosed in the National Laboratory of Asmara, Eritrea, on December, 2008, is reported. This is an extremely rare neoplasia, which represents from 1 to 2 percent of the gynecological cancers. It deals about a four- year-old female patient, assisted at the gynecologist consultation office in Adikey Hospital, in the Eritrean territory, suffering from vaginal bleeding. On physical examination, a tumor was found, taking up the entire vagina. A sample was taken for biopsy, and the histological examination showed a clear cell adenocarcinoma, which is a very rare tumor and should be included in the differential diagnosis of other vaginal tumors, described with an aggressive behavior in children and with the recommendation of a radical surgical treatment (AU)

Mifepristone 2.5 mg versus 5 mg daily in the treatment of leiomyoma before surgery.

OBJECTIVES: To evaluate the efficacy and safety of 2.5 mg and 5 mg mifepristone during 3 months for the treatment of uterine fibroids before surgery. DESIGN: Multicenter randomized clinical trial. LOCATIONS: Eusebio Hernández Hospital, Havana, Cuba and the Alemán Hospital, Managua, Nicaragua. SUBJECTS: Included in the study were 146 women with symptomatic uterine fibroids. TREATMENT: GROUP I: half a tablet of 5 mg (2.5 mg) mifepristone taken orally every 24 hours, and Group II: one tablet of 5 mg mifepristone taken orally every 24 hours over a period of 3 months in both groups. Two endometrial biopsies were performed. VARIABLES TO EVALUATE EFFICACY: Increase in average hemoglobin, changes in fibroid and uterine volume, and symptomatic improvement. RESULTS: The average hemoglobin at the end of treatment was 0.6 g/dL greater in the 5 mg mifepristone group (P = 0.033). In both groups there were similar reductions in fibroid volumes. Clinical improvement was more significant in the 5 mg group. CONCLUSION: The dose to be used should be 5 mg.