Metástasis de melanoma en la vesícula biliar: un hallazgo infrecuente / No disponible

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Metastatic melanoma of the gallbladder: an uncommon finding.

Melanoma metastasizes to the gastrointestinal tract in 2-4% of cases. In addition, it is the tumor that most frequently metastasizes to the gallbladder (50-67% of metastasis at this level). Even so, these metastases are infrequent. The indication of cholecystectomy will be provided by the patient performance status, extension and prognosis of disease. Although open surgery is preferred to treat melanoma metastasis at this level, laparoscopic surgery could be a safe technique that allows a fast recovery of the patient. We present the case of a 48-year-old man with melanoma metastases in the gallbladder treated by laparoscopic cholecystectomy.

Espasticidad como signo positivo de daño de motoneurona superior y su importancia en rehabilitación / Spasticity as a positive sign of superior motor neuron damage and its importance in rehabilitation

Resumen Introducción: La espasticidad, como signo clínico de daño de motoneurona superior, cobra gran importancia al momento de definir su impacto en el proceso rehabilitador. Los objetivos de esta revisión bibliográfica son: analizar la evolución de la espasticidad como concepto, describir los hallazgos actuales en relación con su fisiopatología y analizar su importancia en el proceso rehabilitador. Métodos: Búsqueda bibliográfica durante el segundo semestre del 2017 en bases de datos Pubmed, Scielo, Cochrane y Google Académico, utilizando los términos MeSH: muscle spasticity, physiopathology y stroke. Los límites de búsqueda fueron: textos completos en idioma inglés y español, en humanos y publicados durante los últimos cinco años. Resultados: La fisiopatología de la espasticidad no es causada por un solo mecanismo, sino más bien una intrincada cadena de alteraciones en diferentes redes nerviosas interdependientes. Existiendo dos mecanismos principales: la alteración del control espinal y suprasegmentario y los cambios en las propiedades del sistema músculo-esquelético. Conclusión: La evidencia científica es amplia y aborda el concepto de espasticidad, sus implicancias fisiopatológicas y clínicas. Sin embargo, futuras investigaciones deberían orientar y apoyar las decisiones del equipo rehabilitador, en relación con el manejo clínico.

Abstract Background: Spasticity as a clinical sign of upper motor neuron damage becomes highly important when defining its impact on the rehabilitation process. The aim of this bibliographical review is to examine the evolution of spasticity as a concept, describe the current findings in relation to its pathophysiology and to analyze its importance on the rehabilitation process. Material and methods: A bibliographic search was carried out during 2018 using Pubmed, Scielo, Cochrane and Google Academic databases, using the terms MeSH: 'muscle spasticity', 'physiopathology' and 'stroke'. The searches were limited to full texts in English and Spanish language, published during the last 5 years and for human patients. Results: The physiopathology of spasticity is not caused by a single mechanism, but rather an intricate chain of alterations in different interdependent nerve networks. Analyzed articles describe two main mechanisms, alteration of the control spinal and suprasegmental and changes in the properties of the musculoskeletal system. Conclusion: The scientific evidence is broad and addresses the concept of spasticity, its pathophysiological and clinical implications. However, future research should guide and support the decisions of the rehabilitation team, in relation to their clinical management.

SPIB, a novel immunohistochemical marker for human blastic plasmacytoid dendritic cell neoplasms: characterization of its expression in major hematolymphoid neoplasms.

SPIB is an Ets transcription factor that is expressed exclusively in mature B cells, T-cell progenitors, and plasmacytoid dendritic cells. In the present study, we developed a novel mAb against the SPIB protein and characterized its expression in major hematolymphoid neoplasms, including a series of 45 cases of blastic plasmacytoid dendritic cell (BPDC) neoplasms and their potential cutaneous mimics. We found that SPIB is expressed heterogeneously among B- and T-cell lymphoma types. Interestingly, SPIB is expressed in a large proportion of nongerminal center type DLBCLs. In cutaneous neoplasms, SPIB is overexpressed in all BPDC neoplasms, but none of its cutaneous mimics. SPIB remains overexpressed in all cases that lack 1 or 2 of the markers used for BPDC neoplasms (ie, CD4, CD56, TCL1, and CD123). We conclude that SPIB expression can be used as a tool for diagnosing BPDC neoplasms, but it needs to be tested in conjunction with the growing arsenal of markers for human plasmacytoid dendritic cells.

Meningioma parasagital de la hoz con componente intraóseo exofítico gigante aislado: técnica quirúrgica / Parasagittal meningioma of the falx with huge exophytic isolated intraosseous component: surgical technique

Se presenta un caso de un paciente de 42 años con un meningioma parasagital derecho con componente intraóseo de gran tamaño que determinaba invasión de los tejidos blandos adyacente recibiendo irrigación importante por ambas carótidas bilateralmente. Se describe la técnica de resección quirúrgica para este tipo de presentación poco frecuente para meningioma con embolización microselectiva prequirúrgica.

We presented a case of a 42 years old patient with right parasagital falx meningioma with intraoseus component that determined invasion of calvarium with important irrigation for both carotid arteries bilaterally. Indeed we described the surgical technique for resection of this infrecuently type o presentation for meningioma and the importance of microselective presurgical embolization.

Angiolipoma espinal extradural. Reporte de un caso clínico de presentación en el embarazo / Extradural spinal angiolypoma. Report of a clinical case in pregnancy

Spinal Extradural Angiolipomas (SEA) are benign and rare tumors that may clinically presents as subacute spinal cord compression syndrome. The diagnosis may be suspected by spinal MRI, where fat suppression techniques are important to. Usually ,the lesion is amenable to total surgical excision and the functional prognosis is good. Histopathologically consist in a adipose cell matrix intermixed with vascular endothelial channels. We present a case of an thoracic SEA, whose was clinically evident during pregnancy. A literature review is made and the relationships between SEA and pregnancy are discussed as well as the main diagnostic and therapeutic approaches of this lesion.