Estesioneuroblastoma. Revisión de la literatura a propósito de dos casos / Esthesioneuroblastoma. Review of the literature. Report of two cases

El estesioneuroblastoma es un tumor maligno de aparición infrecuente, supone el 3% de todas las neoplasiasintranasales. Debido a su origen anatómico, la mayoría de los pacientes tienen síntomas poco específicos, loque dificulta su diagnóstico precoz. El manejo terapéutico es complejo por la falta de un sistema uniforme deestadificación, y la publicación de pocos casos que se recogen en series heterogéneas que abarcan largos periodos,durante los cuales se han producido cambios muy significativos en el enfoque diagnóstico-terapéutico delestesioneuroblastoma.Se presentan dos casos, y se analiza una revisión bibliográfica del estado actual de esta enfermedad. Fundamentalmentehay dos conclusiones, que el tratamiento es multidisciplinar, parece que la resección quirúrgicacraneofacial asociada a radioterapia es el enfoque terapéutico óptimo, incluso con quimioterapia; así como lanecesidad de un seguimiento prolongado

Esthesioneuroblastoma is a malignant tumor constituting 3% of intranasal neoplasias. As a result of its anatomical origin, most patient have non-specific symptoms, precluding early diagnosis. Several factor make difficult the study of the disease: the lack of a uniform staging system, the relatively small number of cases reported in heterogeneous series, and the fact that most series cover a long period during which significant changes in the management of esthesioneuroblastoma occur. We present two cases and analise a bibliographic review about the present situation of this pathology. There are two conclusions fundamentally: the combination of surgery with craniofacial resection and radiotherapy seems to be the optimum approach to treatment, and the need of a long-term follow-up

Cirrosis hepática por virus de hepatitis C y poliartritis séptica por Streptococcus agalactiae / Hepatitis C virus, liver cirrhosis and Streptococcus agalactiae septic poliartheritis

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[Radiation induced tumors]. / Tumores radioinducidos.

Radiations at cellular level produce different effects, depending on type of radiation and irradiated tissue. The radiation-induced cancers are associated to non-letals genetics mutations, and to classify like radiation induced tumors is necessary that appear in the treatment volume, a long latency period (years), histolo-different to the primary lesion, enough doses quantitatively and that exists a greater incidence in the irradiated populations. The genetics mutations affect at tumoral suppressors gen(Gen RB I, p53, BRCA I, BRCA 2) and repressors gen (hMSH 2, hMLH I,...), they could be longer and multifocals mutations, and produce lack of cellular control and a greater predisposition to develop tumors and a probable risk of increment of radiosensitivity. We present some of the more representatives studies about radiation-induced tumors.

[Mesenteric panniculitis: a case of acute and fatal presentation]. / Paniculitis mesentérica: un caso de presentación aguda y fatal?

Mesenteric panniculitis is a rare process in which there is an inflammation of the mesenteric adipose tissue due to unknown causes and mechanisms. It evolves with abdominal pain and/or mass, among other symptoms, generally with a chronic and bening course. The concomitant tests are generally non-specific, the diagnosis being anatompathological. We present the case of an old woman who died hours after starting an episode of abdominal pain. The autopsy showed the presence of mesenteric panniculitis. The sudden onset of the clinical signs, without other justifying cause than the panniculitis itself, suggests that this must be considered in the differential diagnosis of acute abdominal pain. In addition, the absence of other morphological findings which could suggest a fatal cause make us to consider the relationship between this and the panniculitis.