Diagnóstico, tratamiento y seguimiento de un tumor de reciente descripción: el carcinoma análogo secretor de mama (MASC) de glándula salival. A propósito de 2 nuevos casos / Diagnosis, treatment and follow-up of a recently described tumour: Mammary analogue secretory carcinoma (MASC) of the salivary gland. A report of 2 new cases

Introducción. El carcinoma análogo secretor de mama (MASC) es un tumor de glándula salival de reciente aparición con pocos casos descritos. Tiene un diagnóstico preoperatorio difícil y su tratamiento y seguimiento todavía siguen en estudio. Material y métodos. Revisión sistemática de 367 tumores parotídeos intervenidos entre enero de 2011 y diciembre de 2015 en el Hospital Universitario Miguel Servet. De los 367 casos operados, 45 eran malignos, y de estos, encontramos 2 únicos casos de MASC. Resultados. Cuarenta y cinco de los 367 tumores parotídeos eran malignos, siendo 2 de ellos MASC. La parotidectomía subtotal y superficial asociada a la radioterapia ha sido el tratamiento de elección. Tras 12 y 18 meses, no se han evidenciado recidivas. Discusión. Revisión de los estudios publicados en la literatura sobre su diagnóstico diferencial con otros tumores de glándula salival y su tratamiento, teniendo en cuenta los resultados citológicos e inmunohistoquímicos de cada uno de ellos, y destacando cuáles son los marcadores más específicos para el diagnóstico de MASC. Conclusión. El diagnóstico preoperatorio de este tumor casi nunca es acertado, y todavía no se conoce su tratamiento y supervivencia a largo plazo, por lo que más estudios prospectivos y nuevos casos deben ser documentados y seguidos (AU)

Introduction. Mammary analogue secretory carcinoma (MASC) is a new salivary gland tumour with few cases reported. Pre-operative diagnosis is difficult, and treatment and follow-up are still under study. Material and method. A systematic review was conducted on 367 parotid tumours treated between January 2011 and December 2015 at the University Hospital Miguel Servet, Spain. Of the 367 cases operated on, 45 were malignant, and of these, only two cases were MASC. Results. Of the 367 parotid tumours reviewed, 45 were malignant, and two of them MASC. Sub-total and superficial parotidectomy combined with radiation therapy has been the treatment of choice. They showed no recurrence after 12 and 18 months. Discussion. A review is presented on the studies published in the literature on the differential diagnosis with other salivary gland tumours, taking into account their cytological and immunohistochemical results, focussing on the most specific markers for the diagnosis of MASC. Conclusion. Pre-operative diagnosis of MASC is rarely successful. Its treatment and long-term survival is largely unknown, thus there is a need for more prospective studies, as well as new cases that should be documented and followed-up (AU)

Linfadenoma sebáceo en glándula parótida: a propósito de 2 casos / Lymphadenoma sebaceous of the parotid gland: a report of 2 cases

Objetivo: Reportar casos de linfadenoma sebáceo, un tumor raro, localizado principalmente en la glándula parótida, con muy pocos casos descritos en la literatura. Casos clínicos: Presentamos 2 casos de esta rara afección, tratados en el Hospital Universitario Miguel Servet de Zaragoza, de enero de 2010 a diciembre de 2014. El diagnóstico, tanto por imagen como citológico, es difícil debido a su baja prevalencia y a la gran variedad de tumores de glándula parótida que existen. En los 2 casos presentados ha sido necesaria la exéresis para llegar al diagnóstico. El tratamiento curativo consiste en la exéresis completa de la tumoración.

Aim: To report a rare parotid tumour: sebaceous lymphadenoma, with very few cases reported in the literature. Cases report: We present 2 cases of lymphadenoma sebaceous of the parotid gland treated by surgery at University Hospital Miguel Servet of Zaragoza between January 2010 and December 2014. The diagnosis, both radiological and cytological, is difficult because of their low prevalence and the great variety of parotid gland tumors existent. In our 2 cases described, excision has been required for diagnosis. A complete excision of the tumor is required for curative treatment.

Platysma flap: an alternative to free flaps.

OBJECTIVE: The objective of this paper is to show that platysma flaps have good results and should be an alternative in reconstructive surgery for oral tumors when microsurgery is not possible. It is a versatile, portable, and thin flap, is easy to perform, and can be obtained during neck dissection, with a primary closure of the donor site. METHODS: Five cases are presented, three men and two women, 51 and 71 years old, with medium size (2-4 cm) defects of oral cavity after the excision of squamous cell carcinomas. All of them were reconstructed with a platysma flap after neck dissection. This reconstruction technique was chosen because of the poor conditions of these patients to allow a microsurgical reconstruction. RESULTS: Non-local complications occurred with this technique. Overall aesthetic results were acceptable in all the patients. There were no cases of total necrosis flap, dehiscence, fistula or fibrosis. Only one case of partial necrosis occurred in one end of the flap, which was resolved with excision of necrotic tissue and closure by secondary intention. CONCLUSION: The platysma flap is a good method to reconstruct small and medium sized defects of oral cavity, especially in patients where a microsurgery reconstruction is not possible.

Linfoma no Hodgkin primario de mandíbula / Primary Non-Hodgkin lymphoma of the mandible

Introducción: Los linfomas primarios extranodales, delocalización mandibular suponen menos del 0,6% de los linfomas.Desde 1939 únicamente hay descritos 41 casos deLinfoma No-Hodgkin intramandibular, la mayoría de subtiposagresivos, ninguna de las referencias corresponde a linfomalinfocítico crónico. Pacientes y métodos: Se presentael caso de una mujer de 64 años con radiología de lesiónaparentemente quística. Se realiza resección que se remitepara estudio histopatológico donde se comprueba infiltraciónmedular por linfocitos de pequeña talla, con patrónparcheado, mientras que el análisis inmunohistoquímicoresulta positivo para CD20, CD23 y BCL-2 y negativo paraCD 10, CD5 y Ciclina D1. Resultados: Se diagnostica delinfoma No-Hodgkin mandibular, de bajo grado, (Linfocíticocrónico) mostrando ausencia de diseminación en el estudiode extensión, por lo que se cataloga de estadio I de Ann-Arbor. Discusión y conclusiones: El diagnóstico es siemprehistológico con apoyo inmunohistoquímico, ya que con frecuenciason asintomáticas o de clínica inespecífica, y conradiología no sospechosa. El pronóstico es muy favorable enlos casos diagnosticados en estadios iniciales, con supervivenciaslibres de enfermedad muy largas

Introduction: Primary extranodal mandibular bonelymphomas account for less than 0,6%. Since 1939 only 41reported cases were found in a literature review, none ofthem corresponding to small cell lymphocitic lymphoma.Patients and Methods: A case of a 64-years-old womanwith a mandibular radiologically cystic lesion is reported.Surgical resection specimen was submitted for histopathologicalstudy. A patchy bone marrow infiltration by smalllymphocytes was found. By immunohistochemistrylymphocytes were positive for CD20, CD23 and BCL-2 andnegative for CD 10, CD5 and Cycline D1. Results: Diagnosisof of low grade non disseminated (after a stagingstudy) mandibular non-Hodgkin lymphoma, belonging toAnn-Arbor´Stage I was delivered. Discussion: Diagnosis isalways histopathologic with immunohistochemical support,since these lesions are usually asymptomatic with non-specificradiology. Prognosis is really favorable with very longdisease free survival periods in those cases diagnosed atinitial stages