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1.
Plast Reconstr Surg Glob Open ; 12(1): e5520, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38204871

RESUMO

Breast-implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a non-Hodgkin lymphoma that arises in the space between the surface of a breast implant and the fibrous capsule that grows around the implant. Since its first description 20 years ago, almost 1000 cases of BIA-ALCL have been diagnosed worldwide. Nowadays, guidelines describe the diagnosis, staging, and treatment of this disease. We present the first two cases diagnosed and treated in Peru, demonstrating a wide range of aggressiveness of BIA-ALCL.

2.
Rev. esp. patol ; 56(3): 196-200, Jul-Sep. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-223325

RESUMO

La enfermedad de Paget extramamario y la neoplasia intraepitelial vulvar son lesiones comunes de la vulva. No obstante, su ocurrencia sincrónica es una manifestación sumamente rara en la misma localización. Presentamos el caso de una paciente de 77años, quien hace 16meses aqueja de prurito y sarpullido en la región vulvar con sangrado escaso que empezó a incrementarse en frecuencia y en cantidad. Es sometida a hemivulvectomía derecha y vulvectomía simple izquierda. El informe de patología reportó la presencia concurrente de enfermedad de Paget vulvar y neoplasia intraepitelial vulvar de alto grado.(AU)


Extramammary Paget's disease and intraepithelial vulvar neoplasia are common lesions in the vulva. However, their simultaneous occurrence is extremely rare. We present the case of a 77year-old woman who presented with a 16month history of pruritus and a rash in the vulvar region with gradually increasing bleeding. She underwent a right hemivulvectomy and a left simple vulvectomy. The histopathology revealed a coexistence of both Paget's disease and high grade intraepithelial vulvar neoplasia.(AU)


Assuntos
Humanos , Doença de Paget Extramamária , Lesões Intraepiteliais Escamosas Cervicais , Carcinoma in Situ , Vulva/lesões , Pacientes Internados , Exame Físico , Neoplasias Vulvares
3.
Rev Gastroenterol Peru ; 43(2): 161-165, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37597233

RESUMO

Pancreatic hamartomas (PH) are extremely unusual non-neoplastic tumor-like lesions and accounts for <1% of all hamartomas. Moreover, there is a distinct variant of PH denominated Pancreatic lipomatous hamartoma (PLH), that is even rarer, with only 5 cases, including the present case, reported in the literature. PLH lacks well-defined features and clinically can be mistaken with other lipomatous lesions of the pancreas, including lipoma, pancreatic lipomatosis, PEComa, liposarcoma, and malignant tumors with lipomatous components. Here, we describe a case of PLH in a 70-year-old male with abdominal pain and a lesion, which was preoperatively diagnosed as a pancreatic no functional low-grade neuroendocrine tumor, and subsequent underwent a laparoscopic enucleation of the tumor. The postoperative pathology and immunohistochemical analyses confirmed the diagnosis of PLH.


Assuntos
Hamartoma , Lipoma , Pancreatopatias , Masculino , Humanos , Idoso , Pâncreas , Lipoma/diagnóstico , Lipoma/patologia , Pancreatopatias/diagnóstico , Pancreatopatias/cirurgia , Hamartoma/diagnóstico , Hamartoma/cirurgia , Hamartoma/patologia
4.
Rev Esp Patol ; 56(3): 196-200, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37419559

RESUMO

Extramammary Paget's disease and intraepithelial vulvar neoplasia are common lesions in the vulva. However, their simultaneous occurrence is extremely rare. We present the case of a 77year-old woman who presented with a 16month history of pruritus and a rash in the vulvar region with gradually increasing bleeding. She underwent a right hemivulvectomy and a left simple vulvectomy. The histopathology revealed a coexistence of both Paget's disease and high grade intraepithelial vulvar neoplasia.


Assuntos
Adenocarcinoma , Doença de Paget Extramamária , Neoplasias Vulvares , Feminino , Humanos , Doença de Paget Extramamária/patologia , Neoplasias Vulvares/patologia , Vulva/patologia , Adenocarcinoma/patologia
5.
Rev. gastroenterol. Perú ; 43(2)abr. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1450025

RESUMO

Los hamartomas pancreáticos (HP) son lesiones no neoplásicas extremadamente inusuales y representan < 1% de todos los hamartomas. Además, existe una variante distintiva denominada Hamartoma Lipomatoso Pancreático (HLP), que es aún más raro, con solo 5 casos, incluyendo el presente reporte, descritos en la literatura. HLP carecen de características específicas y clínicamente puede ser confundido con otras lesiones lipomatosas pancreáticas, como lipoma, lipomatosis pancreática, PEComa, liposarcoma y tumores malignos con componentes lipomatosos. El presente reporte describe un caso de HLP en un paciente varón de 70 años, que aquejaba de dolor y masa abdominal, preoperatoriamente diagnosticado como tumor neuroendocrino de bajo grado no funcionante pancreático. Subsecuentemente, fue sometido a enucleación laparoscópica del tumor. El reporte patológico postoperatorio y los estudios de inmunohistoquímica confirmaron el diagnóstico de HLP.


Pancreatic hamartomas (PH) are extremely unusual non-neoplastic tumor-like lesions and accounts for <1% of all hamartomas. Moreover, there is a distinct variant of PH denominated Pancreatic lipomatous hamartoma (PLH), that is even rarer, with only 5 cases, including the present case, reported in the literature. PLH lacks well-defined features and clinically can be mistaken with other lipomatous lesions of the pancreas, including lipoma, pancreatic lipomatosis, PEComa, liposarcoma, and malignant tumors with lipomatous components. Here, we describe a case of PLH in a 70-year-old male with abdominal pain and a lesion, which was preoperatively diagnosed as a pancreatic no functional low-grade neuroendocrine tumor, and subsequent underwent a laparoscopic enucleation of the tumor. The postoperative pathology and immunohistochemical analyses confirmed the diagnosis of PLH.

6.
Ecancermedicalscience ; 17: 1613, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38414973

RESUMO

45,X/46,XY mosaicism is a sex development disorder with an estimated incidence of less than 1 in 15,000 live births. Various studies have shown there is an increased risk of germ cell tumours forming in Mosaic Turner syndrome. This includes gonadoblastoma, a clinically benign mixed germ-stromal cell tumour. However, this can later develop into one or several malignant germ cell neoplasms, for which early prophylactic gonadectomy is often recommended in patients with 45,X/46,XY mosaicism. The study presents the case of an 11-year-old patient diagnosed with a Mosaic Turner syndrome karyotype, who underwent prophylactic bilateral gonadectomy.

7.
Rev. esp. patol ; 55(4): 259-266, Oct-Dic. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-210616

RESUMO

El carcinoma coloide (CC) es una variante histológica inusual del adenocarcinoma ductal del páncreas, el cual se caracteriza por la presencia de grandes lagos de mucina extracelular que contiene células neoplásicas y está asociado a una mejor sobrevida a los cinco años, comparada con los adenocarcinomas ductales (DAC) tubulares o no tipo especial (NOS).Presentamos el caso de una paciente mujer de 74 años con una lesión multiquística de tabiques finos en cola de páncreas con diagnóstico clínico radiológico sugestivo de cistoadenoma seroso vs. neoplasia mucinosa. En el acto operatorio se evidenció una lesión de 10 x 6 cm, que infiltraba hilio esplénico y mesocolon transverso. Por otro lado, se identificaron dos nódulos en la pared del fondo gástrico que también fue resecado en conjunto. El estudio anatomopatológico concluyó que la tumoración del páncreas correspondía a un CC asociado incidentalmente a un tumor del estroma gastrointestinal (GIST) de fondo gástrico.(AU)


Colloid carcinoma (CC) is a rare histological type of adenocarcinoma of the pancreatic duct and is characterized by the presence of large lakes of extracellular mucin containing neoplastic cells. Its 5 year prognosis is more favourable than that of ductal, tubular or not otherwise specified (NOS) adenocarcinomas.We present the case of a 74-year-old woman with a thin walled, multicystic lesion in the tail of the pancreas, radiologically suggestive of a serous cystadenoma as opposed to a mucinous neoplasm. Surgery revealed a 10 x 6 cm lesion invading the splenic hilum and transverse mesocolon. Two nodes on the wall of the gastric fundus were also removed. Histopathology showed the pancreatic tumour to be a colloid carcinoma with a synchronous gastrointestinal stromal tumour of the gastric fundus.(AU)


Assuntos
Humanos , Feminino , Idoso , Adenocarcinoma Mucinoso , Neoplasias Pancreáticas , Adenocarcinoma Mucinoso/patologia , Estômago/patologia , Carcinoma Ductal Pancreático , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Anamnese , Patologia , Serviço Hospitalar de Patologia , Neoplasias , Patologistas
8.
Rev. esp. patol ; 55(4): 282-287, Oct-Dic. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-210620

RESUMO

El hígado ectópico (HE) es una entidad infrecuente, debida a la migración aberrante de las células hepáticas durante la embriogénesis. La incidencia se estima entre el 0,24 y el 0,47%. Puede presentarse en numerosas localizaciones, siendo la vesícula la localización más común. Existen alrededor de 100 casos publicados de HE, de los cuales 28 han desarrollado carcinoma hepatocelular (CHC); mientras que el hígado ortotópico no presenta ninguna alteración; todos provienen de la literatura asiática y caucásica. Reportamos el caso de un paciente de 42 años con lesión sólida de 17×12×12cm, aparentemente dependiente de la pared posterior del cuerpo gástrico, y con desplazamiento de numerosas vísceras, sugiriendo como posibilidad diagnóstica GIST. Mientras que, otras estructuras como el hígado y las vías biliares fueron topográficamente normales. El estudio anatomopatológico concluyó que la tumoración descrita correspondía a un CHC originado en un HE.(AU)


Ectopic liver (EL) is a rare developmental anomaly caused by the migration of hepatic cells to other locations during embryogenesis. Its incidence is thought to be between 0.24 and 0.47% and can occur in various sites, although the gall bladder is the most frequent. Approximately 100 cases of EL have been published, of which 28 developed hepatocellular carcinoma, whilst the orthotopic liver was unaffected. All cases are reported in Asian and Caucasian patients.We report the case of a 42-year-old patient with a solid lesion measuring 17×12×12cm apparently arising from the posterior wall of the stomach, displacing various organs and suggestive of a gastrointestinal stromal tumour (GIST). The liver, biliary tract and other structures were unremarkable. Histopathology revealed a diagnosis of hepatocellular carcinoma in ectopic liver tissue.(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Hepatocelular , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Desenvolvimento Embrionário , Fígado , alfa-Fetoproteínas , Neoplasias , Patologia , Serviço Hospitalar de Patologia , Hepatopatias
9.
Rev Esp Patol ; 55(4): 259-266, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-36154734

RESUMO

Colloid carcinoma (CC) is a rare histological type of adenocarcinoma of the pancreatic duct and is characterized by the presence of large lakes of extracellular mucin containing neoplastic cells. Its 5 year prognosis is more favourable than that of ductal, tubular or not otherwise specified (NOS) adenocarcinomas. We present the case of a 74-year-old woman with a thin walled, multicystic lesion in the tail of the pancreas, radiologically suggestive of a serous cystadenoma as opposed to a mucinous neoplasm. Surgery revealed a 10 x 6 cm lesion invading the splenic hilum and transverse mesocolon. Two nodes on the wall of the gastric fundus were also removed. Histopathology showed the pancreatic tumour to be a colloid carcinoma with a synchronous gastrointestinal stromal tumour of the gastric fundus.


Assuntos
Adenocarcinoma Mucinoso , Adenocarcinoma , Carcinoma Ductal Pancreático , Tumores do Estroma Gastrointestinal , Neoplasias Pancreáticas , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/cirurgia , Idoso , Carcinoma Ductal Pancreático/patologia , Feminino , Humanos , Mucinas , Pâncreas/patologia , Neoplasias Pancreáticas/patologia , Estômago/patologia
10.
Rev Esp Patol ; 55(4): 282-287, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-36154738

RESUMO

Ectopic liver (EL) is a rare developmental anomaly caused by the migration of hepatic cells to other locations during embryogenesis. Its incidence is thought to be between 0.24 and 0.47% and can occur in various sites, although the gall bladder is the most frequent. Approximately 100 cases of EL have been published, of which 28 developed hepatocellular carcinoma, whilst the orthotopic liver was unaffected. All cases are reported in Asian and Caucasian patients. We report the case of a 42-year-old patient with a solid lesion measuring 17×12×12cm apparently arising from the posterior wall of the stomach, displacing various organs and suggestive of a gastrointestinal stromal tumour (GIST). The liver, biliary tract and other structures were unremarkable. Histopathology revealed a diagnosis of hepatocellular carcinoma in ectopic liver tissue.


Assuntos
Carcinoma Hepatocelular , Coristoma , Tumores do Estroma Gastrointestinal , Neoplasias Hepáticas , Adulto , Carcinoma Hepatocelular/diagnóstico , Coristoma/patologia , Humanos , Neoplasias Hepáticas/patologia
11.
Horiz. meÌüd. (Impresa) ; 22(3): e1510, jul.-sep. 2022. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1405047

RESUMO

RESUMEN El cáncer de testículo es el tumor sólido más común en los varones de 15 a 29 años. Puede producirse metástasis por vía hematógena o linfática a distintos órganos como pulmón e hígado (usuales) y estómago (inusual). Se presenta el caso de un varón de 30 años que cursa con hemorragia digestiva alta por dos úlceras en el cuerpo gástrico con histología de neoplasia maligna indiferenciada de células pequeñas. En las tomografías se observa tumor testicular derecho con implantes secundarios en cerebro, pulmón, hígado y bazo. Se estudia β-HCG (35 5354 mUI/ml), AFP (500 ng/mL) y DHL (1669 UI/L). Se realiza una orquiectomía radical derecha y se concluyeque es un tumor de células germinales primario de testículo derecho de estadio clínico IIIC por metástasis hepática, esplénica, pulmonar, gástrica y cerebral.


ABSTRACT Testicular cancer is the most common solid tumor in men between ages 15 and 29. It can metastasize through the hematogenous or lymphatic routes to different organs such as the lung and liver (common) and the stomach (uncommon). We present the case of a 30-year-old male patient with upper gastrointestinal bleeding due to two ulcers in the stomach body with histology of unspecified small-cell malignant neoplasm. CT scans showed a right testicular tumor with secondary implants in the brain, lung, liver and spleen. β-HCG (35,5354 mIU/mL), AFP (500 ng/mL) and LDH (1,669 IU/L) tests were conducted. A right radical orchiectomy was performed. It is concluded that this was a clinical stage IIIC primary germ cell tumor of the right testis due to liver, spleen, lung, gastric and brain metastases.

12.
Rev Gastroenterol Peru ; 41(2): 112-116, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34724693

RESUMO

Mucinous cystic neoplasm (MCN) of the liver is an unusual cyst-forming epithelial neoplasm, typically showing no communication with the bile ducts. This neoplasm represents less than 5% of all cystic lesions of the liver and there are only 250 cases in the world literature. We present the case of a 23-year-old female with a 13.5 x 10.2 cm lesion, hypodense, lobulated, with multiple septa up to 2.5 mm thick and small cystic images inside, which produces intrahepatic bile duct and common bile duct dilatation. The pathological study concluded that the tumor corresponded to a mucinous cystic neoplasm of the liver.


Assuntos
Neoplasias dos Ductos Biliares , Neoplasias Hepáticas , Neoplasias Epiteliais e Glandulares , Adulto , Ductos Biliares , Ductos Biliares Intra-Hepáticos , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Adulto Jovem
13.
Rev. gastroenterol. Perú ; 41(4): 254-256, 20211001. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1389078

RESUMO

RESUMEN El cáncer colorectal es el tercer tipo de neoplasia maligna más frecuentemente diagnosticada para ambos sexos. El adenocarcinoma es el tipo histológico que constituye el 86% de todos los casos de carcinoma colónico; sin embargo, existen otros subtipos menos frecuentes, como el carcinoma adenoescamoso, una neoplasia sumamente rara, pero con peor pronóstico y menor sobrevida. Presentamos el caso de una paciente mujer de 68 años con un tiempo de enfermedad de 2 años, caracterizado por anemia, hematoquezia y dolor abdominal. El estudio colonoscópico reveló la presencia de tumoración a nivel de colon ascendente, el cual luego de la resección quirúrgica y estudios anatomopatológicos, resultó corresponder a un carcinoma adenoescamoso primario colónico.


ABSTRACT Colorectal cancer is the third most frequently diagnosed cancer in both men and women. Adenocarcinoma is the most common pathologic subtype of colon cancer and constitutes 86% of all colon cancers. Nontheless, there are other less frequent sybtyes of colorectal carcinomas, such as adenosquamous carcinoma, an extremely rare form of colon cancer, but with worse prognosis and greater potential of metástasis. We present the case of a 68-year-old female presented with a two-month history of anemia, hematochezia and abdominal pain. The colonoscopic study presented a tumor in the ascending colon, which after surgical resection and pathological studies, turned out to be a primary colonoc adenosquamous carcinoma.

14.
Heliyon ; 7(6): e07185, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34141939

RESUMO

PURPOSE: The role of tumor deposits (TDs) in the staging of gastric cancer is currently debatable. TDs are defined as tumoral nodules in perigastric adipose tissue with no evidence of lymphatic, vascular, or neural structures. Clinicopathological factors related to the presence of TDs are not well defined. This study aimed to identify the clinicopathological factors associated with the presence of TDs in resected gastric cancer patients. MATERIALS AND METHODS: This prospective study included patients diagnosed with gastric cancer and treated with D2 radical gastrectomy from January 2019 to January 2020. Univariate and multivariate analyses were performed to determine the factors related to the presence of TDs. RESULTS: A total of 111 patients were eligible and TDs were present in 31 of them (28%). In the univariate analysis, male gender (p = 0.027), tumor size ≥ 5cm (p = ≤0.001), serosa and adjacent organs invasion (pT4a and pT4b) (p = ≤0.001), ≥16 metastatic lymph nodes (pN3b) (p = ≤0.001), and TNM stage III tumors (p = ≤0.001) were significantly associated with the presence of TDs. The multivariate analysis showed that a tumors size ≥5 cm (OR = 3.69, 95% CI: 1.17-11.6), serosa and adjacent organs invasion (pT4a and pT4b) (OR = 3.78, 95% CI: 1.31-10.86) and ≥16 metastatic lymph nodes (pN3b) (OR = 3.21, 95%CI:1.06-9.7) were independent risk factors for the presence of TDs. CONCLUSIONS: Larger tumors (tumor size ≥ 5cm), serosa and adjacent organs invasion (pT4 and pT4b), and ≥16 metastatic lymph nodes (pN3b) were independent risk factors for the presence of TDs.

15.
Rev. gastroenterol. Perú ; 41(2)abr. 2021.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1508574

RESUMO

La neoplasia quística mucinosa (NQM) primaria de hígado es una neoplasia poco usual de tipo epitelial que se caracteriza por la formación de quistes y que típicamente no tienen comunicación con los ductos biliares. Representa menos del 5% de todas las lesiones quísticas del hígado y existen solo 250 casos en la literatura mundial. Presentamos el caso de una paciente mujer de 23 años con una lesión de 13,5 x 10,2 cm, hipodensa, lobulada, con múltiples tabiques de hasta 2,5 mm de espesor y pequeñas imágenes quísticas en su interior, que condiciona dilatación de la vía biliar intrahepática a predominio izquierdo y del colédoco. El estudio anatomopatológico concluyó que la tumoración correspondía a una neoplasia quística mucinosa de hígado.


Mucinous cystic neoplasm (MCN) of the liver is an unusual cyst-forming epithelial neoplasm, typically showing no communication with the bile ducts. This neoplasm represents less than 5% of all cystic lesions of the liver and there are only 250 cases in the world literature. We present the case of a 23-year-old female with a 13.5 x 10.2 cm lesion, hypodense, lobulated, with multiple septa up to 2.5 mm thick and small cystic images inside, which produces intrahepatic bile duct and common bile duct dilatation. The pathological study concluded that the tumor corresponded to a mucinous cystic neoplasm of the liver.

16.
Rev Gastroenterol Peru ; 41(4): 254-256, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-35613396

RESUMO

Colorectal cancer is the third most frequently diagnosed cancer in both men and women. Adenocarcinoma is the most common pathologic subtype of colon cancer and constitutes 86% of all colon cancers. Nontheless, there are other less frequent sybtyes of colorectal carcinomas, such as adenosquamous carcinoma, an extremely rare form of colon cancer, but with worse prognosis and greater potential of metástasis. We present the case of a 68-year-old female presented with a two-month history of anemia, hematochezia and abdominal pain. The colonoscopic study presented a tumor in the ascending colon, which after surgical resection and pathological studies, turned out to be a primary colonoc adenosquamous carcinoma.


Assuntos
Adenocarcinoma , Carcinoma Adenoescamoso , Neoplasias do Colo , Adenocarcinoma/diagnóstico , Idoso , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Feminino , Humanos , Masculino , Prognóstico
17.
Rev Gastroenterol Peru ; 40(2): 193-197, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32876639

RESUMO

BACKGROUND: Desmoid type fibromatosis is a benign neoplastic process non-encapsulated locally invasive and aggressive, which arises from a proliferation of bland-looking fibroblasts and myofibroblasts. The most frequent location of fibromatosis is extraabdominal (60%), abdominal wall (25%) and intra-abdominal (8-15%), rarely can originate in the viscera (0.73%), such as the pancreas, gastroesophageal junction, diaphragm and appendix. The annual incidence of desmoid tumor is estimated at 2 to 5 cases per million. In this article, we report a case of unusual presentation, originated in the cecal appendix. CASE: A 41-year-old female patient with acute pelvic pain, admitted to surgical ward with a clinical and ultrasound diagnosis of probably ovarian pedicle tumor. An explorative laparotomy revealed a solid mass of 15 cm in diameter arising from the cecal appendix, with the anatomopathological study corresponding to a desmoid tumor of the cecal appendix. CONCLUSIONS: The desmoid tumor can arise from several extra and intra-abdominal locations, the latter being the rarest and most aggressive. Accurate preoperative diagnosis is very difficult and almost always patients enter to surgery with suspected diagnosis of intraabdominal tumor of unknown etiology. The risk factors associated to its appearance are not yet characterized. The complete surgical resection of the tumor -with free surgical margins (R0)- is the treatment of choice; however, the risk of recurrence is high even with optimal tumor removal.


Assuntos
Neoplasias do Apêndice/diagnóstico , Fibromatose Agressiva/diagnóstico , Adulto , Feminino , Humanos
18.
Rev. gastroenterol. Perú ; 40(2): 193-197, abr-jun 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1144661

RESUMO

RESUMEN Antecedente : La fibromatosis tipo desmoide es un proceso neoplásico benigno no encapsulado localmente invasivo y agresivo, que se origina de la proliferación de fibroblastos y miofibroblastos aparentemente normales. La localización más frecuente de la fibromatosis es extra-abdominal (60%), pared abdominal (25%) e intra-abdominal (8-15%), en raras ocasiones puede originarse en las vísceras (0,73%), como el páncreas, unión gastroesofágica, diafragma y apéndice. La incidencia anual de tumor desmoide se estima de 2 a 5 casos por millón. En el presente artículo, reportamos un caso de presentación inusual, originado en el apéndice cecal. Caso : Paciente de sexo femenino de 41 años con dolor pélvico agudo, que ingresa a sala de operaciones con diagnóstico clínico y ecográfico de probable tumor de ovario a pedículo torcido. En el intraoperatorio se evidenció una tumoración sólida de 15 cm de diámetro que dependía del apéndice cecal, correspondiendo el estudio anatomopatológico a tumor desmoide de apéndice cecal. Conclusiones : El tumor desmoide puede originarse en diversas localizaciones extra e intra-abdominales, siendo esta última la más rara y agresiva. El diagnóstico preoperatorio exacto es muy difícil y casi siempre los pacientes ingresan al quirófano con sospecha diagnostica de tumoración intraabdominal de etiología desconocida. Los factores de riesgos asociados a su aparición aún no se encuentran caracterizados, siendo la resección quirúrgica completa del tumor -con márgenes quirúrgicos libres (R0)- el tratamiento de elección; sin embargo, el riesgo de recurrencia es alto incluso con la remoción óptima del tumor.


ABSTRACT Background : Desmoid type fibromatosis is a benign neoplastic process non-encapsulated locally invasive and aggressive, which arises from a proliferation of bland-looking fibroblasts and myofibroblasts. The most frequent location of fibromatosis is extra- abdominal (60%), abdominal wall (25%) and intra-abdominal (8-15%), rarely can originate in the viscera (0.73%), such as the pancreas, gastroesophageal junction, diaphragm and appendix. The annual incidence of desmoid tumor is estimated at 2 to 5 cases per million. In this article, we report a case of unusual presentation, originated in the cecal appendix. Case : A 41-year-old female patient with acute pelvic pain, admitted to surgical ward with a clinical and ultrasound diagnosis of probably ovarian pedicle tumor. An explorative laparotomy revealed a solid mass of 15 cm in diameter arising from the cecal appendix, with the anatomopathological study corresponding to a desmoid tumor of the cecal appendix. Conclusions : The desmoid tumor can arise from several extra and intra-abdominal locations, the latter being the rarest and most aggressive. Accurate preoperative diagnosis is very difficult and almost always patients enter to surgery with suspected diagnosis of intraabdominal tumor of unknown etiology. The risk factors associated to its appearance are not yet characterized. The complete surgical resection of the tumor -with free surgical margins (R0)- is the treatment of choice; however, the risk of recurrence is high even with optimal tumor removal.


Assuntos
Adulto , Feminino , Humanos , Neoplasias do Apêndice/diagnóstico , Fibromatose Agressiva/diagnóstico
19.
Horiz. méd. (Impresa) ; 18(4): 81-89, oct.-dic. 2018. ilus
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1012259

RESUMO

La amiloidosis cardiaca es una entidad clínica poco frecuente y por tanto poco conocida. Su presentación, por ser una enfermedad infiltrativa debido al depósito extracelular del amiloide en la pared cardiaca, es la de una cardiomiopatía del tipo restrictivo, que si bien puede ser sistémica, es la afección cardiaca la que determina su mal pronóstico. Se presenta el caso de un paciente de 38 años de edad, que fue hospitalizado por disnea y fatiga severa, y al que se diagnosticó mieloma múltiple IgA de cadenas ligeras lambda, estadio clínico IIIB, e inició tratamiento con ciclofosfamida, talidomida y dexametasona. El paciente abandonó el tratamiento y regresó luego de un año y 2 meses con la enfermedad avanzada y con presencia de amiloidosis. El paciente evoluciona tórpidamente y fallece.Se realiza una revisión de la literatura médica sobre los tipos de amiloidosis, la fisiopatología, los métodos diagnósticos y el tratamiento.


Cardiac amyloidosis is a rare clinical entity and, therefore, almost unknown. It shows as a restrictive cardiomyopathy, since it is an infiltrative disease caused by the extracellular deposition of amyloids in the cardiac wall. Although it may be systemic, the heart condition determines its poor prognosis. This is the case of a 38-year-old patient who was admitted for dyspnea and severe fatigue. He was diagnosed with IgA multiple myeloma, lambda light chains, clinical stage IIIB, and initiated treatment with cyclophosphamide, thalidomide and dexamethasone. The patient stopped the treatment, and returned after one year and 2 months with an advanced disease and presence of amyloidosis. The patient progressed torpidly and eventually died. A review of the medical literature is performed concerning amyloidosis types, physiopathology, diagnostic methods and treatment.

20.
Horiz. méd. (Impresa) ; 18(2): 80-85, abr.-jun. 2018. ilus
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1012236

RESUMO

El tumor pseudopapilar de páncreas, también conocido como tumor de Frantz, es una enfermedad muy rara en nuestro medio, comprende menos del 3 % de los tumores pancreáticos (1). Su etiología es desconocida, y su incidencia se observa en mujeres jóvenes con predominancia de la tercera década de la vida. Presentamos el caso de una mujer de 23 años que ingresa por epigastralgia urente desde hace 3 meses, además de llenura precoz. Al examen presenta dolor a la palpación profunda. Cuenta con perfil bioquímico, hepático, marcadores tumorales dentro de valores normales, la tomografía espiral multicorte (TEM) abdomino-pélvica reporta lesión neoformativa sólida quística de morfología redondeada de bordes bien definidos, la patología confirma tumor sólido pseudopapilar de páncreas. La paciente se somete a resección de tumor, con evolución favorable.


The solid pseudopapillary tumor of the pancreas, also known as Frantz's tumor, is a very rare disease in our country, comprising less than 3 % of pancreatic tumors (1). Its etiology is unknown and it is predominantly found in young women in their third decade of life. We present the case of a 23-year-old woman who was admitted due to a 3-month burning epigastralgia and early satiety. On examination, she had pain with deep palpation. Her biochemical profile, liver profile, and tumor markers were within normal values. An abdomen and pelvis multislice helical/spiral computed tomography (CT) scan showed a solid cystic neoformative lesion with rounded structure and well-defined borders. Pathology confirmed a solid pseudopapillary tumor of the pancreas. The patient underwent a tumor resection with favorable evolution.

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