Metástasis pancreáticas por carcinoma renal. Nuestra casuística y revisión de la literatura / Pancreatic metastases due to renal carcinoma. Our cases and a literature review

Analizar los casos de metástasis pancreáticas por carcinoma renal intervenidos en nuestro hospital entre los años 2000 y 2011.Material y métodos Estudio retrospectivo donde se recogen diferentes variables de 8 pacientes con metástasis pancreáticas por carcinoma renal intervenidos. Comparación de nuestros datos con los de la literatura. Resultados La enfermedad metastásica del páncreas por carcinoma renal en nuestra serie ha sido de 1,2%. Todas las metástasis han sido metacrónicas. La afectación por sexo ha sido igual. El tiempo medio entre la resección del tumor renal y el diagnóstico de las metástasis ha sido de 12,42 años (rango: 1,62-30,13 años). La actitud terapéutica ante las lesiones pancreáticas ha sido quirúrgica en todos los casos. Hasta la fecha, 7 pacientes continúan vivos. Conclusión La enfermedad metastásica del páncreas por carcinoma renal es poco frecuente (1-2,8%). El intervalo entre la resección primaria y las metástasis puede ser bastante largo. Siempre debe sospecharse metástasis pancreática en los pacientes que presenten masa pancreática e historia de carcinoma renal. Se recomienda un tratamiento quirúrgico agresivo en casos seleccionados. La cirugía en estos casos mejora la supervivencia y la calidad de vida (AU)

Objective: To analyse the cases of pancreatic metastases due to renal carcinoma operated on in our hospital between the years 2000 and 2011.Material and methods: A retrospective study using the variables of 8 patients who were subjected to surgery of pancreatic metastases due to renal carcinoma, and a comparison of our data with those from the literature. Results: The incidence of metastatic disease of the pancreas due to renal carcinoma in our series was 1.2%. All the metastases were metachronous, with both sexes being affected equally. The mean time between resection of the renal tumour and the diagnosis of the metastasis was 12.42 years (range: 1.62-30.13 years). The therapeutic approach to the pancreatic lesions was surgical in all cases. Seven patients are currently still alive. Conclusion: Metastatic disease of the pancreas due to renal carcinoma is uncommon(1%-2.8%). The interval between the primary resection and the metastasis can be quite long. Pancreatic metastasis must always be suspected in patients who present with a pancreatic mass and a history of renal carcinoma. Aggressive surgical treatment is recommended in selected cases. The surgery in these cases improves survival and the quality of life (AU)

Evaluation of alpha 1-antitrypsin and the levels of mRNA expression of matrix metalloproteinase 7, urokinase type plasminogen activator receptor and COX-2 for the diagnosis of colorectal cancer.

BACKGROUND: Colorectal cancer (CRC) is the second most common cause of death from cancer in both men and women in the majority of developed countries. Molecular tests of blood could potentially provide this ideal screening tool. AIM: Our objective was to assess the usefulness of serum markers and mRNA expression levels in the diagnosis of CRC. METHODS: In a prospective study, we measured mRNA expression levels of 13 markers (carbonic anhydrase, guanylyl cyclase C, plasminogen activator inhibitor, matrix metalloproteinase 7 (MMP7), urokinase-type plasminogen activator receptor (uPAR), urokinase-type plasminogen activator, survivin, tetranectin, vascular endothelial growth factor (VEGF), cytokeratin 20, thymidylate synthase, cyclooxygenase 2 (COX-2), and CD44) and three proteins in serum (alpha 1 antitrypsin, carcinoembryonic antigen (CEA) and activated C3 in 42 patients with CRC and 33 with normal colonoscopy results. RESULTS: Alpha 1-antitrypsin was the serum marker that was most useful for CRC diagnosis (1.79 ± 0.25 in the CRC group vs 1.27 ± 0.25 in the control group, P<0.0005). The area under the ROC curve for alpha 1-antitrypsin was 0.88 (0.79-0.96). The mRNA expression levels of five markers were statistically different between CRC cases and controls: those for which the ROC area was over 75% were MMP7 (0.81) and tetranectin (0.80), COX-2 (0.78), uPAR (0.78) and carbonic anhydrase (0.77). The markers which identified early stage CRC (Stages I and II) were alpha 1-antitrypsin, uPAR, COX-2 and MMP7. CONCLUSIONS: Serum alpha 1-antitrypsin and the levels of mRNA expression of MMP7, COX-2 and uPAR have good diagnostic accuracy for CRC, even in the early stages.

[Pancreatic metastases due to renal carcinoma. Our cases and a literature review]. / Metástasis pancreáticas por carcinoma renal. Nuestra casuística y revisión de la literatura.

OBJECTIVE: To analyse the cases of pancreatic metastases due to renal carcinoma operated on in our hospital between the years 2000 and 2011. MATERIAL AND METHODS: A retrospective study using the variables of 8 patients who were subjected to surgery of pancreatic metastases due to renal carcinoma, and a comparison of our data with those from the literature. RESULTS: The incidence of metastatic disease of the pancreas due to renal carcinoma in our series was 1.2%. All the metastases were metachronous, with both sexes being affected equally. The mean time between resection of the renal tumour and the diagnosis of the metastasis was 12.42 years (range: 1.62-30.13 years). The therapeutic approach to the pancreatic lesions was surgical in all cases. Seven patients are currently still alive. CONCLUSION: Metastatic disease of the pancreas due to renal carcinoma is uncommon (1%-2.8%). The interval between the primary resection and the metastasis can be quite long. Pancreatic metastasis must always be suspected in patients who present with a pancreatic mass and a history of renal carcinoma. Aggressive surgical treatment is recommended in selected cases. The surgery in these cases improves survival and the quality of life.

El caso de la paciente que no podía ponerse el bikini: una forma inaudita de presentación clínica del cordoma sacro / The patient who could not wear her bikini. An amazing clinical presentation of sacral chordoma

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