Dermoscopy of squamous cell carcinoma: from actinic keratosis to invasive forms. / Dermatoscopia del carcinoma epidermoide: de la queratosis actínica a las formas invasivas.

When performing the dermoscopy of squamous cell carcinoma and its precursors we differentiate among keratin-related, vascular, and pigment-related criteria. Non-pigmented actinic keratoses are characterized by the "strawberry pattern". Pigmented actinic keratosis shows a significant dermatoscopic overlap with lentigo maligna, but the presence of pigmented scales, erythema, and prominent follicles favors its diagnosis. Bowen's disease is characterized by clustered glomerular vessels, white-yellowish scales, and brown or grey dots arranged in lines in its pigmented variant. Finally, dermoscopy allows us to detect invasive squamous cell carcinoma in its early stages and differentiate it from its precursors. Furthermore, its presentation may vary depending on the degree of differentiation, with keratin-associated criteria predominating in well-demarcated tumors, while the atypical vascular pattern will predominate in poorly differentiated tumors.

Vitamin D and Skin Cancer: A Controversial Society. Literature Update and Review. / Vitamina D y cáncer cutáneo: una asociación controvertida. Actualización y revisión de la literatura.

Vitamin D (VD) deficiency has been associated with various tumors. However, the association between VD and skin cancer is controversial. Although in non-melanoma skin cancer, adequate or even high levels of VD can be associated with a higher risk of developing tumors, this could be biased by the direct association between sun exposure and VD levels. Regarding melanoma, results are contradictory. Most studies analyzed state that higher levels of VD could reduce the risk of melanoma, be associated with melanomas with better prognosis and with an enhanced antitumor response, and also with fewer adverse events associated with melanoma immunotherapy. However, prospective studies of adequate methodological quality are still needed to assess the association between VD levels and its supplementation and development/prognosis in skin cancer.

Caracterización de pacientes con cáncer de pulmón en un servicio de neumología / Characterization of patients with lung cancer in a pneumology service i: en

Introducción: El cáncer de pulmón es un problema de salud pública a escala mundial y Cuba no está exenta de este. Objetivo: Caracterizar a los pacientes diagnosticados con cáncer de pulmón según variables clínicas, epidemiológicas y morfológicas. Métodos: Se realizó un estudio transversal, descriptivo y retrospectivo de los 145 adultos diagnosticados con cáncer de pulmón en el Servicio de Neumología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero del 2018 hasta diciembre del 2019. A tal efecto, en el procesamiento estadístico se emplearon como medidas de resumen el porcentaje y la media para variables cualitativas y cuantitativas, respectivamente; asimismo, se aplicaron el coeficiente kappa para establecer el grado de concordancia entre datos y la prueba de independencia de la Χ2 para identificar asociación significativa entre los criterios de interés seleccionados (con p<0,05). Resultados: Se obtuvo un predominio del sexo masculino (62,1 %) y el grupo etario de 65-75 años (37,9 %). Respecto a la variedad histológica, resultó más frecuente el carcinoma epidermoide (42,7 %). El pulmón derecho fue el más afectado, específicamente su lóbulo superior (33,8 %); del mismo modo, existieron alteraciones morfológicas, como la infiltración bronquial (100,0 %), la irregularidad y el edema de la mucosa (con 98,5 % en cada caso) y la inflamación con engrosamiento de la pared bronquial (90,3 %). Conclusiones: La determinación de las características clínicas, epidemiológicas y morfológicas relacionadas con el cáncer de pulmón permite efectuar el correcto seguimiento de los pacientes y aplicar un adecuado protocolo terapéutico.

Introduction: Lung cancer is a public health problem worldwide and Cuba is not exempt from it. Objective: Characterize patients diagnosed with lung cancer according to clinical, epidemiological and morphological variables. Methods: A cross-sectional, descriptive and retrospective study was carried out on 145 adults diagnosed with lung cancer in the Pneumology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from January, 2018 to December, 2019. For this purpose, in the statistical processing, the percentage and mean were used as summary measures for qualitative and quantitative variables, respectively; Likewise, there were applied the kappa coefficient to establish the degree of agreement between data and the Χ2 independence test to identify a significant association between the selected criteria of interest (with p<0.05). Results: There was a predominance of the male sex (62.1%) and the age group of 65-75 years (37.9%). Regarding the histological type, squamous cell carcinoma was more common (42.7%). The right lung was the most affected, specifically its upper lobe (33.8%); also, there were morphological alterations, such as bronchial infiltration (100.0%), mucosal irregularity and edema (with 98.5% in each case), and inflammation with bronchial wall thickening (90.3%). Conclusions: The determination of the clinical, epidemiological and morphological characteristics related to lung cancer makes it possible to carry out the correct follow-up of the patients and apply an appropriate therapeutic protocol.

Uso del músculo temporal en reconstrucción periorbitaria post exéresis de carcinoma epidermoide cutáneo del globo ocular izquierdo / Use of the temporal muscle in post exeresis periorbital reconstruction of cutaneous epidermoid carcinoma of the left eyeball

Introducción. El carcinoma epidermoide cutáneo (CEC) es la segunda neoplasia cutánea más frecuente después del carcinoma basocelular. La incidencia del CEC ha aumentado de forma considerable durante los últimos 20 años y predicen un incremento en la próxima década. La mayoría de los CEC están localizados y se resuelven habitualmente mediante la extirpación quirúrgica u otros procedimientos locales. El uso del músculo temporal es una alternativa quirúrgica para corregir el defecto periorbitario tras la extirpación del CEC. Objetivo. Evaluar el resultado de la cobertura del músculo temporal en la corrección del defecto periorbitario. Material y métodos. Se presenta un caso quirúrgico de un paciente masculino, 62 años, que presenta una gran lesión tumoral que compromete el globo ocular, región orbitaria y periorbitaria izquierda, acompañado de dolor, anemia, astenia y pérdida ponderal de aproximadamente 20 libras. Con una evolución de 6 años. Conclusión. El uso del músculo temporal es una alternativa eficaz en la reconstrucción de lesiones craneofaciales, que ha sido utilizado por más de 100 años.

Introduction. Skin epidermoid carcinoma (SEC) is the second most common skin neoplasm after basal cell carcinoma. The incidence of SEC has increased considerably over the past 20 years and predicts an increase over the next decade. Most SECs are located and usually resolved by surgical removal or other local procedures. The use of the temporal muscle is a surgical alternative to correct the peri-orbital defect after removal of the SEC. Objective. To evaluate the result of temporal muscle coverage in the correction of the peri-orbital defect. Material and methods. There is a surgical case of a male patient, 62 years old who has a large tumor injury that compromises the eyeball, orbital region and left periorbital. Accompanied by pain, anemia, asthenia, and weight loss approximately 20 pounds. With an evolution of 6 years. Conclusion. The use of the temporalis muscle is an effective alternative in the reconstruction of craniofacial lesions that has been used for more than 100 years

Clinical-epidemiological characterization of patients with non-melanoma skin cancer treated with superficial radiotherapy / Caracterización clínica-epidemiológica de pacientes con cáncer de piel no melanoma tratados con radioterapia superficial / Caracterização clínico-epidemiológica de pacientes com câncer de pele não melanoma tratados com radioterapia superficial

Introduction: Basal cell carcinoma and squamous cell carcinoma collectively called non-melanoma skin cancer, are the most common malignant tumors worldwide. Objective: To identify the clinical and epidemiological characteristics of patients with non-melanoma skin cancer treated with superficial radiotherapy. Methods: A descriptive, longitudinal and retrospective study was carried out at the "Conrado Benítez García" Cancer Hospital in Santiago de Cuba in the period from October 2018 to January 2021. The universe consisted of all patients (n=147). with non-melanoma skin cancer with confirmed clinical and histological diagnosis and treated with superficial radiotherapy, older than 31 years and up to 95 years of age. The data collected from the medical records were entered into a database in the statistical program SPSS version 25 for Windows, the descriptive statistics of frequency distribution and absolute numbers were used. Results: according to age groups, the most affected was 75 - 85 years, the male sex, white skin color, urban origin and the largest number of affected patients belonged to the retired sector. Most of the patients received surgical treatment prior to radiant treatment, and the most used treatment scheme was D (320 cGy/ 17 frac / 2 times a week. Conclusions: Histological type squamous cell carcinoma had the highest incidence, as well as head and neck location was the most frequent.

Introducción: El carcinoma basocelular y el carcinoma espinocelular denominados en conjunto, cáncer de piel no melanoma, son los tumores malignos más comunes a nivel mundial. Objetivo: Identificar las características clínicas y epidemiológicas de los pacientes con cáncer de piel no melanoma tratados con radioterapia superficial. Métodos: Se realizó un estudio descriptivo, longitudinal y retrospectivo en el Hospital Oncológico "Conrado Benítez García" de Santiago de Cuba en el periodo comprendido de octubre de 2018 a enero de 2021. El universo estuvo constituido por todos los pacientes (n=147) con cáncer de piel no melanoma con diagnóstico clínico e histológico confirmado y tratados con radioterapia superficial, mayores de 31 años y hasta 95 años de edad. Los datos recogidos de las historias clínicas, fueron vaciados en una base de datos en el programa estadístico SPSS versión 25 para Windows, se utilizó la estadística descriptiva distribución de frecuencias y números absolutos. Resultados: según grupos de edades el más afectado fue 75 ­ 85 años, el sexo masculino, el color de la piel blanca, la procedencia urbana y el mayor número de pacientes afectados perteneció al sector jubilado. La mayoría de los pacientes recibieron tratamiento quirúrgico previo al tratamiento radiante, siendo el esquema de tratamiento más usado fue el D (320 cGy/ 17 frac / 2 veces a la semana Conclusiones: El carcinoma epidermoide tipo histológico fue el de mayor incidencia, así como la localización de cabeza y cuello fue la más frecuente.

Introdução: O carcinoma basocelular e o carcinoma espinocelular, chamados coletivamente de câncer de pele não melanoma, são os tumores malignos mais comuns em todo o mundo. Objetivo: Identificar as características clínicas e epidemiológicas de pacientes com câncer de pele não melanoma tratados com radioterapia superficial. Métodos: Foi realizado um estudo descritivo, longitudinal e retrospectivo no Hospital de Câncer "Conrado Benítez García" de Santiago de Cuba no período de outubro de 2018 a janeiro de 2021. O universo foi constituído por todos os pacientes (n=147). câncer de pele melanoma com diagnóstico clínico e histológico confirmado e tratados com radioterapia superficial, maiores de 31 anos e até 95 anos de idade. Os dados coletados dos prontuários foram inseridos em um banco de dados no programa estatístico SPSS versão 25 para Windows, foi utilizada a estatística descritiva de distribuição de frequência e números absolutos. Resultados: segundo as faixas etárias, a mais acometida foi de 75 a 85 anos, sexo masculino, cor da pele branca, procedência urbana e o maior número de acometidos pertencia ao setor aposentado. A maioria dos pacientes recebeu tratamento cirúrgico antes do tratamento radiante, e o esquema de tratamento mais utilizado foi o D (320 cGy/ 17 frac / 2 vezes por semana). local foi o mais frequente.

Utilização da morfometria celular no microambiente neoplásico e sua relação com a imunoexpressão da interleucina-4 / Use of cellular morphometry in the neoplastic microenvironment and its relationship with the immunoexpression of interleukin-4

A morfometria celular é um tipo de análise quantitativa que utiliza as medidas geométricas para obter informações acerca da morfologia nuclear, citoplasmática e outras medidas gerais das células, sendo que estes parâmetros podem estar alterados devido a processos fisiológicos e patológicos que modificam a morfologia celular normal, sendo uma análise relevante no prognóstico de diversas lesões. Os ceratinócitos possuem morfologia poliédrica com núcleos ovoides, mas podem sofrer alterações com eventos patológicos e fisiológicos, por exemplo, no núcleo. Essas alterações podem estar presentes em neoplasias malignas, como, no carcinoma epidermoide. A interleucina-4 (IL-4) é uma citocina secretada por diversos tipos de células, estando envolvida no desenvolvimento e diferenciação de células Th2, atuando na resposta antiinflamatória e sua expressão parece estar relacionada com o desenvolvimento de algumas neoplasias, incluindo o câncer oral. O objetivo da pesquisa foi realizar análise morfométrica celular (compartimentos nuclear e citoplasmático), identificação de irregularidades nucleares de ceratinócitos malignos e comparar com a imunoexpressão da IL-4 e profundidade de invasão nos casos de Carcinoma Epidermoide de Lábio Inferior (CELI) e Língua Oral (CELO). Foram analisados 30 casos de cada lesão. Para morfometria celular foram analisados 16 ceratinócitos malignos por caso; a imunoexpressão de IL-4 foi analisada no parênquima e estroma das lesões, utilizando softwares de análises de imagens. Foram aplicados os testes estatísticos de Análise de Variância, Kruskal-Wallis e Correlação de Spearman. A imunoexpressão de IL-4 no parênquima foi maior nos casos de CELI em todos os campos analisados (p<0,05); Houve correlação positiva entre área celular total e profundidade de invasão (p=0,038) e negativa entre imunoexpressão da IL-4 no parênquima superficial e perímetro nuclear superficial (p=0,007). Portanto, sugere-se que exista uma relação protetora da imunoexpressão IL-4 com as lesões analisadas, bem como alterações morfométricas dos ceratinócitos malignos com a imunoexpressão da IL-4 nessas lesões (AU).

Cell morphometry is a type of quantitative analysis that uses geometric measurements of cells to obtain information about the nuclear, cytoplasmic and general morphology of cells. Such parameters may be altered due to physiological and pathological processes that modify normal cell morphology, being a relevant analysis in the prognosis of several injuries. Keratinocytes have a polyhedral morphology with ovoid nuclei, but may undergo changes with pathological and physiological events, for example, in the nucleus. These changes may be present in malignant neoplasms, such as squamous cell carcinoma. Interleukin-4 (IL-4) is a cytokine secreted by several types of cells, being involved in the development and differentiation of Th2 cells, acting in the anti-inflammatory response and its expression seems to be related to the development of some neoplasms, including the oral cancer. The objective of the research was to perform cellular morphometric analysis (nuclear and cytoplasmic compartments), identification of nuclear irregularities of malignant keratinocytes and compare with the immunoexpression of IL-4 and depth of invasion in cases of Epidermoid Carcinoma of the Lower Lip (CELI) and Oral Tongue. (CELLO). Thirty cases of each lesion were analyzed. For cell morphometry, 16 malignant keratinocytes were analyzed per case; IL-4 immunoexpression was analyzed in the parenchyma and stroma of the lesions, using image analysis software. The statistical tests of Analysis of Variance, Kruskal-Wallis and Spearman's Correlation were applied. The immunoexpression of IL-4 in the parenchyma was higher in cases of CELI in all analyzed fields (p<0,05); There was a positive correlation between total cell area and depth of invasion (p=0.038) and a negative correlation between IL-4 immunoexpression in the superficial parenchyma and superficial nuclear perimeter (p=0.007). Therefore, it is suggested that there is a protective relationship between IL-4 immunoexpression and the lesions analyzed, as well as morphometric alterations of malignant keratinocytes with IL-4 immunoexpression in these lesions (AU).

El pH salival como marcador biológico en pacientes diagnosticados con carcinoma epidermoide oral de Guantánamo / Salivary pH as diagnostic biomarker in patients diagnosed with oral squamous cells carcinoma in Guantanamo / pH salivar como marcador biológico em pacientes diagnosticados com carcinoma epidermóide oral de Guantánamo

RESUMEN Introducción: El cáncer bucal constituye un problema de salud de connotación mundial. Objetivo: Comparar las variaciones del pH salival entre pacientes con carcinoma epidermoide recién diagnosticados, después del tratamiento oncoespecífico y sujetos aparentemente sanos de la provincia Guantánamo, Cuba, en el período noviembre 2019- enero 2022. Método: Se realizó un estudio descriptivo, comparativo, transversal, en pacientes ambulatorios de la consulta de Cirugía Maxilofacial del Hospital General Docente "Dr. Agostinho Neto". El grupo de estudio estuvo conformado por 200 pacientes divididos en 3 subgrupos: subgrupo I (50 pacientes recién diagnosticados con carcinoma epidermoide oral, con diagnóstico concomitante de caries dental y periodontitis crónica del adulto); subgrupo II (50 pacientes con la referida patología después de tratamiento oncoespecífico, tratados por las enfermedades bucales antes citadas) y subgrupo III (100 pacientes controles aparentemente sanos). Se estudiaron las variables: edad, sexo, tipo de dieta y pH salival. Resultados: La edad media fue de 59,8 años, 70 % fueron hombres. Se asoció la dieta consumida y cada subgrupo (p=0,001). El pH salival de los pacientes con carcinoma epidermoide recién diagnosticados afectados por ambas enfermedades bucales fue ácido (6,25±0,37) en comparación a los otros subgrupos. El 98,6 % de los pacientes con pH salival ácido presentaron una dieta usual a base de carbohidratos y grasas (p=0,000). Conclusiones: Se evidenció que el pH salival de los pacientes con carcinoma epidermoide recién diagnosticados fue ácido en comparación a los otros subgrupos, por lo que este parámetro puede usarse como un marcador biológico de la enfermedad.

ABSTRACT Introduction: Oral cancer is a common health problem worldwide. Objective: Compare the salivary pH range changes among patients diagnosed recently with oral squamous cells carcinoma after receiving oncospecific treatment and subjects apparently healthy, Guantanamo, Cuba, period time November 2019 -January 2022. Method: A descriptive, comparative, cross-sectional study was carried out in outpatients of the Maxillofacial Surgery Consultation room at the Hospital General Docente "Dr. Agostinho Neto". The study group consisted of 200 patients divided into 3 subgroups: subgroup I (50 newly diagnosed patients with oral squamous cell carcinoma, with concomitant diagnosis of dental caries and chronic adult periodontitis); subgroup II (50 patients with the aforementioned pathology after oncospecific treatment, treated for the aforementioned oral diseases) and subgroup III (100 apparently healthy control patients). The following variables were studied: age, sex, type of diet and salivary pH. Results: Average age was 59.8 years, 70% were men. There was an association between the diet consumed and each subgroup (p= 0.001). The salivary pH of newly diagnosed squamous cell carcinoma patients affected by both oral diseases was acidic (6.25±0.37) compared to the other subgroups. The 98.6% of patients with acid salivary pH presented a usual diet based on carbohydrates and fats (p=0.000). Conclusions: It was shown that the salivary pH of newly diagnosed patients with squamous cell carcinoma was acidic compared to the other subgroups. Therefore, this parameter can be used as a biological marker of the disease.

RESUMO Introdução: O câncer bucal é um problema de saúde global. Objetivo: Comparar as variações do pH salivar entre pacientes com carcinoma espinocelular recém-diagnosticado, após tratamento oncoespecífico, e indivíduos aparentemente saudáveis da província de Guantánamo, Cuba, no período de novembro de 2019 a janeiro de 2022. Método: Estudo descritivo, comparativo, cruzado seccional, em pacientes ambulatoriais da consulta de Cirurgia Bucomaxilofacial do Hospital General Docente "Dr. Agostinho Neto". O grupo de estudo foi composto por 200 pacientes divididos em 3 subgrupos: subgrupo I (50 pacientes recém-diagnosticados com carcinoma espinocelular oral, com diagnóstico concomitante de cárie dentária e periodontite crônica do adulto); subgrupo II (50 pacientes com a patologia supracitada após tratamento oncoespecífico, tratados para as doenças bucais supracitadas) e subgrupo III (100 pacientes controles aparentemente saudáveis). As variáveis estudadas foram: idade, sexo, tipo de dieta e pH salivar. Resultados: A média de idade foi de 59,8 anos, 70% eram homens. A dieta consumida e cada subgrupo foram associados (p=0,001). O pH salivar de pacientes recém-diagnosticados com carcinoma espinocelular afetados por ambas as doenças bucais foi ácido (6,25±0,37) em comparação com os outros subgrupos. 98,6% dos pacientes com pH salivar ácido apresentaram dieta habitual baseada em carboidratos e gorduras (p=0,000). Conclusões: Evidenciou-se que o pH salivar dos pacientes com carcinoma espinocelular recém-diagnosticado foi ácido em relação aos demais subgrupos. Portanto, esse parâmetro pode ser utilizado como marcador biológico da doença.

Nuevos biomarcadores de cáncer de pulmón basados en miRNA / [New biomarkers of lung cancer based on miRNA]

Objetivo: Determinar si existen diferencias de expresión entre los miRNA de tejido sano y tumoral de adenocarcinoma de pulmón y carcinoma epidermoide de pulmón, con lo que podrían ser usados como biomarcadores. Material y métodos: Se ha extraído y secuenciado el miRNA de tejido tumoral y sano adyacente de muestras de adenocarcinoma y carcinoma epidermoide de dieciséis pacientes intervenidos en el Hospital Regional de Málaga. Esas secuencias se han analizado con un flujo de trabajo bioinformático específico que conlleva varios pasos: 1o) preprocesar las lecturas, 2o) mapearlas sobre el genoma humano de referencia, 3o) determinar la expresión de los miRNA en cada una de las muestras, 4o) calcular su expresión diferencial entre el tejido sano y el tumoral de cada paciente, 5o) realizar un análisis funcional de los miRNA encontrados. Resultados: Hemos analizado los miRNA con expresión diferencial en cada uno de los tipos histológicos estudiados. El análisis del adenocarcinoma y carcinoma epidermoide de pulmón ha dado como resultado un total de 82 y 360 miRNA diferencialmente expresados (miDE), respectivamente. Hemos encontrado 50 miRNA comunes a los dos tipos histológicos, y su análisis funcional indica que están implicados en el crecimiento, desarrollo y movimiento celular, que se produce tanto en la célula normal como en el cáncer. Conclusiones: Los miDE encontrados son una fuente de biomarcadores, al tener una reprogramación específica en cáncer, y ser obtenibles de forma no invasiva. (AU)

Objective: Determine if there are differences in expression between the miRNAs of healthy and tumor tissue of lung adenocarcinoma and squamous cell carcinoma of the lung, with which they could be used as biomarkers. Material and methods: miRNA has been extracted and sequenced from tumor and adjacent healthy tissue from samples of adenocarcinoma and squamous cell carcinoma from sixteen patients operated at the Regional Hospital of Malaga. These sequences have been analyzed with a specific bioinformatic workflow that involves several steps: 1st) preprocessing the reads, 2nd) mapping them onto the reference human genome, 3rd) determining the expression of the miRNAs in each of the samples, 4th) calculate its differential expression between the healthy and tumor tissue of each patient, 5th) perform a functional analysis of the miRNAs found. Results: We have analyzed the miRNAs with differential expression in each of the histological types studied. Analysis of adenocarcinoma and squamous cell carcinoma of the lung has resulted in a total of 82 and 360 differentially expressed miRNAs (miDE), respectively. We have found 50 miRNAs common to the two histological types, and their functional analysis indicates that they are involved in cell growth, development and movement, which occurs both in normal cells and in cancer. Conclusions: The miDEs found are a source of biomarkers, as they have a specific reprogramming in cancer, and are obtainable non-invasively. (AU)

Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional / Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer –Basal Cell Carcinoma or Squamous Cell Carcinoma-Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study

Objetivo: Los pacientes diagnosticados de cáncer queratinocítico (carcinoma basocelular y carcinoma epidermoide cutáneo) o cáncer cutáneo no melanoma (CCNM) tienen un riesgo aumentado de desarrollar una segunda neoplasia cutánea. Nuestro objetivo es describir la frecuencia, tasa de incidencia y factores de riesgo predisponentes para desarrollar una segunda neoplasia cutánea en una cohorte de pacientes tratados mediante cirugía micrográfica de Mohs (CMM). Material y métodos: Estudio prospectivo de una cohorte nacional de pacientes incluidos para realización de CMM para tratar CCNM en 22 centros españoles (julio 2013-febrero 2020) REGESMOHS. Las variables analizadas incluyen las características demográficas, la frecuencia de aparición de segundas neoplasias cutáneas, sus tasas de incidencia y factores de riesgo, y se estimaron utilizando un modelo de regresión logístico multivariante de efectos mixtos. Resultados: Fueron intervenidos 4.768 pacientes: 4.397 (92%) carcinomas basocelulares, y 371 (8%) carcinomas epidermoides. El tiempo medio de seguimiento fue de 2,4 años. Se diagnosticó un nuevo tumor durante el seguimiento en 1.201 pacientes (25%); 1.013 (21%) fueron carcinomas basocelulares, 154 (3%) carcinomas epidermoides cutáneos, 20 melanomas (0,4%) La tasa de incidencia fue de 107 (101-113) por 1.000 personas/año para cualquier tumor; 90 (85-96) para el carcinoma basocelular, 14 (12-16) para el carcinoma epidermoide cutáneo y 2 (1-3) para el melanoma. El riesgo de nueva neoplasia fue mayor en varones que en mujeres 738 (61%) vs. 463 (39%). Los factores de riesgo más significativos fueron la historia de múltiples tumores previos al diagnóstico (RR: 4,6; IC 95%: 2,9-7,1); la inmunosupresión (RR: 2,1; IC 95%: 1,4-3,1) y paciente varón (RR: 1,6; IC 95%: 1,4-1,9) (AU)

Objective: Patients with nonmelanoma skin cancer (NMSC)—ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)—have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Material and methods: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. Results: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). Conclusion: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex (AU)

[Translated article] Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer – Basal Cell Carcinoma or Squamous Cell Carcinoma – Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study / Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional

Objective: Patients with nonmelanoma skin cancer (NMSC)—ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)—have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Material and methods: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. Results: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). Conclusion: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex (AU)

Objetivo: Los pacientes diagnosticados de cáncer queratinocítico (carcinoma basocelular y carcinoma epidermoide cutáneo) o cáncer cutáneo no melanoma (CCNM) tienen un riesgo aumentado de desarrollar una segunda neoplasia cutánea. Nuestro objetivo es describir la frecuencia, tasa de incidencia y factores de riesgo predisponentes para desarrollar una segunda neoplasia cutánea en una cohorte de pacientes tratados mediante cirugía micrográfica de Mohs (CMM). Material y métodos: Estudio prospectivo de una cohorte nacional de pacientes incluidos para realización de CMM para tratar CCNM en 22 centros españoles (julio 2013-febrero 2020) REGESMOHS. Las variables analizadas incluyen las características demográficas, la frecuencia de aparición de segundas neoplasias cutáneas, sus tasas de incidencia y factores de riesgo, y se estimaron utilizando un modelo de regresión logístico multivariante de efectos mixtos. Resultados: Fueron intervenidos 4.768 pacientes: 4.397 (92%) carcinomas basocelulares, y 371 (8%) carcinomas epidermoides. El tiempo medio de seguimiento fue de 2,4 años. Se diagnosticó un nuevo tumor durante el seguimiento en 1.201 pacientes (25%); 1.013 (21%) fueron carcinomas basocelulares, 154 (3%) carcinomas epidermoides cutáneos, 20 melanomas (0,4%) La tasa de incidencia fue de 107 (101-113) por 1.000 personas/año para cualquier tumor; 90 (85-96) para el carcinoma basocelular, 14 (12-16) para el carcinoma epidermoide cutáneo y 2 (1-3) para el melanoma. El riesgo de nueva neoplasia fue mayor en varones que en mujeres 738 (61%) vs. 463 (39%). Los factores de riesgo más significativos fueron la historia de múltiples tumores previos al diagnóstico (RR: 4,6; IC 95%: 2,9-7,1); la inmunosupresión (RR: 2,1; IC 95%: 1,4-3,1) y paciente varón (RR: 1,6; IC 95%: 1,4-1,9) (AU)

Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer -Basal Cell Carcinoma or Squamous Cell Carcinoma-Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study. / Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional.

OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.

Caracterización de pacientes con cáncer ocular en un hospital de Santiago de Cuba / Characterization of patients with eye cancer in a hospital from Santiago de Cuba i: en

Introducción: La neoplasia ocular puede afectar el ojo, los anexos y la órbita. El tratamiento eficaz depende de un diagnóstico precoz, presuntivo y certero. Objetivo: Caracterizar a los pacientes con cáncer ocular según variables de interés. Método: Se realizó un estudio observacional, descriptivo y retrospectivo de 58 pacientes con tumor maligno ocular, confirmado mediante biopsia, atendidos en el Servicio de Cirugía Plástica Ocular del Centro Oftalmológico del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde octubre del 2015 hasta igual periodo del 2020. Se utilizó la media para las variables cuantitativas. Resultados: En la serie la edad media fue de 62,49 años; primaron el sexo masculino (51,7 %) y el color de la piel mestizo (53,4 %). La localización más frecuente de las lesiones tumorales en los anexos fue en los párpados (53,4 %) y la conjuntiva (41,4 %). Los tipos histológicos predominantes fueron carcinoma basocelular palpebral (44,8 %) y carcinoma epidermoide de la conjuntiva (41,4 %). La estadificación del tumor se estableció: T1 en 47 pacientes, T2 y T3 en 4, así como T4 en 3. Conclusiones: El control del cáncer ocular es de suma importancia, pues permite trazar estrategias para el diagnóstico precoz y el tratamiento adecuado de los pacientes.

Introduction: The ocular neoplasm can affect the eye, annexes and orbit. The effective treatment depends on an early, presumptive and accurate diagnosis. Objective: To characterize patients with eye cancer according to variables of interest. Method: An observational, descriptive and retrospective study of 58 patients with eye malignancy confirmed by means of biopsy was carried out. They were assisted in the Ocular Plastic Surgery Service of the Ophthalmologic Center at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from October, 2015 to the same period in 2020. The mean was used for the quantitative variables. Results: In the series the mean age was of 62.49 years; there was a prevalence of the male sex (51.7 %) and the mixed race color of the skin (53.4 %). The most frequent localization of the tumoral lesions in the annexes was in the lids (53.4 %) and the conjunctive (41.4 %). The predominant histologic types were palpebral basal cell carcinoma (44.8 %) and squamous cell carcinoma of the conjunctive (41.4 %). The estadification of the tumor was established: T1 en 47 patients, T2 and T3 in 4, as well as T4 in 3. Conclusions: The control of the eye cancer is very important, because it allows to trace strategies for the early diagnosis and the appropriate treatment of patients.

Carcinoma epidermoide de piel tratado con HeberFERON®

RESUMEN Introducción: en la literatura biomédica son escasos los reportes sobre el uso de los interferones como tratamiento en el carcinoma epidermoide. En una unidad de atención primaria, en Colón, Matanzas, se implementó el HeberFERON® en este tipo de tumor, con experiencias favorables. Objetivo: describir la efectividad del HeberFERON® en el carcinoma epidermoide. Materiales y métodos: se realizó un estudio observacional, descriptivo en 33 lesiones de carcinoma epidermoide en 29 pacientes. La dosis fue de 7,0 y 10,5 MUI de actividad antiviral, infiltrada de forma perilesional tres veces por semana durante tres semanas. Se realizó el seguimiento clínico de los pacientes antes del tratamiento y a las 16 semanas del inicio del mismo. Las variables fueron: edad, sexo, fototipo de piel, procedencia, localización, tipo clínico, estadio y respuesta clínica al tratamiento. Se consideraron cuatro categorías de respuesta: completa, parcial, enfermedad estable y progresiva. Se incluyó la respuesta objetiva (completa más parcial). Se recogieron los datos en una historia clínica. Se utilizaron los programas Microsoft Excel y SPSS para el procesamiento estadístico. Resultados: el 65,5 % de los pacientes correspondió al sexo masculino. Un 58,6 % son fototipo II y de procedencia urbana. Predominaron las edades entre 61 y 80 años (55,2 %). Hubo respuesta objetiva en 57,6 % (cinco completas y 14 parciales). Las mejores respuestas la mostraron el carcinoma epidermoide queratósico superficial y el noduloulceroso. Conclusiones: la mezcla de interferones fue efectiva en el carcinoma epidermoide en todos los subtipos clínicos, aunque los autores sugieren un segundo ciclo de HeberFERON® o asociarlo con quimioterapia cuando la respuesta no sea completa.

ABSTRACT Introduction: there are few reports in the literature on the use of interferon in the treatment of the squamous cell carcinoma. In a primary care unit in Colon, Matanzas, HeberFERON® was implemented in this type of tumor with favorable experiences. Objective: to describe the effectiveness of HeberFERON® in epidermoid carcinoma. Materials and methods: an observational, descriptive study was conducted in 33 epidermoid carcinoma lesions in 29 patients. The doses were 7.0 and 10.5 MUI of antiviral activity, perilesionally infiltrated three times a week for three weeks. Clinical follow-up of patients was performed before the treatment and at 16 weeks from the beginning of the treatment. The variables were: age, sex, skin phototype, origin; location, clinical type, stage and clinical response to treatment. Four categories of response were considered: complete, partial, stable and progressive disease. The objective response (complete plus partial) was included. Data were collected in a clinical record. The Microsoft Excel and SPSS programs were used for statistical processing. Results: 65.5 % of patients were male. 58.6 % are phototype II and of urban origin. Ages ranging from 61 to 80 years (55.2 %) predominated. There was objective response in 57.6 % (five complete and 14 partials). The superficial keratotic squamous cell carcinoma and the nodular ulcerative one showed the best responses. Conclusions: interferon mixing was effective in all clinical subtypes of epidermoid carcinoma, although the authors suggest a second cycle of HeberFERON® or to associate it with chemotherapy when the response is not complete.

Reconstrucción mandibular mediante colgajo miocutáneo de pectoral mayor en carcinoma epidermoide, reporte de caso clínico y revisión de la literatura / Mandibular reconstruction using pectoralis major myocutaneous flap in squamous cell carcinoma, clinical case report and literature review

RESUMEN El carcinoma epidermoide surge del epitelio de la mucosa oral, es frecuente en la quinta y sexta décadas de la vida y está típicamente asociado con factores de riesgo como tabaquismo y el consumo de alcohol. En todo el mundo, la incidencia de cáncer oral es más alta en hombres que en mujeres. El incremento en la incidencia del cáncer en México requiere de un manejo adecuado, como colgajos vascularizados para reparar defectos generados por una hemimandibulectomía con márgenes de seguridad. A pesar de la llegada de injertos de tejido libres vascularizados, el colgajo pectoral mayor miocutáneo sigue siendo un colgajo pediculado ampliamente utilizado para la reconstrucción de defectos de tejidos blandos en la región oral y maxilofacial. Se muestra el protocolo quirúrgico realizado en el Hospital Regional "General Ignacio Zaragoza" ISSSTE para el tratamiento de un carcinoma epidermoide mandibular.

ABSTRACT Squamous cell carcinoma arises from the epithelium of the oral mucosa, common in the fifth and sixth decades of life and is typically associated with risk factors such as smoking and alcohol consumption. Worldwide, the incidence of oral cancer is higher among men than women. The increase in the incidence of cancer in Mexico requires proper management and the use of vascularized flaps to repair defects generated by a hemimandibulectomy with safety margins. Despite the advent of vascularized free tissue grafts, the myocutaneous pectoralis major flap remains a pedunculated flap widely used for the reconstruction of soft tissue defects in the oral and maxillofacial region. The surgical protocol carried out at the ISSSTE "General Ignacio Zaragoza" Regional Hospital for the treatment of mandibular squamous cell carcinoma is shown.

Desenvolvimento de metodologia para identificação de fungos através de metabarcoding aplicada em amostras humanas de adenocarcinoma gástrico e carcinoma epidermoide de pênis / Development of methodology for fungi identification through metabarcoding applied in gastric adenocarcinoma and penile epidermoid carcinoma of human sample

O microbioma humano compreende material genético da microbiota de um local do corpo e tem influência direta ou indireta na manutenção da homeostase. O distúrbio da microbiota pode estar relacionado ao desenvolvimento de doenças. A população fúngica ainda é muito pouco estudada no contexto do microbioma. No presente estudo, foi desenvolvida uma metodologia para identificação de fungos por metabarcoding. A metodologia desenvolvida foi aplicada em mostras de pacientes portadores de adenocarcinoma gástrico ou carcinoma epidermoide de pênis. De modo geral, em ambos os tumores foi verificada a redução de diversidade fúngica conforme a evolução do estadiamento patológico. Também foram verificados resultados não concordantes ao analisar espécies diferencialmente abundantes em dados de sequenciamento da região ITS2 e de WGS nas amostras de lavado gástrico. Este trabalho reforça a importância em se estudar os fungos e sua associação com doenças como o câncer e incentiva próximos estudos através do desenvolvimento de uma metodologia específica para o micobioma.

The human microbiome comprises genetic material from the microbiota of a body site and has a direct or indirect influence on the maintenance of homeostasis. The disturbance of the microbiota may be related to the development of diseases. The fungal population is still very little studied in the context of the microbiome. In this study, a methodology was developed to identify fungi by metabarcoding. The methodology developed was applied to samples from patients with gastric adenocarcinoma or squamous cell carcinoma of the penis. In general, in both tumors, a reduction in fungal diversity was observed according to the evolution of the pathological staging. Discordant results were also found when analyzing differentially abundant species in sequencing data from the ITS2 region and WGS in gastric lavage samples. This work reinforces the importance of studying fungi and their association with diseases such as cancer and encourages further studies through the development of a specific methodology for the mycobiome

Caracterización clínico-patológica de pacientes con cáncer esofágico avanzado en el Hospital Princess Marina, Botsuana / Clinicopathological characterization of patients with advanced esophageal cancer at Princess Marina Hospital, Botswana / Caracterização clínico-patológica de pacientes com câncer de esôfago avançado no Hospital Princess Marina, Botswana

RESUMEN Introducción: El cáncer de esófago avanzado es una de las neoplasias más agresivas con una elevada morbilidad y mortalidad. Botsuana ocupa el duodécimo cuarto puesto mundial con respecto a las muertes ocasionadas por esta enfermedad. Objetivo: Determinar las características clínico-patológicas de los pacientes con cáncer esofágico avanzado en el Hospital Princess Marina de Gaborone, Botsuana. Método: Se realizó un estudio prospectivo-descriptivo donde se caracterizó clínica y patológicamente a 45 pacientes con el diagnóstico endoscópico e histológico de cáncer de esófago avanzado en el periodo de enero a septiembre de 2019. Resultados: Predominó el sexo masculino (86,7 %) y los pacientes mayores de 60 años (60,0 %). La disfagia, la anorexia y la pérdida de peso fueron los síntomas más frecuentes y prevalecieron los pacientes con un tiempo entre la aparición de los síntomas y el diagnóstico-endoscópico entre tres y seis meses; la dieta inadecuada, el etilismo crónico y el hábito de fumar fueron los factores de riesgo predominantes. La localización anatómica más frecuente fue el tercio medio (51,1 %), el tipo endoscópico predominante fue el vegetante (46,7 %) y la mayoría de los pacientes presentó el tipo histológico carcinoma epidermoide (95,6 %) bien diferenciado (84,4 %). Conclusiones: El estudio de las características clínico-patológicas de los pacientes con cáncer esofágico avanzado permite su correcta estadificación, siendo una herramienta útil en la valoración multidisciplinaria del tratamiento debido a su complejo manejo clínico e institucional.

ABSTRACT Introduction: Advanced esophageal cancer is one of the most aggressive neoplasms with high morbidity and mortality. Botswana ranks 14th in the world for deaths from this disease. Objective: To determine the clinicopathological characteristics of patients with advanced esophageal cancer at the Princess Marina Hospital in Gaborone, Botswana. Method: A prospective-descriptive study was carried out, where 45 patients with endoscopic and histological diagnosis of advanced esophageal cancer were characterized clinically and pathologically, from January to September 2019. Results: Males predominated (86.7%), and also patients older than 60 years (60.0%). Dysphagia, anorexia and weight loss were the most frequent symptoms, and prevailed patients with three to six months between the appearance of symptoms and endoscopic diagnosis; inadequate diet, chronic alcoholism, and smoking were the predominant risk factors. The most frequent anatomical location was the middle third (51.1%), the predominant endoscopic type was the vegetative (46.7%) and most of the patients presented the histological type squamous cell carcinoma (95.6%) well differentiated (84.4%). Conclusions: The study of the clinical-pathological characteristics of patients with advanced esophageal cancer allows its correct staging, being a useful tool in the multidisciplinary assessment of treatment due to its complex clinical and institutional management.

RESUMO Introdução: O câncer de esôfago avançado é uma das neoplasias mais agressivas com alta morbimortalidade. Botswana ocupa o 14º lugar no mundo em mortes por esta doença. Objetivo: determinar as características clínico-patológicas de pacientes com câncer de esôfago avançado no Hospital Princesa Marina em Gaborone, Botsuana. Método: Foi realizado estudo prospectivo-descritivo em que 45 pacientes com diagnóstico endoscópico e histológico de câncer de esôfago avançado foram caracterizados clínica e patologicamente de janeiro a setembro de 2019. Resultados: Predominou o sexo masculino (86,7%) e pacientes com mais de 60 anos ( 60,0%). Disfagia, anorexia e perda de peso foram os sintomas mais frequentes e prevaleceram os pacientes com tempo entre o aparecimento dos sintomas e o diagnóstico endoscópico entre três e seis meses; dieta inadequada, alcoolismo crônico e tabagismo foram os fatores de risco predominantes. A localização anatômica mais frequente foi o terço médio (51,1%), o tipo endoscópico predominante foi o vegetativo (46,7%) e a maioria dos pacientes apresentou o tipo histológico carcinoma espinocelular (95,6%) bem diferenciado (84,4%). Conclusões: O estudo das características clínico-patológicas dos pacientes com câncer de esôfago avançado permite seu correto estadiamento, sendo uma ferramenta útil na avaliação multidisciplinar do tratamento devido ao seu complexo manejo clínico e institucional.

Carcinoma de células escamosas del conducto auditivo que infiltra al hueso temporal: a propósito de un caso / Squamous cell carcinoma of the ear canal infiltrating the temporal bone: A case report

El carcinoma epidermoide del conducto auditivo es una entidad derivada del estrato espinocelular, es una neoplasia poco frecuente, con baja incidencia presentándose uno a seis casos por millón de habitantes, por lo cual existe poca información bibliográfica sobre esta patología. La clínica de presentación del cáncer de hueso temporal usualmente es inespecífica, por lo que su diagnóstico es siempre tardío. El diagnóstico definitivo requiere de biopsia de la lesión para estudio histopatológico e inmunohistoquímico y así poder establecer el comportamiento y el grado de diferenciación. Presentamos a continuación el caso de una paciente adulta con antecedente clínico de osteoporosis, diagnosticada con otitis media crónica de oído izquierdo de años de evolución, acompañada de secreción purulenta del mismo que no respondió a múltiples esquemas de tratamiento. Cursó con cefalea de predominio temporal izquierdo refractaria a analgesia convencional. En tomografía computarizada de cráneo se evidenció lesión osteolítica del hueso temporal izquierdo con invasión hacia duramadre. Tras resección y toma de biopsia de la lesión se confirma carcinoma epidermoide moderadamente diferenciado (AU)

Squamous cell carcinoma of the ear canal is an entity that arises from the stratum spinosum; it is a rare neoplasm, with a low incidence presenting 1 to 6 cases per million inhabitants, so there is little literature on this pathology. The clinical presentation of temporal bone cancer is usually nonspecific, meaning that its diagnosis is always a late-stage discovery. The definitive diagnosis requires biopsy of the lesion for histopathological and immunohistochemical study to establish the behaviour and the degree of differentiation. We present the case of an adult female patient with a clinical history of osteoporosis, diagnosed with chronic otitis media of the left ear of years of evolution, accompanied by purulent secretion of the same ear that did not respond to multiple treatment regimens. The patient also presented with a headache of left temporal predominance refractory to conventional analgesia. Cranial CT scans showed an osteolytic lesion of the left temporal bone with dural invasion. After resection and biopsy of the lesion, moderately differentiated squamous cell carcinoma was confirmed (AU)