Paraganglioma de cuerpo carotideo / Carotid body paraganglioma

Contexto: Los paragangliomas del cuerpo carotideo son tumores adrenales de mayor frecuencia entre los paragangliomas; en términos generales, son infrecuentes y deben ser diagnosticados por técnicas de imagen para caracterizar la anatomía y grado de invasión del tumor, a fin de su planificación quirúrgica. Objetivo: evaluar la experiencia institucional del Hospital Carlos Andrade Marín en el manejo de los tumores del cuerpo carotideo. Sujetos y métodos: el estudio retrospectivo analizó los registros médicos de 26 pacientes con paragangliomas del cuerpo carotideo tratados en el Hospital Carlos Andrade Marín de Quito, en un periodo de 21 meses; se complementa con una revisión de la bibliografía. Resultados: del total del universo estudiado el paragaglioma se presentó en 20 mujeres que corresponde al 76%, y en 6 hombres que corresponde al 23. El tamaño promedio del tumor en los pacientes fue de 3,7 ± 1,4 cm. Según la clasificación de Shamblin el paraganglioma en el 74% de los pacientes se encontraba en clasificación ll, el 22% se encontraban en clasificación l, mientras que el 37% se encontraban en clasificación lll. El promedio de sangrado en los pacientes fue 331 ± 284 ml .El tiempo quirúrgico fue de 112 ± 37 minutos. La resección completa del tumor se realizó en el 100 % de los pacientes, en donde en el 7,4% hubieron complicaciones de lesion del nervio craneal y otras complicaciones ocurrieron en el 7,4 % de los pacientes. Conclusión: la experiencia del equipo quirúrgico del Hospital Carlos Andrade Marín ofreció una alternativa segura, con resultados satisfactorios y baja incidencia de secuelas a largo plazo. (AU)

Context: The paragangliomas of the carotid body are adrenal tumors of greater frequency among the paragangliomas; In general terms, they are infrequent and must be diagnosed by imaging techniques to characterize the anatomy and degree of tumor invasion, in order to plan their surgery. Objective: To evaluate the institutional experience of the Hospital Carlos Andrade Marin in the managemen of tumors of the carotid body. Subjects and methods: The retrospective study analyzed the medical records of 26 patients with paragangliomaof the carotid body treated in the Carlos Andrade Marín Hospital in Quito, in a period of 21 months; It icomplemented by a review of the bibliography. Results: of the total universe studied, paragaglioma was present in 20 women, corresponding to 76%, and in 6 men, corresponding to 23%. The average tumor size in the patients was 3.7 ± 1.4 cm. According to the classification of Shamblin paraganglioma in 74% of patients were in classification II, 22% were in classification I, while 37% were in classification III. The average bleeding in the patients was 331 ± 284 ml. The surgical time was 112 ± 37 minutes. Complete resection of the tumor was performed in 100% of the patients, where in 7.4% there were cranial nerve lesions and other complications occurred in 7.4% of the patients. Conclusions: The experience of the surgical team of the Hospital Carlos Andrade Marín offers a safe alternative, with satisfactory results and low incidence of long-term sequelae. (AU)

Influencia del tipo histológico en la supervivencia de niños y adolescentes con osteosarcoma / Influence of histological type in the survival of children and adolescents with osteosarcoma

Objetivos: Determinar la influencia del tipo histológico en la supervivencia de niños y adolescentes con osteosarcoma diagnosticados en el servicio de Anatomía Patológica del Hospital Edgardo Rebagliati Martins del año 2002 al 2012. Materiales y métodos: Estudio retrospectivo, descriptivo y transversal. Se revisaron las láminas histológicas de 49 niños y adolescentes con osteosarcoma diagnosticados en el servicio de Anatomía Patológica del Hospital Edgardo Rebagliati Martins del año 2002 al 2012, luego del cual se correlacionó con la supervivencia para determinar la influencia de cada tipo histológico. Resultados: De los 49 pacientes 34 fueron localizados y 15 metastásicos predominando el tipo osteoblástico; correlacionando el DHL de inicio, tamaño tumoral, respuesta a quimioterapia y la cirugía se observó que el osteosarcoma telangiectásico influye negativamente en la supervivencia, al realizar el análisis multivariado mediante la regresión de Cox se observó que el tipo histológico tiene significancia estadística e influye en la supervivencia de la enfermedad. Conclusiones: El tipo histológico telangiectásico del osteosarcoma es un factor pronóstico fundamental a tener en cuenta al momento del diagnóstico y tratamiento de la enfermedad.

Incidencia de cáncer de vesicula biliar y su correlación anatomo patológico en los pacientes colecistectomizados - Hospital Nacional Dos de Mayo 2009-2011 / Incidence of gallbladder cancer and its correlation anatomo-pathological in patients with cholecystectomy-National Hospital Dos de Mayo 2009-2011

El carcinoma de la vesícula biliar es la neoplasia maligna más frecuente del sistema biliar, y ocupa el quinto lugar entre los carcinomas prevalentes del aparato digestivo. Representa entre el 2 al 4 por ciento del total de los tumores malignos. Es una neoplasia infrecuente asociada a una alta mortalidad propia del diagnóstico tardío y el cuadro clínico no especifico. El abordaje quirúrgico, sus complicaciones y el impacto de este a largo plazo en desenlaces de sobrevida, aún son motivo de controversia en la práctica clínica. El propósito del presente trabajo de investigación es determinar la incidencia, los factores que están asociados, el tipo histológico más frecuente así como determinar el porcentaje de diagnóstico como hallazgo histopatológico en un periodo de tres años 2009, 2010, 2011 en pacientes colecistectomizados en el Hospital Dos de Mayo el cual es considerado punto referencial de una población importante del Perú en especial del grupo con menor recurso económico. El tipo de estudio es descriptivo transversal retrospectivo en una población de colecistectomizados con un total de 2768 de los cuales 36 pacientes fueron diagnosticados de cáncer de vesícula biliar a quienes se reviso sus historias clínicas para llenar la ficha de recolección de datos luego se utilizo el programa SPSS versión 15 para su respectivo análisis. La incidencia de cáncer de vesícula biliar en este estudio es de 1.3 por ciento de cada 100 colecistectomías y predominantemente en mujeres en un 91.7 por ciento mayores de 60 años y relacionado con la presencia de cálculos en 77.8 por ciento de los cuales son mayor de 10 mm en el 52.8 por ciento. Con lo anterior se determina que los principales factores de riesgo son sexo femenino, la edad y la presencia de cálculos. En relación al tipo histológico el más frecuente es adenocarcinoma y al estadiaje TNM es el T2, como hallazgo histopatológico (insospechado) es de 66.7 por ciento...

Carcinoma of the gallbladder is the most common malignancy of the biliary system, and ranks fifth among prevalent gastrointestinal carcinomas. Accounts for 2 to 4 per cent of all malignant tumors. It is a rare neoplasm associated with high mortality typical of late diagnosis and the clinical picture did not specify. The surgical approach, complications, and the impact of long-term survival outcomes, are still controversial in clinical practice. The purpose of this research is to determine the incidence, associated factors, the most common histological type and to determine the percentage of histopathologic diagnosis and a period of three years 2009, 2010, 2011 cholecystectomy patients at the Hospital May 2 which is considered the reference point of an important population of Peru in particular of the group with the lowest economic resource. The type of retrospective cross-sectional descriptive study in a population of cholecystectomy with a total of 2768 of which 36 patients were diagnosed with gallbladder cancer who was reviewed medical records to complete the data collection form was used after the program SPSS version 15 for examination. The incidence of gallbladder cancer in this study is 1.3 per cent of 100 cholecystectomies and predominantly in women of 91.7 per cent over 60 years and related to the presence of stones in 77.8 of which are greater than 10 mm in 52.8 per cent. With the above it is determined that the main risk factors include female sex, age and the presence of gallstones. Regarding the histologic type is the most common adenocarcinoma and TNM staging is the T2, and histopathological findings (unexpected) is 66.7 per cent. Our incidence data are similar to the global reporting ranging from 0.2 to 5 per cent cholecystectomies. But in relation to a study by Loayza Hospital in 2002 where its incidence is 0.99 per cent incidence in the National Hospital on May 2 is high.

Primary thyroid lymphoma

@#pEight cases of primary thyroid lymphoma were reported in a tertiary government hospital from January 2005 to August 2011. All patients presented with a diffuse enlargement of both thyroid lobes with associated obstructive symptoms. Five of these cases were extranodal marginal zone lymphoma and three were diffuse large B-cell lymphoma. Clinical features that would favor a thyroid lymphoma include tumor size of greater than 7 cm, obstructive symptoms, clinical hypothyroidism or history of Hashimoto thyroiditis. Thus, these features must be considered in evaluating thyroid nodules during fine-needle aspiration biopsy. Histologically, extranodal marginal zone B-cell lymphoma shows vaguely nodular to diffuse infiltrates of small to intermediate size atypical lymphoid cells infiltrating the thyroid follicles while diffuse large B-cell lymphoma shows sheets of large atypical lymphoid cells infiltrating the thyroid follicular epithelium./p

The role of 18F-FDG PET in the evaluation of treatment for lymphoma: Philippine setting

PET is essential for the post-treatment assessment of lymphomas because a negative PET scan after treatment is required for a complete remission and curative outcome. Functional imaging with 18F-FDG PET enables evaluation of the early metabolic changes rather than the moprphologic changes of the lymphoma occurring later. Among 186 patients diagnosed with Hodgkin's Disease or Non-Hodgkin's Lymphoma who were referred to the PET Center in this institution from April 2002 to June 2010, 35 patients were included in this study. All 14 patients who only had end-of-chemotherapy scans without midcycle scans had no tumor recurrence on subsequent scan/s, with a median follow-up of 17.5 months. Of the remaining 21 patients, 11 patients had positive studies, 9 had negative studies and 1 had an indeterminate study of the midcycle scans. All the patients obtained similar results on the subsequent scans, excluding 5 with no follow-up scans, with median follow-ups of 13 months for the PET-positive patients and 23 months for the PET-negative patients. These results support the strong prognostic value of PET for aggressive lymphomas, whether the imaging is performed at the end of therapy or after only a few cycles of chemotherapy. PET has consistently been shown to identify positive respondents with higher survival probabilities and longer progression-free survival periods from non-responders on subsequent scans.

Small (<4 cm), Unclassified Renal Cell Carcinoma Presenting with Initial Bone Metastasis: A Case of a Metastatic Lesion Missed at the Initial Diagnosis

A 49-year-old man presented with an incidentally detected right renal mass on a health examination. The abdominal computed tomography and magnetic resonance imaging showed a 3-cm right renal mass suspected of being a hypovascular tumor, such as papillary renal cell carcinoma, and an osteoblastic metastatic lesion on the right iliac bone. However, we missed a bone lesion at the time of diagnosis. A laparoscopic radical nephrectomy was performed and the final pathology confirmed unclassified renal cell carcinoma. The follow-up imaging studies showed several neck lymph nodes and multiple bone metastases at the lumbar spine, right iliac bone, and left femur. Thirteen cycles of temsirolimus were administered to the patient, but follow-up positron emission tomography showed newly developed liver and left adrenal metastasis and increased bone metastasis. It is important to note that T1a renal cell carcinoma can present with distant metastasis and thus demands scrupulous examination even though the tumor size may be small.

Primary sinonasal ameloblastoma in a Filipino female

@#<p style="text-align: justify;">Primary sinonasal ameloblastoma is an extremely rare odontogenic epithelial tumor histomorphologically identical to its gnathic counterparts but with distinct epidemiologic and clinicopathologic characteristics. We present a case of a 46-year-old female with a one year history of recurrent epistaxis, nasal obstruction and frontonasal headache. Clinical examination, CT scan and subsequent surgical excsion revealed an intranasal mass attached to the lateral nasal cavity with histomorphologic features of ameloblastoma and was signed out as extragnathic soft tissue ameloblastoma of the sinonasal area. Extraosseous extragnathic primary sinonasal ameloblastoma are rare but do occur and should be distinguished from infrasellar craniopharyngiomas.</p>

Osteosarcoma in the preadolescent Filipino patient

Objective. Classic high-grade osteosarcoma is uncommon in preadolescents (less than or equal to 10 years of age). The possibilities of clinicopathologic differences from the typical adolescent osteosarcoma patient have been raised. We sought to compare the presentation, treatment and survival of this subgroup of patients with published rates in order to determine if there is a need to use a treatment regimen different from that for regular adolescent osteosarcoma patients. Methods. Records of the University of the Philippines-Musculoskeletal Tumor Unit (UP-MuST) over a 15-year period (1993-2008) were reviewed and data collected on patients 10 years and younger with biopsy-proven classic high-grade intramedullary osteosarcoma who underwent complete treatment by the Unit. Demographics and survival rates were then compared with published rates for preadolescent and regular adolescent osteosarcoma cases. Results. There were fourteen patients; (6M:8F; age: 4-10 years). The most common presentation was a painful mass in the distal femur (8); the tumors most commonly had osteoblastic histology (12). Treatment consisted of neoadjuvant chemotherapy, wide surgical excision through ablation (9) or limb-saving surgery (5), and postoperative chemotherapy. There was a good histologic response (over 90% tumor necrosis) in four patients. Seven patients are ANED (alive no evidence of disease) 25 to 186 months after diagnosis. Five-year survival estimate is 52%, compared to a dismal 5 to 10% 15 years ago. Conclusion. Clinicopathologic presentation, clinical course, and overall survival in this subgroup of patients are comparable with published results for both preadolescent and adolescent osteosarcoma patients. There is no need to alter the present treatment regimen for this group of young patients.

Whole body bone scintigraphy correlation in a case of multiple extramedullary plasmacytoma

Multiple extramedullary (soft tissue) plasmacytoma is a rare neoplasm of plasma cells. This is a case of a 63-year-old male who presented with back pain and a one month history of a painful, progressively growing mass at the right anterior chest wall. Since radiographs and computed tomography of the chest showed lytic lesions on the ribs and L4 compression deformity, the patient was referred for whole body bone scintigraphy to evaluate the remainder of the skeleton. Bone scintigraphy revealed osteoblastic lesions and osteolytic lesions in the thoracic cage. Diagnosis of plasmacytoma was established by biopsy and confirmation of microscopic characteristics and immunohistochemical staining.

Basal Cell Nevus Syndrome Showing Several Histologic Types of Basal Cell Carcinoma

Basal cell nevus syndrome (BCNS), or Gorlin Syndrome, is an autosomal dominant disorder, characterized by multiple developmental abnormalities and associated with germline mutations in the PTCH gene. Patients show multiple and early onset basal cell carcinomas (BCCs) in skin, odontogeniccysts in the jaw, pits on palms and soles, medulloblastoma, hypertelorism, and calcification of the falx cerebri. Clinical features of BCCs in these patients are indistinguishable from ordinary BCCs. However, some patients show variable histologic findings in subtypes of BCCs, and only one case associated with several histologic types of BCCs in the syndrome has been reported in Korea. We present a case of BCNS characterized by multiple BCCs, odontogenic keratocysts, multiple palmar pits, and calcified falx cerebri. Histopathologic findings of BCCs showed several patterns, which were nodular, superficial, and pigmented types.

Histopathological Pattern of Breast Carcinoma in Different Age Groups

Background: Breast cancers tend to be more aggressive in younger patients and some histopathological types like medullary; mucinous and tubular variants have a better prognosis. This study describes the histopathologic pattern and tumour grade of breast carcinoma in younger patients. Methods: This was a retrospective analysis of all consecutive breast cancer specimens submitted to the histopathology department of Federal Medical Centre Gombe during the study period. The data was analyzed with EPI Info 2002 using simple means and percentages. Results: A total of 167 cases of breast carcinoma in 164 females were reviewed with three patients having bilateral disease. The age range of the study population was 22-75 years with a mean age of 44 +/-11.7 years. One hundred and twenty seven patients (76) were aged less than 50 years while the rest were above 50 years. A total of 133 tumours were invasive ductal carcinomas; 107(80.45) of which were in the premenopausal age group and 26(19.55) in post menopausal age. One hundred and six patients (63.5) had low grade tumours (grades 1 and 2) while 61(36.5) had high grade tumours (Grades III and IV tumours). Forty three (70.5) of these high grade tumours were seen in premenopausal age group. Eleven patients had invasive lobular carcinoma of which 4(36.4) were premenopausal while 7(63.6) were post menopausal. Conclusion: It is concluded that younger patients tended to frequently have aggressive and high grade disease

Carcinoma adenoescamoso de vesícula biliar / Adenoescamosal carcinoma of the gallbladder

El carcinoma adenoescamoso (CAE) de vesícula biliar es un tumor raro que representa el 1,4 al 5 % de todas las neoplasias de vesícula biliar. Está constituido por dos componentes que varían en proporción: glandular y escamoso. Presentamos el caso de una mujer de 91 años con dolor en hipocondrio derecho de 5 días de evolución e ictericia. Los hallazgos microscópicos revelaron proliferación de glándulas atípicas y de células escamosas dispuestas en nidos con moderada queratinización y formación de perlas córneas. Las células neoplásicas comprometían el tejido hepático adyacente. Los estudios inmunohistoquímicos mostraron positividad para citoqueratina K 20 en el componente escamoso, y para antígeno carciembrionario (CEA) y antígeno epitelial de membrana (EMA) en el componente glandular.

The gallbladder adenosquamous carcinoma (ASC) is a rare tumor accounting for 1.4 to 5 % of all gallbladder neoplasias. It consists in two components in varying ratios: the glandular and squamous components. Here we introduce the case of a 91 year old female patient with a 5 day evolution pain in the right hypocondrium and jaundice. Microscopic findings showed proliferation of atypical glands and squamous cells arranged in nests with mild keratinization and corneal pearl formation. Neoplastic cells affected the adjacent hepatic tissue. Immunohistochemical studies turned positive for cytokeratin K20 in the squamous component and for carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) in the glandular component.

Etude des caracteristiques epidemiologiques; cliniques et evolutives de la maladie de Hodgkin sclero-nodulaire et a cellularite mixte chez le noir africain : a propos de 66 cas colliges dans le service d'Hematologie Clinique du CHU de Yopougon

La maladie de Hodgkin ou MDII est une maladie du tissu lymphoide; caracterisee par la presence et la proliferation d'une cellule particuliere appelee cellule de Reed-Sternberg; dont l'origine reste inconnue C'est la premiere hemopathie maligne guerie. Des donnees de la litterature rapportent une predominance du type 2 histologique ou sclero-nodulaire en occident; tandis que le type 3 ou a cellularite mixte semble preferentiel en Afrique. Nous nous sommes proposes; a travers cette etude retrospective; allant de fevrier 1991 a septembre 2004 et qui a porte sur 66 dossiers de patients atteints de MDH; de degager les caracteristiques epidemiologiques; cliniques et evolutives de ces deux entites histopathologiques de la MDH chez le noir africain. = Les objectifs specifiques etaient les suivants: -determiner la prevalence des deux types histologiques : -Comparer les aspects epidemiologiques; cliniques et paracliniques ; -Comparer la reponse therapeutique; le devenir et la survie des patients. = A la fin de cette etude; les resultats suivants sont a retenir: -A propos de la prevalence : Le type 3 histologique est predominant avec 59 pour cent des cas; contre 41 pour cent pour le type 2. -A propos des caracteristiques des types histologiques. = Les donnees suivantes sont statistiquement significatives:* Concernant le type 2 : - L'age: on note une predominance chez l'enfant et l'adolescent ; (10-19ans) avec 41 pour cent des cas ; - Le stade d'ANN-ARBOR: les stades localises (l et II) predominent avec 51 pour cent des cas ; - La reponse therapeutique: elle est elevee; avec 85 pour cent de RC et 22 pour cent de deces; donc le pronostic est favorable a court terme avec une survie a 1 an de 80 pour cent. * Concernant le type3 : - L'age: on note une predominance chez l'adulte jeune (20-29ans) avec 49 pour cent des cas ; - Le stade d'ANN-ARBOR: les stades avances (III et 1V) predominent avec 54 pour cent des cas ; - La reponse therapeutique: elle est moins elevee par rapport a celle du type 2; avec 54 pour cent seulement de R.C. En conclusion; nous devons mettre l'accent sur le diagnostic precoce afin d'ameliorer le pronostic des patients

Les cancers du tractus genital feminin : aspects epidemiologiques et histologiques de 1455 cas diagnostiques dans les laboratoires d'anatomie pathologique des CHU de Cocody et de Treichville (1984-1993)

Notre travail a porte sur l'etude de 1455 cancers du tractus genital de la femme histologiquement diagnostiques de 1984 a 1993 dans les laboratoires d'anatomie pathologique des CHU de Cocody et Treichville. II ressort de notre etude que : les cancers du tractus genital feminin representaient 20;13 pour cent de l'ensemble des cancers et 40;27 pour cent des cancers de la femme ; la localisation cervicale etait nettement la plus frequente avec 70;45 pour cent et un age moyen de 35;28 ans ; une nette predominance des tumeurs d'origine epitheliales avec 84;81 pour cent en particulier le carcinome epidermoide (78;04 pour cent) ; les sarcomes et les autres types histologiques representaient respectivement 2;34 pour cent et 12;85 pour cent

Histological classification of gastric cancers

A histological study on gastric cancers was carried out on 452 gastric cancers diagnosed at K hospital. The results: (1) Gastric cancers are commonest at the age 61-70, the male/female rate is 1.38. (2) The great majority of gastric cancers are gastric carcinomas (96.68%) with the highest rate of tubular adenocarcinoma (56.16%) and most of these cases are highly differentiated (40.24%); stromal tumors and malignant lymphomas are very rare tumors (1.55% for each type); Non mucinous carcinoma rate is higher than that of mucinous carcinoma rate is higher than that of mucinous carcinomas (94.47% vs. 5.53%). (3) Immunohistochemical is very useful in the diagnosis of small cell carcinomas, one neuroendocrine tumor, one c-kit mutation gastrointestinal stromal tumor (Cajal cell tumor) and three gastric T cell lymphomas. The significance of the data was discussed.

Associaçäo da neoplasia intraepitelial prostática com achados histopatológicos em ressesçöes cirúrgicas / The prostatic intraepithelial neoplasia associated with histopathological findings in surgical ressections

O câncer de próstata é um dos tumores mais freqüentes no sexo masculino, cuja patogênese é conhecida. Atualmente existem diversas alteraçöes displásicas no órgäo que estariam relacionadas com a origem do tumor, sendo portanto, consideradas lesöes pré-malígnas. Dentre estas, a principal é a Neoplasia Intraeptelial Prostática (PIN). O objetivo deste estudo foi verificar a presença do PIN associada aos achados histológicos benignos e malignos em amostras cirúrgicas de pacientes submetidos à cirurgia protática. Foram estudadas 73 pacientes que foram operados através de ressecçäo transuretral (RTU), biópsia transretal ou prostatectomia (radical ou adenomectomia) no ano de 1997, no Hospital Ofir Loiola. A procura do PIN foi realizada através da revisäo das lâminas dos espécimes cirúrgicos por um único patologista. Os resultados foram analisados estatisticamente baseando-se na presença do PIN relacionado à idade dos pacientes, ao tipo de cirurgia, e ao diagnóstico histológico das amostras. Observou-se que o percentual de positividade do PIN foi mais significativo nas amostras de biópsia, coexistindo com o câncer na maioria dos casos. Conclui-se entäo que o PIN está mais relacionado ao câncer de próstawta, do que as alteraçöes benignas do órgäo, reforçando a hipótese de que seja uma lesäo pré-maligna

Estudo da expressäo da glicoproteína CD44 padräo, por técnica imunohistoquímica, como fator prognóstico na neoplasia urotelial da bexiga / Immunohistochemical study of expression CD44 standard as a prognostic factor in human bladder cancer

A glicoproteína CD44 tem sido estudada e associada à progressão de tumores, além de apresentar uma relação com a capacidade de invasão tecidual e metástase. A determinação específica do papel da CD44 no comportamento clínico dos diferentes tipos de câncer humano ainda não foi definida completamente. O objetivo do presente trabalho foi estudar por métodos imunohistoquímico, a expressão da CD44 padrão como fator prognóstico em pacientes portadores de urotelioma vesical superficial no momento do diagnóstico. A expressão da glicoproteína CD44 foi estudada em 49 pacientes portadores de urotelioma vesical. As amostras foram analisadas por meio de lâminas de cortes histológicos de material fixado em blocos parafinados, obtidos pelo ato cirúrgico. Foram excluídos os pacientes com urotelioma que acometia a lâmina própria (pT1) e os portadores de carcinoma in situ (pTis). Dos 49 pacientes selecionados, 31 (63,2 por cento) apresentaram uroteliomas superficiais (pTa), dos quais 14 (45,2 por cento) evoluíram com invasão da camada muscular da bexiga no decorrer do acompanhamento, os quais foram considerados como grupo de interesse. Dezoito pacientes (36,8 por cento) apresentavam tumor invasivo (pT2-pT4) no momento do diagnóstico e 11 das amostras de tecido vesical eram livres de neoplasias, sendo utilizadas como grupo controle. O estudo revelou uma perda progressiva da expressão da CD44 relacionada ao estádio tumoral. A proteína estava expressa em 94,1 por cento dos casos de urotelioma superficiais e ausente em 61,1 por cento dos tumores invasivos. A especificidade do método imunohistoquímico em detectar alterações na expressão da CD44 em uroteliomas superficiais (Ta) no momento do diagnóstico e sua relação com a progressão tumoral foi de 28,5 por cento. Os resultados apresentados no presente trabalho indicam que a expressão da CD44 padrão, por método imunohistoquímico, pode ser utilizada como um poderoso marcador metástatico e deve ser considerada com ressalvas quando da determinação do prognóstico para uroteliomas superficiais (pTa) no momento do diagnóstico

Tratamento da leucemia mielóide aguda experiência do Hospital das Clínicas da UFG / Treatment of acute myeloid leukemia, experience of the Clinical Hospital of UFG

No período de 39 meses, compreendendo janeiro de 1989 a junho de 1992, foram tratados, no Serviço de Hematologia do Hospital das Clinicas da UFG, 12 pacientes com leucemia mielóide aguda (LMA). A idade média foi de 32 anos (variando entre 12 e 74 anos), sendo 8 do sexo masculino e 4 do feminino. Nos estudo um esquema de tratamento foi proposto com dupla quimioterapia de induçäo, consolidaçäo precoce e quimioterapia de manutençäo. Dos 12 pacientes tratados, 10 entraram em remissäo completa (RC), tendo duas compliçöes fatais na fase aplásica da induçäo. Os 10 pacientes que obtiveram RC apresentaram uma média de duraçäo de RC de 387 dias, com 40 por cento dos pacientes permanecendo em RC por mais de 2 anos. O uso do tratamento intensivo agrega a vantagem da curva de dose-resposta, näo sendo, porém, possível estabelecer qual das três modalidades teve maior impacto na duraçäo da RC

Melanoma de la vulva: informe de 12 casos / Melanoma of the vulva: report of 12 cases

El melanoma de la vulva es un padecimiento poco frecuente, se acompaña de un diagnóstico tardío con lesiones de espesor mayor a dos mm, frecuentemente con metástasis ganglionares y distantes. Se hace el análisis de 12 casos atendidos en el Servicio de Oncología del Hospital Central Militar, dos del servicio privado de uno de los autores. Se describen las características clínica, histopatlógicas y de espesor. Existen cuatro sobrevivientes a más de dos años, uno de ellos tiene seis años de sobrevida. Se establecen los factores a considerar para el tratamiento quirúrgico del tumor primario y se considera la indicación de la disección inguinal terapéutica y electiva, se plantean nuevos métodos de detección de matástasis ganglionares con isótopos o colorantes y se refieren los resultado del manejo médico del melanoma

Cáncer gástrico incipiente: reporte de 40 casos / Early gastric cancer: report of 40 cases

Se revisan los aspectos clínicos y epidemiológicos de 40 pacientes con el diagnóstico de cáncer gástrico incipiente. Eran menores de 40 años un 27.5 por ciento y mayores de dicha edad, el 72.5 por ciento. Predominó el sexo femenino con 65 por ciento. Las lesiones ulceradas y deprimidas llegaron al 79 por ciento. La sintomatología clínica referida fue síndrome ulceroso en 42.5 por ciento y epigastralgia no característica en 35 por ciento; los síntomas duraron menos de 6 meses o entre 6 y 12 meses o entre 1 y 2 años, en cerca al 30 por ciento en cada grupo. Como antecedente, en 25 por ciento del total se encontró diagnóstico radiológico y/o endoscópico de úlcera péptica gástrica o de haber obtenido alivio con tratamiento antiulceroso