RESUMEN
INTRODUCTION: Acellular Dermal Matrix (ADM) assisted breast reconstruction has transformed the single-stage Immediate Breast Reconstruction (IBR) with an impact on the cosmetic outcomes. However, there is limited data available on patient reported outcomes. This study highlights the Patient Reported Outcome Measures (PROMs), post-operative complications and lessons learnt from ADM assisted single-stage immediate breast reconstruction. METHODS: This prospective study enrolled consecutive patients from Feb 2012 - May 2015 undergoing mastectomy with direct-to-implant ADM assisted breast reconstruction, using Strattice™ (Acelity, San Antonio, TX, USA). Patients were recruited from the beginning of our unit's use of ADMs and completed a post-operative questionnaire at 6 weeks, covering pre-operative, operative and post-operative outcomes. Information on tumour biology and post-operative complications was obtained from the medical notes. RESULTS: This study included 49 patients undergoing a total of 53 procedures. Following surgery 93.3% of women reported a high level of body confidence when clothed. 6.7% of patients reported severe post-operative pain during the first week. Mean length of hospital stay was 1.7 days, return to light activities was within 2.5 weeks and normal activities in 5.4 weeks. Implant loss at 3 months occurred in 5.7% of procedures, of which two thirds were smokers. CONCLUSIONS: PROMs for Strattice™ ADM based reconstruction show high levels of satisfaction with cosmetic outcomes, low incidences of severe post-operative pain and a short recovery process. PROMs help us to better describe patients' experience, allowing women to make more informed choices about ADM based breast reconstruction, which reassures and helps to achieve better outcomes.
Asunto(s)
Dermis Acelular , Neoplasias de la Mama/cirugía , Mamoplastia/métodos , Evaluación del Resultado de la Atención al Paciente , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Neoplasias de la Mama/patología , Estudios de Cohortes , Estética , Femenino , Humanos , Tiempo de Internación , Mamoplastia/efectos adversos , Mastectomía/métodos , Persona de Mediana Edad , Dolor Postoperatorio/fisiopatología , Cuidados Posoperatorios/métodos , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/terapia , Estudios Prospectivos , Medición de Riesgo , Encuestas y Cuestionarios , Expansión de Tejido/métodos , Resultado del Tratamiento , Reino Unido , Cicatrización de Heridas/fisiologíaRESUMEN
INTRODUCTION: One-Step Nucleic acid Amplification (OSNA) is a molecular biological assay of cytokeratin-19 (a breast epithelial marker) mRNA. It can be employed intra-operatively for detection of lymph node metastases in breast carcinoma. Patients with positive sentinel nodes may proceed to axillary lymph node dissection (ALND) level I or higher dependent upon the OSNA quantitative result, during the same surgical procedure, avoiding a second operation and eliminating the technical difficulties possibly associated with delayed ALND. AIMS: Our Breast Unit was the first in the UK to implement this novel technique in routine practice. This study reviews our first 44-month data following introduction of OSNA "live" on whole sentinel nodes following an extensive validation study (Snook et al.).(9) METHODS: Data was collected prospectively from the period of introduction 01/12/2008 to 30/08/2012. All patients eligible for sentinel node biopsy were offered OSNA and operations were performed by five consultant breast surgeons. On detection of macro-metastasis a level II/III and for a micro-metastasis a level I ALND was performed. RESULTS: A total of 859 patients (1709 sentinel lymph nodes) were analysed. All except one were females. The majority underwent wide local excision (73.4%, n = 631) or mastectomy 25% (n = 215) and 1.6% (13) underwent SLN biopsy alone. IDC was seen in 79% (n = 680) of the patients and 53.5% (n = 460) had grade II tumours. One-third (30.8%, n = 265) had positive sentinel nodes and had further axillary surgery at the time of SLN biopsy. Of these, 47% (n = 125/265) had macro-metastases, 38% (n = 101/265) had micro-metastases and 14.7% (n = 39/265) had "positive but inhibited" results. Positive non-sentinel lymph nodes (NSLN) were seen in 35% (44/125) of those with macro-metastases; 17.8% (18/101) of the patients with micro-metastases and 10.2% (4/39) of the "positive but inhibited" group. CONCLUSION: In our series over a third of our patients had positive lymph nodes detected with OSNA allowing them to proceed directly to axillary surgery at the same operation. This technique eliminates the need for a second operation in sentinel lymph node positive patients and avoids the anxiety waiting for histological results.
Asunto(s)
Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/secundario , Monitoreo Intraoperatorio/métodos , Técnicas de Amplificación de Ácido Nucleico/métodos , Biopsia del Ganglio Linfático Centinela/métodos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/mortalidad , Carcinoma Ductal de Mama/cirugía , Distribución de Chi-Cuadrado , Estudios de Cohortes , Femenino , Humanos , Escisión del Ganglio Linfático/métodos , Ganglios Linfáticos/patología , Ganglios Linfáticos/cirugía , Persona de Mediana Edad , Invasividad Neoplásica/patología , Micrometástasis de Neoplasia/patología , Estadificación de Neoplasias , Servicio de Oncología en Hospital , Pronóstico , ARN Mensajero/análisis , Reproducibilidad de los Resultados , Estudios Retrospectivos , Medición de Riesgo , Tasa de Supervivencia , Reino UnidoRESUMEN
BACKGROUND: Classical anatomical descriptions fail to describe variants often observed in the axilla as they are based on studies that looked at individual structures in isolation or textbooks of cadaveric dissections. The presence of variant anatomy heightens the risk of iatrogenic injury. The aim of this study was to document the nature and frequency of these anatomical variations based on in vivo peroperative surgical observations. METHODS: Detailed anatomical relationships were documented prospectively during consecutive axillary dissections. Relationships between the thoracodorsal pedicle, course of the lateral thoracic vein, presence of latissimus dorsi muscle slips, variations in axillary and angular vein anatomy, and origins and branching of the intercostobrachial nerve were recorded. RESULTS: Among a total of 73 axillary dissections, 43 (59 per cent) revealed at least one anatomical variant. Most notable variants included aberrant courses of the thoracodorsal nerve in ten patients (14 per cent)--three variants; lateral thoracic vein in 12 patients (16 per cent)--four variants; bifid axillary veins in ten patients (14 per cent); latissimus dorsi muscle slips in four patients (5 per cent); and variants in intercostobrachial nerve origins and branching in 26 patients (36 per cent). The angular vein, a subscapular vein tributary, was found to be a constant axillary structure. CONCLUSION: Variations in axillary anatomical structures are common. Poor understanding of these variants can affect the adequacy of oncological clearance, lead to vascular injury, compromise planned microvascular procedures and result in chronic pain or numbness from nerve injury. Surgeons should be aware of the common anatomical variants to facilitate efficient and safe axillary surgery.
Asunto(s)
Axila/anatomía & histología , Axila/cirugía , Axila/irrigación sanguínea , Axila/inervación , Vena Axilar/anatomía & histología , Vena Axilar/cirugía , Plexo Braquial/anatomía & histología , Plexo Braquial/cirugía , Disección/métodos , Humanos , Nervios Intercostales/anatomía & histología , Nervios Intercostales/cirugía , Venas/anatomía & histología , Venas/cirugíaRESUMEN
AIM: Oncoplastic techniques are increasingly used to facilitate breast conservation and maintain breast aesthetics but evidence with regards to the oncological safety of oncoplastic breast conservation surgery (oBCS) remains limited. The aim of this study was to compare re-excision and local recurrence rates for oBCS with standard breast conserving surgery (sBCS). METHODS: From June 2003 to Feb 2010 data was obtained from contemporaneously recorded electronic patient records on patients who had oBCS and sBCS within a single breast cancer centre. Re-excision rates and local recurrence rates were compared. RESULTS: A total of 440 sBCS and 150 oBCS (in 146 women) were included in this study. Median tumour size and specimen weight was 21 mm and 67 g for oBCS and 18 mm and 40 g in the sBCS group (p < 0.001). Re-excision was 2.7% (4/150) and 13.4% (59/440) for oBCS and sBCS respectively (p < 0.001). At a median follow-up of 28 months, local relapse was 2.7% (4) and 2.2% (10) and distant relapse 1.3% (2) and 7.5% (33) for oBCS and sBCS respectively. CONCLUSIONS: Oncoplastic breast conserving techniques decrease re-excision rates. Early follow up data suggests oncological outcomes of oncoplastic breast conservation surgery are similar to standard breast conservation.
Asunto(s)
Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/cirugía , Mamoplastia/efectos adversos , Mamoplastia/métodos , Mastectomía Segmentaria/efectos adversos , Mastectomía Segmentaria/métodos , Recurrencia Local de Neoplasia/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Incidencia , Estimación de Kaplan-Meier , Londres/epidemiología , Sistemas de Registros Médicos Computarizados , Persona de Mediana Edad , Clasificación del Tumor , Recurrencia Local de Neoplasia/etiología , Estadificación de Neoplasias , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
AIMS: Axillary nodal status is the most important prognostic indicator which in turn influences adjuvant therapy and long term outcomes. The aim of this study was to compare total nodal yields from primary axillary lymph node dissection (pALND) with completion ALND after a cancer positive SLNB: either concurrently (cALND) following intra-operative assessment (IOA) of the SLN's or as a delayed procedure (dALND) when the SLN was found to be cancer positive on post-operative histological examination. METHODS: All axillary procedures performed between May 2006 and September 2009 were identified from a prospective database and categorised into four groups: SLNB with no further axillary surgery, pALND, cALND and dALND. Total nodal yield was the sum of SLN/s and ALND yields. RESULTS: Of 1025 axillary procedures, ALND accounted for 332 (32.4%) of which 207 (62.3%) underwent pALND, 43 (12.9%) cALND, and 82 (24.6%) dALND. Median nodal yields were 15.0, 16.0 and 14.5 respectively (p = 0.3). CONCLUSION: Total nodal yields for primary, concurrent and delayed ALND were comparable suggesting completion dALND performed as a second operation does not compromise axillary staging.
Asunto(s)
Neoplasias de la Mama/cirugía , Escisión del Ganglio Linfático/métodos , Ganglios Linfáticos/cirugía , Axila/cirugía , Neoplasias de la Mama/patología , Femenino , Humanos , Ganglios Linfáticos/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Biopsia del Ganglio Linfático CentinelaRESUMEN
BACKGROUND: The molecular determinants of the severity and persistence of allergic asthma remain poorly understood. Suppressor of cytokine signalling 1 (SOCS1) is a negative regulator of IL-4-dependent pathways in vitro and might therefore control T-helper type 2 (Th2) immunity associated traits, such as IgE levels, mucin production, IL-5 and IL-13 induction, and eosinophilic mucosal inflammation, which are implicated in allergic asthma. OBJECTIVE: To investigate the role of SOCS1 in regulating Th2-associated disease traits in a murine sub-chronic aeroallergen-driven asthma model. METHODS: Following sensitization and challenge with ovalbumin (OVA), bronchoalveolar lavage and serum were collected from mice lacking the Socs1 gene on an IFN-gamma null background (Socs1(-/-)Ifngamma(-/-)). The composition of infiltrating cells in the lung, serum IgE and IgG1 levels and cytokine levels were analysed. RESULTS: Serum IgE levels and infiltrating eosinophils were considerably increased in the lungs of OVA-treated Socs1(-/-)Ifngamma(-/-) mice compared with Ifngamma(-/-) and C57BL/6 controls. Expression of the Th2 cytokines, IL-4, IL-5 and IL-13 was increased in CD4+ cells and lung tissue from OVA-treated Socs1(-/-)Ifngamma(-/-) mice. IgE, IL-5 levels and infiltrating eosinophils were also elevated in saline-treated Socs1(-/-)Ifngamma(-/-) mice, suggesting that in the absence of SOCS1, mice are already biased towards a Th2 response. It is at present unclear whether the elevated cytokine levels are sufficient to result in the exacerbated Th2 response to OVA challenge or whether enhanced intra-cellular signalling also contributes. Surprisingly, of the various IL-4/IL-13 responsive genes tested, only Arginase I appeared to be modestly up-regulated in the lungs of OVA-treated Socs1(-/-)Ifngamma(-/-) mice, suggesting that regulation by SOCS1 occurs primarily in haematopoietic cells and not in the airway epithelium. CONCLUSIONS: Together these results indicate that SOCS1 is an important regulator of the Th2 response.
Asunto(s)
Asma/inmunología , Linfocitos T CD4-Positivos/inmunología , Citocinas/inmunología , Interferón gamma/metabolismo , Proteínas Supresoras de la Señalización de Citocinas/metabolismo , Animales , Asma/metabolismo , Líquido del Lavado Bronquioalveolar/inmunología , Linfocitos T CD4-Positivos/metabolismo , Citocinas/metabolismo , Eosinófilos/inmunología , Eosinófilos/metabolismo , Femenino , Inmunoglobulina E/sangre , Interferón gamma/genética , Interferón gamma/inmunología , Pulmón/inmunología , Pulmón/patología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Ovalbúmina/inmunología , Proteína 1 Supresora de la Señalización de Citocinas , Proteínas Supresoras de la Señalización de Citocinas/genética , Proteínas Supresoras de la Señalización de Citocinas/inmunologíaRESUMEN
The aim of this study was to evaluate the role of mammography and the outpatient follow up in the management of breast cysts. Prospective data was collected in 203 women from July 2000 to July 2005. All women had an ultrasound scan and aspiration. One hundred and seventy-six women above 35 years had a mammogram. All women were followed up 4-6 weeks later. Women with M3 or M4 mammography or with suspicious ultrasound findings on initial clinical visit were investigated further; 96.53% presented with a lump in the breast. Aspiration was performed in all women. Three patients had a residual lump on 4-6 week follow up. One was found to be benign and two were revealed to have cancer. The mammogram findings in these two patients were M3 and they would have merited further investigation anyway. In total 176 patients had a mammogram and a departmental ultrasound scan of the breasts of which 41 patients required further investigations following which cancer was found in nine patients (4.4%). Mammography is an important tool in the management of breast cysts. Outpatient follow up did not contribute significantly to the care of these patients.
Asunto(s)
Quiste Mamario/patología , Neoplasias de la Mama/prevención & control , Mama/patología , Ultrasonografía Mamaria/normas , Adolescente , Adulto , Anciano , Biopsia con Aguja Fina , Quiste Mamario/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
The asymmetry in the rho angular distribution in the sequential decay Omega+-->LamdaKappa+-->rhopi+Kappa+. has been measured to be alphaOmegaalphaLamda=[+1.16+/-0.18(stat)+/-0.17(syst)]x10(-2) using 1.89x10(6) unpolarized Omega+ decays recorded by the HyperCP (E871) experiment at Fermilab. Using the known value of alphaLamda, and assuming that alphaLamda=-alphaLamda, alphaOmega=[-1.81+/-0.28(stat)+/-0.26(syst)]x10(-2). A comparison between this measurement of alphaOmegaalphaLamda and recent measurements of alphaOmegaalphaLamda made by HyperCP shows no evidence of a violation of CP symmetry.
RESUMEN
A sensitive search for the lepton-number-violating decay Xi(-)-->pmu(-)mu(-) has been performed using a sample of approximately 10(9) Xi(-) hyperons produced in 800 GeV/c p-Cu collisions. We obtain B(Xi(-)-->pmu(-)mu(-))<4.0x10(-8) at 90% confidence, improving on the best previous limit by 4 orders of magnitude.
RESUMEN
A sensitive search for the rare decays Omega(-)--> Lambdapi(-) and Xi(0)--> ppi(-) has been performed using data from the 1997 run of the HyperCP (Fermilab E871) experiment. Limits on other such processes do not exclude the possibility of observable rates for |DeltaS| = 2 nonleptonic hyperon decays, provided the decays occur through parity-odd operators. We obtain the branching-fraction limits B(Omega(-)-->Lambdapi(-)) < 2.9 x 10(-6) and B(Xi(0)--> ppi(-)) < 8.2 x 10(-6), both at 90% confidence level.
RESUMEN
We report the first evidence for the decay Sigma(+)-->pmu(+)mu(-) from data taken by the HyperCP (E871) experiment at Fermilab. Based on three observed events, the branching ratio is B(Sigma(+)-->pmu(+)mu(-))=[8.6(+6.6)(-5.4)(stat)+/-5.5(syst)]x10(-8). The narrow range of dimuon masses may indicate that the decay proceeds via a neutral intermediate state, Sigma(+)-->pP(0),P0-->mu(+)mu(-) with a P0 mass of 214.3+/-0.5 MeV/c(2) and branching ratio B(Sigma(+)-->pP(0),P0-->mu(+)mu(-))=[3.1(+2.4)(-1.9)(stat)+/-1.5(syst)]x10(-8).
RESUMEN
We have compared the p and p angular distributions in 117 x 10(6) Xi- -->Lambdapi- -->ppi-pi- and 41 x 10(6) Xi+ -->Lambda pi+ -->p pi+pi+ decays using a subset of the data from the HyperCP experiment (E871) at Fermilab. We find no evidence of CP violation, with the direct-CP-violating parameter AXiLambda identical with (alphaXialphaLambda-alpha Xialpha Lambda)/(alphaXialphaLambda+alphaXialphaLambda)=[0.0+/-5.1(stat)+/-4.4(syst)] x 10(-4).
RESUMEN
Based on 1.35 x 10(6) polarized Xi(-) events, we measure the parameter phi(Xi) to be -1.61 degrees +/-2.66 degrees +/-0.37 degrees for the Xi(-)-->Lambda pi(-) decay. New results for the parameters beta(Xi) and gamma(Xi) are also presented. Assuming that the CP-violating phase difference is negligible, we deduce the strong phase difference between the P-wave and S-wave amplitudes of the Lambda pi final state to be 3.17 degrees +/-5.28 degrees +/-0.73 degrees, reducing the uncertainty in estimating the level of CP violation in Xi-hyperon decay.
RESUMEN
Glycosmis arborea is a plant possessing various medicinal properties. The aim of the present study was to investigate the hepatoprotective efficacy of the butanol extract obtained from the aerial parts of the plant. The test sample was prepared by extracting the material through different steps. The extract thus obtained was dissolved in normal saline. Albino rats were prophylactically treated with the extract (i.p.) for 3 weeks. At the end of 3rd week all the groups were injected with hepatotoxic agents. After 48 h of injection, blood was collected and livers were taken out. Different enzymes in the serum were assayed and histopathological study was performed with liver. Glycosmis arborea extract was able to overcome the toxic effects of hepatotoxic agents in terms of lowering the levels of serum GPT, alkaline phosphatase and increased level of SOD in serum. TBARS generation in liver was also altered. Moreover, necrosis of liver produced by carbon tetrachloride was reversed by the extract.
Asunto(s)
Hígado/efectos de los fármacos , Extractos Vegetales/farmacología , Rutaceae , Acetaminofén/toxicidad , Alanina Transaminasa/sangre , Alanina Transaminasa/efectos de los fármacos , Fosfatasa Alcalina/sangre , Fosfatasa Alcalina/efectos de los fármacos , Animales , Peso Corporal/efectos de los fármacos , Tetracloruro de Carbono/toxicidad , Enfermedad Hepática Inducida por Sustancias y Drogas , Galactosamina/toxicidad , Dosificación Letal Mediana , Peroxidación de Lípido/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Hepatopatías/prevención & control , Masculino , Ratones , Ratones Endogámicos BALB C , Fitoterapia , Ratas , Ratas Sprague-Dawley , Superóxido Dismutasa/sangre , Superóxido Dismutasa/efectos de los fármacos , Tasa de Supervivencia , Pruebas de Toxicidad AgudaRESUMEN
Using data collected with the HyperCP (E871) spectrometer during the 1997 fixed-target run at Fermilab, we report the first observation of the decay K--->pi(-)mu(+)mu(-) and new measurements of the branching ratios for K+/--->pi(+/-)mu(+)mu(-). By combining the branching ratios for the decays K+-->pi(+)mu(+)mu(-) and K--->pi(-)mu(+)mu(-), we measure Gamma(K+/--->pi(+/-)mu(+)mu(-))/Gamma(K+/--->all) = (9.8+/-1.0+/-0.5)x10(-8). The CP asymmetry between the rates of the two decay modes is [Gamma(K+-->pi(+)mu(+)mu(-))-Gamma(K--->pi(-)mu(+)mu(-))]/[Gamma(K+-->pi(+)mu(+)mu(-))+Gamma(K--->pi(-)mu(+)mu(-))] = -0.02+/-0.11+/-0.04.
Asunto(s)
Acetilcolinesterasa/metabolismo , Glutatión/metabolismo , Linfocitos/metabolismo , Plaguicidas/envenenamiento , Intoxicación/metabolismo , gamma-Glutamiltransferasa/metabolismo , Administración Oral , Adolescente , Adulto , Eritrocitos/química , Eritrocitos/enzimología , Femenino , Hexaclorociclohexano/envenenamiento , Humanos , Malatión/envenenamiento , Masculino , Análisis por Apareamiento , Propoxur/envenenamientoRESUMEN
The concerned diphosphines are Ph2P(CH2)nPPh2 (1), abbreviated PnP, and the ReVO reagents are ReOCl3L (2) and ReOCl3L' (3), where L and L' are the azopyridine and pyridine-imine ligands p-ClC6H4N=NC5H4N and p-MeC6H4N=CHC5H4N, respectively. One atom transfer from 2 to 1 has afforded Re(OPnP)Cl3L (4a, n = 1; 4b, n = 2; 4c, n = 3). Of these 4b and 4c are stable, but 4a undergoes spontaneous isomerization to Re(PlPO)Cl3L (5) in solution. Two-atom transfer studied with both 2 and 3 has afforded binuclear LCl3Re(OPnPO)ReCl3L (8a, n = 2; 8b, n = 3) and L'Cl3Re(OPnPO)ReCl3L' (9a, n = 2; 9b, n = 3) for n = 2, 3 and mononuclear Re(OP1PO)Cl3L (11) and Re(OP1PO)Cl3L' (12) for n = 1. The mixed system L'Cl3Re(OP2PO)ReCl3L (10) has been prepared from 3 and 4b. The complex Re(PPh3)Cl3L (7a) is furnished by the reaction of Re(OPPh3)Cl3L (6a) or 4b or 11 with PPh3. The species have been characterized with the help of spectral, electrochemical, and X-ray structural data. All the complexes have mer geometry except 5 and 7a, which have fac geometry. The latter is best suited for concurrent Re-N and Re-P back-bonding. Variable-temperature rate data of the reaction 4a-->5 are consistent with an intramolecular strongly associative transition state (delta S++, -22.6 eu) in which the dangling phosphine function lies close to the metal. Two-atom transfer to P1P is believed to proceed via a transient binuclear intermediate which undergoes cleavage at one end due to steric crowding, affording 11 and 12. Crystal data for the complexes are as follows: 5.1.5 C6H6, empirical formula C45H39Cl4N3OP2Re, crystal system triclinic, space group P1, a = 10.034(2) A, b = 10.737(2) A, c = 20.357(4) A, alpha = 89.38(3) degrees, beta = 87.79(3) degrees, gamma = 80.22(3) degrees, V = 2159.7(7) A3, Z = 2; 7a.CH2Cl2, empirical formula C30H25Cl6N3PRe, crystal system monoclinic, space group P2(1)/n, a = 11.695(6) A, b = 17.745(7) A, c = 15.459(9) A, beta = 100.94(5) degrees, V = 3150(3) A3, Z = 4; 9a, empirical formula C52H48Cl6N4O2P2Re2, crystal system monoclinic, space group C2/c, a = 19.769(12) A, b = 12.864(6) A, c = 22.20(2) A, beta = 101.76(6) degrees, V = 5530(6) A3, Z = 4; 11, empirical formula C36H30Cl4N3O2P2Re, crystal system monoclinic, space group I2/a, a = 16.866(6) A, b = 12.583(6) A, c = 34.78(2) A, beta = 99.22(4) degrees, V = 7285(7) A3, Z = 8.
RESUMEN
Pseudomyxoma peritonei is characterized by diffuse collections of gelatinous flux resulting from implantation of malignant tumors or irritation from ruptured benign cysts. We report a patient with pseudomyxoma peritonei caused by an occult primary adenocarcinoma, who had both pleural and hepatic metastases.