RESUMEN

Natural killer/T cell lymphomas chiefly involving the midline facial structures including the nasal cavity or nasopharyns are a relatively rare type of non-Hodgkin's lymphoma. Apart from the upper respiratory tract, the disease occasionally presents in certain extranodal sites, such as the central nervous system, skin, gastrointestinal tract, or testes. We report a case of natural killer NK/T cell lymphoma as a testicular tumor in a 36-year-old man with a history of progressive swelling of his right testicle. Histologically, the testicular mass showed a diffuse infiltrate of medium-sized and atypical large lymphoid cells with angiocentric infiltration and areas of coagulative necrosis. Immunohistochemical studies demonstrated tumor cells staining positively with CD3, TIA-1, and Granzyme B. The Epstein-Barr virus genoma was detected by in situ hybridization. There were no abnormal findings in the nasal and nasopharyngeal regions. Classified as stage IEA, the patient received involved-field irradiation to contralateral testis (45 Gy), followed by systemic chemotherapy with a combination regimen ofL-asparaginase, methotrexate and dexamethasone. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.

Asunto(s)

Humanos , Masculino , Adulto , Linfoma de Células T/patología , Linfoma de Células T/terapia , Testículo/patología , Metotrexato , Herpesvirus Humano 4 , Infecciones por Virus de Epstein-Barr

RESUMEN

Natural killer/T cell lymphomas chiefly involving the midline facial structures including the nasal cavity or nasopharyns are a relatively rare type of non-Hodgkin's lymphoma. Apart from the upper respiratory tract, the disease occasionally presents in certain extranodal sites, such as the central nervous system, skin, gastrointestinal tract, or testes. We report a case of natural killer NK/T cell lymphoma as a testicular tumor in a 36-year-old man with a history of progressive swelling of his right testicle. Histologically, the testicular mass showed a diffuse infiltrate of medium-sized and atypical large lymphoid cells with angiocentric infiltration and areas of coagulative necrosis. Immunohistochemical studies demonstrated tumor cells staining positively with CD3, TIA-1, and Granzyme B. The Epstein-Barr virus genoma was detected by in situ hybridization. There were no abnormal findings in the nasal and nasopharyngeal regions. Classified as stage IEA, the patient received involved-field irradiation to contralateral testis (45 Gy), followed by systemic chemotherapy with a combination regimen ofL-asparaginase, methotrexate and dexamethasone. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.

Asunto(s)

Infecciones por Virus de Epstein-Barr , Linfoma de Células T , Masculino , Humanos , Adulto , Testículo/patología , Herpesvirus Humano 4 , Metotrexato , Linfoma de Células T/patología , Linfoma de Células T/terapia

RESUMEN

OBJECTIVE: Our main objective was to assess the association between the markers p16 and Ki-67 and recurrence of disease in patients previously treated for cervical high-grade squamous intraepithelial lesion (HSIL). DESIGN: This is a case-control study at the National Cancer Institute conducted between 2005 and 2015. Of the patients with a pathologically confirmed diagnosis of HSIL, 107 cases were selected. They were divided into 2 groups: 28 cases with recurrence after treatment and a control group of 79 patients without recurrence. We identified clinical, pathological, and treatment variables. METHODS: Two experienced pathologists performed immunohistochemical analysis of biomarkers; they agreed on their interpretation, and we calculated the odds ratios (ORs) associated with recurrence. For group comparisons, we used the Wilcoxon signed-rank, χ2, or Fisher's exact test, depending on the type of variable. We conducted logistic regression models to estimate ORs and determine the factors associated with recurrence. The recurrence-free period was defined as the time frame between conization and either recurrence of disease or the last date the patient was seen. We used Kaplan-Meier plots to visualize survival curves and log-rank tests to compare the curves. We established a p value <0.05 as statistically significant. RESULTS: After pathologists performed immunohistochemical analysis, they achieved an agreement level of 83.7% for p16 and 60% for Ki-67. We did not find an association between recurrence and either p16 expression (p = 0.69) or the percentage of Ki-67 expression (p = 0.71). The recurrence-free period analysis did not reveal a difference in p16 expression (p = 0.57) nor in the percentage of Ki-67 expression in the 3-tiered scale (p = 0.56). LIMITATIONS: Our main limitation was a reduced sample size. CONCLUSION: We found no association between p16 and Ki-67 positivity and the risk of recurrence in previously treated HSIL.

Asunto(s)

Infecciones por Papillomavirus , Lesiones Intraepiteliales Escamosas de Cuello Uterino , Lesiones Intraepiteliales Escamosas , Displasia del Cuello del Útero , Neoplasias del Cuello Uterino , Biomarcadores de Tumor , Estudios de Casos y Controles , Inhibidor p16 de la Quinasa Dependiente de Ciclina , Femenino , Humanos , Antígeno Ki-67 , Recurrencia Local de Neoplasia

RESUMEN

INTRODUCTION: Metastasis involves the accumulation of genetic and epigenetic alterations leading to activation of prometastatic genes and inactivation of antimetastatic genes. Among epigenetic alterations, DNA hypermethylation and histone hypoacetylation are the focus of intense translational research because their pharmacological inhibition has been shown to produce antineoplastic activity in a variety of experimental models. AIMS: This study aimed to evaluate the antimetastatic effect of the DNA-methylation inhibitor, hydralazine, and the histone deacetylase inhibitor, valproic acid. METHODS: NIH 3T3-Ras murine cells were treated with hydralazine and valproic acid to evaluate their effects upon cell proliferation, cell motility, chemotaxis, gelatinase activity, and gene expression. Lung metastases were developed by intravenous injection of NIH 3T3-Ras cells in BALB/c nu/nu mice and then treated with the drug combination. RESULTS: Treatment induced a growth-inhibitory effect on NIH 3T3-Ras cells, showed a trend toward increased gelatinase activity of MMP2 and MMP9, and inhibited chemotaxis and cell motility. The combination led to a strong antimetastatic effect in lungs of nude mice. CONCLUSION: Hydralazine and valproic acid, two repositioned drugs as epigenetic agents, exhibit antimetastatic effects in vitro and in vivo and hold potential for cancer treatment.

RESUMEN

Epidermal growth factor receptor (EGFR) is overexpressed in >60% of non-small cell lung cancer (NSCLC) cases. In combination with radiotherapy or chemotherapy, first-line treatments with antibodies against EGFR, including cetuximab and necitumumab, have demonstrated benefits by increasing overall survival (OS), particularly in patients who overexpress EGFR. The present study evaluated the interobserver agreement among three senior pathologists, who were blinded to the clinical outcomes and assessed tumor samples from 85 patients with NSCLC using the H-score method. EGFR immunohistochemistry was performed using a qualitative immunohistochemical kit. The reported (mean ± standard deviation) H-scores from each pathologist were 111±102, 127±103 and 128.53±104.03. The patients with average H-scores ≥1, ≥100, ≥200 and between 250-300 were 85.9, 54.1, 28.2 and 12.9, respectively. Patients who had an average H-score >100 had a shorter OS time compared with those with lower scores. Furthermore, patients with EGFR mutations who were treated with EGFR-tyrosine kinase inhibitors (TKIs) and had an average H-score >100 had a longer OS time compared with those with an average H-score <100. The interobserver concordance for the total H-scores were 0.982, 0.980 and 0.988, and for a positive H-score ≥200, the interobserver concordance was 0.773, 0.710 and 0.675, respectively. The determination of EGFR expression by the H-score method is highly reproducible among pathologists and is a prognostic factor associated with a poor OS in all patients. Additionally, the results of the present study suggest that patients with EGFR mutations that are treated with EGFR-TKIs and present with a high H-score have a longer OS time.

RESUMEN

BACKGROUND: Melanoma of the vulva is the second most common vulvar cancer after epidermoid carcinoma. Patients suffering from this disease usually present with a late-stage disease with a poor prognosis. The prognostic factors reported in previous studies are not homogeneous and the clinical/pathogenic role of c-KIT expression is not clear. Breslow staging currently is the most accurate predictor factor. METHODS: A clinicopathological study with literature review was performed to identify predictors of prognosis and survival in melanoma of the vulva and investigated the expression of c-KIT (by immunohistochemistry) in 10 patients from the National Institute for Cancer Research (Mexico City). RESULTS: The 10 patients enrolled were all older women with delayed presentation, high-stage disease and limited response to treatment. Five patients (50%) were found to have c-KIT expression; 4 of them recurred (P=0.01), and ultimately 3 died (P=0.038). We identified satellitosis and c-KIT expression as prognostic predictors for death. CONCLUSIONS: We conclude that c-KIT expression is a valuable predictor of prognosis and survival, especially in thick (>4 mm) melanomas.

Asunto(s)

Melanoma/patología , Proteínas Proto-Oncogénicas c-kit/metabolismo , Neoplasias de la Vulva/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , México , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Sobrevida

RESUMEN

BACKGROUND: Androgen insensitivity syndrome is an X-linked disorder, and is characterised by a female phenotype in a chromosomally male individual. It usually occurs in puberty with primary amenorrhoea or as an inguinal tumour in a female infant. In recent years, it is often also diagnosed in fertility clinics in adulthood. OBJECTIVE: The case is presented of a pure seminoma in a woman with the reference diagnosis of inguinal hernia. CLINICAL CASE: A 53 year old woman, who was operated on in 2014 due to a nodule in left groin. Androgen insensitivity syndrome was corroborated, and histopathology reported it as a right testicular seminoma. DISCUSSION: The importance of early diagnosis is discussed, highlighting the consequences of misdiagnosis, and question whether these patients have been adequately treated in the past. The risk of malignant transformation of an undescended testicle increases with age, thus gonadectomy should be performed after puberty, and in some cases hormone replacement therapy.

Asunto(s)

Síndrome de Resistencia Androgénica/complicaciones , Criptorquidismo/complicaciones , Disgenesia Gonadal 46 XY/complicaciones , Neoplasias Primarias Múltiples/diagnóstico , Seminoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Síndrome de Resistencia Androgénica/sangre , Síndrome de Resistencia Androgénica/diagnóstico , Biomarcadores de Tumor/sangre , Gonadotropina Coriónica/sangre , Diagnóstico Tardío , Errores Diagnósticos , Disgerminoma/diagnóstico , Detección Precoz del Cáncer , Femenino , Hernia Inguinal/complicaciones , Humanos , Hormona Luteinizante/sangre , Imagen por Resonancia Magnética , Masculino , Neoplasias Ováricas/diagnóstico , Seminoma/sangre , Seminoma/etiología , Neoplasias Testiculares/sangre , Neoplasias Testiculares/etiología , Testosterona/sangre

RESUMEN

BACKGROUND: Radical hysterectomy is the standard treatment for patients with early-stage cervical cancer. However, for women who wish to preserve fertility, radical trachelectomy is a safe and viable option. OBJECTIVE: To present the first case of laparoscopic radical trachelectomy performed in the National Cancer Institute, and published in Mexico. CLINICAL CASE: Patient, 34 years old, gravid 1, caesarean 1, stage IB1 cervical cancer, squamous, wishing to preserve fertility. She underwent a laparoscopic radical trachelectomy and bilateral dissection of the pelvic lymph nodes. Operation time was 330minutes, and the estimated blood loss was 100ml. There were no intraoperative or postoperative complications. The final pathology reported a tumour of 15mm with infiltration of 7mm, surgical margins without injury, and pelvic nodes without tumour. After a 12 month follow-up, the patient is having regular periods, but has not yet tried to get pregnant. No evidence of recurrence. CONCLUSIONS: Laparoscopic radical trachelectomy and bilateral pelvic lymphadenectomy is a safe alternative in young patients who wish to preserve fertility with early stage cervical cancer.

Asunto(s)

Carcinoma de Células Escamosas/cirugía , Cuello del Útero/cirugía , Preservación de la Fertilidad/métodos , Laparoscopía/métodos , Neoplasias del Cuello Uterino/cirugía , Vagina/cirugía , Adulto , Pérdida de Sangre Quirúrgica , Carcinoma de Células Escamosas/diagnóstico por imagen , Femenino , Humanos , Escisión del Ganglio Linfático , Imagen por Resonancia Magnética , Resultado del Tratamiento , Neoplasias del Cuello Uterino/diagnóstico por imagen

RESUMEN

Primary mucinous adenocarcinomas of the ovary are a diagnostic challenge because their histologic and immunohistochemical features usually overlap with metastatic tumors. SATB2 is a recently identified protein with restricted expression in the glandular cells lining the lower gastrointestinal tract. The aim of this study is to examine the differential expression of SATB2 in primary and metastatic tumors of the ovary. Mucinous ovarian tumors of intestinal type were retrieved from the pathology files of the Instituto Nacional de Cancerología de México. A double reading of the hematoxylin and eosin-stained slides was performed to confirm the diagnosis, and a detailed review of the clinical chart was performed to define the primary origin of the tumor (ovarian vs metastatic). Immunohistochemical staining for CK20, CDX2, and SATB2 was performed and evaluated by 2 gynecopathologists. A total of 106 mucinous tumors were identified, 26 of which were considered to be metastatic, and 80 of which were primary ovarian tumors. All of the primary tumors that were not associated with cystic teratomas were negative for SATB2, and the 4 that were associated with a teratoma were positive for SATB2. All 20 of the metastatic tumors of the colon and appendix were positive for CK20, and 4 were positive for CK7. In addition, all 20 of these tumors were positive for SATB2, and 19 were positive for CDX2. SATB2 appears to be a useful marker for the diagnosis of primary vs metastatic mucinous intestinal-type neoplasms and is highly sensitive in detecting lower gastrointestinal tract metastasis.

Asunto(s)

Adenocarcinoma Mucinoso/diagnóstico , Biomarcadores de Tumor/metabolismo , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/patología , Proteínas de Unión a la Región de Fijación a la Matriz/metabolismo , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/secundario , Factores de Transcripción/metabolismo , Adenocarcinoma Mucinoso/metabolismo , Adenocarcinoma Mucinoso/patología , Adulto , Anciano , Factor de Transcripción CDX2 , Neoplasias del Colon/metabolismo , Diagnóstico Diferencial , Femenino , Proteínas de Homeodominio/metabolismo , Humanos , Inmunohistoquímica , Queratina-20/metabolismo , Persona de Mediana Edad , Neoplasias Ováricas/metabolismo , Neoplasias Ováricas/patología , Teratoma/patología

RESUMEN

BACKGROUND: The carcinosarcoma, or Mixed Mullerian Malign Tumors, represent 1% of malignant ovarian neoplasm, they are formed by a component epithelium and another mesenquimal malignant both. OBJECTIVE: Report the experience of the Ginecological Department of the Instituto Nacional de Cancerología (Mexico) in the treatment of patients with ovarian carcinosarcoma or primary malignant of the ovary. METHODS: A retrospective of 8 cases of carcinosarcoma primary of ovary at National Institute of Cancerology, from January, 2005 to December, 2008. RESULTS: The carcinosarcoma or Mixed Mullerian Malign Tumors appeared in 4.1% of all the malignant primary tumors of ovary, the clinical initial presentation was with pain and abdominal expansion both in 62.5% and mass palpable and bled vaginal in 25% of the patients. In 2/8 (25%) patients there was achieved a residual tumor minor of 1cm, in 4/8 (50%) cases one administered chemotherapy. In 3/8 (37.5%) they were kept free of disease in the follow-up of 42 months, 1/8 (12.5%) with stable disease and 4/8 (50%) they died for disease. CONCLUSIONS: Ovarian carcinosarcoma is a rare tumor, the clinical of this neoplasm is aggressive, usually presenting in advanced stages, with a poor prognosis with existing medical treatment.

Asunto(s)

Carcinosarcoma/terapia , Neoplasias Ováricas/terapia , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven

RESUMEN

Plasmablastic lymphoma is an uncommon B-cell lymphoma representing <3% of all non-Hodgkin lymphoma associated with human immunodeficiency virus infection. It displays a distinctive affinity for extranodal presentation in the oral cavity. The case of a plasmablastic lymphoma present in the ovary, cervix and soft thigh tissues of a 27-year-old woman with human immunodeficiency infection is reported.

Asunto(s)

Linfoma de Células B/patología , Neoplasias Ováricas/patología , Adulto , Femenino , Humanos

RESUMEN

INTRODUCTION: Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically. CONCLUSIONS: In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.

Asunto(s)

Neoplasias Ováricas , Cuidados Posteriores , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Terapia Combinada , Resistencia a Antineoplásicos , Diagnóstico Precoz , Femenino , Genes Relacionados con las Neoplasias , Humanos , Laparoscopía , Escisión del Ganglio Linfático , Terapia Neoadyuvante , Estadificación de Neoplasias/normas , Síndromes Neoplásicos Hereditarios/genética , Epiplón/cirugía , Compuestos Organoplatinos/administración & dosificación , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/epidemiología , Neoplasias Ováricas/genética , Neoplasias Ováricas/patología , Neoplasias Ováricas/terapia , Ovariectomía/métodos , Cuidados Paliativos , Calidad de Vida , Radioterapia Adyuvante , Terapia Recuperativa , Taxoides/administración & dosificación

RESUMEN

BACKGROUND: Germ cell testicular tumors have survival rate that diminishes with high tumor marker levels, such as human chorionic gonadotropin (hCG). hCG may regulate vascular neoformation through vascular endothelial growth factor (VEGF). Our purpose was to determine the relationship between hCG serum levels, angiogenesis, and VEGF expression in germ cell testicular tumors. METHODS: We conducted a retrospective study of 101 patients. Serum levels of hCG, alpha-fetoprotein (AFP), and lactate dehydrogenase were measured prior to surgery. Vascular density (VD) and VEGF tissue expression were determined by immunohistochemistry and underwent double-blind analysis. RESULTS: Histologically, 46% were seminomas and 54%, non-seminomas. Median follow-up was 43 +/- 27 months. Relapse was present in 7.5% and mortality in 11.5%. Factors associated with high VD included non-seminoma type (p = 0.016), AFP > or = 14.7 ng/mL (p = 0.0001), and hCG > or = 25 mIU/mL (p = 0.0001). In multivariate analysis, the only significant VD-associated factor was hCG level (p = 0.04). When hCG levels were stratified, concentrations > or = 25 mIU/mL were related with increased neovascularization (p < 0.0001). VEGF expression was not associated with VD or hCG serum levels. CONCLUSION: This is the first study that relates increased serum hCG levels with vascularization in testicular germ cell tumors. Hence, its expression might play a role in tumor angiogenesis, independent of VEGF expression, and may explain its association with poor prognosis. hCG might represent a molecular target for therapy.

Asunto(s)

Biomarcadores de Tumor/sangre , Gonadotropina Coriónica/sangre , Neoplasias de Células Germinales y Embrionarias/sangre , Neovascularización Patológica/patología , Neoplasias Testiculares/sangre , Adulto , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , L-Lactato Deshidrogenasa/sangre , Masculino , Estadificación de Neoplasias , Neoplasias de Células Germinales y Embrionarias/irrigación sanguínea , Neoplasias de Células Germinales y Embrionarias/patología , Neoplasias Testiculares/irrigación sanguínea , Neoplasias Testiculares/patología , Factor A de Crecimiento Endotelial Vascular/biosíntesis , alfa-Fetoproteínas/análisis

RESUMEN

BACKGROUND: We explore the use of a clinical orthovoltage X-ray treatment unit as a small-animal radiation therapy system in a tumoral model of cervical cancer. METHODS: Nude mice were subcutaneously inoculated with 5 x 106 HeLa cells in both lower limbs. When tumor volume approximated 200 mm3 treatment was initiated. Animals received four 2 mg/kg intraperitoneal cycles (1/week) of cisplatin and/or 6.25 mg/kg of gemcitabine, concomitant with radiotherapy. Tumors were exposed to 2.5 Gy/day nominal surface doses (20 days) of 150 kV X-rays. Lead collimators with circular apertures (0.5 to 1.5 cm diameter) were manufactured and mounted on the applicator cone to restrict the X-ray beam onto tumors. X-ray penetration and conformality were evaluated by measuring dose at the surface and behind the tumor lobe by using HS GafChromic film. Relative changes in tumor volume (RTV) and a clonogenic assay were used to evaluate the therapeutic response of the tumor, and relative weight loss was used to assess toxicity of the treatments. RESULTS: No measurable dose was delivered outside of the collimator apertures. The analysis suggests that dose inhomogeneities in the tumor reach up to +/- 11.5% around the mean tumor dose value, which was estimated as 2.2 Gy/day. Evaluation of the RTV showed a significant reduction of the tumor volume as consequence of the chemoradiotherapy treatment; results also show that toxicity was well tolerated by the animals. CONCLUSION: Results and procedures described in the present work have shown the usefulness and convenience of the orthovoltage X-ray system for animal model radiotherapy protocols.

Asunto(s)

Neoplasias del Cuello Uterino/radioterapia , Animales , Modelos Animales de Enfermedad , Femenino , Células HeLa , Humanos , Ratones , Ratones Desnudos , Ensayos Antitumor por Modelo de Xenoinjerto

RESUMEN

The ovaries are common sites for metastatic disease, however, the most frequent ones are carcinomas. Metastatic sarcomas are very rare in ovary and most of them arise from genital tract. We present the case of a 33-year-old woman with subcutaneous angiosarcoma who had metastatic disease to the ovary resulting in acute abdominal pain. Discussion of the case and a review of the literature are presented.

Asunto(s)

Hemangiosarcoma/patología , Neoplasias Ováricas/secundario , Neoplasias de los Tejidos Blandos/patología , Adulto , Femenino , Humanos , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/patología , Tomografía Computarizada por Rayos X

RESUMEN

BACKGROUND: Retroperitoneal cystadenocarcinomas are rare lesions, the majority of cases presented as one-patient reports. METHODS: We present two cases of retroperitoneal cystadenocarcinoma, both in women of reproductive age: one with aggressive behavior, and the remaining case, with a more indolent clinical evolution. RESULTS: One case presented as pelvic tumor, was treated with surgical resection of the disease, but manifested with recurrent disease a few months later despite use of chemotherapy. The second case involved a patient with diagnosis of abdominal tumor; during laparotomy, a retroperitoneal tumor was found and was totally removed. At follow-up, the patient is disease-free with no other treatment. CONCLUSION: The behavior and treatment of retroperitoneal cystadenocarcinoma are controversial. We suggest aggressive surgery including radical hysterectomy and bilateral salpingoopherectomy with adjuvant chemotherapy in these cases.

Asunto(s)

Cistadenocarcinoma Mucinoso/patología , Neoplasias Retroperitoneales/patología , Adulto , Cistadenocarcinoma Mucinoso/diagnóstico , Femenino , Humanos , Neoplasias Retroperitoneales/diagnóstico , Adulto Joven

RESUMEN

BACKGROUND: Despite significant achievements in the treatment of cervical cancer, it is still a deadly disease; hence newer therapeutical modalities are needed. Preliminary investigations suggest that platelet-derived growth factor (PDGF) might have a role in the development of cervical cancer, therefore it is important to determine whether this growth factor pathway is functional and its targeting with imatinib mesylate leads to growth inhibition of cervical cancer cells. RESULTS: PDGF receptors (PDGFR) and their ligands are frequently expressed in cervical cancer and the majority exhibited a combination of family members co-expression. A number of intronic and exonic variations but no known mutations in the coding sequence of the PDGFRalpha gene were found in cancer cell lines and primary tumors. Growth assays demonstrated that PDGFBB induces growth stimulation that can be blocked by imatinib and that this tyrosine kinase inhibitor on its own inhibits cell growth. These effects were associated with the phosphorylation status of the receptor. CONCLUSION: The PDGFR system may have a role in the pathogenesis of cervical cancer as their members are frequently expressed in this tumor and cervical cancer lines are growth inhibited by the PDGFR antagonist imatinib.

RESUMEN

BACKGROUND: The antihypertensive compound hydralazine is a known demethylating agent. This phase I study evaluated the tolerability and its effects upon DNA methylation and gene reactivation in patients with untreated cervical cancer. METHODS: Hydralazine was administered to cohorts of 4 patients at the following dose levels: I) 50 mg/day, II) 75 mg/day, III) 100 mg/day and IV) 150 mg/day. Tumor biopsies and peripheral blood samples were taken the day before and after treatment. The genes APC, MGMT; ER, GSTP1, DAPK, RARbeta, FHIT and p16 were evaluated pre and post-treatment for DNA promoter methylation and gene expression by MSP (Methylation-Specific PCR) and RT-PCR respectively in each of the tumor samples. Methylation of the imprinted H19 gene and the "normally methylated" sequence clone 1.2 was also analyzed. Global DNA methylation was analyzed by capillary electrophoresis and cytosine extension assay. Toxicity was evaluated using the NCI Common Toxicity Criteria. RESULTS: Hydralazine was well tolerated. Toxicities were mild being the most common nausea, dizziness, fatigue, headache and palpitations. Overall, 70% of the pretreatment samples and all the patients had at least one methylated gene. Rates of demethylation at the different dose levels were as follows: 50 mg/day, 40%; 75 mg/day, 52%, 100 mg/day, 43%, and 150 mg/day, 32%. Gene expression analysis showed only 12 informative cases, of these 9 (75%) re-expressed the gene. There was neither change in the methylation status of H19 and clone 1.2 nor changes in global DNA methylation. CONCLUSION: Hydralazine at doses between 50 and 150 mg/day is well tolerated and effective to demethylate and reactivate the expression of tumor suppressor genes without affecting global DNA methylation.

Asunto(s)

Enfermedades Cardiovasculares/tratamiento farmacológico , Metilación de ADN/efectos de los fármacos , Regulación Neoplásica de la Expresión Génica , Genes Supresores de Tumor , Hidralazina/farmacología , Neoplasias del Cuello Uterino/tratamiento farmacológico , Neoplasias del Cuello Uterino/genética , 5-Metilcitosina/farmacología , Adulto , Anciano , Sitios de Unión , Biopsia , Estudios de Cohortes , Citosina/química , ADN/genética , Electroforesis Capilar , Femenino , Humanos , Persona de Mediana Edad , Regiones Promotoras Genéticas , ARN Largo no Codificante , ARN no Traducido/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Vasodilatadores/farmacología

RESUMEN

BACKGROUND: Transitional cell carcinoma of the cervix (TCCC) is a rare neoplasm of recent description. The cytologic characteristics of the tumor have not been published to date. Six cases of TCCC are described, including their clinical, histologic, cytologic and immunohistochemical features. CASES: All cases presented at an advanced clinical stage; two recurred, and one metastasized. Five cases showed a papillary exophytic pattern, and one case showed an "inverted" endophytic pattern similar to that of transitional cell carcinoma of the urothelium (TCCU). The cytokeratin profile was similar to that of squamous cell carcinoma of the cervix (SCCC), positive for CK 7 and negative for CK 20. The cervical smears showed a background that was necrotic or hemorrhagic. The cells with transitional features formed cohesive groups in a multilayered fashion and had an oval or spindle shape with tapered ends. The nuclei were hyperchromatic, with coarse and medium-sized granules that frequently displayed a wrinkled membrane, nuclear grooves and rare pseudoinclusions. The nucleoli were small or absent. Others cells with cytologic characteristics of SCCC were seen in all cases. CONCLUSION: TCCC is a rare neoplasm that probably represents a subgroup of SCCC. The most frequent histologic pattern is papillary-exophytic, but it can be inverted-endophytic. In cervical smears there are cells with characteristics of regular SCCC and others resembling those of TCCU. A larger number of cases is needed to define the evolution and clinical outcome.

Asunto(s)

Carcinoma de Células Transicionales/patología , Neoplasias del Cuello Uterino/patología , Adulto , Anciano , Biomarcadores de Tumor/análisis , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Transicionales/química , Carcinoma de Células Transicionales/diagnóstico , Nucléolo Celular/patología , Núcleo Celular/patología , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Queratinas/análisis , Queratinas/inmunología , Persona de Mediana Edad , Estudios Retrospectivos , Neoplasias del Cuello Uterino/química , Neoplasias del Cuello Uterino/diagnóstico

RESUMEN

Se efectuó un estudio retrospectivo analizado dos periodos (1960-1970 y 1980-1990) y comparando la asociación de Helicobacter pylori con cáncer gástrico. De cada periodo se estudiaron 50 casos con esta neoplasia. En el primer periodo la frecuencia de H. pylori fue de 44 por ciento y en el segundo de 42 por ciento. Si bien la presencia de la infección fue casi la misma, no resultó así la de cáncer gástrico, la cual fue de 47 por ciento para los tumores gastrointestinales en los años 70 y de 36 por ciento en los años 80. Lo anterior sugiere que el H. pylori es un factor más en el cortejo multifactorial de la génesis del cáncer gástrico. Por lo que respecta a la edad de aparición del cáncer gástrico, ésta no fue estadísticamente entre pacientes con o sin infección de H. pylori; por lo tanto, esta infección no condiciona, al parecer, una evolución más rápida de la neoplasia

Asunto(s)

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Neoplasias Gástricas , Estudios de Casos y Controles , Helicobacter pylori , Registros Médicos