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OBJECTIVE: Our objective was to determine the identification and the percentage of false negatives in sentinel node biopsies in patients with early breast cancer at the Hospital La Línea (Spain), during the period between November 2007 and September 2010. METHODS: We collected 50 patients with early breast cancer, without clinical and ultrasonographic involvement of axillary nodes, from November 2007 to September 2010. We used the vital dye in the first 20 patients and the combined technique of vital dye and albumin labelled with technetium 99 in the other 30 patients. The site of injection for patients using blue dye was subdermal for palpable tumours and periareolar for non-palpable tumours. The technique of injection with the radioisotope for patients for palpable and most non-palpable tumours was the periareolar technique. We used albumin labelled with technetium 99. In seven patients with non-palpable tumours, we used the sentinel node occult lesion localisation (SNOLL) technique. The sentinel node biopsy was examined during surgery, with the frozen section examination and imprint as follows: the sentinel node was cut in three transversal sections along the axis and five frozen sections of each portion were done at a distance of 60 µm each; in total, 15-20 frozen sections and three imprints were done for each sentinel node. The axillary dissection was completed in the first 17 patients, and we performed total axillary dissection on the remaining patients if the sentinel node was positive for metastasis. RESULTS: The sentinel nodes were identified in 49 of 50 patients (98%). The patient in whom we did not identify the sentinel node was a patient in the combined technique. The number of nodes identified in the patients with vital dye was one sentinel node, and with the combined technique, it was two sentinel nodes. The false-negative rate was 8% (four patients); the micrometastasis was the principal factor of the false-negative rate (p < 0.05). The cases of false negatives were present at the beginning of the study with the use of the blue dyes; this factor was statistically significant (p < 0.05). The tumour size, the vascular invasion, and the periganglionar adipose tissue invasion were statistically significant for the presentation of axillary metastasis (p < 0.05). CONCLUSION: This study shows that the micrometastasis and the use of vital dye were the principal factors for the presentation of the false-negative rate. The size of the tumour, the vascular invasion, and the periganglionar adipose tissue invasion were statistically significant for the appearance of the axillary metastasis.

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Breast sarcoma is a rare entity that accounts for less than 1% of all breast malignancies; it may spread by direct invasion and/or through the blood. Axillary lymph node involvement is extremely rare and usually associated with advanced-stage disease. In the surgical treatment of this neoplasm, complete axillary lymphadenectomy is important for the local clearance of the clinically involved lymph nodes. We report a case of a 65-year-old woman affected by follicular dendritic cell sarcoma of the left breast. Six months after breast surgery she developed an axillary metastasis from the same disease.

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Este estudio analizó la evolución postoperatoria de 31 pacientes con diagnóstico confirmado de cáncer gástrico temprano (CGT) en seis diferentes instituciones hospitalarias de Medellín, entre Enero de 1994 y Diciembre de 2000. La edad promedio fue de 57.6 años, y predominancia del sexo femenino (61.3 por ciento) sin ser estadísticamente significativa. El 54.8 por ciento de las lesiones fueron adenocarcinomas bien diferenciados, con tipo morfológico superficial (29 por ciento), tamaño promedio de 1.98 cm. e invasión hasta la submucosa en el 61.3 por ciento de los casos. Solo dos pacientes tuvieron compromiso ganglionar asociado...

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La organización Mundial de la Salud (OMS) definió todos los tumores carcinoides integrales del sistema neuroendocrino excepto el cáncer (Ca) medular del tiroides, Ca de células pequeñas del pulmón, paragangliomas, tumor de Merckel de la piel, tumor de islotes pancreáticos, adenomas pituitarios y feocracitoma.

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En 1838 Merling describió la patología macroscópica de un tumor carcinoide del apéndice, dando los crecimientos para el estudio de estos tumores, fue entonces Oberndorfer en 1907 quien utilizó el término Karzinoide a meoplasias con comportamiento mas benigno que los carcinomas. El termino carcinoide es hoy menos bien definido, en un reciente simposio internacional de tumores carcinoides un grupo de patólogos con especial interés en tumores endocrinos has propuesto una clasificación revisada de tumores neuroendocrinos del pulmón, páncreas y el intestino, con esta nueva clasificación el termino carcinoide ha sido remplazado por el termino “tumor neuroendocrino” para designar la totalidad de neoplasia con características neuroendocrinas. Estos tumores tienen una incidencia de 1.5 por 100.000 habitantes y representan el 55 por ciento de todas las neoplasias endocrinas del intestino y entre el 13 – 34 por ciento de los tumores del intestino delgado.

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