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Because of advances in the understanding of histological and molecular characteristics in ovarian cancer, it is now possible to recognize the existence of five subtypes, which in turn has allowed a more refined therapeutic approach and better design of clinical trials. Each of these five subtypes has specific histological features and a particular biomarker expression, as well as mutations in different genes, some of which have prognostic and predictive value. CA125 and HE4 are examples of ovarian cancer biomarkers used in the diagnosis and follow-up of these malignancies. Currently, somatic or germinal mutations on BRCA1 and BRCA2 genes are the most important biomarkers in epithelial ovarian cancer having prognostic and predictive value. This article will review the histological and molecular characteristics of the five subtypes of ovarian cancer, describing the most important biomarkers and mutations that can guide in diagnosis, screening and tailored treatment strategy (AU)

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Because of advances in the understanding of histological and molecular characteristics in ovarian cancer, it is now possible to recognize the existence of five subtypes, which in turn has allowed a more refined therapeutic approach and better design of clinical trials. Each of these five subtypes has specific histological features and a particular biomarker expression, as well as mutations in different genes, some of which have prognostic and predictive value. CA125 and HE4 are examples of ovarian cancer biomarkers used in the diagnosis and follow-up of these malignancies. Currently, somatic or germinal mutations on BRCA1 and BRCA2 genes are the most important biomarkers in epithelial ovarian cancer having prognostic and predictive value. This article will review the histological and molecular characteristics of the five subtypes of ovarian cancer, describing the most important biomarkers and mutations that can guide in diagnosis, screening and tailored treatment strategy.

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Silicone breast prostheses prompt the development of a fibrous casing or periprosthetic capsule. Capsular contracture, due to retraction of the fibrous tissue, is the most frequent and important complication of these implants. It produces varying degrees of hardening and, in advanced cases, deformity of the breast. It has been closely related to the type of surface of the implant (smooth or textured) and with the alignment of the collagen fibers, and it has been suggested that the formation of a continuous capsule, with collagen fibers aligned in parallel and circularly around the smooth prostheses, promotes the development of concentric contractile forces that pulling in unison give rise to contracture. With microporous textured prostheses a significantly lower incidence of capsular contracture has been shown in comparison with smooth prostheses. It is believed that tissue growth within the microporous structure gives rise to multidirectional contractile forces, with a tendency to neutralize one another when their effect is added over the implant. The capsule of these implants presents a base zone composed of multiple layers of collagen fibers aligned in parallel, which might contract. However, the adherence of the microporous textured prostheses might counteract the contractile forces.

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Las prótesis mamarias de silicona provocan eldesarrollo de una envoltura fibrosa o cápsula periprotésica.La contractura de la cápsula, por retracción deltejido fibroso, es la complicación más frecuente eimportante de estos implantes. Produce un endurecimientode grado variable y, en los casos avanzados,deformidad de la mama. Se ha relacionado estrechamentecon el tipo de superficie del implante (lisa o texturada)y con la disposición de las fibras de colágeno,habiéndose sugerido que la formación de una cápsulacontinua, con fibras de colágeno dispuestas paralela ycircularmente alrededor de las prótesis lisas, promueveel desarrollo de fuerzas contráctiles concéntricas,que traccionando al unísono producirían la contractura.Con las prótesis texturadas microporosas se hademostrado una incidencia significativamente másbaja de contractura capsular en comparación con laslisas. Se considera que el crecimiento tisular dentro dela estructura microporosa origina fuerzas contráctilesmultidireccionales, con tendencia a neutralizarse entreellas cuando su efecto se suma sobre el implante. Lacápsula de estos implantes presenta una zona basalcompuesta de múltiples capas de fibras de colágenoalineadas paralelamente, la cual podría contraerse. Sinembargo, la adherencia de las prótesis texturadasmicroporosas podría contrarrestar las fuerzas contráctiles

Silicone breast prostheses prompt the ;;development of a fibrous casing or periprosthetic ;;capsule. Capsular contracture, due to retraction of the ;;fibrous tissue, is the most frequent and important ;;complication of these implants. It produces varying ;;degrees of hardening and, in advanced cases, ;;deformity of the breast. It has been closely related to ;;the type of surface of the implant (smooth or textured) ;;and with the alignment of the collagen fibers, and it has ;;been suggested that the formation of a continuous ;;capsule, with collagen fibers aligned in parallel and ;;circularly around the smooth prostheses, promotes ;;the development of concentric contractile forces that ;;pulling in unison give rise to contracture. With ;;microporous textured prostheses a significantly lower ;;incidence of capsular contracture has been shown in ;;comparison with smooth prostheses. It is believed that ;;tissue growth within the microporous structure gives ;;rise to multidirectional contractile forces, with a ;;tendency to neutralize one another when their effect is ;;added over the implant. The capsule of these implants ;;presents a base zone composed of multiple layers of ;;collagen fibers aligned in parallel, which might ;;contract. However, the adherence of the microporous ;;textured prostheses might counteract the contractile ;;forces

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Se presenta el caso de una paciente diagnosticada de metástasis peritoneales múltiples por adenocarcinoma de colon intervenido 2 años antes, y un pólipo endometrial metastatizado por el mismo tumor. Después de realizarle laparotomía exploradora y legrado diagnóstico, y debido a que el pólipo le provocaba metrorragias anemizantes, se inició tratamiento paliativo con análogos de la LHRH y quimioterapia, con lo que cedió la hemorragia. Casi 3 años después, la paciente continúa con buena calidad de vida. Se destaca la buena respuesta al tratamiento con análogos de la LHRH y a propósito del caso se revisa la bibliografía existente (AU)

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La habilidad del melanoma maligno metastásico para asumir una amplia variedad de patrones morfológicos, incluyendo distintos tipos de sarcoma es bien conocida. Las metástasis de melanoma maligno en ovario, cuando se presentan como tumor primitivo ovárico son un hecho excepcional. Presentamos en este artículo un caso inusual de metástasis unilateral de melanoma maligno, sin una evidencia clínica de tumor primario. Se discute la historia clínica y el diagnostico diferencial . La paciente presentó una tumoración ovárica de 12 cm, acompañada de un nódulo en meso de colon transverso de 2 cm, ambos presentaban una superficie lobulada. En algunas áreas y particularmente en el ovario, la morfología del tumor era predominatemente epitelioide y el patrón de crecimiento periteliomatoso. En el mesenterio la morfología era predominantemente fusocelular y su apariencia recordaba a un tumor maligno de vaina nerviosa periférica, incluyendo areas de necrosis geográfica. Las células tumorales expresaron vimentina, HMB-45, actina y S-100 (difusa). La distribución de los nódulos tumorales, la combinación de patrones mortológicos, y el perfil inmunohistoquímico es consistente con el diagnóstico de metastasis de melanoma maligno (AU)

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Sobre la cresta láctea, inicio de la organogénesis de la mama, pueden producirse alteraciones del desarrollo. Destaca por su frecuencia la polimastia, caracterizada por el aumento del número de mamas morfológicamente completas o tan sólo de tejido glandular. Aunque su localización más frecuente es la axila pueden aparecer en cualquier sitio de la "cresta láctea" (línea axila- vulva); están expuestas a influjos hormonales y sobre ellas puede asentar cualquier tipo de patología mamaria. Presentamos el caso clínico de una paciente de 33 años, con antecedentes familiares de cáncer de mama, que presentaba un nódulo vulvar sintomático, cuyo estudio histológico reveló que se trataba de un papiloma intraductal asentado, probablemente, sobre tejido mamario. Sólo por motivos estéticos o ante la existencia de síntomas, sobretodo si se asocian a antecedentes familiares de cáncer de mama, está indicada la extirpación quirúrgica del tejido mamario accesorio, ectópico o aberrante. (AU)

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A 42 year-old female with a preoperative clinical diagnosis of ovarian cancer underwent laparotomy which revealed leiomyomatosis peritonealis disseminata (LPD) in the peritoneum and omentum and a left ovarian endometriotic cyst associated with a clear cell carcinoma. A grade 1, superfically invasive villoglandular endometrial endometrioid adenocarcinoma was also found. Microscopically, the endometriotic cyst wall contained an extensive peripheral band-like condensation of stromal cells. These cells were strongly positive for alpha inhibin and may have been the hormonal source responsible for the induction of the simultaneous LPD and endometrial adenocarcinoma. It is proposed that endometriosis is not only a precursor of clear cell carcinoma but, through secondary hormonal induction of the surrounding ovarian stroma, may also provide a hormonal stimulus for diverse proliferative processes.

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Aiming to assess the development of the anorectal sphincteric apparatus and whether it is influenced by the presence of an intestinal conduit through the muscular complex, we seek to develop an experimental model of anorectal atresia in foetuses of female pregnant rats, given orally the herbicide ethylenethiourea (ETU). Six 3-months-old, 300 g female Wistar rats were included in the study group (SG). The foetuses of another unexposed rat formed the control group (CG). In the SG 54, foetuses were alive, all had hypoplasia of the tail and 47 (87%) had no visible anal orifice. The 18 foetuses of the CG were normal. The histological study was performed at the level of the pubic symphysis. Type I anorectal atresia was defined when this section demonstrated an intestinal conduit and Type II when only a muscular cord was found, without any intestinal tube. This study was completed in 15 (32%) of the SG, 9 (60%) with anorectal atresia Type II and 6 (40%) with atresia Type I, and in 11 animals (61%) of the CG. The thickness of the sphincter muscle was larger in the CG (260.47+/-35.32 micro) than in the SG (208.98+/-55.01 micro), p<0.05, but this difference was due to the animals showing atresia Type II. To conclude: ETU had a teratogenic effect. The foetuses with atresia, particularly Type II, had a decreased development of the muscular complex. The presence of an intestinal conduit does not significantly influence the development of the muscular complex.

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OBJECTIVE: To collect quantitative and stereologic data on the main cell types represented in the seminiferous tubule in order to produce a three-dimensional representation of the morphologic events of normal cell production and maturation. STUDY DESIGN: Three-dimensional reconstruction and differential cell counting were performed on serial sections of normal testicular tissue from normal young men through image analysis and computer-based rendering. RESULTS: Peculiar periodicity in the total number of tubular cells considered along the sequence of serial sections was recognized. Also, consensual periodicity pertaining to each cell type was recognized. Adjacent high cellularity and low cellularity segments included a fairly constant mixture of cell types considered. CONCLUSION: A newly defined cellular wave, composed of regular alternations of high and low cellularity segments, was identified in the normal human seminiferous tubule.

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