RESUMEN
Extraskeletal chondrosarcoma is a rare malignant tumor. The well differentiated histological type, which is found primary in soft tissue, is extremely rare. This report describes the case of a 58-year-old woman presented with a large palpable mass in the right buttock. Imaging studies revealed a well-defined soft tissue mass, with extensive calcification. A histological examination after surgical resection confirmed the diagnosis of well-differentiated extraosseous chondrosarcoma. The outcome was favorable, without recurrence or metastasis.
Asunto(s)
Diferenciación Celular , Condrosarcoma/patología , Neoplasias de los Tejidos Conjuntivo y Blando/patología , Biopsia , Nalgas , Condrosarcoma/diagnóstico por imagen , Condrosarcoma/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neoplasias de los Tejidos Conjuntivo y Blando/diagnóstico por imagen , Neoplasias de los Tejidos Conjuntivo y Blando/cirugía , Valor Predictivo de las Pruebas , Tomografía Computarizada por Rayos X , Carga TumoralRESUMEN
BACKGROUND: Uterine tumours resembling ovarian sex-cord tumours (UTROSCT) are very rare, benign uterine tumours, composed solely of sex cord elements. These tumours have a polyphenotypic immunophentype that favours a derivation from uterine mesenchymal stem cells. CASE REPORT: A 43-year-old female presented with recurrent vaginal bleeding. On hysteroscopy, she had multiple endometrial and cervical polyps that were removed endoscopically. Histologically, the specimen contained epithelioid cells arranged in tubules, trabeculae and anastomosing cords, without significant cellular atypia or mitotic activity. Immunohistochemical studies were performed. The tumour was found to be diffusely positive for vimentin, calretinin and desmin, focally positive for cytokeratin, CD99 and inhibin and negative for chromogranin and CD10. A subsequent total hysterectomy was performed and revealed neoplastic infiltration of the myometrium. CONCLUSION: A polyphenotypic immunophenotype is a characteristic feature of UTROSCT, and may be helpful in diagnosis and in exclusion of other lesions. Familiarity with this tumour by gynaecologists and pathologists is essential to avoid misdiagnosis:correct diagnosis of this neoplasm is important in patient management.
Asunto(s)
Neoplasias Endometriales/patología , Neoplasias Ováricas/patología , Pólipos/patología , Tumores de los Cordones Sexuales y Estroma de las Gónadas/patología , Neoplasias del Cuello Uterino/patología , Adulto , Biomarcadores de Tumor/análisis , Biopsia , Neoplasias Endometriales/química , Neoplasias Endometriales/cirugía , Femenino , Humanos , Histeroscopía , Inmunohistoquímica , Pólipos/química , Pólipos/cirugía , Valor Predictivo de las Pruebas , Neoplasias del Cuello Uterino/química , Neoplasias del Cuello Uterino/cirugíaRESUMEN
Mixed stromal and smooth muscle uterine tumours, defined as those containing at least 30% of each component as seen by routine light microscopy, are rare. This report describes the morphological features of two such tumours diagnosed in 44-year-old and 50-year-old females complaining from recurrent uterine bleeding that was unresponsive to medical treatment. Morphological and immunohistochemical evaluations were performed, and a final diagnosis of mixed endometrial stromal nodule and smooth muscle tumour of the uterus was rendered in both cases.
Asunto(s)
Neoplasias Endometriales/patología , Tumor Mixto Maligno/patología , Tumor de Músculo Liso/patología , Neoplasias Uterinas/patología , Útero/patología , Adulto , Diagnóstico Diferencial , Neoplasias Endometriales/complicaciones , Neoplasias Endometriales/diagnóstico , Femenino , Humanos , Persona de Mediana Edad , Tumor Mixto Maligno/diagnóstico , Tumor de Músculo Liso/complicaciones , Tumor de Músculo Liso/diagnóstico , Neoplasias Uterinas/diagnósticoRESUMEN
OBJECTIVES: To assess the postoperative morbidity of a technique for caesarean section without closing the visceral and parietal peritoneum. PATIENTS AND METHODS: We conducted a prospective cohort study randomized 252 patients over a period of four months (from March 1 to June 30, 2009). We studied the early postoperative morbidity. RESULTS: Among the 252 patients, 137 were included in the group "with peritonisation" and 115 in the group "without peritonisation". Clinical and hematology maternal characteristics were comparable in both groups. The duration of intervention was reduced significantly in the absence of peritonisation (31.1 instead of 41.4 minutes; P<0.001). The postoperative pain was less but not significant between h0 and h12, however it is significant at h18, h24 and h30 in the absence of peritonisation (respectively 2.37 versus 2.81; P=0.030; 1.98 versus 2.37; P<0.001 and 1.38 versus 1.72; P=0.018). Resumption of transit was significantly faster "without peritonisation" (24.3 versus 24.7 hours; P<0.001). However, there is no significant difference between the two groups as regards the immediate postoperative complications. CONCLUSION: The absence of visceral and parietal peritoneum shortens the operative time and favors an earlier resumption of transit. It also decreases pain symptoms. We therefore recommend not to suture the parietal and visceral peritoneum during cesarean section.