RESUMEN

Female breast cancer is one of the major causes of death among women while male breast cancer is relatively uncommon and accounts for about 1% of all breast cancers in both sexes. Influencing factors are: gynecomasty, familiarity for male breast cancer, Jewish and African-American male population. From the histological point of view, it is not different from the female breast cancer, except for the infiltrant ductal carcinoma, but with a much severe prognosis. Breast cancer metastases to the jaws are rare, only 1%; the most common sites of metastases are: lungs(59-69%), liver (58-65%), bone (44-71%), pleura (23-37%), brain (9-22%) and kidney (4-17%). At present, based on a literature research (May 2006), there have been just two other case reports of male breast cancer metastasis to the maxillofacial region, both to the mandible. The case of a 69-year-old white man who in 2001 underwent a radical mastectomy due to ductal breast cancer is reported. In 2005 the patient was referred to our department by his oncologist for multiple oral fistula. A mandibular TC revealed osteolytic lesions and the patient underwent mandibular surgery to remove the lesions and clean up the area. The histological examination was consistent with that of a metastatic deposit of adenocarcinoma of the breast. In June 2006 the patient died due to worsening of the general clinical conditions, in particular due to ascites and hepatic insufficiency.

Asunto(s)

Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama Masculina/patología , Carcinoma Ductal de Mama/secundario , Neoplasias Mandibulares/secundario , Anciano , Androstadienos/administración & dosificación , Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos Hormonales/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Conservadores de la Densidad Ósea/uso terapéutico , Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundario , Neoplasias de la Mama Masculina/tratamiento farmacológico , Neoplasias de la Mama Masculina/cirugía , Carcinoma Ductal de Mama/tratamiento farmacológico , Carcinoma Ductal de Mama/cirugía , Cortisona/administración & dosificación , Ciclofosfamida/administración & dosificación , Difosfonatos/uso terapéutico , Docetaxel , Resultado Fatal , Fluorouracilo/administración & dosificación , Furosemida/uso terapéutico , Humanos , Imidazoles/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Masculino , Neoplasias Mandibulares/tratamiento farmacológico , Neoplasias Mandibulares/cirugía , Mastectomía Radical Modificada , Metotrexato/administración & dosificación , Omeprazol/administración & dosificación , Osteólisis/tratamiento farmacológico , Osteólisis/etiología , Fenobarbital/administración & dosificación , Taxoides/administración & dosificación , Toremifeno/uso terapéutico , Vinblastina/análogos & derivados , Vinblastina/uso terapéutico , Vinorelbina , Ácido Zoledrónico

RESUMEN

INTRODUCTION: Sentinel lymph node biopsy (SLNB) has been proposed as a reliable method for staging of early invasive breast cancer (EIBC). In the present study we analyse the impact of this procedure when systematically applied to all unselected women of a community-based Breast Cancer Unit (BCU). METHODS: All consecutive women with unifocal cT1-2 (

Asunto(s)

Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Carcinoma Lobular/patología , Biopsia del Ganglio Linfático Centinela/métodos , Adulto , Anciano , Anciano de 80 o más Años , Axila , Estudios de Factibilidad , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Prospectivos , Radiofármacos , Agregado de Albúmina Marcado con Tecnecio Tc 99m , Tórax , Resultado del Tratamiento

RESUMEN

The aims of this study were to analyse the feasibility and accuracy of the sentinel lymph node biopsy (SLNB) procedure as performed in a general hospital compared with the literature results; to report on the organizational aspects of planning surgical time with higher accuracy of pathological analysis; and to verify that there is a real advantage of SLNB in the surgical management of breast cancer. From October 1999 to September 2000, 371 consecutive patients with T1-2N0 breast lesions underwent SLNB. The immunoscintigraphic method of sentinel node identification was the main one used, the blue dye method being used only when the lymphoscintigraphic method was unsuccessful in identifying sentinel nodes. SLNB was done under either general or local anaesthesia, depending on how the surgical procedure was organized and clinically planned. SLNB was successful in 99% of these T1-2N0 breast cancer cases, and in 71% no metastases were found in the sentinel node. In 47% of cases with axillary metastasis only the sentinel node was involved. Nodal involvement was not present in any case of microinvasive or in situ carcinoma. In T1 cancers nodal involvement was present in 21%; in T2 cases the corresponding rate reached 51%. The results obtained with the SLNB procedure at Bergamo Hospital are similar to the literature data. When a dedicated surgical team, the nuclear medicine department and the pathology department work together, a general hospital can provide breast cancer patients with appropriate surgical treatment.

Asunto(s)

Neoplasias de la Mama/cirugía , Competencia Clínica , Evaluación de Resultado en la Atención de Salud , Biopsia del Ganglio Linfático Centinela/normas , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Neoplasias de la Mama Masculina/diagnóstico por imagen , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/cirugía , Femenino , Hospitales Generales , Humanos , Italia , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Grupo de Atención al Paciente , Cintigrafía

RESUMEN

The authors report the case of a baby girl with an unusual communicating bronchopulmonary foregut malformation consisting of extralobar pulmonary sequestration and cystic adenomatoid malformation. A well-formed bronchus was the communication between the sequestration and lower esophagus.

Asunto(s)

Anomalías Múltiples/diagnóstico , Bronquios/anomalías , Secuestro Broncopulmonar/diagnóstico , Malformación Adenomatoide Quística Congénita del Pulmón/diagnóstico , Estómago/anomalías , Anomalías Múltiples/cirugía , Secuestro Broncopulmonar/cirugía , Malformación Adenomatoide Quística Congénita del Pulmón/cirugía , Femenino , Humanos , Recién Nacido , Tomografía Computarizada por Rayos X , Ultrasonografía Prenatal

RESUMEN

Previous cytogenetic/FISH data have demonstrated 1p36 deletions in a relapsing familial clivus chordoma developed by a patient who has 2 daughters, respectively affected with childhood astrocytoma and clivus chordoma. Using an approach that combined the LOH (loss of heterozygosity) study of the father chordoma and the daughter astrocytoma and a segregation analysis from parents to sibs using 17 CA-repeats spanning 1p36.32-1p36.11, we mapped the cancer susceptibility locus in this family to the 1p36 region. The LOH and haplotype information was elaborated using a pairwise linkage analysis that gave a maximum lod score of 1.2. Additional LOH data relating to 6 sporadic chordomas allowed us to define an SRO (the smallest region of overlapping loss) of about 25 cM from D1S2845 (1p36.31) to D1S2728 (1p36.13). Our overall findings converge on mapping to 1p36 a tumor-suppressor gene involved in familial and sporadic chordoma.

Asunto(s)

Neoplasias Encefálicas/genética , Cordoma/genética , Cromosomas Humanos Par 1/genética , Fosa Craneal Posterior , Genes Supresores de Tumor/genética , Adulto , Astrocitoma/genética , Neoplasias Cerebelosas/genética , Niño , Preescolar , Mapeo Cromosómico , Repeticiones de Dinucleótido , Femenino , Ligamiento Genético , Marcadores Genéticos , Haplotipos , Humanos , Pérdida de Heterocigocidad , Masculino , Linaje

RESUMEN

BACKGROUND: To review a series of 11 patients affected by hyperplasia of parathyroid glands and to discuss diagnostic and therapeutic tools. METHODS: A series of 11 patients out of 44 (= 25%) with primary hyperparathyroidism has been retrospectively reviewed. They underwent surgery in I surgical Department of OORR of Bergamo. All 11 patients were submitted to ultrasound and computed tomography examination before surgery, without any localisation of hyperplastic or adenomatous tissue. An exploring cervicotomy was performed with subtotal parathyroidectomy after the anatomopathological result of hyperplasia. RESULTS: No adverse effects related to surgery were observed. All patients could be considered as cured with a median follow-up of 36 months. CONCLUSIONS: Among hyperparathyroidism, hyperplasia is an underhand form and even if the laboratory diagnosis is simple, the imaging techniques cannot always localise the pathologic tissue. Personal experience shows the role of subtotal parathyroidectomy (removal of 3 parathyroid glands and a half of the last one) confirmed by the absence of adverse effects or relapse with a median follow-up of 36 months.

Asunto(s)

Hiperparatiroidismo/cirugía , Glándulas Paratiroides/patología , Glándulas Paratiroides/cirugía , Paratiroidectomía , Adulto , Anciano , Femenino , Humanos , Hiperparatiroidismo/patología , Hiperplasia/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento

RESUMEN

We report a case of renin-producing leiomyosarcoma associated with the hyponatremic hypertensive syndrome and nephrotic-range proteinuria. Extremely high levels of active renin and, to a greater extent, of prorenin were found in plasma and tumor tissue. Immunohistochemical and in situ hybridization studies demonstrated that the neoplastic cells were the source of renin production. The hyponatremic hypertensive syndrome and proteinuria promptly responded to treatment with angiotensin-converting enzyme inhibitors, suggesting an angiotensin II dependency of these disorders. After removal of the leiomyosarcoma, plasma concentration of active renin, but not of prorenin, normalized and the hypertension, proteinuria, and electrolyte abnormalities disappeared. However, 5 months after operation, the patient presented once again with hypertension, hypokalemia, proteinuria, and markedly increased plasma levels of both active renin and prorenin that heralded the relapse of neoplastic disease.

Asunto(s)

Hipertensión/etiología , Hiponatremia/etiología , Leiomiosarcoma/complicaciones , Proteinuria/etiología , Renina/metabolismo , Neoplasias Retroperitoneales/complicaciones , Precursores Enzimáticos/metabolismo , Femenino , Humanos , Hipertensión/fisiopatología , Hiponatremia/fisiopatología , Leiomiosarcoma/metabolismo , Persona de Mediana Edad , Proteinuria/fisiopatología , Neoplasias Retroperitoneales/metabolismo , Síndrome

RESUMEN

The Authors report a case of primary cerebral lymphoma occurred in a 62 years old lady, who came to observation for headache and mood alterations. An enhanced CT showed a lesion recalling a meningeal sarcoma. Points of interest in this case are the unusual radiological appearance and the infrequent localization. Main anatomical and clinical characteristics of primary CNS non-Hodgkin lymphomas are recalled, even with regard to modern immunohistochemical techniques.

Asunto(s)

Neoplasias Encefálicas/diagnóstico por imagen , Linfoma no Hodgkin/diagnóstico por imagen , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Femenino , Humanos , Linfoma no Hodgkin/patología , Linfoma no Hodgkin/cirugía , Persona de Mediana Edad , Radiografía

RESUMEN

Hyponatremia is a state of relatively common observation among neurosurgical patients and it may determine or precipitate a condition of brain swelling in the head-injured. The quick reversal to normal values of serum sodium concentration may cause relevant neurological disturbances: they are related to peculiar neuropathological changes, the most representative of which is central pontine myelonilysis. Two cases (one in pediatric age) of head injured patients with brain damage resulting from rapid correction of a SIADH related hyponatremia are presented.

Asunto(s)

Enfermedades Desmielinizantes/etiología , Hiponatremia/complicaciones , Puente , Preescolar , Femenino , Humanos , Hiponatremia/terapia , Síndrome de Secreción Inadecuada de ADH/complicaciones , Síndrome de Secreción Inadecuada de ADH/terapia , Masculino , Persona de Mediana Edad , Factores de Tiempo