RESUMEN
BACKGROUND: Clear cell carcinoma originating in the abdominal wall is a rare event. It is generally associated with endometrial tissue implants left behind after a caesarean section or other gynaecological operations. Its pathophysiology is complex and controversial. CLINICAL CASE: The case is presented of a 45 year-old female with history of three caesarean sections, who was seen due to having a tumour mass of 6 months onset in the anterior abdominal wall. Imaging studies confirmed its location, and due to measuring 9 by 7 cm it was suspected to be an urachal tumour. A resection with wide margins was performed. The histopathology report was of a clear cell adenocarcinoma originated in ectopic endometrial tissue, with negative margins. CONCLUSION: This is a very rare case, with few cases reported in the literature. This diagnosis should be included in tumours of the abdominal wall.
Asunto(s)
Neoplasias Abdominales/etiología , Pared Abdominal/patología , Adenocarcinoma de Células Claras/etiología , Endometriosis/complicaciones , Neoplasias Abdominales/diagnóstico por imagen , Neoplasias Abdominales/cirugía , Pared Abdominal/diagnóstico por imagen , Pared Abdominal/cirugía , Adenocarcinoma de Células Claras/diagnóstico por imagen , Adenocarcinoma de Células Claras/cirugía , Cesárea/efectos adversos , Diagnóstico Diferencial , Femenino , Humanos , Enfermedad Iatrogénica , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , UracoRESUMEN
BACKGROUND: Noniatrogenic traumatic injuries of the esophagus are rare and are associated with considerable morbidity and mortality. This result is influenced by the time elapsed, severity of injury and concomitant organ damage. Current management is controversial. Different treatment options exist; however, choice should be individualized to obtain the best result. OBJECTIVE: To discuss the current management of esophageal trauma. CLINICAL CASE: We report the case of a 19 year-old male with a grade V esophageal injury caused by shotgun and treated by esophagectomy and immediate gastric reconstruction. CONCLUSION: Current treatment of traumatic iatrogenic esophageal injury should be individualized for a better clinical outcome.
Antecedentes: las lesiones traumáticas del esófago no iatrogénicas son raras y dan lugar a una considerable morbilidad y mortalidad. A esto contribuyen el tiempo trascurrido, la severidad de la lesión y las lesiones orgánicas concomitantes. El tratamiento actual es motivo de controversia. Existen diferentes opciones terapéuticas; sin embargo, su elección debe individualizarse para obtener el mejor resultado. Objetivo: discutir el tratamiento actual del traumatismo esofágico. Caso clínico: se comunica el caso de un paciente masculino de 19 años de edad, con lesión grado V de esófago, causada por proyectil de arma de fuego, tratada con esofagectomía y reconstrucción inmediata mediante ascenso gástrico. Conclusión: el tratamiento actual de una lesión traumática de esófago no iatrogénica debe individualizarse para obtener un mejor resultado clínico.
Asunto(s)
Esofagectomía , Esófago/lesiones , Esófago/cirugía , Heridas por Arma de Fuego/cirugía , Tratamiento de Urgencia , Humanos , Masculino , Adulto JovenRESUMEN
BACKGROUND: Germ cell tumors of the testis represent 1% of all cancers in males. The mean age of occurrence is between 15 and 35 years. Early diagnosis and accuracy of staging are factors that have an impact in survival. According with stage I SO in nonseminoma tumors, there are three management options. Choice among them is based on the risk of recurrence, their morbidity and informed consent of the patient. The objective of this paper is to present the first results of retroperitoneal laparoscopic lymphadenectomy (RLL) in testicular germ cell nonseminoma tumors stage I S-0 at the Oncology Unit of Hospital Juarez de México. METHODS: Retrospective study of the data base of patients diagnosed with nonseminomatous testicular cancer Stage I, S-0 and subject to retroperitoneal laparoscopic lymphadenectomy in the period between May 2010 to December 2011. RESULTS: Ten patients underwent transperitoneal retroperitoneal laparoscopic lymphadenectomy with modified limits, ipsilateral to the affected testicle, 70% were stage I-A, showing a nodal count of 15.3 nodes. None suffered from metastases. The followup mean for all patients was 9.6 months. One patient suffered retroperitoneal relapse off lymphadenectomy's reach 10 months after the original surgery. CONCLUSION: Retroperitoneal laparoscopic lymphadenectomy is a safe procedure with reasonable morbidity, hospital stay and nodal count. It requires a surgeon expert in laparoscopic techniques.