RESUMEN
Mucoepidermoid carcinoma is a very rare primary tumour of the breast. Until now only 17 cases have been described in the literature. Generally these malignancies have a good prognosis, especially if well differentiated. We report a case of low-grade which recurred as high-grade after 32 months. She also developed a poorly differentiated adenocarcinoma in the other breast 12 years after her initial treatment. At present the patient is well without any sign of disease for 156 months. A literature review of this rare entity is presented.
Asunto(s)
Adenocarcinoma/patología , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/terapia , Recurrencia Local de Neoplasia/patología , Neoplasias Primarias Secundarias/patología , Adenocarcinoma/cirugía , Biopsia con Aguja , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Mastectomía Segmentaria/métodos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/cirugía , Estadificación de Neoplasias , Neoplasias Primarias Secundarias/cirugía , Radioterapia Adyuvante , Resultado del TratamientoRESUMEN
BACKGROUND: Fifteen to 20% of type 1 diabetic patients exhibit parietal cell antibodies (PCA), which are associated with autoimmune gastritis, hypochlorhydria, iron deficiency and pernicious anaemia. AIM: To examine whether Helicobacter pylori infection could explain the high prevalence of PCA and autoimmune gastropathy in diabetes. If so, H. pylori eradication could prevent autoimmune gastritis. METHODS: In 229 type 1 diabetics (M/F: 135/94; age: 41 +/- 12 years) PCA were measured. H. pylori infection was assessed by serology, urea breath test in all and by histology (updated Sydney system) in 88 subjects. Pentagastrin tests were performed in 42 patients. RESULTS: Sixty-nine patients were PCA-positive. H. pylori infection was present in 72 patients and was negatively associated with HLA-DQA1*0103-B1*0603 (OR=0.12, P=0.015) and positively with DQA1*0501-B1*0201 (OR=1.9, P=0.032). PCA-positivity was linked to HLA-DQA1*0501-B1*0301 (OR=3.9, P=0.017). A link between H. pylori and PCA was observed when PCA-positivity was defined as a titre > or = 1/20 (OR=2.0, P=0.03), but not if > or =1/40 was the cut-off point. PCA-positivity, but not H. pylori infection, was associated with iron deficiency anaemia (OR=2.7, P=0.008), pernicious anaemia (OR= 33.5, P < 0.0001), hypochlorhydria (OR=12.1, P=0.0008) and autoimmune gastritis (OR=12.5, P < 0.0001). CONCLUSIONS: The HLA-bound susceptibility of H. pylori and PCA differed. PCA-positivity but not ongoing H. pylori infection is associated with autoimmune gastritis. Low titres of PCA might reflect H. pylori infection rather than autoimmune gastropathy.