RESUMO

La enfermedad de Castleman (EC) describe una serie de desórdenes linfoproliferativos de patrones histológicos similares, pero de etiologías, presentaciones clínicas y enfrentamientos notoriamente variables. Se presenta el caso de un paciente que consultó por masa cervical, cuyo estudio final concluyó EC unicéntrica, la cual se resolvió de forma quirúrgica. Además, se presenta una revisión actualizada del tema, con foco en la enfermedad unicéntrica.

Castleman's disease (CD) describes several lymphoproliferative disorders with similar histological patterns, but with notoriously variable etiologies, clinical presentations, and management. We present the case of a patient who consulted with cervical mass, whose final study concluded with unicentric CD, which was treated surgically. In addition, an updated review of the subject is presented, focusing on unicentric disease.

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RESUMO

Objetivos: identificar factores que intervienen en el grado de resección de los meningiomas de base de cráneo y proponer una escala para calcular la probabilidad de resección total. Materiales y métodos: estudio unicéntrico, observacional, retrospectivo, de pacientes operados en el período 06/2018 ­ 06/2022. Se utilizaron como variables: edad, clínica, localización, tamaño, embolización previa, edema perilesional, calcio intratumoral, características en T2 y T1 e invasión ósea. El grado de resección se midió con la clasificación de Simpson tradicional y también se dividió en resección total (Simpson I, II y III) y subtotal (Simpson IV y V). Con los resultados se propuso una escala teniendo en cuenta las variables con significación estadística (p < 0.05). Se realizó una revisión bibliográfica del tema. Resultados: Se operaron un total de 23 pacientes. Fueron estadísticamente significativas asociadas con el grado de Simpson, la localización (p 0,002) y el tamaño (p 0,001). Asociada con resección total y subtotal, la invasión ósea (p 0,013). Para la escala utilizamos: localización (anterior 1 punto, posterior 2 puntos, medial 2 puntos y medial que involucra seno cavernoso 3 puntos), tamaño (<5 cm 1 punto, >5 cm 2 puntos) e invasión ósea (no 1 punto y si 2 puntos). Realizamos un análisis inferencial y se observó asociación entre la escala realizada y el grado de resección (p 0,005). Conclusión: En nuestro estudio se observó una asociación entre el tamaño, la localización y la invasión ósea con el grado de resección conseguido. Propusimos una escala para medir la probabilidad de resección total(AU)

Objectives: identify factors that intervene in the degree of resection of skull base meningiomas and propose a scale to calculate the probability of total resection. Materials and methods: single-center, observational, retrospective study of patients operated in the period 06/2018 - 06/2022. The following variables were used: age, symptoms, location, size, previous embolization, perilesional edema, intratumoral calcium, characteristics in T2 and T1 and bone invasion. The degree of resection was measured using the traditional Simpson scale and was also divided into total (Simpson I, II, and III) and subtotal (Simpson IV and V) resection. With the results, a scale was proposed taking into account the variables with statistical significance (p < 0.05). A bibliographic review of the subject was carried out. Results: A total of 23 patients were operated. They were statistically significant associated with Simpson's grade the location (p 0.002) and size (p 0.001). Associated with total and subtotal resection, the bone invasion (p 0.013). For the scale we use: location (anterior 1 point, posterior 2 points, medial 2 points and medial involving the cavernous sinus 3 points), size (<5 cm 1 point, >5 cm 2 points) and bone invasion (no 1 point and yes 2 points). We performed an inferential analysis and an association was observed between the scale used and the degree of resection (p 0.005). Conclusion: In our study, an association was observed between the size, location and bone invasion with the degree of resection achieved. We proposed a scale to measure the probability of total resection(AU)

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The prediction of meniscus reparability is quite useful for surgeons to optimize surgical planning. The main objective of this study was to evaluate the ability of magnetic resonance imaging (MRI) to predict the suture of meniscal lesions. This was an unicentric retrospective study that included 104 patients who underwent knee joint ligament reconstruction and / or arthroscopy for the treatment of meniscal injury at knee joint level. The MRI images of the meniscus were evaluated and later the arthroscopic findings were used as the gold standard. After the operative procedure, the cases were allocated into two groups according to the necessity of meniscus suture: Sutured Group "MSu" (n = 58) and Non sutured Group "MNSu" (n = 150). Considering the lesion detection capacity in the medial meniscus, the sensitivity, specificity and accuracy of MR were 85.3%, 63.9% and 77.9%, respectively. The positive predictive value (PPV) was 81.7% and the negative predictive value (NPV) was 69.7%. The agreement between MRI and arthroscopy was moderate. For the lateral meniscus, sensitivity, specificity and accuracy of MRI were 80.6%, 89.0% and 86.5%, respectively, with PPV of 75.7% and NPV of 91.5% and a substantial agreement. Regarding suture predictability, the sensitivity, specificity and accuracy were respectively 60.3%, 66.7% and 64.9% with PPV of 41.2% and NPV of 81.3%, with weak agreement. According to the arthroscopy, the 58 meniscal lesions of the MSu group were more frequent in the posterior horn, had the longitudinal pattern and were located in the red-red vascular zone. In our study, MRI was not a good predictor of meniscal suture, although it is an useful tool for the diagnosis of medial and lateral meniscal lesions

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