RESUMO
Fallopian tube cancer is the less frequent gynecological cancer. It occurs typically between 40 and 65 years old. Diagnosis is usually achieved earlier than in ovarian cancer cases, due to early symptoms (typically abdominal pain, hydro-hematorrhea and adnexal mass). Preoperative correct diagnosis is infrequent, being most cases diagnosed during the surgery or in the pathological study. Histologically and clinically is similar to ovarian cancer, being the serous low differentiated the most frequent type. An early suspicion and a correct intervention are essential to obtain correct diagnosis and treatment. Treatment protocols are similar to those of ovarian cancer recommended by the FIGO.
Assuntos
Doenças dos Anexos/etiologia , Carcinoma/complicações , Neoplasias das Tubas Uterinas/complicações , Anormalidade Torcional/etiologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
BACKGROUND: This report describes a partial nephrectomy with a minimally invasive approach, carried out laparoscopically as a treatment for a hydrocalicosis caused by a congenital infundibular stenosis. CLINICAL CASE: The patient presented a clinical background of one year of evolution, manifested as recurrent urinary tract infections caused by urine accumulation in the adjacent collecting tubules which were compressed by the superior hydrocalicosis. This procedure was made using a transperitoneal access, making a superior pole resection of the right kidney and respecting the adrenal gland. CONCLUSIONS: In our opinion, to widen the usage of the laparoscopic surgery in urology can benefit patients to reduce post-surgery complications and hospitalization time, with a more comfortable recovery.
Assuntos
Cálices Renais/anormalidades , Laparoscopia/métodos , Nefrectomia/métodos , Procedimentos Cirúrgicos Ultrassônicos/métodos , Adulto , Quimioterapia Adjuvante , Terapia Combinada , Neoplasias das Tubas Uterinas/complicações , Neoplasias das Tubas Uterinas/terapia , Feminino , Humanos , Histerectomia , Cálices Renais/patologia , Cálices Renais/cirurgia , Complicações Pós-Operatórias/etiologia , Recidiva , Salpingectomia , Infecções Urinárias/etiologiaRESUMO
BACKGROUND: Synchronous gynecological tumors are rare; it is even rarer to find the rarest of gynecological tumors that of the fallopian tube, together with a histological sub-type as rare as verrucous cervix. CASE PRESENTATION: We report a synchronic fallopian tube adenocarcinoma and a verrucous cervical cancer. A 85-year-old woman with postmenopausal genital hemorrhage, endometrial biopsy was reported as squamous metaplasia, an exploratory laparotomy was performed finding a tubal tumor diagnosed as adenocarcinoma, a staging procedure was performed. Final staging revealed IB1 cervical carcinoma and IA G3 fallopian tube carcinoma. Adjuvant treatment with chemotherapy was not accepted by the patient. The patient has remained in follow-up, and at 9 months, there has been no documented evidence of recurrent disease. CONCLUSION: Reasons for our presentation of this work are: first, due to the rarity of these, and second, because of the usefulness of possessing a case report for establishing a norm for later behavior with respect to treatment of these patients.
Assuntos
Carcinoma Verrucoso/patologia , Cistadenocarcinoma Seroso/patologia , Neoplasias das Tubas Uterinas/patologia , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias do Colo do Útero/patologia , Idoso de 80 Anos ou mais , Carcinoma Verrucoso/complicações , Carcinoma Verrucoso/terapia , Cistadenocarcinoma Seroso/complicações , Cistadenocarcinoma Seroso/terapia , Neoplasias das Tubas Uterinas/complicações , Neoplasias das Tubas Uterinas/terapia , Feminino , Humanos , Neoplasias Primárias Múltiplas/terapia , Neoplasias do Colo do Útero/complicações , Neoplasias do Colo do Útero/terapiaRESUMO
The primary fallopian tube invader adenocarcinoma is a preoperative diagnosis rarely reported in the literature, because is the most uncommon of all gynecological tumors, with prevalence from 0.3 to 1.8%. Since its clinical evolution is very unspecific, in general this tumor is diagnosed during a laparothomy for other purpose or by the pathologist in the final histopathological report. The most frequent signs and symptoms are abdominal pain or a pelvic mass in 80% of cases; transvaginal bleeding in 50%, intense transvaginal serohematic discharge (hidrops tubae profluens) in 11.1%, and peritonitis in pelvis in 3.7%. In 25 to 60% of the cases a report of adenocarcinoma in the pap smear with negative endometrial biopsy can be found. The treatment is predominantly surgical, as that of epithelial ovarian carcinoma, and consists of an intraperitoneal washing, total abdominal hysterectomy with bilateral salpingo-oophorectomy and a proper staging. It is required an omentectomy with pelvic and paraaortic lymphadenectomy in systematic way. In the more advanced stages III and IV that required a radical debulking, we have to be very emphatic in citoreduction. In some cases, as the persistence or recurrence of illness, it can be necessary adjuvant chemotherapy. In some patients in early stage I or II with low risk, the complete staging could not be necessary. There is controversy about administration criteria of adjuvant treatment, since there is not evidence of survival increase related to its use. The five years survival rate was 64% for stage I, 42% for stage II, 32% for stage III, and 17% for stage IV. Fallopian tube malignancies are rare and involve a poor prognosis.
Assuntos
Adenocarcinoma/genética , Neoplasias das Tubas Uterinas/complicações , Doença Inflamatória Pélvica/complicações , Abdome Agudo/etiologia , Injúria Renal Aguda/etiologia , Adenocarcinoma/epidemiologia , Adenocarcinoma/cirurgia , Antibacterianos/uso terapêutico , Anuria/etiologia , Ceftriaxona/uso terapêutico , Clindamicina/uso terapêutico , Neoplasias das Tubas Uterinas/epidemiologia , Neoplasias das Tubas Uterinas/cirurgia , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Ovariectomia , Doença Inflamatória Pélvica/tratamento farmacológico , Peritonite/tratamento farmacológico , Peritonite/etiologiaRESUMO
Fifty cases of tuboperitoneal endometriosis with sterility, are reviewed. Laparoscopy was done in all the patients to confirm disease, and its severity was classified to AFS; 18 cases were of minimal endometriosis; 8 slight; 12 moderate; and 12 severe. The endometriotic profile in our environment is described and compared with which has been described in progresist countries; 32% of pregnancy at term, was obtained. The possible mechanisms producing sterility, are mentioned.
Assuntos
Endometriose/complicações , Neoplasias das Tubas Uterinas/complicações , Infertilidade Feminina/etiologia , Neoplasias Peritoneais/complicações , Adulto , Endometriose/patologia , Endometriose/terapia , Neoplasias das Tubas Uterinas/patologia , Neoplasias das Tubas Uterinas/terapia , Feminino , Humanos , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/terapiaRESUMO
Es motivo de la presentación, comentar el caso de una paciente joven, que consultó por cuadro álgico pelviano intenso, de rápida evolución y masa palpable a ese nivel, compatible con origen anexial derecho, con diagnóstico de: "abdomen agudo quirúrgico" es llevada a laparatomía exploradora y resección completa de masa tumoral con la patología ya citada. Completó el tratamiento con Telecobaltoterapia, por compromiso sigmoideo, hasta 4,500 CGy en campo pelviano amplio, incluyendo cadenas lumboaórticas, más un esfuerzo pelviano de 600 RADS en campos anterior y posterior. Recibió poliquimioterapia con esquema CAP (Ciclosfosfamida 600 mg/m2, adriamicina 50 mg/m2 y DDP 75 mg/m2 en dos (2) días E.V. por seis (6) ciclos con mínima toxicidad, permaneciendo hasta la fecha, libre de enfernedad clínica, radiológica y patológicamente comprobada, por "second lool" negativo