Metastatic pheochromocytoma to liver without elevation of metanephrines and catecholamines

AbstractIntroductionMalignant pheochromocytoma represents 10% of all patients with pheochromocytoma. Of these cases, only 5–9% presents without elevation of metanephrines and catecholamines.Presentation of caseA 43-year-old female patient presented with an abdominal tumor. An exploratory laparotomy was performed and the final report was a pheochromocytoma. After ten years, multiple liver lesions were detected and surgical treatment was performed. Pathological evaluation revealed a malignant pheochromocytoma with negative margins after 5 years of follow-up without evidence of disease.DiscussionThe recurrence rate of malignant pheochromocytoma is 15–20% at ten years and a 5-year survival rate that ranges from 50% to 80%. The presence of synchronous metastases is rare (10–27%), but have been reported until 20 years later with the most common metastatic sites being the local lymph nodes, bone (50%), liver (50%) and lung (30%). The prognostic factor such as size >6cm, age over 45 years, synchronous metastasis and no tumor excision are related with poor prognosis.ConclusionSurgical treatment offers the best survival rate and the only chance of cure so far and the goal is an R0 resection as in our case. So it should be the treatment of choice

Conservative surgery in scapular tumors. State of the art on the scapulectomies.

CONTENIDO Artículos Originales Mecanismos de resistencia a los antimicrobianos en el Hospital Universitario Dr. Miguel Oraá de Guanare, Estado Portuguesa, Venezuela. Resistance mechanisms to antimicrobial drugs in the Hospital Universitario Dr. Miguel Oraá at Guanare, estado Portuguesa, Venezuela Gómez Gamboa, Andreina L.; Maurera R., Thanya L. y Rosales Borjas, Disney M. Casos Clínicos Síndrome miomatoso eritrocitario. Reporte de un caso. Myomatous erythrocytosis syndrome. A case report Labastida, César; Tapia G., José L.; Uzcátegui Paz, Estrella Celeste; Plata, José; Rocha, Maria y Gil, Dina Meningitis por Mycoplasma pneumoniae en un niño. Caso clínico. Meningitis caused by mycoplasma pneumoniae in a child. A case report. Espinoza, Ramón A.; Herrera, Vigdalys K.; Bruzual, Andrea T.; González, Maria J.; Freitez, Leunam G. y Perozo , Alexander Revisiones Cirugía preservadora en tumores escapulares. Estado actual de las escapulectomías . Conservative surgery in scapular tumors. State of the art on the scapulectomies. Valderrama Landaeta, José Luis; Padilla Rosciano, Alejandro; Cuellar, Mario y Alfeizan Ruiz, Antonio Virus y cáncer: el ejemplo de los papilomavirus humanos. Virus and cancer: the example of human papillomaviruses. Mendoza, José A.; Muñoz, Maritza; Téllez G., Luis E.; Vielma, Silvana; Mosqueda, Noraida; Pérez, Saberio y Quintero, Beatriz Notas Detección del antígeno de superficie del virus de la hepatitis B (HBsAg) en individuos que asisten a consultas odontológicas. Detection of the hepatitis B virus surface antigen (HBsAg) in individuals that attend odontologist consultations. Pérez Maldonado, César I.; Ilbi, Raieda; Rivera, Marlen y López, Reinaldo126 - [email protected] analíticobimestra

Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability

Introduction: Colorectal medullary carcinoma (MC) is a rare subtype of poorly differentiated adenocarcinoma (PDA) with unclear prognostic significance. Microsatellite instable (MSI) colorectal carcinomas have demonstrated better prognosis in clinical stage II. Aim: To analyze the survival and clinicopathological characteristics of MCs versus PDAs with MSI in clinical stage III. Material and methods: We studied 22 cases of PDAs with MSI versus 10 MCs. Results : Of the 10 MCs, 7 patients were men; the mean age was 57.8 ±5.6 years. The mean tumor size was 9.6 ±4.1 cm, and the primary site was the right colon in 9; 7 patients showed lymph node metastases (LNM) and lymphovascular invasion (LVI). Of the 22 PDA cases, 12 (54.5%) were women with a mean age of 75 ±16.1 years. The mean tumor size was 6.4 ±3.2 cm. Twelve (54.5%) presented in the right colon, 21 (95.5%) showed LNM and 7 (31.8%) LVI. Follow-up was 32 ±8 months, with a 5-year overall survival of 42.9% for MCs and 76.6% for PDAs (p = 0.048). Univariate analysis found local recurrence (p = 0.001) and medullary subtype (p = 0.043) associated with lower survival. Conclusions : Medullary carcinomas were of greater tumor size and associated with more LVI and worse survival versus PDAs with MSI in stage III