Localized Fibrous Tumors of the Pleura: Experience With 7 Recent Cases

OBJECTIVE: Localized fibrous tumors of the pleura are rare. We report 7 cases and review the literature in order to define the range of clinical characteristics of these tumors, treatment options, and prognosis. METHODS: A retrospective review of 7 cases treated between 1997 and 2003, focusing on clinical presentation, diagnostic tests, and treatment. The tumor was removed surgically in all cases, by thoracotomy in 6 cases and by video-assisted thoracoscopic surgery in 1 patient. RESULTS: All patients recovered fully after surgery, with no postoperative complications. One patient experienced recurrence twice, 33 and 67 months after the initial resection. All are alive at the time of writing, after a mean follow up period of 19 months (range 1 month to 5 years and 10 months). CONCLUSIONS: The treatment of choice for a fibrous tumor of the pleura is full resection and follow up to detect possible late recurrence

Resultados a medio y largo plazo de la utilización de videotoracoscopia en la cirugía de resección de las metástasis pulmonares

The surgical resection of pulmonary metastases is a method of treatment accepted as habitual in thoracic surgery. However, it continues to be a source of controversy if this resection must be realised by thoracotomy or by modern video-assisted techniques. With the aim of finding a response to this controversy in our work milieu, a review was made of the surgical interventions carried out in order to resect pulmonary metastases. Between January 1997 and December 2001, 56 patients were found whose pulmonary metastases had been resected by videothorascopy out of a total of 252 metastasectomies (22.2%). The primary tumours were classified in 4 groups: sarcoma (n=11); colorectal (n=25); renal (n=5); and others (n=15). Videothoroscopy was carried out on the right hemithorax (n=28), left hemithorax (n=22) or on both at once (n=6). Operational mortality was nil and the only morbidity attributable to the technique was a defect of re-expansion following the removal of the thoracic drainage in one patient. Using the Kaplan-Meier method, the probability of survival in this series of patients was 60.4% after 5 years, with an average survival time of 48 months. All of this data supports the use of videothorascopy in our milieu on patients with pulmonary metastases. However, in the light of the results, it is important in using this technique to place special emphasis on obtaining good margins of resection, due to the real risk of local recurrence on these margins in the medium term

Novedades en el tratamiento quirúrgico del cáncer de mama

Adecuate surgical treatment is mandatory in order to achieve cure in patients with breast cancer. Breast surgeons have to choice the best surgical technique over the breast and over the axillary nodes. Two new surgical aproaches have been implemented in the last decade: oncoplastic conservative surgery and sentinel lymph node biopsy. Oncoplastic surgery provides oncologic safety results and good cosmetic outcome. In this paper the technical steps and indications of different oncoplastic techniques in conservative breast surgery are review. Concerning to axillary surgery sentinel lymph node biopsy is the gold standard. However there are several controversial points in sentinel node biopsy referring to indications, identification and histological findings

Angiomiolipoma epitelioide hepático

Abstract: We describe the case of a hepatic epithelioid angiomyolipoma in a 50-year-old woman with epigastric pain and well-circumscribed 47 mm hepatic mass detected by ultrasonography. Angiomyolipoma is a rare benign mesenchymal tumor of the liver, composed of variable amounts of smooth muscle cells, abnormal blood vessels and adipose tissue. Preoperative diagnosis is difficult. Immunoreactivity with HMB-45 antibody helps to distinguish this tumor from other benign and malignant tumors of the liver

Colgajo DIEP de cobertura tras mastectomía de limpieza paliativa en cáncer de mama localmente avanzado

The DIEP reconstruction offers great cutaneous extension. It can be a resource in highly selected cases of locally advanced breast cancer in which surgery becomes the main treatment

Tratamiento conservador del cáncer de mama: valoración de los resultados

Introducción: La asociación de cirugía limitada y radioterapia es el tratamiento de elección para un gran número de mujeres con cáncer de mama; no obstante esta opción terapéutica va asociada a un número no despreciable de recidivas sobre la mama tratada (1-1,5% por año de seguimiento). Material y Métodos: Se analizan 641 casos de mujeres con cáncer de mama, tratados mediante cirugía conservadora de la mama y radioterapia y seguidos durante una media de 50 meses. La técnica consistió preferentemente en la practica de una Resección Segmentaria de mama con vaciamiento axilar, al menos de los niveles I y II (excepto en los CIS a partir de 1997), complementada con la administración de Radioterapia (45-50 Gy sobre la mama y una sobreimpresión de 15-20 Gy). Resultados: La edad media fue de 52.3 años, con extremos en 21 y 82 años El tamaño medio tumoral fue pT: 1,7 cm y el 63,1% de los casos correspondieron a tumores pT1. En 41 casos no se realizó vaciamiento axilar (35 CIS y 6 pT1mic). En 4 casos existió afectación puntual de bordes (componente intraductal) que fueron sometidos a sobreimpresión radioterápica con 20Gy. Tras un seguimiento medio de 50 meses, el 91,4% están libres de enfermedad y en 12 casos (1,9%) se desconocía su estado. Se han producido 13 recidivas (2%) a nivel mamario (2 de ellas en un cuadrante distinto). Conclusiones: El estado de los bordes de resección en un factor fundamental en la cirugía conservadora del cáncer de mama. La resección del tumor debe ser suficientemente amplia e incluir el segmento mamario asiento del tumor, para asegurar un alto índice de control local, sin comprometer el resultado cosmético. El estudio histológico de los bordes de resección permite reducir significativamente la necesidad de una segunda cirugía.Introduction: Conservative surgery combined with radiotherapy is an effective treatment in many cases of breast cancer. Nevertheless this therapy is associated with a not inconsiderable number of recurrences in the remaining breast after excision (1-1.5% recurrences per year of follow-up). Material and Methods: We reviewed 641 cases of breast cancer (age average was 52.3 years (21-82) and tumour size average 1.7 cm, 3% corresponded to pT1 tumours) treated with conservative surgery combined with radiotherapy, average follow-up of 50 months. The technique consisted of segmentectomy and at least level I-II axilary dissection (excluding in situ carcinoma diagnosed since 1997, in which lymphadenectomy was not performed). Adjuvant radiotherapy was also indicated (giving a dose of 45-50 Gy to the breast, and another 15-20 Gy dose was given to tumour size). Results: In 41 cases lymphadenectomy was not performed (35 cases of Tis, and 6 pTmic). In 4 cases, 20 Gy radiotherapy was administered to the tumour excision site because of in situ carcinoma disease in the margins. During follow-up of 50 months, 91.4% of the patients were disease- free; in 12 cases we are not informed of the present status. 13 recurrences (2%) have been found, two of which were in a different quadrant. Conclusions: The status of the surgical margins is an important factor in the practice of conservative surgery. Tumour excision must be broad enough and must include the whole segment in which the tumour is located to obtain local control of the disease, maintaining an acceptable cosmetic appearance. The intraoperative study of specimen margins permits the reduction of cases in which a second operation is needed

Early lung cancer detection using spiral computed tomography and positron emission tomography

RATIONALE: Lung cancer screening using computed tomography (CT) is effective in detecting lung cancer in early stages. Concerns regarding false-positive rates and unnecessary invasive procedures have been raised. OBJECTIVE: To study the efficiency of a lung cancer protocol using spiral CT and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET). METHODS: High-risk individuals underwent screening with annual spiral CTs. Follow-up CTs were done for noncalcified nodules of 5 mm or greater, and FDG-PET was done for nodules 10 mm or larger or smaller (> 7 mm), growing nodules. RESULTS: A total of 911 individuals completed a baseline CT study and 424 had at least one annual follow-up study. Of the former, 14% had noncalcified nodules of 5 mm or larger, and 3.6% had nodules of 10 mm or larger. Eleven non-small cell lung cancers (NSCLC) and one small cell lung cancer (SCLC) were diagnosed in the baseline study (prevalence rate, 1.32%), and two NSCLCs in the annual study (incidence rate, 0.47%). All NSCLCs (92% of prevalence cancers) were diagnosed in stage I (12 stage IA, 1 stage IB). FDG-PET was helpful for the correct diagnosis in 19 of 25 indeterminate nodules. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET for the diagnosis of malignancy were 69, 91, 90, and 71%, respectively. However, the sensitivity and negative predictive value of the screening algorithm, which included a 3-month follow-up CT for nodules with a negative FDG-PET, was 100%. CONCLUSION: A protocol for early lung cancer detection using spiral CT and FDG-PET is useful and may minimize unnecessary invasive procedures for benign lesions

Papel de la cirugía en el tratamiento del linfoma gástrico primario

Primary gastric lymphoma's optimum management remains controversial. We reviewed our series of 23 patients with primary gastric lymphoma treated in our hospital between 1976 and 1998 with surgery as main therapy. Ten patients underwent surgical resection alone, whereas 13 also received postoperative adjuvant therapy, depending on the oncologist-haematologist's recommendations. No differences were found between treatments regarding mortality and morbidity. Clinical-histological features and patients, follow-up are analyzed. No patient died because of lymphoma and there wasn't either local or distant recurrence. We consider that surgery remains a valid option for the primary gastric lymphoma treatment. The introduction of combined modalities of radiation therapy and chemotherapy will depend on the final stage, the tumor histological features, and the feasibility of getting a radical resection

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13