Determinación del papel oncogénico de la expresión de proteínas de fusión de la vía tirosinquinasa en las neoplasias Spitzoides

Los tumores de Spitz son neoplasias melanocíticas frecuentes en personas jóvenes. Dada la gran diversidad genética de dichos tumores se han descrito subgrupos en base a sus alteraciones genéticas únicas, que en algunos casos pueden constituir dianas terapéuticas.Objetivos Determinar la prevalencia y validar la expresión de alteraciones genéticas en las neoplasias melanocíticas de Spitz, usando técnicas de inmunohistoquímica, FISH y PCR; así como identificar las características histológicas de dichas alteraciones moleculares y comparar los resultados con nevus y melanomas convencionales. Por último proponer un algoritmo que permita predecir alteraciones moleculares en base a las características clínicas e histológicas..

Management of incidentally discovered appendiceal neuroendocrine tumors after an appendicectomy

Appendiceal neoplasms; Carcinoid tumor; Treatment outcomeNeoplasias apendiculares; Tumor carcinoide; Resultado del tratamientoNeoplàsies apendiculars; Tumor carcinoide; Resultat del tractamentAppendiceal neuroendocrine tumors (aNETs) are an uncommon neoplasm that is relatively indolent in most cases. They are typically diagnosed in younger patients than other neuroendocrine tumors and are often an incidental finding after an appendectomy. Although there are numerous clinical practice guidelines on management of aNETs, there is continues to be a dearth of evidence on optimal treatment. Management of these tumors is stratified according to risk of locoregional and distant metastasis. However, there is a lack of consensus regarding tumors that measure 1-2 cm. In these cases, some histopathological features such as size, tumor grade, presence of lymphovascular invasion, or mesoappendix infiltration must also be considered. Computed tomography or magnetic resonance imaging scans are recommended for evaluating the presence of additional disease, except in the case of tumors smaller than 1 cm without additional risk factors. Somatostatin receptor scintigraphy or positron emission tomography with computed tomography should be considered in cases with suspected residual or distant disease. The main point of controversy is the indication for performing a completion right hemicolectomy after an initial appendectomy, based on the risk of lymph node metastases. The main factor considered is tumor size and 2 cm is the most common threshold for indicating a colectomy. Other factors such as mesoappendix infiltration, lymphovascular invasion, or tumor grade may also be considered. On the other hand, potential complications, and decreased quality of life after a hemicolectomy as well as the lack of evidence on benefits in terms of survival must be taken into consideration. In this review, we present data regarding the current indications, outcomes, and benefits of a colectomy