[Hydatid cysts of the pancreas. 2 new surgical cases].
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Biomedical subjects
Publications and source records attributed to A Espí.
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We report a 11 year-old boy with ileo-ileal intussusception due to a pediculated tumor of the bowel wall. This lesion was found to be a lymphangiolipoma in which mature adipose cells were interspersed with dilated lymphatic ressels. Tumorectomy by enterotomy was curative. The ranty of this hamartomatous lesion is pointed out.
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Breast physical examination which is enormous help in clinical diagnosis of cancer of the breast is not useful in the diagnosis of early lesions. We analized in this study different complementary examinations we do for the diagnosis of the cancer of the breast. Mammography, though maintaining a 5-7% false negative results is the examination of choice of the breast. Not with standing its simplicity, its contribution with respect to breast and neoplastic biology makes it a useful investigation. The diagnosis obtained through mammography in non palpable tumors permit the use of conservative therapeutic techniques at the same time allowing improvement in curation and survival rates when we deal preferently with Stage I cancer. It is still necessary in our means an information-sensibilization of the female population about breast autoexamination and the need for early specialized medical consultation. Any abnormal breast sign should alert us that more than 2.5 months delay would suppose a difference from a T1 to a T2 tumor.
Recurrence of breast cancer can present in very small tumors even 20 years after initial treatment. Periodic revision of all the operated population during a long time will be necessary to detect all the recurrences. For this the cost-benefit relation of follow-up in breast cancer is a controversial topic. We present our results in 750 cases of breast cancer operated from 1980 and submitted to a follow-up protocol during five years. We analyzed the value of follow-up for the discovery of metastases, local recurrence after conservative treatment and after mastectomy. Finally we considered the usefulness of early diagnosis of familial breast cancer and cancer in the contralateral breast. Metastases was discovered in asymptomatic patients in 68%, which could improve the survival. Recurrence after mastectomy was seen in 1.3% of the patient and a half of these after treatment presented survival superior to 3 years. Follow-up favours early diagnosis and could have influence on survival.
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.