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A Torné

Publications and source records attributed to A Torné.

At least 19 recordsLinked to original sources
PubMed2005

Port-site metastasis after laparoscopic surgery for endometrial carcinoma: two case reports.

BACKGROUND: Although studies have reported good results with laparoscopic-assisted vaginal hysterectomy (LAVH) to treat endometrial cancer, it has been associated with recurrent disease at trocar insertion sites. Long-term follow-up is necessary to detect possible adverse effects of this technique. CASES: We present two case reports of stage IIB endometrial cancer with port-site metastasis 39 and 48 months after initial surgery with LAVH. CONCLUSION: Although LAVH is a good technique to treat patients with endometrial cancer, port-site metastasis is a possible complication and should be taken into consideration until a randomized study shows the long-term benefits and risks of laparoscopic over standard treatment.

Aged↗
PubMed1998

Intraabdominal desmoplastic small round cell tumor with EWS/ERG fusion transcript.

This report describes an intraabdominal small cell tumor in a 37-year-old woman, with clinical, topographic, and morphologic features highly suggestive of the desmoplastic small round cell tumor. Immunohistochemical analysis revealed a polyphenotypic profile consistent with this tumor--positivity for keratin, epithelial membrane antigen, neuron-specific enolase, vimentin, and desmin--but, in addition, a strong membranous immunoreactivity for CD99 (MIC2 protein). Reverse transcription polymerase chain reaction revealed a EWS/ERG fusion transcript characteristic of the Ewing's sarcoma/peripheral primitive neuroectodermal tumor group of tumors, rather than the EWS/WT1 chimeric transcript typical of the desmoplastic small round cell tumor. This is the third report of a hybrid tumor with features of the desmoplastic small round cell tumor and Ewing's sarcoma/peripheral primitive neuroectodermal tumor, and the first one with the EWS/ERG fusion gene. Our case shows the existence of some overlap between these two groups of tumors, which are considered to be histogenetically different, and the need for further studies of molecular characterization of small cell tumors, especially in those with atypical morphologic or immunohistochemical features.

Abdominal Neoplasms↗
PubMed1997

[The detection of papillomavirus by in situ hybridization. Clinico-pathological and virological correlation in patients with squamous intraepithelial lesions of the uterine cervix].

BACKGROUND: Clinical usefulness of human papillomavirus (HPV) detection by molecular techniques is not well established. The aim of the study is to determine, by in situ hybridization, HPV DNA in patients with cervical intraepithelial neoplasia (CIN), assessing the prevalence rate, the association with epidemiologic factors and the correlation with classic diagnostic procedures (cytology, colposcopy and histology). PATIENTS AND METHODS: Among 138 patients diagnosed with CIN, HPV was determined in 75 treated by excisional procedures. All cases underwent pap-smear, colposcopy, and colposcopically directed biopsy. RESULTS: Histologic diagnosis was as follows: 1 cervical condyloma (1.3%); 31 CIN-I (41.3%); 23 CIN II (30.7%), and 20 CIN-III (26.7%). HPV was detected in 31 cases (41.3%), being more frequent in higher histologic grades (35.5%) CIN-I, 43.5% CIN-II and 45% CIN-III). No association between cytologic, colposcopic and histologic diagnoses and HPV positivity was observed. HPV detection in patients with false negative cytologies was lower than in positive ones (p = 0.021). Smoking was the only epidemiologic factor significantly associated to HPV presence (chi 2 for trend = 4.022; p = 0.045). CONCLUSIONS: Clinical usefulness of in situ hybridization for HPV detection remains controversial because of its low sensitivity, and the scarce relationship between its results and those obtained by cytology, colposcopy and histology. Smoking is associated with a higher detection rate of HPV in patients with squamous intraepithelial lesions of the uterine cervix.

Adult↗
PubMed1996

Septate uterus with cervical duplication and longitudinal vaginal septum: a report of three new cases.

The first case of a rare mullerian anomaly characterized by the presence of a complete uterine septum with duplication of the cervix and a longitudinal vaginal septum has been reported very recently. We present here three new cases of such an anomaly in an attempt to alert gynaecologists to the possible occurrence of such a malformation. The cases challenge the classical views of unidirectional (caudad to cranial) mullerian development and support the alternative embryologic hypothesis of Muller et al. according to which fusion and resorption begins at the isthmus and proceeds simultaneously in both the cranial and caudal directions.

Adult↗
PubMed1996

Endometrial ossification successfully treated by hysteroscopic resection.

BACKGROUND: Endometrial ossification is a rare condition. The common feature in most reported cases is a previous history of abortion and retention of fetal bones. Few cases of endometrial ossification can be explained by osseous metaplasia. Clinical presentation may include abnormal vaginal bleeding or discharge, dysmenorrhoea, pelvic pain, and secondary infertility. Hysterectomy or dilation and curettage have been the usual therapeutic methods used. Recently, some cases have been treated by means of hysteroscopic resection. CASE: We report a case of endometrial ossification in a woman who presented with dysmenorrhoea, dyspareunia and pelvic pain. The patient had a pregnancy voluntarily terminated at 16 weeks. Five subsequent routine annual gynaecological exams, including ultrasonographies, were normal. A new gestation was also voluntarily terminated at 6 weeks. One month later the patient started with clinical manifestations. Ultrasonograms performed 4 months after the second abortion revealed a strong uterine echogenic band. Bone tissue was successfully removed by hysteroscopic resection. CONCLUSION: This case adds further evidence favouring new bone formation in the uterus as a pathogenic mechanism for endometrial ossification and illustrates the feasibility of hysteroscopic treatment for this condition.

Abortion, Induced↗
PubMed1996

Successful pregnancy in a patient with hemolytic-uremic syndrome during the second trimester of pregnancy.

BACKGROUND: Hemolytic uremic syndrome (HUS) is a rare, well-characterized complication of the puerperium constituting a cause of acute renal failure after an uncomplicated delivery. However, its presentation during pregnancy is unusual, with only four cases before the 20th week of gestation reported. CASE: A case of HUS occurred at 18 weeks' gestation. Despite the initial severity of the clinical presentation, therapy, consisting of corticosteroids and plasmapheresis, resulted in complete recovery of renal function, with a rapid improvement in thrombocytopenia and hemolysis. No remarkable events occurred after this episode, and a full-term pregnancy with a normal fetal outcome was achieved. CONCLUSION: We are aware of no other reports of successful pregnancy after the development of HUS during the first half of pregnancy. This provides evidence that continuation of pregnancy until term is possible. Rapid diagnosis and intensive treatment with plamapheresis, corticosteroids and dialysis, when required, may improve the maternal and fetal prognosis.

Adult↗
PubMed1995

Primary adenocarcinoma of the endometrium associated with genital tuberculosis. A case report.

BACKGROUND: Adenocarcinoma of the endometrium is a common tumor of the female reproductive tract, and tuberculosis accounts for only about 1% of postmenopausal metrorrhagia. Tuberculosis of the fallopian tubes is the most frequent location; that of the cervix is the most uncommon. CASE: A case of primary adenocarcinoma of the endometrium was diagnosed after curettage in a 58-year-old, postmenopausal woman complaining of a bloody vaginal discharge. A laparotomy was performed, and histologic examination of the uterus disclosed an endometrial carcinoma, grade 2/3, with extension to both tubes. The tumor was associated with an extensive granulomatous reaction, with numerous tubercles composed of epithelioid cells, multinucleate giant cells of Langhans and central necrosis type. These granulomas were seen close to the carcinoma in the endometrium and tubes and far from the neoplasm in sections of the cervix, myometrium and lymph nodes. CONCLUSION: The association of endometrial adenocarcinoma with genital tuberculosis is extremely rare. Moreover, similar granulomas may appear in the surrounding stroma of the tumor. For these reasons a diagnosis of genital tuberculosis associated with this neoplasm should be made with caution.

Adenocarcinoma↗
PubMed1995

Massive metastases from a lobular breast carcinoma from an unknown primary during pregnancy. A case report.

BACKGROUND: Carcinoma of the breast during pregnancy represents 2-5% of all breast cancers. The frequency and histopathologic spectrum of breast cancer are similar in pregnant and nonpregnant women. Infiltrating lobular carcinoma is one of the less understood types of breast cancer, and its metastatic pattern seems to be different from that of infiltrating ductal carcinoma. Breast neoplasms rarely present as cancer from an unknown primary site. CASE: A woman in the third trimester of pregnancy developed carcinoma massively metastatic to the bone marrow and liver from an unknown primary tumor. At 32 weeks' gestation a healthy male was delivered by cesarean section. The patient died 12 hours after delivery. The autopsy revealed an infiltrating lobular carcinoma, 1.5 cm, of the breast. CONCLUSION: Massive metastases from an occult lobular breast carcinoma in a pregnant woman are very rare. Diffuse metastatic spread, which often complicates or delays the diagnosis, is a characteristic pattern of infiltrating lobular carcinoma. Cancer from an unknown primary site during pregnancy is an exceptional finding. If a metastatic adenocarcinoma is diagnosed in a pregnant woman, a breast primary should be strongly suspected.

Adult↗
PubMed1994

Solitary vaginal metastasis as a presenting form of unsuspected renal adenocarcinoma.

Vaginal bleeding may be the first clinical manifestation of an occult renal neoplasm. The renal adenocarcinoma is a tumor with a wide variety of presenting forms. Sometimes the clinical signs of the metastatic lesions are the first evidence of disease. The prevalence of solitary metastases at diagnosis is lower than 3%, and solitary vaginal metastasis from this tumor is rare. Histologically, this metastasis is indistinguishable from that of a primary vaginal mesonephric adenocarcinoma, making electron microscopy necessary for the differential diagnosis. Treatment consists of surgical removal of the renal neoplasm as well as the vaginal lesion.

Adenocarcinoma, Clear Cell↗
PubMed1994

Transvaginal sonography of the endometrium in postmenopausal women: monitoring the effect of hormone replacement therapy.

BACKGROUND: It is well known that progestins given in sufficient dosage reduce the risk of endometrial cancer and endometrial hyperplasia. It is also not uncommon that patients receiving hormone replacement therapy (HRT) require endometrial biopsy in order to evaluate the effects of oestrogens and progestogens on endometrium. However, endometrial biopsy is often associated with pain and discomfort, and transvaginal sonography has been suggested as a new and painless method of monitoring the effects of HRT on the endometrium. METHODS: Transvaginal ultrasonography was performed in a series of women on several regimens of HRT immediately prior to endometrial biopsy (Cornier cannula). We correlated the morphology and thickness of the endometrium as assessed by transvaginal ultrasonography with the endometrial histology. Patients were assigned into four groups. The first (n = 15) received 0.6 mg/day of conjugated equine oestrogen (CEE) cyclically and the second (n = 6) received 50 micrograms/day of transdermal oestradiol cyclically. All these groups also received 5 mg of medroxy-progesterone acetate (MPA) sequentially for the last 12 days of HRT, while the third therapy group (n = 7) received 0.625 mg/day of CEE and 5 mg/day of MPA uninterruptedly. The fourth group (n = 8) constituted a treatment-free control group. In total 36 biopsies were taken. Our initial results suggest that endometrial thickness under 4 mm measured by ultrasonography is not associated with endometrial abnormalities and that transvaginal ultrasonographic scanning of the endometrium may be a useful tool in determining which patients require endometrial histologic evaluation and perhaps in detecting those who need adjustment in the progestin dosage.

Administration, Cutaneous↗
PubMedDate not supplied

[Usefulness of the sentinel node in the treatment and staging of initial cervix cancer].

OBJECTIVE: The aim of this study was to evaluate the usefulness of intraoperative sentinel node (SN) detection in patients with initial cervix cancer. PATIENTS AND METHODS: Lymphoscintigraphy and intraoperative SN detection was performed in 17 patients with initial cervix cancer who we going to have a radical laparoscopic hysterectomy and pelvic lymphadenectomy. Conization was performed in 4/17. The day before surgery, an injection of 111 MBq 99mtechnetium nanocolloid around the primary tumour and a subsequent lymphoscintigraphy were carried out. Blue dye was injected at the same location intraoperatively. A laparoscopic gamma probe was used to identify SNs. RESULTS: SNs were successfully localized using a combination of radiocolloid and blue dye in 16/17 patients (detection rate 94 %). The detection rate only using blue dye technique decreases to 71 % (12/17) and it reaches an 82 % (14/17) if we avoid the blue dye injection. In 3 cases, there was no migration in lymphoscintigraphy and in one of the three SN could not be detected. Thirty-three SNs were identified (1.9 nodes/patient). The most frequent location was left external iliac nodal group (13 nodes: 39 %). SNs were identified in regions that are not included in usual lymphadenectomy: right parametrium (2 sentinel nodes, one of them in the retrouterine region), and interiliac (2 SNs). In all four patients with previous conization SNs were identified (detection rate 100 %). CONCLUSIONS: The rate of SN detection combining lymphoscintigraphy with gamma probe and blue dye is 82 %. The use of blue dye allows increasing this rate to 94 % in those cases which migration was not seen or when the SN is placed near the injection site. The SN technique offers the possibility to find SNs in regions not included in usual lymphadenectomy.

Adult↗
PubMedDate not supplied

Preoperative and intraoperative assessment of myometrial invasion and histologic grade in endometrial cancer: role of magnetic resonance imaging and frozen section.

The objective of this study was to determine the value of myometrial invasion by magnetic resonance imaging (MRI), histologic typing and grading by endometrial biopsy, and the intraoperative evaluation of both parameters by frozen section in the evaluation of endometrial cancer. The preoperative and intraoperative records of 180 patients with endometrial cancer were used to compare the preoperative endometrial biopsy, the myometrial invasion by MRI, and the intraoperative frozen sections, with the final histopathologic findings. The preoperative endometrial biopsy gave us the tumor histologic type and grade. MRI gave us the depth of myometrial invasion. The evaluation of intraoperative frozen sections gave us the tumor histologic type, the tumor grade, and also the myometrial invasion. Patients were classified as low risk (grade 1 and 2, and myometrial invasion <50%) and high risk (grade 3 or myometrial invasion >50%). Standard statistical calculations were used. Evaluation of the tumor grade by preoperative biopsy has a sensitivity and a specificity of 75% and 95%, respectively. Evaluation of the tumor grade by intraoperative biopsy has a sensitivity and a specificity of 40% and 98%, respectively. Evaluation of the depth of myometrial invasion with MRI has a sensitivity and a specificity of 79% and 82%, respectively. Evaluation of the depth of myometrial invasion with intraoperative frozen sections has a sensitivity and a specificity of 74% and 95%, respectively. Evaluation of all four of the parameters together has a sensitivity and a specificity of 80% and 82%, respectively with a kappa of 0.621. In our opinion, the combination of preoperative biopsy and intraoperative frozen section is the best way to decide whether a lymphadenectomy is necessary with a low rate of understaging patients. MRI would have a fringe benefit in these patients.

Adult↗
PubMedDate not supplied

[Ovarian and para-aortic recurrence from cervix cancer detected by PET/CT].

We present the case of a 34-year-old woman diagnosed of an adenosquamous carcinoma of the uterine cervix, stage IIB of the FIGO classification (International Federation of Gynecology and Obstetrics), treated with quimiotherapy, radiotheraphy and brachytheraphy with posterior hysterectomy. A recurrence of the disease was suspected due to the progressive rise of CEA levels. A PET/CT revealed abnormal foci in both ovaries, that had been transposed to avoid lesions due to radiation, and in a left para-aortic adenopathy. The diagnosis of recurrence in these sites was confirmed by biopsy. PET with FDG (F18-fluorodeoxyglucose) is useful in the staging of primary tumour and in the detection of recurrence in uterine cervical carcinoma, with better sensitivity and specificity than CT and MRI. PET/CT improves anatomic resolution and helps to resolve the origin of unclear foci like in the case presented in which ovaries were not in their normal situation due to transposition.

Adult↗