-
Endocrine Pathology 06/2012; 23(3):168-71. · 1.36 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We evaluated allergy/hypersensitivity clinical markers and their correlation with Helicobactor pylori infection in children and adults to analyze how early acquisition of H. pylori could modulate allergic disorder expression.
H. pylori presence was assessed by the rapid urease test and histology of antrum biopsies in 165 patients. Skin tests, serum IgE, and two clinical allergy questionnaires were performed. Allergy severity was operationally defined using a combined score. Findings were correlated with H. pylori status and cytotoxin-associated gene A presence in pediatric and adult patients. Transforming growth factor β (TGF-β) levels were measured by an enzyme-linked immunosorbent assay in serum and gastric biopsies of H. pylori (+) patients.
H. pylori (-) children had more positive skin tests to a higher number of antigens than H. pylori (+) children (P<0.05). Operationally defined allergy inversely correlates with H. pylori infection in children, but not in adults. The percentage of H. pylori infection was lower in children with severe allergy (32.3%) compared with children with mild allergy (43.4%) or no allergy (64.3%) (P<0.05). Colonization with virulent strains (cytotoxin-associated gene A+) showed a nonsignificant inverse correlation with severity of allergies in pediatric patients. H. pylori-infected children, but not adults, without allergy markers showed increased levels of TGF-β compared with allergic children both in serum and gastric mucosa (P<0.05).
There was a strong inverse correlation between allergy markers and H. pylori infection in pediatric patients associated with elevated levels of TGF-β locally and systemically. H. pylori-associated chronic gastritis might downregulate clinical allergy expression.
European journal of gastroenterology & hepatology 05/2011; 23(8):656-63. · 1.66 Impact Factor
-
Gonzalo Carrasco,
Jose Diaz,
Jose R Valbuena,
Paulina Ibanez,
Paz Rodriguez,
Gabriela Araya,
Carolina Rodriguez, Javiera Torres,
Ignacio Duarte,
Edmundo Aravena,
Fernando Mena,
Carlos Barrientos,
Alejandro H Corvalan
[show abstract]
[hide abstract]
ABSTRACT: Histologic assessment of high-risk gastritis for the development of gastric cancer is not well defined. The identification of tissue markers together with the integration of histologic features will be required for this assessment.
Matched tumor/nontumor adjacent mucosa (NTAM) of 91 early gastric cancer and 148 chronic gastritis cases were evaluated for histologic characteristics (atrophy, intestinal metaplasia, chronic inflammation, polymorphonuclear infiltration, and Helicobacter pylori) by the Sydney System. Atrophy risk assessment was also evaluated by the Operative Link on Gastritis Assessment (OLGA) staging system. Eight tissue markers (BRCA1, HSP90, STAT1, FHIT, EGFR, p73, p53, p16INK4a) and EBV were also evaluated by tissue microarray/immunohistochemistry/in situ hybridization platform. Data were analyzed by contingency tables (2 x 2) using Fisher's exact two-tailed test (P < 0.001) and integrated by Significance Analysis of Microarrays (SAM) and clustering analysis.
Histologically, NTAM have severe intestinal metaplasia/chronic inflammation and severe atrophy assessed by Sydney and OLGA staging systems. H. pylori infection was similar in both groups, and EBV was found only in 5.5% of the tumor samples. Overexpression of p73 was higher in NTAM (50.5%) than in chronic gastritis (10.8%; P < 0.0001). Integration of histologic features and tissue markers showed that overexpression of p73, severe atrophy, and OLGA stage 4 were the most relevant features in NTAM. Clustering analysis correctly assigned NTAM and control cases (P < 0.0001).
Overexpression of p73 should be considered for the assessment of high-risk chronic gastritis. SAM allows the integration of histology and tissue markers for this assessment.
Clinical Cancer Research 06/2010; 16(12):3253-9. · 7.74 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Appendiceal carcinoids are the most frequent tumors of the appendix and are usually detected as an incidental finding in the final pathology report. The aim of this study was to evaluate the clinical and pathological characteristics, surgical treatment and long-term survival in patients with an appendiceal carcinoid tumor.
We performed a retrospective study of patients treated from 1980 to 2007 with a pathological diagnosis of appendiceal carcinoid tumor. In all patients, clinical and pathological characteristics, surgical treatment and long-term survival were evaluated.
In this period, 8903 appendectomies were performed. Carcinoid tumor was diagnosed in 40 patients (25 women and 15 men), aged 37+/-18 years old. The appendectomy was performed for appendicitis in 33 of these patients, and the final pathology report confirmed the diagnosis in 24. The tumor was localized in the distal third of the appendix in 24 patients (60%), and the size of the tumor was less than 1cm in 28 (70%). Twenty-nine (72.5%) of these tumors infiltrated the subserosal and/or the serosal layer. Three patients were treated with a complementary right colectomy and none had lymph node compromise. The mean follow-up was 81.2 months. The overall 5- year survival was 97.5%.
Appendiceal carcinoid tumor is usually detected incidentally in the pathological analysis in patients undergoing surgery for suspected appendicitis. Long-term survival is high with appendectomy alone.
Gastroenterología y Hepatología 08/2009; 32(8):537-41. · 0.73 Impact Factor
-
José Miguel Domínguez,
René Baudrand,
Eugenio Arteaga,
Claudia Campusano,
Gilberto González,
Lorena Mosso,
Gabriel Cavada,
Francisco Cruz, Javiera Torres,
Antonieta Solar,
Tatiana Arias,
Alejandra Pizarro,
Marcelo Gómez,
Carlos Fardella
[show abstract]
[hide abstract]
ABSTRACT: Thyroid nodules are common and associated to a low risk of malignancy. Their clinical assessment usually includes a fine needle aspiration biopsy (FNAB).
To identify ultrasonographic characteristics associated to papillary thyroid carcinoma (PTC) and generate a score that predicts the risk of PTC.
Retrospective review of all fine needle aspiration biopsies of the thyroid performed in a lapse of two years. Biopsies that were conclusive for PTC were selected and compared with an equal amount of randomly selected biopsies that disclosed a benign diagnosis.
One hundred twenty two biopsies of a total of 1,498 were conclusive for PTC. Univariate analysis showed associations with PTC for the presence of micro-calcifications (Odds ratio (OR) 49.2: 95% confidence intervals (CI) 18.7-140.9), solid predominance (OR 25.1; 95% CI 6-220), hypoechogenicity (OR 23.5, 95% CI 6.5-122.6), irregular borders (OR 17, 95% CI 7.2-42.9), lymph node involvement (OR 12.3, 95% CI2.7-112), central vascularization (OR 12.2, 95% CI 4.8-33.3), local invasion and hyperechogenicity (OR 0.2; CI 95% CI 0.03-0.6). Multivariate analysis disclosed microcalcifications (OR 28.1; CI 95% 8.9-89), hypoechogenicity (OR 9.4; 95% CI 1.5-59.5) and irregular borders (OR 4.7; CI 95% 1.5-15) as the variables independently associated with the presence of PTC. The prevalence of PTC in the presence of the three variables was 97.6% (Likelihood ratio (LR) 45) and 5.4% in their absence (LR 0.06).
This scale predicts the presence or absence of PTC using simple ultrasound characteristics.
Revista medica de Chile 08/2009; 137(8):1031-6. · 0.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Hepatectomy for cholangiocarcinoma in one patient with Dubin Johnson syndrome
Dubin-Johnson syndrome (SDJ) is a rare benign autosomal recessive congenital disease that causes
jaundice. We report a 71 years old male with a Dubin Jonson syndrome diagnosed at the age of 40. On a
ultrasound examination and magnetic resonance imaging, a liver tumor was found, that was excised. The
pathology report showed a cholangiocarcinoma. During the postoperative period, the patient had a
hyperbilirubinemia that subsided slowly. There are reports of hyperbilirubinemia of difficult management
after hepatectomy in patients with Dubin-Johnson syndrome.
Revista Chilena de Cirugía. 06/2009; 61(3-61):279 - 284.
-
[show abstract]
[hide abstract]
ABSTRACT: Eosinophilic esophagitis in adults (EE) is a disease of unknown cause, characterized by symptoms such as reflux and dysphagia that traditionally do not respond to antacid treatment. It affects mostly young men with a strong personal or familial history of atopy asthma and allergies. We report three male patients aged 10, 14 and 15 years, all with symptoms of dysphagia, two of them with chest pain caused by spasm of the esophagus, with heterogeneous endoscopic findings which included from leucoplakia to stenosis that needed endoscopic dilatation. All of them had abnormal findings in immunity studies (prick test or IgE levels). They received treatment based on diet measures, acid suppression and leukotriene inhibitors, with satisfactory clinical, endoscopic and histological response. EE should be suspected in children and adults with esophageal symptoms and personal or family history of allergy and asthma.
Revista medica de Chile 06/2009; 137(5):666-71. · 0.33 Impact Factor
-
Enrique Norero,
Nicolás Jarufe,
Jean M Butte,
Blanca Norero,
Ignacio Duarte, Javiera Torres,
George Pinedo,
Francisco López,
Juan Francisco Guerra,
Luis Ibáñez,
Alvaro Zúñiga,
Sergio Guzmán,
Jorge Martínez
[show abstract]
[hide abstract]
ABSTRACT: Surgical resection is the only treatment associated with long-term cure in patients with liver metastasis from colorectal cancer, achieving a 30% to 40% five years survival.
To evaluate the results of liver resection for metastatic colorectal cancer in our centre.
Retrospective study. Epidemiological, perioperative and follow up data of patients undergoing liver resection for metastatic colorectal cancer between January 1990 and July 2007 were assessed. We compared the results between two periods; period 1 (1990-1997) and period 2 (1998-2007).
Sixty six patients aged 61+/- 12 years (46 males) underwent 75 resections. An anatomical excision was performed in 54 (72%) cases, a right hepatectomy in 18, an extended right hepatectomy in 11, a left hepatectomy in 1, and a segmentectomy in 24. In 24 (32%) patients the liver resection was simultaneous with the colorectal cancer resection. Operative time was 221+/-86 min. Hospital stay was 11+/-5 days. Postoperative morbidity was 35% and surgical mortality was 0%. Resection margin was free of tumor in 53 (80%) patients. Five years overall and hepatic disease-free survival was 38% and 23%, respectively. In period 2, more anatomical resections than in period 1 were performed (77% and 55%, respectively, p =0.04), without an increase in complications (35% and 34%, respectively; p =ns), but with a better five years survival (45% and 21 %, respectively, p =0.04).
Five years survival for excision of liver metastatic colorectal cancer in our center is similar to that reported abroad. During the second period there has been a trend toward more extensive resections which was associated with a better survival, without an increase in complications or mortality .
Revista medica de Chile 05/2009; 137(4):487-96. · 0.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Early gastric cancer involves mucosa and submucosa, independent of lymph node involvement. Radical gastrectomy is the standard treatment.
To assess long term survival of patients operated for an early gastric cancer.
Retrospective review of medical and pathology records of patients subjected to a gastrectomy for an early gastric cancer, between 1975 and 2002. All were treated using a standardized protocol and staged according to 2002 TNM classification of the American Joint Committee of Cancer (AJCC). Demographic and pathologic features, operation performed and long term survival were recorded. Survival was analyzed using Kaplan-Meier method.
The series is comprised by 64 males and 41 females aged 61 +/- 1 years. Tumor was located in the upper third of the stomach on 33 subjects and a total gastrectomy was performed in 53. Pathology showed an intestinal type adenocarcinoma in 82 and a diffuse type in 23. In patients with involvement of mucosa and submucosa, 24 +/- 14 and 22 +/- 14 lymph nodes were excised, respectively. Lymph node involvement was present in 8% and 22% of patients with involvement of mucosa and submucosa, respectively. Five years survival was 94% and 78% in patients without and with lymph node involvement, respectively. Survival among patients in stage IA and IB was 94% and 76%, respectively. Multivariate analysis showed that the lymph node involvement was an independent mortality risk factor.
Total gastrectomy in patients with early gastric cancer is associated with a good survival. Lymph node involvement is a mortality risk factor.
Revista medica de Chile 12/2008; 136(11):1424-30. · 0.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Helicobacter pylori infection results in a systemic immune response characterized by the initial rise of immunoglobulin (Ig) M followed by the elevation of IgG- and IgA-specific antibody levels in serum. Age and regional considerations may modify the accuracy of serological tests.
To determine the accuracy of specific IgG, IgA, and IgM in H pylori infection determination in different age groups.
We enrolled 179 patients referred for endoscopy. Patients were considered infected if they had positive histological or urease test results for H pylori. Titers of IgG, IgA, and IgM were determined in serum by enzyme-linked immunosorbent assay. Through receiver operator characteristic curves, cutoff, sensitivity, and specificity values were obtained. Agreement and correlation between immunoglobulin titers and inflammation markers were explored.
Infection with H pylori was present in 58% of adults, 62% of adolescents, and 25% of children. Sensitivity and specificity were higher in children younger than 12 years old for IgG and IgA. All diagnostic performance values were lower for IgM. Agreement measures were approximately 0.5 in adults and reached values of approximately 0.7 for adolescents and children. IgM had negative agreement with other methods. There was a correlation between inflammation markers, H pylori load, and immunoglobulin titers for IgG and IgA. These associations decreased with age and were not observed for IgM.
IgG and IgA serological tests reached high performance values, particularly in children younger than 12 years old, indicating that they are reasonable screening methods once cutoff values are adjusted to local population and age. IgM does not present an additional contribution.
Journal of pediatric gastroenterology and nutrition 12/2008; 47(5):612-7. · 2.18 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The association of gastric lymphoma and gastric adenocarcinoma in the same patient is uncommon. We report a 76 year-old male with a previous history of massive upper gastrointestinal bleeding who required a subtotal gastrectomy with Billroth II reconstruction in 1974. Pathology demonstrated a gastric lympho-histiocytic non-Hodgkin's lymphoma. The patient received complementary radiotherapy and was followed with annual endoscopies for 23 years. In 2006, he presented with fatigue. An upper gastrointestinal endoscopy showed an ulcerated and proliferative lesion at the gastric stump. Biopsy demonstrated a gastric adenocarcinoma. Gastric stump resection with lymph node dissection was performed. Pathology of the excised specimen showed a moderately differentiated tubular adenocarcinoma of the gastrojejunal anastomoses which infiltrated up to the subserosa. Additionally lymphatic permeations were observed and 10 of the 16 excised lymph nodes were invaded by the tumor.
Revista medica de Chile 11/2008; 136(10):1317-20. · 0.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Intraductal papillary mucinous neoplasm of the pancreas is characterized by a dilatation of the main pancreatic duct and/or secondary ducts, mucin production and the absence of ovarian-like struma. The symptoms are non-specific and often the diagnosis is incidental. The treatment of choice is surgery, since these tumors may become malignant. The prognosis depends on the type of lesion, whether the excision is complete and lymph node involvement. The aim of this review is to analyze the clinical, diagnostic, therapeutic and pathological characteristics of this disease.
Revista medica de Chile 05/2008; 136(4):517-27. · 0.33 Impact Factor
-
Paul R Harris,
Shelton W Wright,
Carolina Serrano,
Francisca Riera,
Ignacio Duarte, Javiera Torres,
Alfredo Peña,
Antonio Rollán,
Paola Viviani,
Ernesto Guiraldes,
Julia M Schmitz,
Robin G Lorenz,
Lea Novak,
Lesley E Smythies,
Phillip D Smith
[show abstract]
[hide abstract]
ABSTRACT: Helicobacter pylori infection in children infrequently causes gastroduodenal mucosal ulceration. Because H pylori induces T-cell dependent gastric inflammation in adults and T regulatory (Treg) cells suppress T-cell-dependent pathology, we evaluated gastric histopathology and Treg cell responses in H pylori-infected children and adults.
Gastric tissue from 36 children and 79 adults with abdominal symptoms in Santiago, Chile, was evaluated prospectively for H pylori bacteria and histopathology using the Sydney classification and Treg responses using immunoassay, immunohistochemistry, and real-time polymerase chain reaction.
Eighteen (50%) of the children and 51 (65%) of the adults were infected with H pylori. Children and adults were colonized with similar levels of H pylori. However, the level of gastritis in the children was reduced substantially compared with that of the adults (P < .05). Coincident with reduced gastric inflammation, the number of Treg cells and levels of Treg cytokines (transforming growth factor [TGF]-beta1 and interleukin-10) were increased markedly in the gastric mucosa of H pylori-infected children compared with that of infected adults (P < .03 and < .05, respectively). Also, H pylori infection in the children was associated with markedly increased levels of gastric TGF-beta1 and interleukin-10 messenger RNA. Importantly, gastric TGF-beta1 in H pylori-infected children localized predominantly to mucosal CD25(+) and Foxp3(+) cells, indicating a Treg source for the TGF-beta1.
Gastric pathology is reduced and local Treg cell responses are increased in H pylori-infected children compared with infected adults, suggesting that gastric Treg cell responses down-regulate the inflammation and ulceration induced by H pylori in children.
Gastroenterology 03/2008; 134(2):491-9. · 11.68 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Multiple endocrine neoplasia type 1 (MEN 1) is a syndrome characterized by tumors of the parathyroid glands, pancreatic islet cells, duodenum, and pituitary gland. We report a case of cervical metastases of glucagonoma with MEN 1. The patient was a 34-year-old woman admitted to our hospital with epigastric pain. Her medical history included two resections of prolactinoma and two upper GI hemorrhages secondary to duodenal ulcers. Computed tomography (CT) showed two hypervascular lesions in the tail of the pancreas and cervical ultrasound showed multiple hypoechogenic ovoid images in the neck. A cervical CT scan confirmed two 15-mm lymph nodes in the left cervical region and 111In-DOTATOC imaging showed focal abnormal somatostatin expression in the pancreatic tail and the cervical nodes. The patient had asymptomatic hypoglycemic episodes, with blood sugar levels as low as 30 mg/dl, which raised our suspicion of MEN 1 associated with pancreatic insulinoma. Thus, we performed a distal pancreatectomy with bilateral cervical dissection and parathyroid gland resection. Histopathological examination revealed 12 pancreatic tumors as well as metastases in four cervical lymph nodes. The resected parathyroid glands had normal structure, suggesting parathyroid hyperplasia. A follow-up CT scan, 18 months after surgery, showed new tumors in the head of the pancreas and in the duodenal wall. A pancreatoduodenectomy was performed and histopathological examination revealed nine nonfunctioning endocrine tumors in the pancreas, one tumor in the duodenal wall, and metastases in two peripancreatic lymph nodes. The patient recovered well and remains asymptomatic.
Surgery Today 02/2008; 38(12):1137-43. · 1.22 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Obesity is highly prevalent in both liver transplant candidates and recipients, and can have a significant impact on perioperative morbidity and mortality and the overall cost of transplantation. Herein, we describe an obese patient who was managed sequentially with an intragastric balloon in the pre-transplant setting and a gastric sleeve following transplantation, with good long-term results. Sleeve gastrectomy is a non-malabsorptive bariatric procedure with potential benefit for liver transplant patients due to its lack of influence on the absorption of immunosuppressive agents.
Obesity Surgery 12/2007; 17(11):1517-9. · 3.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Colonic composite tumors are uncommon masses composed of endo- and exocrine cells. Treatment is similar to that of adenocarcinomas. We report the case of a 44-year-old woman who consulted for abdominal pain. A computed tomography (CT) scan showed a tumor at the splenic flexure bowel and 2 hepatic nodules, suggesting metastases. Preoperative biopsies confirmed an adenocarcinoma. The patient underwent surgery, which confirmed the CT findings. Extended right colectomy was performed, followed by an ileal-sigmoid anastomosis, resection of a diaphragm segment, and resection of both hepatic metastases. The patient made a good postoperative recovery. Histological analysis showed moderately differentiated tubular adenocarcinoma combined with a poorly differentiated neuroendocrine carcinoma and metastases in 25 of 28 lymph nodes. The 2 hepatic metastases showed areas of poorly differentiated neuroendocrine carcinoma. The patient is currently asymptomatic and is undergoing chemotherapy.
Cirugía Española 09/2007; 82(2):128-30. · 0.87 Impact Factor
-
Journal of the American College of Surgeons 04/2007; 204(3):510. · 4.55 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To validate a non-invasive method to detect gastric mucosal atrophy in a Chilean population with high prevalence of gastric cancer and a poor survival rate.
We first determined the optimal cut-off level of serum pepsinogen (PG)-1, PG-1/PG-2 ratio and 17-gastrin in 31 voluntary symptomatic patients (mean age: 66.1 years), of them 61% had histologically confirmed gastric atrophy. Then, in a population-based sample of 536 healthy individuals (209 residents in counties with higher relative risk and 327 residents in counties with lower relative risk for gastric cancer), we measured serum anti-H pylori antibodies, PG and 17-gastrin and estimated their risk of gastric cancer.
We found that serum PG-1 < 61.5 microg/L, PG-1/PG-2 ratio < 2.2 and 17-gastrin > 13.3 pmol/L had a high specificity (91%-100%) and a fair sensitivity (56%-78%) to detect corpus-predominant atrophy. Based on low serum PG-1 and PG-1/PG-2 ratio together as diagnostic criteria, 12.5% of the asymptomatic subjects had corpus-predominant atrophy (0% of those under 25 years and 20.2% over 65 years old). The frequency of gastric atrophy was similar (12% vs 13%) but H pylori infection rate was slightly higher (77% vs 71%) in the high-risk compared to the low-risk counties. Based on their estimated gastric cancer risk, individuals were classified as: low-risk group (no H pylori infection and no atrophy; n = 115; 21.4%); moderate-risk group (H pylori infection but no atrophy; n = 354, 66.0%); and high-risk group (gastric atrophy, with or without H pylori infection; n = 67, 12.5%). The high-risk group was significantly older (mean age: 61.9+/-13.3 years), more frequently men and less educated as compared with the low-risk group.
We propose to concentrate on an upper gastrointestinal endoscopy for detection of early gastric cancer in the high-risk group. This intervention model could improve the poor prognosis of gastric cancer in Chile.
World Journal of Gastroenterology 12/2006; 12(44):7172-8. · 2.47 Impact Factor
-
Carlos Fardella,
Marcela Jiménez,
Hernán González,
Augusto León,
Ignacio Goñi,
Francisco Cruz,
Antonieta Solar, Javiera Torres,
Lorena Mosso,
Gilberto González,
José Adolfo Rodríguez,
Claudia Campusano,
José Manuel López,
Eugenio Arteaga
[show abstract]
[hide abstract]
ABSTRACT: Thyroid microcarcinoma is a tumor of 10 mm or less, that should have a low risk of mortality. However, a subgroup of these carcinomas is as aggressive as bigger tumors.
To describe the pathological presentation of these tumors, and compare them with larger tumors.
All pathological samples of thyroid carcinoma that were obtained between 1992 and 2003, were studied. In all biopsies, the pathological type, tumor size, the focal or multifocal character, the presence of lymph node involvement and the presence of lymphocytic thyroiditis or thyroid hyperplasia, were recorded.
One hundred eighteen microcarcinomas and 284 larger tumors were studied. The mean age of patients with microcarcinoma and larger tumors was 42.7+/-14 and 49.3+/-16 years respectively (p <0,001) and 83% were female, without gender differences between tumor types. Mean size of microcarcinomas was 8.6 mm and 116 (98%) were papillary carcinomas. Of these, 109 (94%) were well differentiated and seven (6%) were moderately differentiated. Thirty six (31%) were multifocal and in 10 (8,6%), there was lymph node involvement. The mean size of larger tumors was 23.8 mm and 241 (85%) were papillary carcinomas. Of these, 200 (83%) were well differentiated, and 41 (17%) were moderately differentiated. Eighty five (35%) were multifocal and in 44 (18%) there was lymph node involvement. The prevalence of thyroiditis and hyperplasia was significantly higher among microcarcinomas than in larger tumors (15 and 2.5%, respectively, p <0.001, for the former; 32.4 and 1.7%, respectively, p <0.001, for the latter).
In this series, one third of microcarcinomas were multifocal and 10% had lymph node involvement. Therefore, the aggressiveness of these tumors is higher than what is reported in the literature and they should be treated with total thyroidectomy.
Revista medica de Chile 11/2005; 133(11):1305-10. · 0.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The treatment of papillary thyroid carcinoma of less than 10 mm diameter is a matter of controversy. The incidental finding of papillary microcarcinomas in autopsies is frequent and some authors postulate that these tumors are biologically inactive and should only be observed. We report a 21 years old woman with a papillary thyroid cancer of 6 x 5 x 5 mm and bilateral paratracheal metastases, that was subjected to a total thyroidectomy. She received 200 mCi of radioiodine. Two years after surgery, a new nodule of 9.6 mm diameter was detected by ultrasound, that was treated with a new dose of 200 mCi of radioiodine. One year later a suprasternal mass of 2 cm diameter and 3 enlarged lymph nodes were detected. She was subjected to a surgical lymph node dissection of the neck and the biopsy confirmed the presence of cancer. She received a new dose of 300 mCi of radioiodine. The mother of the patient had a 7 mm thyroid nodule that was also a papillary carcinoma.
Revista medica de Chile 04/2005; 133(3):323-6. · 0.33 Impact Factor
