Tumor de células de la granulosa de patrón difuso sarcomatoide. Presentación de un caso

Granulosa-cell tumors are rare malignant neoplasms characterized by a long natural history and a tendency to recur years after the initial diagnosis.     

Recurrencia del tumor ovárico de las células de la granulosa

We present the case of a 79-year-old woman who was misdiagnosed with an ovarian fibroma 5 years previously. The patient presented with pain in the right iliac fossa with leukocytosis and was diagnosed with diverticulitis. A mass was incidentally found in the anterior abdominal wall, which was later confirmed as metastasis from a granulosa cell tumor of the ovary.We provide a literature review, focussing on the clinical findings and treatment of this tumor. Few reports have been published of this uncommon entity, characterized by a long natural history and tendency to recur years after the initial diagnosis.     

Tumor ovárico virilizante mixto de células de Sertoli-Leydig/granulosa (ginandroblastoma) en adolescente de 15 años

Sertoli-Leydig cell tumors constitute less than 5% of ovarian tumors. We report the case of a 15-year-old girl with virilization, amenorrhea, and abdominal pain, who was diagnosed with a left annexal tumor. Laboratory investigations revealed isolated testosterone elevation. Because the tumor was unilateral, the capsule was intact, and the patient wished to preserve her fertility, left salpingooophorectomy was performed. Histopathological examination revealed a mixed Sertoli-Leydig/juvenile granulosa cell tumor with a cartilaginous heterologous component, which could be considered a gynandroblastoma. Symptoms of virilization progressively improved.     

Tumor ovárico secretor de andrógenos en una mujer posmenopáusica

We report the case of a woman with established menopause and Sertoli-Leydig cell tumor. The first symptom was excess facial hair and increased serum androgen level. The patient rapidly developed the characteristic symptoms of hyperandrogenism with high testosterone level. Computed axial tomography and ultrasound did not identify the tumor, but hormone suppression-stimulation suggested the gynecological origin of the tumor. Postsurgical outcome was favorable with normalization of androgen levels and progressive reduction of symptoms of hyperandrogenism.     

Linfoma primario no Hodgkin difuso de células grandes B de vagina

Advanced lymphoma and leukemia can infiltrate the uterus and vagina. However, primary lymphomas affecting the female reproductive system are extremely uncommon (representing 1% of non-nodal tumors). We present a case of primary non-Hodgkin’s lymphoma of the vagina, diffuse large B cell type, stage IE according to the Ann-Arbor staging system. Complete remission was obtained after treatment with chemotherapy and radiotherapy. Five years after diagnosis, the patient is disease free.     

Carcinoma de células pequeñas neuroendocrino de cérvix uterino

We report a case of a neuroendocrine small-cell carcinoma of the cervix seen in our Gynaecology Department. This is a rare diagnosis and is of interest. Small-cell carcinoma of the cervix is a rare tumour with poor prognosis and high aggressiveness. Optimal treatment has not been established due to the rarity of the tumour.     

Metástasis vaginal del carcinoma de células renales

Renal cell carcinoma behaves unpredictably, with a strong tendency to produce metastasis, which can affect the vagina, leading to genital bleeding. Treatment is based on wide local excision of the lesion.     

Tumor de células epitelioides perivasculares en cuerpo uterino asociado a complejo de esclerosis tuberosa en mujer de 18 años

Perivascular epithelioid cell tumors (PEComa) are an uncommon group of neoplasms, distinguished by epithelioid-like cells, with perivascular disposition. These tumors express myogenic and melanocytic markers, for which there is no known equivalent counterpart in non-neoplastic cells.     

Tumor del seno endodérmico ovárico

The endodermal sinus ovarian tumor is a malignant tumor derived from germinal cells. Usually one appears in young women and with very fast growth. Characteristically it makes debut with elevated levels of alfafetoprotein (AFP). Its classic badly prognosis at the present time, has improved and is possible to obtain complete remissions after radical surgery an chemotherapy. This is the case of a younger patient with an endodermic sinus tumour ovarian that was presented how an acute abdominal pain because of ovarian torsion, first treated with conservative surgery and after the recurrence with multi-agent chemotherapy and radical surgery. Actually the patient is live and free of disease.     

Linfoma primario de cérvix: gestación tras tratamiento conservador

The cervix is a rare localization of lymphomas, with an incidence of 0.41- 0.6% of extranodal lymphomas. The initial symptom is usually vaginal bleeding. Diagnosis is made by biopsy. There is no standard treatment due to the low incidence of this tumor. Surgery causes irreversible loss of reproductive capacity.     

Carcinoma de células pequeñas de mama

Oat cell breast cancer is a rare and aggressive form of cancer. Because only a few cases have been described in the literature, there is no standard treatment. We report the case of a 64-year-old woman who attended our unit for investigation of a node in her left breast that was diagnosed as infiltrative oat-cell breast carcinoma.     

Adenoma de células de Sertoli bilateral en paciente con síndrome de insensibilidad a los andrógenos

Androgen insensitivity syndrome is characterized by the presence of a female phenotype, masculine gonads, and 46,XY karyotype. This syndrome is the most common cause of masculine pseudohermaphroditism and is the third most frequent cause of primary amenorrhea after gonadal dysgenesis and congenital absence of the vagina. The importance of this entity lies in its early diagnosis in puberty because of the risk of testicular tumors. In this article, we present a case of late diagnosis of androgen insensitivity syndrome related to Sertoli cell adenoma.     

Tumor virilizante de células esteroideas del ovario

Steroid cell tumors account for 0.1% of ovarian tumors and are classified within the group of stromal tumors, also known as sex cord tumors. These neoplasms can appear at any age but are more common in menopausal women and are associated with endocrine syndromes. The most significant clinical findings are hirsutism and virilization. Management should be individualized according to histological findings, surgical stage and the woman's reproductive wishes.     

Linfoma cervical primario: presentación de un caso y revisión de la literatura

Primary lymphoma of the uterine cervix is extremely rare and the clinical presentation is similar to that of carcinoma of the cervix. Diagnosis is made with a deep cervical biopsy because smear tests can show false negative results. The standard treatment has not yet been established but used to be radiotherapy. Currently, combination chemotherapy is used with or without surgery. We report a case of cervical lymphoma that needed several biopsies to establish the diagnosis and was successfully treated with neoadjuvant chemotherapy and surgery.     

Evaluación de un nuevo protocolo de cribado de cáncer cervical con citología convencional y test del virus del papiloma humano

Objective

To compare the effectiveness of cervical cancer screening using cytology plus the high risk human papillomavirus (HR-HPV) DNA test in 2011 versus cytology alone in 2010.

Method

Screening was performed in primary care. The target population in the Barbastro sector consisted of 26,936 women (aged 25 to 65 years). The HPV test was performed with hybrid capture (HC2) and the PCR cobas^® system in women between the ages of 30 and 65 years. Women with negative Pap and HPV test results underwent a 5-year recheck as per the latest protocol of Spanish Society of Obstetrics and Gynecology (SEGO, 2010).

Results

A total of 4,770 Pap tests were received in 2010 and 5,241 in 2011 with coverage between 36.8 and 46.8%; 784 HPV tests were carried out in 2010 and 3,560 in 2011, with positive results in 10.58% the first year and in 7.5% the second year. Eighteen new cases of cervical intraepithelial neoplasia grades 2/3 were diagnosed in 2010 and 35 in 2011, along with 3 invasive carcinomas each year (in 2011, 3 microinvasive carcinomas).

Conclusions

The implementation of HPV testing in primary screening for cervical cancer increased the number of pre-invasive lesions detected by 98% in the year of its introduction. Primary Care involvement allows screening for cervical cancer to be performed without additional costs.     

Tratamiento conservador del adenosarcoma mülleriano de cérvix uterino

Müllerian adenosarcoma of the cervix is a rare tumor that usually presents in young women as a bleeding cervical polyp. There is a tendency for local recurrence due to their low malignant potential. The optimal therapy for these tumors is uncertain but conservative treatment can be provided in selected patients to preserve female fertility. Long-term follow-up is of paramount importance. We present the case of a 19-year-old girl who was diagnosed with a Müllerian adenosarcoma of the uterine cervix treated with a wide cervical conization.     

Endometriosis cervical. Presentación de un caso

We report a case of cervical endometriosis in a 33-year-old patient who was diagnosed by means of colposcopy and histopathological study of directed neck biopsy and who was attended in the lower genital tract clinic of the Mariana Grajales de Santa Clara Provincial Maternity Hospital, in Villa Clara. The patient underwent diathermy loop conization of the uterine neck, which gave the diagnosis of cervical endometriosis. Outcome was satisfactory.