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Resumen: Introducción: La vasculitis primaria del sistema nervioso central (VPSNC) representa una enfermedad rara que afecta a los vasos sanguíneos de mediano y pequeño calibre del sistema nervioso central. Objetivo: Realizar una descripción de los hallazgos clínicos y aspectos diagnósticos, con especial atención a los hallazgos histopatológicos, así como a los tratamientos utilizados y la respuesta a los mismos en pacientes diagnosticados de VPSNC en nuestro centro. Pacientes y métodos: Presentamos un análisis descriptivo retrospectivo.Se ha analizado el registro de altas hospitalarias del Hospital General Universitario de Castellón entre enero de 2000 y mayo de 2020, escogiéndose aquellos con diagnóstico al alta de VPSNC que reunían los criterios de Calabrese en 1988, una vez revisada la historia clínica. Resultados: Se analizan una serie de 7 pacientes que ingresaron con cuadros de alteraciones focales transitorias y otros más inespecíficos, como cefalea o mareo, alcanzándose el diagnóstico mediante histología en 5 de ellos y mediante angiografía sugestiva en los 2 restantes.La neuroimagen fue patológica en todos los casos y el estudio del LCR resultó alterado en 3 de los 5 casos practicados.Todos ellos recibieron tratamiento inicial con megadosis de corticoides seguido de tratamiento inmunosupresor.La evolución fue desfavorable en 6 casos, resultando exitus 4 de ellos. Conclusiones: A pesar del reto diagnóstico que representa la VPSNC es fundamental tratar de aproximarse al máximo al diagnóstico definitivo, valiéndonos de herramientas como la histopatología y/o angiografía para establecer un tratamiento adecuado de manera precoz y reducir así la morbimortalidad de esta entidad. Abstract: Introduction: Primary central nervous system vasculitis (PCNSV) is a rare disease affecting medium- and small-calibre blood vessels of the central nervous system. Objective: The aim of this study was to analyse clinical findings and diagnostic aspects, with special attention to histopathological findings, as well as the treatments used and treatment response in patients diagnosed with PCNSV at our hospital. Patients and methods: We conducted a retrospective descriptive analysis of patients with a diagnosis of PCNSV at discharge from our centre and meeting the 1988 Calabrese criteria. To this end, we analysed the hospital discharge records of Hospital General Universitario de Castellón between January 2000 and May 2020. Results: We analysed a series of 7 patients who were admitted with transient focal alterations and other less specific symptoms such as headache or dizziness; diagnosis was based on histological findings in 5 cases and on suggestive arteriographic findings in the remaining 2.Neuroimaging results were pathological in all cases, and CSF analysis detected alterations in 3 of the 5 patients who underwent lumbar puncture.All patients received initial treatment with megadoses of corticosteroids followed by immunosuppressive treatment.Progression was unfavorable in 6 cases, with fatal outcomes in 4. Conclusions: Despite the diagnostic challenge of PCNSV, it is essential to attempt to reach a definitive diagnosis using such tools as histopathology and/or arteriography studies, in order to promptly establish appropriate treatment and thus reduce the morbidity and mortality of this condition.

ABSTRACT Objective: To evaluate and correlate the bacterial profile identified in blood cultures, urine cultures and vertebral biopsies in patients at Hospital Santa Marcelina in São Paulo - SP. Methods: Cross-sectional study of 20 patients affected by spondylodiscitis. Blood culture, urine culture, and spinal biopsy results were evaluated, in addition to sex and age. Results: The sample consisted of 20 patients, between 32 and 79 years old, predominantly male, diagnosed with spondylodiscitis. Most blood culture and urine culture results were negative, 80% and 65%, respectively. Among the spinal biopsy samples, 60% identified pathogens. When correlating the samples, 50% of the blood culture and biopsy cases presented the same result; however, between urine culture and biopsy, none identified the same germ between the samples. Conclusion: It is concluded that results from blood cultures, urine cultures, and spinal biopsies may frequently differ, making biopsy essential in diagnosing and treating spondylodiscitis. Level of Evidence IV; Cross-Sectional Study.

Pregnancies after kidney transplantation are considered high risk. Preconceive care is crucial for favorable mother-fetal outcome but also for good renal graft function. Herein, we report a case of kidney transplant recipient secondary to lupus nephritis with three consecutive successful pregnancies and excellent graft function after 16 post-transplant years. Preconception care included two protocolar biopsies performed prior to immunosuppressive treatment modifications. No signs of rejections were found in either biopsy, no additional treatment was necessary, and the patient was safely converted from mycophenolate mofetil to azathioprine. First pregnancy was naturally conceived, its course was uncomplicated and a healthy female newborn wasdelivered via vaginal birth. Within one year after delivery the patient presented proteinuria, borderline changes were found in the biopsy of allograft and were treated with immunosuppression augmentation and ACEI. At 7th post implantation year, after surveillance biopsy showing no signs of rejection and appropriate pharmacotherapy adjustments, second pregnancy occurred from in vitro fertilization (IVF). It was complicated with deep vein thrombosis, intrauterine growth restriction and premature birth in 32nd week of gestation. Three months after delivery, the patient conceived spontaneously, third pregnancy course was uncomplicated. Close follow up, including protocol and indication biopsies, allowed to preserve excellent graft function in the context of multiple immunosuppressive treatment adjustments. Here we present a case where natural conception and in vitro fertilization intertwine without harming the transplanted organ.

Resumen: Introducción: La biopsia discal es una herramienta necesaria en el proceso diagnóstico y terapéutico de las espondilodiscitis. Su rentabilidad es variable según condicionantes como la técnica utilizada, el uso concomitante de antibióticos o el germen causante. Estudiamos los resultados de este procedimiento en nuestro centro en un periodo de 5 años. Material y métodos: Análisis retrospectivo de todos los casos que requirieron biopsia discal por posible espondilodiscitis en nuestro centro entre enero de 2015 y noviembre de 2019, tanto percutánea (26 casos) como abierta (13 casos). Recogemos datos de filiación y clínicos, comorbilidad, antibioterapia concomitante, pruebas de imagen, tipo de biopsia, resultado de cultivos y evolución clínica. Resultados: Treinta y nueve pacientes: 66,7% varones, 66,9 años de edad media. El 74% con factores de riesgo conocidos. El síntoma principal es dolor mayoritariamente (89,7%) y fiebre en el 5%. La RMN en la prueba más frecuentemente realizada (87%). Los segmentos lumbares se afectaron en el 76,9%, por el 23% los dorsales. En 9 casos (23%) los pacientes reciben tratamiento antibiótico simultáneamente a la realización de la biopsia. En estos casos la biopsia siempre arrojó un resultado negativo. Los cultivos fueron positivos más frecuentemente en los pacientes sin antibióticos en el momento de la biopsia (53,3%), con significación estadística. Los microorganismos aislados de manera más repetida fueron los bacilos gramnegativos (31,2%) y los cocos grampositivos (31,2%). Constatamos 2 fallecimientos durante el ingreso por sepsis (dentro del primer mes tras el diagnóstico). Del resto de los pacientes fallecieron 5 de manera tardía durante el seguimiento: 3 por nuevas infecciones complicadas de manera tardía y 2 por complicaciones ulteriores de patologías previas. El resto de pacientes con diagnóstico final de espondilodiscitis evolucionaron satisfactoriamente con antibioterapia. Conclusiones: La espondilodiscitis es potencialmente grave y requiere un adecuado diagnóstico, siendo la biopsia discal un procedimiento necesario en ocasiones. Una mala situación clínica del paciente puede imposibilitar la retirada del antibiótico, lo cual disminuye drásticamente el rendimiento de la biopsia. Abstract: Introduction: Spinal disc biopsy is a necessary tool in diagnosing and treating spondylodiscitis. Its profitability varies according to the technique, concomitant antibiotics therapy or causative germ. We studied the results of this procedure in our institution. Materials and methods: Retrospective analysis of all cases requiring disc biopsy due to possible spondylodiscitis over a 5 year period, both percutaneous (26 cases) and open (13 cases). We collected filiation and clinical data, comorbidity, concomitant antibiotic therapy, imaging tests, biopsy type, cultures results and clinical evolution. Results: 39 patients; 66.7% male, 66.9 years of average age. 74% has known risk factors. The main symptom was pain (89.7%). Fever occurred in 5%. MRI performed in 87%. Lumbar involvement in 76.9%. 9 patients (23%) received antibiotic treatment simultaneously with biopsy. In these cases biopsy always yielded a negative result, but positive in patients without antibiotics at the time of the biopsy (53.3%), with statistical significance. Most frequent isolated microorganisms were gram-negative bacilli (31.2%) and gram-positive cocci (31.2%). We found 2 deaths during admission for sepsis (within the first month after diagnosis). Of the rest of patients, 5 died late during the follow-up: 3 due to new infections and 2 due to subsequent complications of previous pathologies. The remaining patients with final diagnosis of spondylodiscitis evolved satisfactorily with antibiotic therapy. Conclusions: Spondylodiscitis is potentially serious and requires an adequate diagnosis, with disc biopsy being a necessary procedure on occasions. Patients poor clinical condition can make it impossible to withdraw antibiotics, which drastically reduces the performance of the biopsy.

Resumen: Una mujer joven de 40 años acude a nuestra consulta por padecer de un nódulo de consistencia dura en el paladar de 3 meses de evolución. Destaca que tiene una hermana recién diagnosticada de torus palatinus. Ante esta sospecha y con el fin de descartar otras enfermedades tumorales, se deriva a la paciente a la consulta de maxilofacial donde, tras ser valorada, se decide realizar una biopsia de la lesión, con el resultado de hiperplasia, papilomatosis e inflamación, descartándose malignidad. Un TAC con contraste realizado en la cabeza y el cuello, permite el diagnostico de torus palatinus central. Abstract: A young female 40 years of age, presented to our Health center complaining of hard nodule in the hard palate for a period of 3 months. She has a sister with a recent Diagnosis of Torus palatinus. With the aim of ruling out a Malignant condition, the patient was referred to Maxillofacial specialist and after assessment a Biopsy of the lesion was taken and described as hyperplasia, papillomatosis and inflammatory cells with abscence of histological malignancy. A CT scan of the head and neck with contrast material was performed shortly after, with the diagnosis of central Torus Palatinus.

Introduction: Breast cancer progression involves physiological mechanisms such as metastasis. Delays in diagnosis and treatment increase the risk of mortality and are associated with barriers to healthcare access. In Chile, breast cancer is highly prevalent, and early diagnosis has improved, although disparities in the disease evolution persist. This study characterized diagnostic and staging tests, waiting times, and sociodemographic profiles to identify delays and inequities in care., Methods: Survey study. Using a non-probabilistic sample, a questionnaire was applied in an encrypted platform with prior informed consent. The instrument collected data on requested tests, associated times, staging, and sociodemographic characteristics. These variables were analyzed using descriptive statistics, tests of association, confidence intervals, and comparison tests using bootstrapping., Results: A sample of 263 persons was obtained. The most requested tests were biopsy (99.62%) and blood tests (80.23%). The median number of tests requested was six (Q1:4, Q3:8), with a mean of 5.87 (standard deviation: 2.24). No significant differences were observed in the percentage of persons from whom the total number of examinations were requested according to the studied variables. The day-hour-result intervals ranged from 1 to 365 days. The median day-hour-result of the biopsy was 15 days (Q1:10, Q3:30). People between 40 and 49 years old, non-residents of the capital city, belonging to income quintile I, with high school education, from the public health system, with late-stage diagnosis had higher median day-hour-result in biopsy. There was no significant difference in the number of requested tests according to staging (I and II, or III and IV)., Conclusions: Biopsy in Chile is the test of choice for diagnostic confirmation in breast cancer. Other tests are requested regardless of the diagnosis stage, contrary to the recommendations of clinical guidelines. Cancer prognosis is crucial, especially in countries with greater inequalities., Competing Interests: This work is licensed under a Creative Commons Attribution 4.0 International License., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Introduction: Glomerulonephritis (GN) is one of the main causes of end-stage renal disease worldwide and therefore a frequent cause of kidney transplantation, with the possibility of recurrence of GN (Recurrent Glomerulonephritis [GNR]) in the transplanted kidney. The purpose of this study was to identify the clinic and pathological characteristics of GNR in a population of transplant patients., Materials and Methods: A descriptive, retrospective study was carried out in 109 patients in whom GNR was documented in the transplanted kidney demonstrated by biopsy during the period between 1998-2021., Results: Of 109 patients, the most frequent GNR was GNIgA, in 38.5% (42), followed by FSGS with 31.2% (34); These same entities were the ones that presented the greatest graft dysfunction, with 50% (21) and 26.2% (11) respectively. The ranges of proteinuria indicated by the biopsy were 31.2% (34) with a range of 500 to 3500mg/24h and 34.9% (38) with proteinuria >3500mg/24h. In relation to the time elapsed between the transplant and the diagnosis of GNR, 33% (36) of the cases were >5 years, followed by 1 to 5 years in 26.6% (29). Recurrence in patients with GNIgA occurred mostly after 5 years post-transplant with 45.2% (19) and for FSGS it was between 1 and 6 months., Conclusion: We found a general frequency of GNR presentation similar to those reported by other centers where biopsies are performed for clinical indication, finding that the GN that recurred most frequently are GNIgA and FSGS., (Copyright © 2024 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: An association between granuloma annulare (GA) and dyslipidaemia has been reported. Adipophilin expression may play a plausible role as a cutaneous biomarker for dyslipidaemia in patients with GA; however, this potential link remains to be explored., Methods: Patients with GA were identified at our hospital between January 1, 1990, and December 31, 2021, with a thorough review of their clinical and histological characteristics. Adipophilin staining was assessed in biopsies of GA lesions., Results: A total of 107 patients with GA were included. The prevalence of dyslipidaemia in patients with positive adipophilin staining was clearly higher than in those with negative labelling (62.3% vs 13.3%). Relative to the dyslipidaemia risk for patients with negative adipophilin expression, the odds for patients with positive adipophilin expression were increased 10-fold (OR: 10.8; p-value<.01). We identified 23 incident cases of dyslipidaemia over a median follow-up period of 91 months among 54 patients with no history of dyslipidaemia. The patients with positive adipophilin expression showed a higher risk of developing dyslipidaemia (HR: 8.9; p-value<.01)., Conclusions: Patients with positive adipophilin staining in their GA biopsies were found to be associated with a higher risk for both baseline and incident dyslipidaemia., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Introduction: Kidney biopsy is one of the essential tests for the characterization of chronic kidney disease (CKD). Objective: To determine the most frequent primary and secondary glomerulonephritis, complications of renal biopsy and the number of patients on hemodialysis when undergoing renal biopsy. Methods: Observational, descriptive, case series, retrospective and cross-sectional study, carried out at the E. Rebagliati Matins-Peru national hospital. The medical records of patients older than 15 years of age who underwent kidney biopsy between 2008-2016 were reviewed. The data were processed in Stata 16.1 Results: Of 2278 medical records, they corresponded to 1234 women and 1044 men. The most frequent primary and secondary glomerulonephritis were focal and segmental glomerulosclerosis (FSGS) 683 (29.98%) and systemic lupus erythematosus (SLE). ) 434 (19.04%) respectively. Of 1644 biopsied patients, 36 (2.19%) and 241 (14.66%) had major and minor complications respectively. Major complications were more frequent when the procedure was performed by radiology with ultrasound guidance compared to that performed by the nephrologist without ultrasound guidance (p = 0.03694). In 1,324 patients, 329 underwent kidney biopsy while on hemodialysis; of them 43 (13.07%) managed to get out of this therapy and 144 (51.99%) had major or minor complications. Conclusions: GEFyS and SLE were the most frequent primary and secondary glomerulonephritis, respectively. In 1644 patients the major and minor complications were 36 (2.19%) and 241 (14.66%) respectively. In 1,324 patients, 329 (24.8%) were biopsied while on hemodialysis and 144 (51.99%) of them had major or minor complications.

Introduction: To reach the diagnosis of giant cell arteritis (GCA), signs, symptoms, laboratory tests, imaging findings, and occasionally anatomopathological results from temporal artery biopsy are evaluated. This study describes the results of an algorithm analysis based on clinical and ultrasound evaluation of patients with suspected GCA, highlighting its diagnostic utility by contrasting its use in different clinical suspicion scenarios., Method: Prospective multicenter study evaluating patients referred with suspected GCA through a preferential circuit (fast track), grouping them according to low or high clinical suspicion of GCA. Each of these scenarios is evaluated by biopsy and ultrasound for all patients, resulting in positive, indeterminate, or negative outcomes, yielding six possible groups. Potential areas of improvement are explored, emphasizing that, following a negative or indeterminate ultrasound, 18-FDG-PET-CT could be recommended. We analyze the results and application of a diagnostic algorithm, confirming its efficiency and applicability based on whether there is high or low clinical suspicion., Results: Sixty-nine patients (41 in the high suspicion group and 28 in the low suspicion group). There were 41 new diagnoses of GCA: 35 in the high suspicion group and 6 in the low suspicion group. Using ultrasound alone, the initial algorithm has an overall diagnostic efficiency of 72.5%, which improves to 80.5% when including 18F-FDG-PET/CT. The negative predictive value of ultrasound in patients with low clinical suspicion is 84.6%, and the positive predictive value of ultrasound in patients with high suspicion is 100%, improving sensitivity from 57.1% to 80.8% with 18F-FDG-PET/CT in this scenario. Temporal artery biopsy was performed on all patients, with no differences in sensitivity or specificity compared to ultrasound. In cases where all three tests - ultrasound, biopsy, and 18F-FDG-PET/CT - are performed, sensitivity increases to 92.3% in patients with high clinical suspicion., Conclusion: In situations of high clinical suspicion, the algorithm provides sufficient information for the diagnosis of GCA if ultrasound is positive. A negative ultrasound is sufficient to rule out the diagnosis in the context of low clinical suspicion. 18-FDG-PET-CT may be useful in patients with high suspicion and negative or indeterminate ultrasound results., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Myocarditis is defined as myocardial inflammation and its etiology is highly diverse, including infectious agents, drugs, and autoimmune diseases. The clinical presentation also varies widely, extending beyond the classic clinical picture of acute chest pain, and includes cases of cardiomyopathy of unknown cause whose etiology may be inflammatory. Because certain patients may benefit from targeted treatments, the search for the etiology should begin when myocarditis is first suspected. There remain several areas of uncertainty in the diagnosis and treatment of this disease. Consequently, this consensus document aims to provide clear recommendations for its diagnosis and treatment. Hence, a diagnostic algorithm is proposed, specifying when non-invasive diagnosis with cardiac MR is appropriate vs a noninvasive approach with endomyocardial biopsy. In addition, more novel aspects are discussed, such as when to suspect an underlying genetic etiology. The recommendations cover the management of myocarditis and inflammatory cardiomyopathy, both for general complications and specific clinical entities., (Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Abstract Objective: to evaluate the complications of percutaneous renal biopsy based on outcomes and clinical indicators of the Nursing Outcomes Classification. Method: a prospective longitudinal study. The sample consisted of 13 patients submitted to percutaneous renal biopsy, with 65 evaluations. The patients were evaluated in five moments in the 24 hours after the procedure, using an instrument developed by the researchers based on five outcomes (Blood coagulation, Circulation status, Blood loss severity, Pain level, Comfort status: Physical) and 11 indicators. The Generalized Estimation Equation Test was used to compare the scores of the indicators. The project was approved by the institutional ethics committee. Results: in the 65 evaluations, a statistically significant difference was identified in the reduction of the scores of the following nursing outcomes: Blood coagulation, “hematuria” indicator; Circulation status, in the “systolic blood pressure and diastolic blood pressure” indicators and Comfort status: physical, in the “physical well-being” indicator. Conclusion: the evaluated patients did not show major complications. The clinical indicators signaled changes in circulation status, with reduced blood pressure, as well as in blood clotting observed by hematuria, but without hemodynamic instability. The comfort status was affected by the rest time after the procedure.

Objective: To better understand drivers of disease progression in non-alcoholic steatohepatitis (NASH), we assessed clinical and sociodemographic markers of fibrosis progression in adults with NASH., Patients and Methods: Physician-reported patient demographics and clinical characteristics were utilised from the real-world Global Assessment of the Impact of NASH (GAIN) study. Factors associated with likelihood of fibrosis progression since NASH diagnosis were identified using a logistic regression model., Results: Overall, 2349 patients in Europe from the GAIN study were included; mean age was 54.6 years and 41% were women. Significant covariates included age, years since diagnosis, employment status, fibrosis stage at diagnosis, type 2 diabetes mellitus, hypertension, liver transplant and liver biopsy at diagnosis. Risk of progression was 1.16 (95% confidence interval 1.12-1.20; p<0.001) times higher for each additional year since NASH diagnosis and 5.43 (2.68-11.37; p<0.001) times higher when physicians proposed a liver transplant at diagnosis. Compared with full-time employed patients, risk of progression was 1.77 (1.19-2.60; p=0.004) times higher for unemployed patients and 3.16 (1.30-7.63; p=0.010) times higher for those unable to work due to NASH., Conclusions: Disease duration, NASH severity and presence of other metabolic comorbidities could help to assess risk of progression in patients with NASH., (Copyright © 2023 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)

Follicular lymphoma is a relatively indolent B-cell lymphoma composed of neoplastic centrocytes and centroblasts. The histologic transformation of follicular lymphoma is a well-described phenomenon with an average risk of 30% at ten years. The occurrence of Hodgkin lymphoma after follicular lymphoma, as well as composite lymphoma, is extremely rare. We report the case of a 79-year-old man with generalized lymphadenopathy who was diagnosed with follicular lymphoma and treated with six cycles of R-CHOP with a complete response. A lymph node biopsy three years later revealed persistent follicular lymphoma, after which the patient received radiotherapy. The patient returned with progressively enlarging axillary lymph nodes five years later. A lymph node biopsy demonstrated a composite lymphoma that was consistent with follicular lymphoma and Hodgkin lymphoma.

Acquired epidermodysplasia verruciformis is a rare condition, secondary to a state of acquired immunosuppression and is characterized by a susceptibility to infection by human papillomavirus of the beta genus, which carries an increased risk of developing non-melanoma skin cancer. We report the case of a 39-year-old woman receiving a kidney transplant, treated with prednisone and tacrolimus, who after starting immunosuppressive therapy developed papules and warty plaques in the inguinal region. A skin biopsy was performed that was consistent with epidermodysplasia verruciformis, so it was decided to adjust immunosuppressive therapy to everolimus, which achieved a reduction in lesions. There are only 13 other cases of acquired epidermodysplasia verruciformis in kidney transplant recipients; to our knowledge this is the first case reported in Chile.

Objective: To compare the performance of the risk calculators of the European Randomized Study for Screening of Prostate Cancer (ERSPC) and the Prostate Biopsy Collaborative Group (PBCG) in predicting the risk of presenting clinically significant prostate cancer., Material and Methods: Retrospectively, patients who underwent prostate biopsy at Sanatorio Allende Cerro, Ciudad de Córdoba, Argentina, were identified from January 2018 to December 2021. The probability of having prostate cancer was calculated with the two calculators separately and then the results were compared to establish which of the two performed better. For this, areas under the curve (AUC) were analyzed., Results: 250 patients were included, 140 (56%) presented prostate cancer, of which 92 (65.71%) had clinically significant prostate cancer (Gleason score ≥7). The patients who presented cancer were older, had a higher prostate-specific antigen (PSA) value, and had a smaller prostate size. The AUC to predict the probability of having clinically significant prostate cancer was 0.79 and 0.73 for PBCG-RC and ERSPC-RC respectively (P=0.0084)., Conclusion: In this cohort of patients, both prostate cancer risk calculators performed well in predicting clinically significant prostate cancer risk, although the PBCG-RC showed better accuracy., (Copyright © 2023 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Fundamento: el estudio histológico del apéndice es la prueba de oro para diagnosticar patologías que simulan apendicitis aguda.Objetivo: caracterizar las patologías asociadas o que simulan apendicitis aguda, en una muestra de pacientes atendidos en el hospital cubano de Catar, desde enero de 2018 hasta diciembre de 2019.Métodos: se realizó un estudio descriptivo, observacional transversal y retrospectivo, en pacientes admitidos en el departamento de emergencia del referido hospital, con diagnóstico de apendicitis aguda, a los que se les realizó tomografía axial computarizada (TAC) de abdomen, apendicetomía y biopsia de apéndice, en el periodo de tiempo declarado en el objetivo.Resultados: en general los pacientes jóvenes fueron los más afectados (grupo de 21-30 años con el 40,54 % y con 31-40 años el 35,13 %), el promedio de edad fue de 32,05 años con una desviación estándar de 9,37. El principal diagnóstico fue la hiperplasia linfoidea, el grupo más numeroso fueron los de nacionalidad catarí, seguidos de los bangladesís. Los hombres resultaron ser los más afectados por enfermedades benignas y las mujeres por tumores malignos. Existió alguna significación estadística entre la variable tomográfica grosor de la pared, sexo del paciente y los hallazgos histológicos.Conclusiones: el diagnóstico de tumores y enfermedades premalignas no resultó ser tan bajo, basado en ello, se sugiere no retrasar ni abolir la evaluación histológica del apéndice.

The majority of infertility or subfertility cases in mares is caused by uterine pathology. This paper presents the state of the art in diagnostic techniques used to investigate uterine health. Clinical evaluation including physical examination transrectal palpation and ultrasonography as well as endometrial cytology, culture and biopsy remain the cornerstone for working up any case of infertility. Endometritis remains the major infertility causing uterine disorder. New therapeutic strategies have been developed in recent years to deal with infections caused by organisms that produce biofilm. Also, increased understanding of the innate uterine defense mechanisms has generated interest in new therapies. Aging affects uterine health in several ways, but most importantly the development of chronic degenerative disease. New therapeutic approaches are being developed in the hope of slowing down or reversing these degenerative changes. Referral to a specialty hospital may be warranted in some cases for advanced reproductive evaluation.

Objective: The objective of the study was to determine if fine-needle aspiration biopsy is a safe method to diagnose breast cancer in women with a palpable breast tumor. Materials and methods: A prospective, analytical and cross-sectional study on cancer prevention conducted in 105 women with a palpable breast tumor who went to the Department of Cancer Prevention and Diagnosis of the Instituto Nacional de Enfermedades Neoplásicas (INEN) from July 1, 2014 to April 30, 2015. The study sample was selected through non-probabilistic sampling, and based on inclusion and exclusion criteria. Results: The average age was significantly higher in the group with a malignant pathological result (51.21 years). It was observed that, as age increases, benign pathologies decrease in frequency in comparison with malignant pathologies that increase in frequency. It was also observed that out of the total of 105 women with a palpable tumor, 35.2% had a malignant pathology and 64.8% had a benign pathology. Sensitivity, specificity, positive predictive value, and negative predictive value were estimated at 94%, 96%, 94% and 96%, respectively. The diagnostic safety of the FNAB was 90.3% Conclusions: Fine-needle aspiration biopsy is a safe diagnostic method for the detection of breast cancer in women with palpable breast tumors.

Objetivo: describir los hallazgos histopatológicos y la progresión a enfermedad renal crónica de los pacientes sometidos a biopsia renal en un hospital de referencia de la ciudad de Medellín entre 2005 y 2014.Metodología: estudio descriptivo retrospectivo. Se revisaron historias clínicas de pacientes menores de 18 años con diagnóstico de proteinuria persistente, a quienes se les realizó biopsia renal durante el período 2005-2014 en el Hospital Pablo Tobón Uribe. Se analizaron variables sociodemográficas, clínicas, histológicas y de laboratorio. Resultados: se incluyeron 71 pacientes. La edad promedio del diagnóstico de proteinuria persistente fue 10.07 años. El 69.1% y 20.6% de los pacientes presentaron hematuria e hipertensión arterial respectivamente. La glomerulonefritis por IgA fue el hallazgo histológico más frecuente (21.13%), seguido de la nefropatía lúpica (18.31%). Del total de pacientes, 69.0% recibieron inhibidores de la enzima convertidora de angiotensina y el 15.9% presentaron deterioro de la función renal al cuarto año de seguimiento. Conclusiones: la prevalencia de glomerulopatías en niños con proteinuria persistente fue alta. Se sugiere la realización de la biopsia renal con el fin de detectar tempranamente glomerulopatías primarias o secundarias asociadas para así instaurar un tratamiento oportuno que controle o retarde el deterioro de la función renal.

Introducción. Las adenopatías son un hallazgo frecuente en pacientes con infección por el virus de la inmunodeficiencia humana (HIV). El diagnóstico diferencial incluye infecciones, neoplasias malignas o cambios reactivos. No existen datos sobre su etiología en Suramérica. Objetivo. Describir la etiología de la histopatología ganglionar en pacientes con HIV del Hospital La María de Medellín. Materiales y métodos. Se evaluaron de manera retrospectiva historias clínicas de pacientes con HIV y linfadenopatías, a quienes se les había hecho biopsia por escisión de ganglio linfático entre junio de 2009 y octubre de 2011. Se registraron los datos de los resultados de las biopsias en cuanto al estado de inmunosupresión, el uso de tratamiento antirretroviral y el diagnóstico final de los pacientes. Resultados. Se evaluaron 120 historias clínicas, con diagnósticos distribuidos así: 58 % de origen infeccioso, 32,5 % con cambios reactivos, 6,6 % de origen neoplásico y 2,5 % normales. El diagnóstico más frecuente fue la tuberculosis (48,3 %). En 14,1 % de los pacientes, la biopsia de ganglio linfático sirvió para detectar otra infección oportunista además de las encontradas en otros órganos. Conclusión. La biopsia de ganglio linfático en pacientes con HIV es una herramienta útil que permite el diagnóstico de enfermedades infecciosas y neoplásicas graves, y que debería hacerse de rutina en todos los pacientes con adenopatías

Nodular melanoma is the rarest form of melanomas. It does not fulfill the ABCD criteria (asymmetrical skin lesion, irregular border, heterogeneous color, and a diameter greater than 6 mm), making it complicated to be diagnosed and frequently causing clinical errors, delays in treatment and a poor prognosis for these patients. This study presents the case of 39-year-old white female patient with a nevoid lesion having a diameter of 1 cm, of copuliform aspect, of the skin color on the anterior side of the left arm and 4 months of progress. Excisional biopsy was performed. The final diagnosis was nodular melanoma. The clinical and morphological features of the case are described as well as the general characteristics that distinguish this condition.

Pulmonary cryptococcosis is a lung infection caused by the Cryptococcus yeast. It is rare in pediatrics, especially in immunocompetent children. The diagnosis of pulmonary cryptococcosis can be challenging due to the low specificity of symptoms, low index of suspicion, and limited diagnostic resources., Objective: To describe a clinical case of pulmonary cryptococcosis in an immunocompetent adolescent, detailing the diagnostic approach., Clinical Case: A 15-year-old patient, previously healthy, from a rural town, who consulted due to cough and a 1-month rib stitch pain, without fever or associated respiratory difficulty, with two images of condensation in the left lung on the chest x-ray. In the Computed Tomography, the images showed a nodular appearance. Due to suspicion of neoplastic pathology, a Positron Emission Tomography was performed, which showed hypermetabolic nodular lesions. The tomographic characteristics could correspond to fungal or granulomatous involvement. Considering the images and epidemiological risk factors such as rural origin and contact with bird droppings, the possibility of a mycosis was considered. A lung needle biopsy was performed under tomographic guidance. Cryptococcus neoformans was identified in the microbiology laboratory culture. The patient received treatment with itraconazole and fluconazole with good clinical and imaging response after 10 months of therapy and follow-up., Conclusion: In immunocompetent patients with a nonspecific clinical presentation, images can guide the diagnosis of pulmonary cryptococcosis, and an etiological search is essential to confirm it. In our case, the CT-guided needle biopsy was of great diagnostic utility.

Introduction: To compare the diagnostic sensitivity of artificial intelligence (AI) assisted videocolposcopy with standard videocolposcopy performed by specialist colposcopists., Methods: A descriptive retrospective cross-sectional study, 782 anonymized medical records from the Computerized System for Screening (SITAM) of women who underwent videocolposcopy with AI and colposcopy with common videocolposcopy performed by specialists, with their corresponding biopsies (gold standard) were analyzed. The relationship between the results of IA videocolposcopy and regular videocolposcopy and the results of biopsies was evaluated. The overall accuracy of each diagnostic procedure was calculated. The sensitivity and concordance of the results of AI videocolposcopy with the gold standard (biopsy) were determined., Results: A total of 395 patient records of patients with IA videocolposcopy and 387 with regular videocolposcopy were analyzed. The accuracy of results was 80% (IC 95%: 75-83%) in IA videocolposcopy and 65% (IC 95%: 60-69%) in regular videocolposcopy (p<0.001). Videocolposcopy results with IA and common colposcopy were significantly correlated with biopsy results, rs=0.75 vs. rs=0.57 respectively (p<0.001). The sensitivity of videocolposcopy with AI was 96% (95% CI: 94-98%), and 93% (95% CI: 89-95%) for regular colposcopy. The overall agreement of colposcopic impressions classified by videocolposcopy with AI and disease was higher than that of colposcopic interpretation by colposcopists (90% vs. 83%, Kappa 0.59 vs. 0.47, p<0.001)., Conclusion: The high diagnostic accuracy of AI videocolposcopy allows obtaining highly sensitive studies that help in the early detection of precursor lesions of cervical neoplasia.

Autoimmune hepatitis (AIH) is a rare, chronic, inflammatory, and necrotic liver disease characterized by the presence of autoantibodies. Its etiology is unknown. It affects 1 in 200 000 people annually in the US and occurs predominantly in women. Its presentation varies from asymptomatic forms to cirrhosis and acute liver failure and its diagnosis is based on the measurement of autoantibodies, such as antinuclear autoantibodies (ANA), anti-smooth muscle antibodies (ASMA) and anti-liver and kidney microsomal antibodies (anti-LKM). 1). 10% of HAIs do not present antibodies, being called seronegative HAI, requiring a liver biopsy for diagnosis. To date the evidence remains limited and different societies have issued suggestions and recommendations. For this reason, we believe it is relevant to carry out a bibliographic review on the subject, capturing in this document the important information for the understanding and management of this pathology.

Cystic structures represent one of the most common findings in dermatopathology. These encompass both cystic tumors and pseudocysts resulting from the accumulation of certain substances, such as mucin. In a two-part series (of which this is the first part), we have reviewed the principal types of cysts and pseudocysts that may be observed in cutaneous biopsies, examining their histopathological features and primary differential diagnoses. This first part encompasses infundibular cysts, eruptive dermoid cysts, pigmented follicular cysts, pilonidal cysts, tricholemmal cysts, milium cysts, hybrid cysts, bronchogenic cysts, as well as steatocystoma, hydrocystoma, and comedones., (Copyright © 2023 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Membranous nephropathy (MN) is the most common cause of primary nephrotic syndrome in adults (20-30%). Light microscopy shows thickening of glomerular basement membrane with appearance of spikes. These histological findings are not evident in early forms, in which case the granular deposition pattern of IgG and/or C3 in the basement membrane by immunofluorescence (IF) constitutes the diagnostic tool that allows to differentiate it from minimal change disease (MCD). Complement system plays a key role in the pathophysiology of MN. C4d is a degradation product and a marker of the complement system activation. C4d labelling by immunohistochemical (HI) technique can help in the differential diagnosis between both glomerulopathies NM and MCD when the material for IF is insufficient and light microscopy is normal. Our objective was to explore the discrimination power of C4d to differentiate between MN and MCD in renal biopsy material., Methods: Paraffin-embedded samples were recovered from renal biopsies with a diagnosis of MN and MCD performed between 1/1/2008 and 4/1/2019. IH staining was performed by immunoperoxidase technique using a rabbit anti-human C4d polyclonal antibody., Results: In all cases with MN (n = 27, 15 males) with a median age of 63 (range: 18-87) years, C4d deposits were detected. In 21 cases with MCD (12 males) with a median age of 51 (range: 18-87) years, the C4d marking was negative in every samples., Conclusion: The results indicate that the marking of the renal biopsy with C4d is a useful tool for the differential diagnosis between NM and MCD.

A collision tumour (CT) is a neoplastic lesion comprised of two or more distinct cell populations that maintain distinct borders. Mostly, these are incidental findings in skin biopsies, whose pathologic mechanism and prevalence remain unknown, with few references among literature. Here, we present a retrospective study of CT, diagnosed by a dermatopathologist in our hospital between 2019-2022. Lesions have been defined individually and organized into three categories: benign-benign (BB), benign-malignant (BM) and malignant-malignant (MM). A total of 108 CT were diagnosed (1,4% of the biopsies from the dermatopathologist during this period), from which BM was the most frequent collision (48,5%). Globally, basal cell carcinoma (BCC) was the main malignant lesion and melanocytic nevus (MN) the main benign lesion. We have used the software Stata 14.2 in order to analyse results, and we have detected a statistically significant difference between age and collision type., (Copyright © 2023 Sociedad Española de Anatomía Patológica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The diagnosis of lung cancer, as well as that of lung nodules, is increasing. Percutaneous biopsy has become a transcendental tool for its diagnosis. Traditionally, computed tomography is used for these procedures because of its ability to clearly demonstrate bone and aerated lung. However, in selected cases it can be performed with ultrasound., Methods: Retrospective study conducted between January 2020 and December 2021, during the SARS-CoV-2 pandemic. All patients had pleural-based lung lesions or pleural lesions, some with a known history of cancer., Results: Thirty-six procedures were performed, in 32 (88.9%) the sample obtained presented diagnostic yield and the most used additional test was Immunohistochemistry in 23 (63.9%). Complications were reported in 5 patients (13.9%): 2 with mild pneumothorax, 2 with hemothorax (1 mild and 1 moderate) and 1 patient reported pain., Conclusion: Ultrasound is a valid method to be used as a guide for biopsies of pleural and peripheral pulmonary lesions. The complications and diagnostic rate has been shown to be in line with the experience of other authors and international guidelines., (Universidad Nacional de Córdoba)

Gastrointestinal tuberculosis is a rare and difficult pathology to diagnose, which is associated with various social and economic factors as well as the state of health of the sufferer. This case report was made about intestinal tuberculosis in the Department of Boyacá, in which the main clinical, paraclinical, the process of diagnosis and management plan in place in the patient are described. Gastrointestinal involvement of tuberculosis has a low incidence, being the sixth place of commitment. Signs and symptoms manifested by the patient are not specific and often the health staff suspect and first focuses on other diseases that are more prevalent. From this medical case, the various diagnostic suspicions that were raised in the course of the disease are emphasized in order achieve a diagnosis of the intestina

Eccrine spiradenoma is a rare benign tumor originating in the eccrine sweat glands. Pain is an important symptom, which is present in most patients and helps to guide clinical suspicion. Early diagnosis is paramount, due to its potential malignant transformation, especially in cases of multiple or symptomatic lesions. This study presents the case of a 70-year-old man with a single, rounded and soft nodular lesion on his right forearm, without changes in surface color, no adhesion to deep planes, painful on pressure and friction, of one-year progress. Clinically it was interpreted as a lipoma. Surgical treatment was ordered to perform exeresis of the lesion and anatomopathologic study. The preoperative laboratory tests were within normal limits. The definitive histological diagnosis was solitary eccrine spiradenoma. The patient presented a satisfactory progress, and presently is asymptomatic and under medical follow-up.

Background: Primary eosinophilic gastrointestinal diseases (EGID) are chronic inflammatory disorders of the gastrointestinal tract with unknown etiology. Features, utility, and evolution are still unknown in screening for EGID in adult patients with eosinophilic esophagitis (EoE)., Objectives: To evaluate the prevalence, characteristics, comorbidities, and evolution of EGID in adults diagnosed with EoE and investigate differences between both groups., Methods: Prospective unicenter observational and analytical study. Gastric and duodenal biopsies were obtained during upper baseline endoscopy in all consecutive EoE adult patients evaluated. A colonoscopy with colon biopsies was performed upon persistent diarrhea and normal duodenal biopsies., Results: 212 EoE patients were included. Nine patients (4.3%) also showed significant eosinophilic infiltration in at least one organ within the digestive tract. The most common site affected was the small bowel (78%). Gastrointestinal symptoms (43% vs. 100%, p<0.002) and, more specifically, either abdominal pain or diarrhea (17% vs. 78%, p<0.001), some food sensitizations, and digestive comorbidities (p<0.05) were significantly more common in patients with EGID. Gastrointestinal symptoms were present in 94/212 (44%) patients, of whom 9 (10%) had EGID. Considering only abdominal pain or diarrhea, 20% suffered from it., Conclusions: EGID rarely coexist with EoE, even when gastrointestinal symptoms are present. These findings advise against routine gastric, duodenal, or colon biopsies in adult EoE patients with gastrointestinal symptoms. Most of the characteristics of EoE do not change due to having EGID except gastrointestinal symptoms, digestive comorbidities, and sensitizations to some foods. The evolution was generally favorable despite intermittent adherence to treatment, especially maintenance., (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)

The spontaneous disappearance of a segment of bone in a short period without the existence of a tumoral disease that justifies it is an exceptional event. We report the case of an older adult in whom the upper epiphysis of the right humerus and part of the acromion disappeared in a period of 3 weeks in the absence of a malignant tumor. Bone biopsy revealed osteoclasts, lymphatic vessels, and blood vessels. This disorder was first reported in 1838 and in 1955 it was established as a specific disease by Gorham and Stout. Since then, it has been named in their honor.

Patients with immunodeficiency, whether congenital or acquired, have a significantly higher incidence of malignancies, especially mature lymphoid neoplasms and lymphoproliferative disorders. We present the case of a 50-year-old patient with a history of dermatomyositis and antisynthetase syndrome on immunosuppressive therapy, who consulted due to increased volume of the lacrimal gland in the upper left eyelid, associated with weight loss and night sweats. He was admitted for an elective biopsy. The day after the postoperative period, she evolved with an acute abdomen. Computed axial tomography revealed multiple hypodense lesions in the liver, spleen, kidneys, and adrenal glands associated with a perforated tumor in the transverse colon and free fluid in the peritoneal cavity. In this scenario, an infectious, neoplastic, or rheumatological etiology was considered a differential diagnosis, especially in the context of our patient. Finally, the biopsies evidenced extensive necrosis with angiocentric and angiodestructive lymphoid infiltration associated with positive EBV. After extensively reviewing the symptoms, histology, and new classifications of mature B-lymphoid neoplasms, the diagnosis of polymorphic B-lymphoproliferative disorder, lymphomatoid granulomatosis-type was made, an uncommon entity rarely associated with iatrogenic immunosuppression.

Background and Objectives: There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma., Material and Methods: We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm)., Results: We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists' attitudes., Conclusions: Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases., (Copyright © 2023 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Giant Juvenile Xanthogranuloma (GJXG) corresponds to an infrequent variant of Juvenile Xantho- granuloma (JXG) and is characterized by a lesion larger than 2 cm in diameter. It usually presents as a plaque but infrequently, presents as an ulcerated nodule., Objective: To report two cases of atypical presentation of GJXG, highlighting the importance of considering them in the differential diagnosis of large, ulcerated tumors in infants., Clinical Cases: Case 1: A 4-month-old healthy male infant presented with a rapid and progressive growing left inguinal nodule, present since 2 months of age. At physical examination he presented with a 2.6 cm indurated erythematous nodule with central ulceration. Histological study of an incisional biopsy was compatible with JXG. Ophthalmologic involvement was ruled out. Because of functional impairment and parents worry complete surgical removal was performed. The patient had favorable evolution without local recurrence at 4 years of follow-up. Case 2: A 6-month-old healthy male infant presented with a 2.4 cm scapular crusted nodule of rapid and progressive growth, present since birth. Histological study of an incisional biopsy confirmed JXG. Ophthalmologic involvement was ruled out. After 18 months of periodic clinical follow-up, there was a progressive reduction in size of the lesion., Conclusions: The cases presented highlight the importance of considering JXG in the differential diagnosis of large, ulcerated tumors in infants. When encountered to atypical JXG presentations, histologic studies help to confirm the diagnosis. Given the favorable prognosis of this diagnosis, periodic clinical follow-up is advised; in exceptional cases, surgical or ablative treatments may be considered.

Background: Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR., Material and Methods: We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies., Results: After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated., Conclusions: Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions., (Copyright © 2023. Publicado por Elsevier España, S.L.U.)

Background: Renal biopsy has become one of the pillars of nephrology practice, being a very important tool in the diagnostic approach of any nephrology center, since it contributes to the identification and adequate management of glomerular diseases, which represent the third cause of chronic kidney disease in the world. In Mexico there are few reports on the epidemiology of glomerular diseases; therefore, it is important to carry out this type of study., Objective: To identify which are the main glomerulopathies reported in our center, Determine the most prevalent glomerular syndrome according to the reported glomerulopathy, and identify the main complications after percutaneous renal biopsy., Material and Methods: A retrolective cross-sectional study which included patients who underwent percutaneous biopsy of the native kidney from August 2020 to August 2022; we obtained information from the service's database., Results: 89 biopsy reports were analyzed, out of which 66.29% corresponded to the female gender and 32.70% to the male gender. The average age was 37.6 ± 12.86 years. The most frequent primary glomerulopathy was focal segmental glomerulosclerosis (FSG) in 22.5%, followed by membranous nephropathy in 7.9%. The most frequent secondary glomerulopathy was lupus nephropathy in 42.7%. Nephrotic syndrome occurred in 43.85% of cases. 89% of the patients did not present post-biopsy complications., Conclusions: FSG is the most common primary glomerulopathy. Nephrotic syndrome was the main indication for renal biopsy. The vast majority of patients did not present complications, so we can consider it to be a safe and above all useful procedure for the diagnosis of glomerular diseases., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background and Objective: Surgical excision is the treatment of choice for basal cell carcinoma (BCC). Complete excision with clear margins is important for reducing the risk of recurrence. The aims of this study were to describe the characteristics of BCCs in our health care area, calculate the percentage of positive margins after surgical excision, and determine the risk factors for incomplete excision., Material and Methods: Retrospective observational study of BCCs that were surgically removed at Hospital Universitario Nuestra Señora de Candelaria, in Santa Cruz de Tenerife, Spain, between January 1, 2014 and December 31, 2014. Information was collected on demographic, clinical, and histologic variables, surgical approach, margin status, and the department responsible., Results: In total, 966 BCCs were diagnosed in 776 patients. Nine percent of tumors with complete data were biopsied, 89% were surgically excised, and 2% were removed by shave excision. The median age of patients with excised tumors was 71 years and 52% were men. BCCs were most often located on the face (59.1%). Surgical margins were analyzed in 506 cases, 17% of which had positive margins. Incomplete excision was significantly more common in tumors located on the face (22% vs. 10% for other locations) and in high-risk subtypes according to the World Health Organization classification (25% vs. 15% for low-risk subtypes)., Conclusions: The characteristics of BCCs in our health care area are similar to those described elsewhere. Facial location and histologic subtype are risk factors for incomplete excision. Careful surgical planning is therefore important in the initial management of BCCs with these characteristics., (Copyright © 2023 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Ovarian tumor diseases in girls are infrequent. Endodermal sinus tumor is a tumor derived from primitive multipotential cells or germ cells, which differentiate into structures of the yolk sac. The tumor is very aggressive and rare. This study presents the case of a 15-year-old female patient with a chief complaint of increase of the lower abdomen and moderate abdominal pain in the epigastrium. She was thin, pale and had a palpable abdominal mass in the lower hemiabdomen from the hypogastrium up to 3 cm above the navel. On palpation the mass was not painful, and it was firm and smooth with irregular border and unmovable. Investigations were ordered, including imaging tests. Surgical intervention was decided to perform excision of the tumor and anatomopathologic studies. A diagnosis of endodermal sinus tumor or yolk sac tumor of the right ovary was made. This study is presented to the medical community as the first case with a diagnosis of this condition in the province.

A branchial cyst is a congenital lesion that is caused by a defect in the obliteration of the branchial arches whose epithelial component could be the origin of a squamous cell carcinoma. It is located in the lateral region of the neck. It is considered a rare condition. This study presents the case of a 52-year-old patient with a volume increase in the left lateral part of the neck (level II), with a rounded shape. It was mobile, painless and with a hard elastic consistency, although on palpation it was renitent and had an approximate diameter of 4 cm. Exeresis of the tumor was performed. The anatomopathologic and immunohistological study showed a keratinizing squamous cell carcinoma of cystic morphology and cervical location that corresponded to a primary carcinoma originated in a branchial cyst. Nowadays the patient is asymptomatic, under strict follow-up and with oncospecific treatment.