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Hibernoma is a rare benign tumor that becomes from the vestiges of fetal brown adipose tissue. It can be located on different regions of the body, being tight the most frequent. Retroperitoneal region is approximately of 9.4%. The first person to describe this histological type was Merkel. To the present, there are only described 25 cases on this location. It has a slowly growth, so it is normally asymptomatic, and it usually presents doing compression of different structures. To diagnose the MRI is the best prove, although biopsy will provide definite diagnosis describing four possible variants. Immunochemistry of MDM2, CDK4 and p16 genes is really important to do the differential diagnosis with well-differentiated liposarcoma (WDLS). Only one extensive review of hibernoma with 170 cases on different regions is published. But there is no review on literature specifically of retroperitoneal region, so this is the purpose of the current study. Following we present three more cases of retroperitoneal hibernoma that we have treat on our Mesenchymal Tumours Unit and a revision of the previously published.

Resumen Introduccion La principal causa de hiperparatiroidismo primario en nuestro medio es el adenoma paratiroideo unico. La paratiroidectomia se considera el unico tratamiento potencialmente curativo y requiere de estudios de imagen de localizacion preoperatorios para un abordaje quirurgico dirigido. En pacientes con negatividad en pruebas convencionales, la PET-TC colina ha demostrado tasas de sensibilidad superiores respecto al gold-standard. Metodos Se diseno un estudio de cohortes prospectivo que incluyo a 34 pacientes con diagnostico de hiperparatiroidismo primario entre 2017 y 2019, candidatos a cirugia con pruebas de imagen con gammagrafia y SPECT-TC MIBI negativas. A todos se les realizo una PET-TC con 18F-fluorocolina. Los resultados se compararon con un grupo control de 30 pacientes con pruebas convencionales positivas intervenidos en el mismo periodo. Resultados La PET-TC colina detecto tejido paratiroideo hiperfuncionante en el 85% de los pacientes con gammagrafia previa negativa. Se realizo reseccion selectiva del adenoma identificado en estos pacientes, con criterio de curacion en el 87% de los casos, sin precisar de exploracion cervical bilateral. Los niveles de PTH, calcemia y el peso glandular fueron significativamente menores en este grupo con respecto al control. No se identificaron diferencias respecto al criterio de curacion ni a la via de abordaje en ambos grupos. Conclusion En nuestro estudio, la PET-TC colina demostro tasas superiores de deteccion que permitieron aumentar el numero de pacientes candidatos a cirugia dirigida con disminucion de la morbilidad quirurgica, especialmente en grupos con adenomas de menor tamano asociados a niveles mas bajos de calcemia y PTH preoperatorias y en pacientes con cirugias cervicales previas.

Leukemia cutis refers to the infiltration of the skin with leukemia cells. It is a rare extramedullary manifestation of leukemia, but it is a specific sign of disease progression and bad prognosis. Cases of leukemia cutis in sites of skin trauma or surgical scars have been described, but there are very few cases reported in literature. We report a case of a 65-year-old male previously diagnosed with chronic myelomonocytic leukemia that was showing clinical signs of progression to acute myeloid leukemia. He underwent right inguinal herniorrhaphy three months before and was showing poor wound healing. Surgical site infection was suspected, since blood tests showed prolonged neutropenia, so surgical wound debridement was performed. Pathological findings of removed tissue indicated infiltration by leukemic cells, which led to the diagnosis of leukemia cutis, not suspected until that moment. Therefore, we conclude that an exhaustive skin examination (especially in the presence of skin trauma or surgical scars), should be performed in patients with confirmed or suspected diagnosis of leukemia. Moreover, the possible diagnosis of leukemia cutis should be considered in leukemia patients who present cutaneous infectious complications or suboptimal healing following accidental skin trauma or surgery. In these cases, complementary anatomopathological studies should be performed.

Surgical units attending sarcomas in Spain are poor studied. The aim is to know the management of this pathology to identify areas of improvement through multicenter study based on a voluntary survey. The survey was completed by 74 surgeons of different hospitals, which 32,4% is exclusively dedicated to sarcomas. Only 24.3% declared to receive specific training in sarcomas. The most frequent type of hospital was the third level (56.8%), where 38,1% of the surgeons belong to societies or working-groups in sarcoma fields vs. 9,4% in first-second levels. The number of surgeons with specific theoretical training and papers published in this field are higher in third level hospitals. 55,4% belonged to a multidisciplinary unit. A multidisciplinary team was available in 57% of third level hospital vs 28% in others. Most services in charge of this patients are characterized by deficient specialization, low workload and the absence of a multidisciplinary team.

Chronic expansive retroperitoneal hematoma is a hematoma that grows progressively sometime after the original trauma. It can appear in different locations. The mechanism of onset is unclear, but experimental evidence favours an inflammatory cause. For diagnostic imaging, magnetic resonance imaging is more useful than computed tomography (CT). However, it is difficult to differentiate it from other soft tissue tumors, sarcomas, actinomycosis or inflammatory pseudotumors, due to the uneven central uptake. Histopathological analysis of the lesion usually shows a dense fibrous tissue capsule containing numerous old clots without finding clear atypia or signs suggestive of malignancy. The treatment of choice is complete resection of the lesion (including the capsule), as incomplete treatments (such as drainage or curettage of the hematoma contents) may cause recurrence.

Introduction Single parathyroid adenomas are the most common cause of primary hyperparathyroidism (PHP) in our population. Parathyroidectomy is still the only potentially curative treatment and requires preoperative localization imaging studies to perform selective surgery. In patients with negative results on conventional tests, PET/CT has demonstrated higher sensitivity rates. Methods A prospective cohort study was designed, including 34 patients diagnosed with PHP between 2017 and 2019, candidates for surgery with negative preoperative localization tests with scintigraphy and MIBI SPECT/CT. All patients underwent PET/CT with 18F-Fluorocholine. The clinical, biochemical, and postoperative outcome results were compared with a control group of 30 patients with positive standard tests. Results Hyperfunctional parathyroid tissue was detected in 85% of the patients that had undergone choline PET/CT. The selective resection of the adenoma identified in these patients achieved curative criteria in 87% of the cases without undergoing bilateral cervical surgical exploration. The preoperative levels of PTH, calcemia, and gland weight were significantly lower in this group compared to the control group. No differences were identified in cure criteria or approach between the 2 groups. Conclusion In our study, choline PET/CT showed higher detection rates compared to the gold standard. The increase provides the opportunity to perform unilateral selected adenoma resection, especially in patients with smaller adenomas associated with lower calcemia and PTH levels and patients with previous cervical surgery.

Resumen: La regulación de la vida y muerte de las sociedades es una cuestión que corresponde a cada uno de los Estados miembros de la UE. Ante un quizás interesado desinterés armonizador, ha sido el TJUE el encargado de solventar en la medida de lo posible los problemas que, a la luz de la libertad de establecimiento, ha suscitado la mencionada falta de interés. En este trabajo se comenta de manera crítica la jurisprudencia del mencionado Tribunal y los problemas que evidencia. Tales problemas son, en esencia, las contradicciones entre las regulaciones societarias laxas y estrictas de los diferentes Estados miembros y la gran contradicción: las dos teorías contrapuestas para la determinación de la lex societatis que conviven en territorio europeo.Palabras clave: domicilio social, traslado, sede real, incorporación, empresa, compañía.Abstract: The regulation of life and death of companies is a competence of each EU member states. Due to a lack of interest in harmonizing, the CJEU has been in charge of solving the conflict between the freedom of establishment and the mentioned lack of interest. This paper contains a critical commentary of the case law of the CJEU and the problems that it shows. Such problems are basically the contradictions between the lax and strict corporate regulations of the different Member States and, also, the great contradiction: the two opposed theories for the regulation of the lex societatis that coexist in European territory.Keywords: registered office, transfer, real seat, incorporation, enterprise, company.

Rsumen Objetivo La cirugia R0 con margenes libres es el «gold-standard» en el tratamiento de los sarcomas de partes blandas, asi como el mejor predictor de su recurrencia y de la supervivencia de estos pacientes. El objetivo del presente trabajo fue evaluar la evolucion de los pacientes afectos de un SRP tratados mediante cirugia de reseccion «en bloque» frente a los tratados con enucleacion en la primera cirugia. Metodos Una serie de 56 pacientes adultos fueron divididos en 2 grupos segun la reseccion quirurgica. El grupo A mediante una cirugia de enucleacion y el grupo B mediante una cirugia «en bloque». Se valoran la supervivencia global (SG) y el tiempo a la recurrencia (SLE), de acuerdo al tipo histologico y a la estrategia quirurgica inicial. Resultados El tiempo libre de enfermedad fue mas prolongado tras una cirugia en bloque (p Conclusion El tratamiento de los pacientes con un sarcoma retroperitoneal debe ser claramente agresivo, requiriendo exeresis multiviscerales. A partir de los resultados de SG y SLE, es importante que el tratamiento de estos pacientes se base en una primera cirugia lo mas radical posible.

Today, free margin surgery is the gold-standard management for soft-tissue sarcoma patients and one of the most important predictors of recurrence and survival. To obtain optimal results, a multidisciplinary approach is necessary. The aim of this study was to evaluate the evolution of patients with RPS treated by «en bloc«surgical resection versus those treated with enucleation in the first surgery.Fifty-six adult patients were divided into 2 groups. Patients in Group A underwent enucleation surgery, and patients in Group B underwent en bloc surgery. The endpoints of the study were survival time and time to recurrence, according to histological type and first surgical strategy.Disease-free survival was longer for en bloc surgery (P0,05), but there was no difference in overall survival. When comparing the histology of patients who underwent enucleation surgery and en bloc resection surgery, the disease-free survival and overall survival rates were longer for liposarcoma. In the multivariate analysis, only free margins and histology of liposarcoma were significantly associated with a better survival.The surgical management of patients with retroperitoneal sarcoma must be very aggressive, often requiring multivisceral resection. Considering the disease-free survival and overall survival rates obtained, it is clear that it is critical to manage patients as early as possible by a radical en bloc surgery.

The main functionalities conferred by nanomaterials included in coatings and inks used in food packaging have been reviewed with focus on developments in mechanical, barrier, electrical/electronic, optical, and antimicrobial properties. The most important coating and printing technologies employed in the food packaging industry such as flexography, rotogravure, off-set and ink-jet, among others, have been discussed with special emphasis on their use with coatings and inks containing nanomaterials. Nanosafety and regulatory aspects regarding nanomaterials in food contact materials have been addressed. The chapter finalizes by outlining the future trends and challenges in coating and printing technologies in the food packaging industry.