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El cáncer de mama en coraza constituye una de las formas clínicas de presentación de las metástasis cutáneas del cáncer mamario. Es de aparición poco frecuente, sobre todo, en el sexo masculino. Se presenta el caso de un paciente de sexo masculino, de 74 años de edad, de color de piel negra, con antecedente de diabetes e hipertensión arterial que acudió a consulta de mastología provincial por presentar desde hacía algunos meses dolor discreto y unas lesiones pruriginosas en la mama derecha. Además de otros exámenes se le realizó biopsia escisional de pequeño fragmento de la lesión con estudio por parafina que informó metástasis cutánea de un carcinoma mamario en coraza según su forma de presentación clínica. Se muestra el caso porque no se localizó ninguna publicación en la provincia Cienfuegos ni en el país de un caso en el sexo masculino, por lo cual se considera de interés para el personal médico la publicación de este reporte.

Volvulus is the abnormal torsion or rotation of a portion of the intestine on its mesentery, which causes occlusion of the lumen, obstruction, and vascular compromise. Cecum volvulus is a rare clinical condition and represents only between 2 and 3 % of cases of intestinal occlusion in adults. We present the case of a 56-year-old female patient with a history of high blood pressure, diabetes mellitus and chronic constipation, who attended the surgery ward at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos because several days ago she had had intermittent abdominal pain, a feeling of fullness when eating and without expulsion of feces, on occasions she had had nausea and scarce vomiting with other food. The physical examination revealed abdominal asymmetry at the expense of the right hemiabdomen, which was painful, distended, and tympanic. The simple abdominal X-ray reported an image reminiscent of cecum volvulus. A right hemicolectomy was performed with an end-to-end ileotransversostomy in two suture planes. At present, the patient has been operated for 6 months with a favorable evolution. The diagnosis of this entity is made during laparotomy in a large number of cases, as a result of its multiple forms of presentation, which can range from acute abdominal pain to septic shock. The case is presented due to the infrequent nature of this entity.

Background: benign nodular disease of the thyroid is a frequent reason for medical consultation, its knowledge is of vital importance for the surgeon.Objective: to characterize patients operated on for benign thyroid nodules.Methods: a retrospective case series study was carried out on patients operated on for benign thyroid nodules at the Dr. Gustavo Aldereguia Lima Hospital, over a period of five years. Medical records and biopsy protocols were reviewed; whose data were emptied into a collector model. The variables sex, age, skin color, location of the tumor, as well as its physical and imaging characteristics, were analyzed. In addition, biopsy modalities used, as well as the histological variety, the surgical technique used and the complications.Results: women older than 50 years of age and white skin predominated. The predominant clinical manifestation was the increase in volume in the neck, as well as the presence of single and solid nodules. Likewise, the association of fine-needle aspiration biopsy and paraffin were the most used modalities. Multinodular goiter was the most frequently diagnosed entity.Conclusions: Although benign nodular thyroid disease is not a serious health problem, it is very frequently diagnosed in our environment and surgical treatment is performed, mainly in women over 50 years of age.

The case report of a 48 years patient is presented. He went to the Thyroid Pathology Service of Dr. Gustavo Aldereguía Lima Provincial Hospital from Cienfuegos, due to an increase of volume in the anterior region of the neck, weakness, occasionally deglutition disorders and light dyspnea. A tumor was verified in the anteroinferior and lateral right region of the neck, movable, that was prolonged downward to the superior part of the thorax when the physical exam was carried out. A right hemithyroidectomy was carried out with exeresis of the endothoracic extension. The patient had a favorable clinical course.

El íleo biliar es una causa poco frecuente de obstrucción intestinal mecánica. Generalmente se ve en pacientes adultos mayores del sexo femenino con antecedentes de ser portadores de litiasis vesicular, representando solamente del 1 al 6% de las obstrucciones intestinales diagnosticadas. Se presenta el caso de una paciente femenina de 66 años de edad con antecedentes de presentar cólicos a repetición por litiasis vesicular, la cual acude al cuerpo de guardia de nuestro centro por dolor abdominal vómitos y distención abdominal. Se comprobó en el acto quirúrgico la presencia de un íleo biliar. Se concluye que entre las causas infrecuentes de oclusión intestinal mecánica podemos citar el íleo biliar, lo cual lo corrobora el hecho de que en el servicio de cirugía de nuestro centro solo tenemos dos casos anteriores reportados.

La enfermedad de Paget de la mama se encuentra entre las llamadas formas especiales del cáncer de mama. Su incidencia es de solo el 1 al 1,5 % del total de los cánceres mamarios que se diagnostican. Fundamentalmente aparece en mujeres en la quinta o sexta décadas de la vida. Se considera extremadamente rara en su forma bilateral. Se presenta el caso de una paciente de 32 años de edad que acudió a consulta provincial de mastología por presentar lesiones escamosas en el complejo areola pezón de ambas mamas, más acentuadas en la derecha. Se le realizó biopsia con aspiración con aguja fina y se diagnostica enfermedad mamaria de Paget bilateral. La enfermedad de Paget de la mama es una enfermedad de rara aparición y en el caso que se presenta aparecen dos características pocos comunes, el tratarse de una paciente joven y la localización bilateral de la enfermedad, lo cual hace de más valor su publicación para conocimiento del personal médico dedicado a la atención de estas afecciones.

Paget's disease of the breast is among the so-called special forms of breast cancer. Its incidence is only 1 to 1.5 % of all breast cancers that are diagnosed. It mainly appears in women in the fifth or sixth decade of life. It is considered extremely rare in its bilateral form. The case of a 32-years-old female patient of urban origin who attended the provincial mastology clinic for presenting scaly lesions in the nipple areola complex of both breasts, more accentuated on the right side. She underwent a fine needle aspiration biopsy and was diagnosed with bilateral Paget's disease of the breast. Paget's disease of the breast is a disease of rare appearance throughout the world and in the case that it occurs, two uncommon characteristics appear, the fact that it is a young patient and the bilateral location of the disease, which makes it more valuable its publication for the knowledge of medical personnel dedicated to the care of these conditions.

Pancreatic pseudocyst is a local complication due to rupture of the pancreatic duct in acute or chronic pancreatitis, trauma or obstruction of the pancreatic duct. Its incidence is 1: 00,000 year and the prevalence is 6.0 % to 18.5 %. Acute forms usually resolve spontaneously in more than 40 % of cases and chronic forms usually do not disappear spontaneously and are at higher risk of complications. They can be drained by surgical, laparoscopic, percutaneous, and endoscopic methods. A case of a male patient who attended the surgery guard office due to abdominal pain in the epigastrium accompanied by abundant vomiting and a slight icteric tinge, it is presented. The case was studied and elective surgery was scheduled, opening of the anterior and posterior face of the stomach was performed. The Juracz surgical technique, a cystogastrostomy, was performed. The patient has been operated on for 1 year with a favorable evolution. Due to the rare nature of the case, its publication is decided.

Primitive epidermoid carcinoma is considered the rarest breast tumor, with an incidence that represents only 0.04 to 0.075 % of all malignant tumors of this location. It is a variety of metaplastic carcinoma made up of keratinizing pavement cells. The case presented is a 65-year-old white male patient, resident in the Abreus municipality, Cienfuegos province who attended the province's mastology clinic for presenting a 5 cm tumor in the upper external quadrant of the right breast, two months in evolution. Exeresis of the tumor was performed and a report of the biopsy was received with the result of poorly differentiated squamous cell carcinoma. Currently the patient is followed in consultation and is free of metastases. Due to the unusual nature of the case, its publication is decided. This report is presented as the first male patient to undergo surgery for squamous cell carcinoma of the breast in the Cienfuegos province.

El carcinoma epidermoide primitivo está considerado el tumor más raro de la mama, con una incidencia que representa solo del 0,04 al 0,075 % de todos los tumores malignos de esta localización. Es una variedad de carcinoma metaplásico constituido por células pavimentosas queratinizantes. Se presenta el caso de un paciente de sexo masculino, de 65 años, de color de piel blanca, residente en el municipio Abreus, provincia Cienfuegos, que acudió a la consulta de mastología de la provincia por presentar una tumoración de 5 cms. en el cuadrante superior externo de la mama derecha, de dos meses de evolución. Se realizó exéresis de la tumoración y se recibió informe de la biopsia con el resultado de carcinoma epidermoide poco diferenciado. Actualmente el paciente se sigue en consulta y está libre de metástasis. Por lo inusual del caso se decide su publicación. Se presenta este reporte por ser el primer paciente de sexo masculino, operado de carcinoma epidermoide de mama en la provincia Cienfuegos.

Mucinous thyroid carcinomas are very rare and in some cases may appear in association with other tumors, but it does not represent a true primary thyroid carcinoma. A case of a 66-year-old white-skinned patient of rural origin is presented with a history of suffering from ischemic heart disease and arterial hypertension, for which she was undergoing medical treatment. He went to the office with an increase neck volume in the anterior region for several months, accompanied by malaise, gallop rhythm and sometimes dysphagia to solid foods. On the physical examination a tumor was found which occupied almost the entire right lobe, corresponding to a nodule of approximately 4 cm. in diameter, mobile with swallowing. The objective of this work is to present the surgical treatment performed to a patient affected by a thyroid gland mucinous carcinoma. Due to the low frequency of this entity, its publication is considered of interest to scientific staff.

Cystic thyroid nodules in the vast majority of cases are benign, especially if they are pure cysts. Children do not need suppressive treatment with levothyroxine. Puncture may be performed to large cysts to extract its contents. Their reproduction is very frequent, which may involve repeated punctures and the danger of infection. Large cysts reproduce easily, and surgery is necessary, since they rarely respond to medical treatment. We present the case of a 78 year-old male patient, with a history of being an inveterate smoker and hypertensive with treatment, who reported having presented a few months increase in neck volume accompanied by dysphonia and dysphagia to solid foods. Physical examination showed a 5 to 6 cm in diameter tumor in the right antero-lateral region of the neck and part of the left region. It was movable with swallowing and of soft in consistency, without palpable adenopathies. A fine needle aspiration biopsy was performed 3 times, with recurrence and a right lobectomy was performed. The anatomic-pathological study reported nodular goiter with cystic degeneration. In spite of its frequency, communication with teaching purposes is considered important.

Foundation: thyroid cancer represents 1 % of the total of all types of cancer. Its incidence seems to increase 4 % each year and it is currently the eighth most frequent cancers in women. Objective: to determine the behavior of thyroid cancer in the Cienfuegos Province for a 5 year period from January 1st 2011 to December 31st 2015. Method: a descriptive study was carried out in 94 patients operated on thyroid cancer in the Surgery Service of the Gustavo Aldereguía Lima Provincial Hospital Cienfuegos during a five year period. The variables analyzed were: age group, municipality of origin, initial symptom of the disease, tumor location, histological variety, clinical stage of the disease and post-surgical complications. A model of data collection was used with the variables of interest for the study and data were represented in tables of frequency, numbers and percentages. Results: thyroid cancer is more frequent in the age group of 41 to 50 years old, papillary histological variety predominated; the right lobule was the most affected. The disease was diagnosed in early stages, the neck volume increase was the most frequently referred symptom by the patients. Transitory recurrent paralysis was the most frequent complication and Aguada de Pasajeros the most affected municipality. Conclusion: thyroid cancer is more frequent in relatively young patients and it is diagnosed at early stages of the disease.

Several disorders in the structure and morphology of the mammary gland have been described as a result of variations of its development regulating mechanism. It may be found anomalies in number, size, form and location. Among the most frequent congenital anomalies, regarding number, supernumerary breast and regarding location abnormal breast tissue. Both may be the basis for malignant tumors and in a higher frequency the abnormal breast tissue. The abnormal or ectopic breast tissue may present with different forms. It is presented a case of a 48 year old woman from health area 4 at the Cienfuegos municipality who had an abnormal breast tissue on the left axillary, with a secretory orifice from which milk is secreted during pregnancy. Due to the low frequency occurrence of this disease, the publication of this case is considered of scientific interest.

Phyllodes tumor is an uncommon fibroepithelial neoplasia, with an epithelial benign component and mesenchymal component that can be malignant or benign and represents only 0.3 to 0.4 % of all breast tumours. It appears mainly in the female sex; a few male cases have been reported worldwide and they are unusual in girls and adolescents. It appears during the fourth or fifth decade of life. A case of a 49 year old patient is presented who came to the mastology consultation complaining of a protuberance which occupied the two left breast external quadrants. It was diagnosed by paraffin-embedded biopsy as benign phyllodes tumor of the breast. Due to the infrequent presentation of this entity, the publication of this case is considered of scientific value.

Primary neuroendocrine carcinomas of the breast are rare neoplasms, accounting for 2 to 5 % of breast tumors. For their diagnosis it is required that more than 50 % of the tumor present neuroendocrine features. These tumors which are observed mainly in elderly women, present as a well-defined mass, usually unaccompanied by axillary lymphadenopathy. The prognosis for this type of cancer is not enough clear yet, although recent studies show that it is similar to that of conventional infiltrating ductal carcinomas. We present the case of a 76-year-old patient who came to the clinic for having a large tumor that occupied almost all of the right breast without axillary lymphadenopathy and which was informed by paraffin biopsy as a neuroendocrine carcinoma. This is the first tumor of this histological characteristic diagnosed in Cienfuegos, reason why its publication is considered of scientific interest.

Fundamento: el cáncer de mama masculino está considerado como una rareza médica, ya que al contrario del femenino que es un problema de salud a nivel mundial, este solo representa del 0,5 al 1 % del total de cánceres de mama diagnosticados. Objetivo: caracterizar el comportamiento del cáncer de mama masculino en la provincia de Cienfuegos. Método: estudio descriptivo de corte longitudinal de 36 años comprendidos desde el 1 de enero de 1980 hasta el 31 de diciembre del año 2015. El total de pacientes operados en ese periodo fueron 19, representativos del 100 %. Estos pacientes fueron intervenidos en el Servicio de Cirugía General del Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos. Las variables estudiadas fueron: edad, mama afectada, localización anatómica, tipo histológico, modalidad de biopsia empleada, etapa clínica del tumor en el caso de los carcinomas, técnica quirúrgica aplicada y evolución de los pacientes. Se confeccionó un modelo recolector de datos, y se revisaron las historias clínicas y los protocolos biópsicos del departamento de anatomía patológica del centro. La información se muestra en tablas de números y porcientos. Resultados: el cáncer de mama masculino representó el 0,8 % del total de cánceres mamarios operados durante el periodo estudiado, además se constató su detección en etapas clínicas muy avanzadas. Conclusiones: el alza de la incidencia de esta afección en el último decenio en la provincia de Cienfuegos, exige que se establezcan mecanismos para su detección precoz.

Diverse changes in the morphology and structure of the mammary gland have been described as a result of the variation of the regulatory mechanisms of its development. Amastia is one of the less frequent congenital anomalies of the breast and it consists on the total absence of one or both glands. When it is unilateral it is generally also accompanied by the lack of the major and minor pectoral muscle besides other malformations, constituting what is known as Poland Syndrome. A case of a fifteen year old female patient is presented who shows the congenital absence of the right breast. This is the first case of Poland Syndrome diagnosed in Cienfuegos, this is why the publication of this case is considered of interest for the scientific community.

The Phyllodes Tumor is an infrequent mammary fibroepithelial neoplasia, with an epithelial benign component and a mesenquimal component that can be benign or malignant; it only represents 0.3 to 0.4 % of all of the mammary tumours. The case of a 50 year old female sex patient with Phyllodes tumour of the mamma of benign nature is presented. For the infrequent of this disease, it is considered valuable to publish this case.

La enfermedad de Paget de la mama es poco frecuente, representando solamente el 1 a 1,5 % del total de los cánceres mamarios que se reportan, y que algunos autores la consideran una forma especial de cáncer de mama, y otros solo una extensión de un carcinoma intraductal que alcanza el pezón. Tiene dos formas clínicas de presentación: la eczematosa y la ulcerativa. Se presenta el caso de una paciente de sexo femenino, de 67 años de edad, con una enfermedad de Paget de la mama derecha con forma clínica ulcerativa. Por lo poco frecuente de esta enfermedad, se considera de valor para el personal médico dedicado a la atención de las enfermedades de las mamas, el reporte de este caso.

Primary adenocarcinoma of the vermiform appendix is the least common carcinoma of this organ; its exact frequency is unknown. Primary malignant tumors of the appendix are rare; they are generally found in 1 to 2% of all appendices examined. Most appendiceal malignancies arise from a primary tumor in the adjacent organs, and in some cases, may be metastases from distant tumors. The case of a 43-year-old patient with a history of emergency surgery who was presumptively diagnosed with acute appendicitis is presented. The presence of an adenocarcinoma at the base of the appendix was reported by the pathology department. Because of the rarity of the condition, the publication of this case is considered scientifically important.

La enfermedad de Paget de la mama es poco frecuente, representa solo del 1 al 1,5 % del total de los cánceres mamarios que se reportan. Aparece fundamentalmente en el sexo femenino en una relación de 99 a 1 en relación con el sexo masculino, y en la cuarta o quinta décadas de la vida, en mujeres pre o post menopáusicas. Se presenta el caso de una enfermedad de Paget de la mama a forma clínica eczematosa en un paciente de sexo masculino, de 76 años de edad. Es este el primer caso de enfermedad de Paget de la mama en hombre, diagnosticado en la provincia de Cienfuegos. Por lo inusual de la presentación de esta enfermedad en el sexo masculino, se considera de interés el reporte para los profesionales de la salud.

El melanoma de coroides es el tumor intraocular más frecuente en adultos. Su incidencia a nivel mundial es baja, 6 casos por un millón, pero presentan un alto grado de malignidad y propensión a las metástasis. Se presenta el caso de una paciente de sexo femenino, de 34 años de edad, con antecedentes de haberle sido enucleado el ojo derecho hacía 14 años por un melanoma de coroide, que fue atendida en el Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos, por tener metástasis axilar izquierda. Por lo poco frecuente de esta enfermedad, así como la larga sobrevida de la paciente (sin tratamiento sistémico), después de serle enucleado el ojo afectado se consideró de interés para los profesionales de la salud la publicación de este caso.

El tumor phyllodes de la mama es poco frecuente, tiene un origen fibroepitelial con un componente agresivo y representa del 0,3 al 0,4 % de todos los tumores mamarios y el 2,5 % a 3 % de los tumores epiteliales de dicho órgano. La edad promedio de aparición es en la cuarta década de la vida entre los 45 y 50 años, es extremadamente rara su presentación en niñas o adolescentes. Se presenta el caso de un tumor phyllodes en una adolescente de 15 años, este es el segundo caso diagnosticado en la provincia de Cienfuegos en los últimos 33 años. Por lo inusual de la presentación de esta patología en estas edades, se considera el reporte de interés para los profesionales de la salud.

Fundamento: el tumor phyllodes de la mama es poco frecuente, tiene un origen fibroepitelial con potencial agresivo y representa el 0,3 % a 0,4 % de todos los tumores mamarios y el 2,5 % a 3 % de los tumores epiteliales de dicho órgano. Objetivo: caracterizar desde el punto de vista clínico-patológico los tumores phyllodes operados en la provincia de Cienfuegos durante 32 años. Métodos: estudio descriptivo, prospectivo, observacional, en el período del 1 de enero de 1980 al 31 de diciembre de 2011, de 89 pacientes que recibieron un seguimiento de cinco años respectivamente durante los 32 años transcurridos en el estudio realizado en el Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos. Los casos operados en la provincia, se examinaron en consulta de Mastología antes de operarlos y se les dio el referido seguimiento después de la cirugía. Las variables analizadas fueron: edad, localización anatómica, tamaño del tumor, naturaleza del tumor y municipio de procedencia. Los datos fueron obtenidos a partir de las historias clínicas de los pacientes. Resultados: el mayor número de casos se detectó en pacientes de más de 40 años, en este periodo se operaron los únicos tumores phyllodes en niña y en adolescente reportados en Cienfuegos, según la naturaleza del tumor 98,8 % fueron de naturaleza benigna. Conclusiones: el tumor phyllodes de la mama presenta una baja incidencia en la provincia de Cienfuegos, y es el 98,8 % de ellos de naturaleza benigna.

En la evolución clínica de los tumores malignos, entre el 1 y el 10,4 % de estos se presentan metástasis cutáneas, por lo que se considera su presencia sinónimo de enfermedad rápidamente progresiva con bajos índices de supervivencia. En los varones, el tumor que más suele producirlas es el de pulmón y en las mujeres, el de mama. Es poco frecuente que la metástasis en la piel sea la primera manifestación del tumor, y es el carcinoma de mama el que con mayor frecuencia da lugar a esta eventualidad. En el caso que se presenta fue la metástasis en la piel la primera manifestación del tumor primario de mama subyacente.

Breast cancer is now the first location and cause of death from malignant tumors in females both in developed and developing countries and Cuba is not an exception. Because of the current situation, the Cuban Ministry of Public Health has considered breast cancer as a major health issue that has been prioritized for research, diagnosis and treatment. Therefore, a national program for early diagnosis was created in 1988. Its implementation depends on the training of General Medicine Specialists in relation to breast disease, given that they are responsible for performing the diagnosis. In this sense, the present research is aimed at demonstrating the relevance of the role of professional training as a way to achieve an early diagnosis of breast cancer by General Medicine Specialists.

El cáncer de mama constituye actualmente la primera localización y la primera causa de muerte por tumores malignos en el sexo femenino en los países desarrollados y en vías de desarrollo. Cuba no queda excenta de esta situación, lo que ha hecho que sea considerado por el Ministerio de Salud Pública como un problema de salud y una línea priorizada de investigación, diagnóstico y tratamiento. Por ello se creó desde 1988 un Programa Nacional de Diagnóstico Precoz, cuya implementación depende de la capacitación que en relación con las enfermedades de las mamas, posean los especialistas en Medicina General Integral por ser estos los encargados de realizar dicho diagnóstico. Por lo que esta investigación se propone: demostrar el papel de la superación profesional como una vía para lograr un diagnóstico precoz del cáncer de mama por parte de los especialistas de Medicina General Integral.

Supernumerary breasts are different forms of presentation according to the histological components that they pose. They are located mainly in axillary region, epigastric supraumbilical and other areas of the anterior chest wall, where the old lines of milk were. A case of a male patient, aged 39, was admitted to the provincial consultation each breast, presenting an increase in volume of a marble, from its birth on her back. On physical examination is evidence of the presence of a small breast in the patient's right dorsal region, it is a pseudomama, variety in the breast tissue is replaced by fat and to a location in the lumbar region, after checking preoperative into the operating room so it is necessary to perform the excision of the rudimentary breast. Reviewed the literature on the subject is not found similar evidence reported, so this case is considered as of great scientific interest.

The present case is included among the so-called special forms of breast cancer. It appears during pregnancy or up to one year after childbirth. It occurs in 1 in 3,000 pregnant women. The highest incidence rates have been registered in developed or developing countries. Diagnosis is performed, in most cases, in advanced stages of the disease, which leads to a worse prognosis and survival than in non-pregnant and puerperal women. The case of a patient who had given birth 9 months ago and was pregnant at the time she attended consultation is presented. She was diagnosed with undifferentiated breast carcinoma. This is the first case of breast cancer diagnosis during pregnancy in the province of Cienfuegos in the last 30 years.

Gastric volvulus is a rare entity that was first described by Berti in 1866 while performing a necropsy. In 1896, Berg first established the diagnosis during the operation. In 1904, Borchardt described the classic triad of epigastric distension with pain, difficulty for the nasogastric tube to pass and nausea without vomiting. A case of a female patient aged 73 and 56 kg in weight, with a history of ischemic heart disease and gastric ulcer, who visited the emergency department because of vomiting, diffuse abdominal pain and bloating is presented. She had a surgery on an urgent basis to confirm the diagnosis of mixed gastric volvulus without vascular compromise. Gastropexy was performed with the diaphragm. This patient progressed satisfactorily, allowing hospital discharge 72 hours after surgery. Due to the weirdness of this case it was decided to have it published.

Background: Surgery is the unique possibility of cure of survival with life quality for patients with tumor or mediastinal mass. Objective: To describe the results of surgical procedures in patients with mediastinal tumor. Methods: Descriptive, retrospective study of 29 patients operated after being diagnosed with mediastinal tumor in a period of 17 years (1986-2002). Studied variables were: tumor´s locus in the mediastinum, tumor nature, histological diagnosis and strategies regarding surgical approach. Findings: There was a prevalence of benign tumors (81,8%) and the most frequent locus was anterior mediastinum. Conclusions: These findings agree with previous studies, mainly regarding tumors´ locus and nature.

Background: Hepatic surgery currently shows impressive advances. Among the newest techniques we can include digitoclasia, created by Ton That Tung. Objective: To describe the results of hepatic resections in patients operated with digitoclasia. Methods: A descriptive, retrospective study of the outcome of twenty patients operated in the hospital “Dr. Gustavo Aldereguía Lima” in Cienfuegos, carried out in a period of ten years. The following variables were analyzed: Age, sex, disease that determined the intervention, kind of hepatic resection, complications and mortality. Findings: Cavernous haemangioma, hepatocarcinoma, hepatic metastasis of colon cancer and politraumatism were the main causes that led to surgical intervention; right hepatectomy was the most frequent technique. Conclusions: Digitoclasia is a quick and safe procedure, even for wide hepatic resections since, even with some levels of complications and mortality, these do not exceed the figures of studies by other authors.

Background: Video assisted thoracic surgery is an intervention which advantages should be reaffirmed through studies aimed to characterize and describe it, based on real experiences. Objective: To verify the efficacy of this kind of surgery in the department of minimal access surgery in the university hospital Dr. Gustavo Aldereguia Lima. Methods: Descriptive, retrospective study of 135 patients operated through video assisted thoracic surgery in the university hospital in Cienfuegos during a period of seven years (1998-2005). The analyzed variables were: disease that determined the intervention, goals, of the intervention, complications and post-operatory period. Results: The most frequent causes of intervention were pneumothorax, pulmonary tumors, pleural effusion and empyema. There was high accordance between pre and pos operatory diagnosis. There was a prevalence of therapeutic surgeries (55 %), over diagnostic surgeries. The pos-operatory period in the Surgery Department was less than seven days in most of the cases. Conclusion: The study’s results show that the use of this technique has a positive impact on the economic and social indicators of the province.

We present the case of a 20 year-old patient, black race, that ,when going to the Hospital "Princess Marina" in Botswana, February 2nd, 2003, reported to have had, for 5 years, a ball in the internal face of the left arm that had grown slow and progressively. The physical exam, in the moment of admission presented a giant tumour in the internal face of the left arm, of hard consistency, stuck to the skin and with necrosis areas and fetid exudates, but without adherence to deep levels. When carrying out the surgical intervention, the anato- pathological report informed that it was a sarcoma not rhabdomyomata of soft parts.

Presentation of the case of a white male (86 years old) referring to have being operated one year ago due to a tumor in his back which has being enlarging in the last six months including not fetid suppuration in the last month. The physical examination showed a big ulcerated tumor of about 20 cm of diameter with yellow secretion. It turned to be a lymphosarcoma grade II, with wide necroses zones, diameter of 20x14x7 cm and weighing 746grs. This is a very infrequent case, the only one reported in our province.

Presentation of the case of a patient (18 years old) who was assisted in the provincial mastology consultation for a non painful tumor, of sudden growth covering almost all the right breast, without other symptom or sing. After some tests, it was decided to operate. The tumor turned to be benign phyllodes. The relevance of this case lies in the infrequent appearance of this type of tumor, being even the first to be operated in our hospital.

INTRODUCCIÓN. La cirugía es la única posibilidad de curación o de supervivencia con calidad de vida para los pacientes con tumores o masas mediastínicas. El propósito del presente estudio fue presentar los resultados de una serie de 29 pacientes diagnosticados de tumor de mediastino y tratados mediante cirugía convencional o mediante cirugía torácica videoasistida durante un período de 17 años hasta diciembre del 2002. MÉTODOS. Se realizó un estudio descriptivo retrospectivo con un universo de 29 pacientes ingresados en el servicio de cirugía general con diagnóstico de tumor o masa mediastínica. Se tuvo en cuenta los síntomas del paciente y la localización de la tumoración en el mediastino. Se trazaron las estrategias del abordaje quirúrgico y de los detalles técnicos de la intervención. RESULTADOS. Predominaron las patologías benignas (9 pacientes; 81,8 %). Se realizaron resecciones totales a 24 pacientes (80,3 %) y biopsias a 4 pacientes (17 %). Durante el acto quirúrgico falleció un paciente y presentaba un timoma maligno que infiltraba la aurícula derecha. CONCLUSIONES. Los resultados obtenidos fueron satisfactorios y confirmaron que el único tratamiento es el quirúrgico, considerando a la cirugía torácica videoasistida como una variante alternativa de la cirugía para la resección de masas mediastínicas.INTRODUCTION. Surgery is the only possibility of cure or survival with quality of life for those patients with mediastinum tumors or masses. The objective of this paper was to show the results of a series of 29 patients that were diagnosed mediastinum tumor and treated by conventional surgery or by video-assisted thoracic surgery during 17 years until December 2002. METHODS. A descriptive prospective sstudy was undertaken in a universe of 29 patients admitted in the general surgery service with diagnosis of mediastinum tumor or mass. The symptoms of the patient and the localization of the tumor in the mediastinum were taken into consideration. The strategies for the surgical approach and the technical details of the procedure were laid down. RESULTS. It was observed a predominance of benign pathologies (9 patients; 81.8 %). Total resections were performed in 24 patients (80.3 %) and biopsies in 4 (17 %). A patient that presented a malignant timoma infiltrating the right auricle died during surgery. CONCLUSIONS. The results obtained were satisfactory and proved that surgery is the only possible treatment, considering the video-assisted thoracic surgery as an alternative variant of surgery for the resection of mediastinum masses.

Background: Relaparotomies are associated with a considerable percentage of morbidity and mortality in patients who require intensive care; and around this procedure it is complex to decide when and how to do it, so that it is effective in every way. For this reason, the study of its results through the analysis of specific variables is of interest.Objective: to characterize the behavior of relaparotomies in a General Surgery service.Methods: descriptive, longitudinal and prospective observational study, which included patients who required relaparotomies, which were performed in the Surgery service of the Dr. Gustavo Aldereguía Lima General University Hospital General, in Cienfuegos, from January/2015 to December / 2017. The variables analyzed were: operative diagnosis at reintervention, surgical strategy, number of reintervention, and time elapsed from initial surgery to reintervention, among others.Results: a relaparotomy index of 2.7 was obtained. The group over 60 years old and the male sex predominated; peritonitis and postoperative eviscerations were the main causes. The clinical criteria were the most used for reintervention; On-demand relaparotomy was applied to a greater number of patients, compared to the other surgical strategies. Mortality increased in reoperated patients in the first 72 hours.Conclusion: In the series analyzed, the number of reoperations and mortality showed a direct proportionality relationship. Multiple organ dysfunctions were the cause of death most associated with the relaparotomy procedure.

Foundation: Acute pancreatitis is an inflammatory process that affects the pancreatic gland. It is associated with high rates of morbidity and mortality, despite the great advances in the management of critical patients in recent years. Objective: to characterize morbidity and mortality in patients diagnosed with acute pancreatitis. Methods: a descriptive, retrospective and correlational study of patients admitted with a diagnosis of acute pancreatitis in the 2014-2015 period in the General Surgery Department of the Dr. Gustavo Aldereguía Lima Hospital in Cienfuegos. The variables analyzed were age, sex, skin color, clinical presentation, etiology, risk factors, complications, surgery requirement, time to admission to the intensive care unit, and discharge condition. Results: predominance of males (55.5%) and patients aged between 31-50 years (34.1%) was observed. The most frequent clinical presentation was mild (65.4%). The main etiology was vesicular lithiasis (40.7%). Among local complications, the acute necrotic collection was the most frequent, especially in severe cases (66.7%). Mortality was zero for mild and moderate cases, but increased to 63.3% in severe cases. Conclusion: the severity of acute pancreatitis is not related to its etiology; Local complications and mortality are greater in severe cases. Patients with mild acute pancreatitis usually have no relevant findings on computed tomography.

Fundamento: La enfermedad de Paget de la mama es poco frecuente, ya que representa solo del 1 al 1,5 % del total de los cánceres mamarios que se reportan. Algunos autores la consideran una forma especial de cáncer de mama y otros solo una extensión de un carcinoma intraductal que alcanza el pezón.Objetivo: caracterizar desde el punto de vista clínico-epidemiológico la enfermedad de Paget de la mama en pacientes operados.Métodos: se realizó un estudio descriptivo, tipo serie de casos, de las pacientes (N=27) con diagnóstico de enfermedad de Paget de la mama, operadas en el Hospital Provincial de Cienfuegos, desde el 1 de enero de 1980 hasta el 31 de diciembre del 2016. Se analizó para estos pacientes, sexo, edad, mama afectada, forma clínica, presencia de tumor subyacente, técnica quirúrgica aplicada y supervivencia.Resultados: esta enfermedad representó solo el 1,08 % de los cánceres operados en el periodo de estudio. Se presentó con mayor frecuencia en el grupo etario de 61-70 años y la forma clínica que predominó fue la ulcerativa. El mayor número de pacientes (44,0 %), murió antes de los cinco años.Conclusión: en Cienfuegos la enfermedad de Paget de la mama tiene una baja incidencia, lo cual coincide con los resultados de estudios nacionales e internacionales revisados.

Un bocio se considera intratorácico cuando más de un 50 % de la glándula tiroides está en el mediastino, o sea, por debajo del nivel del estrecho torácico superior. Es una enfermedad poco frecuente, que representa alrededor del 10 % del total de las masas mediastínicas. Se presentan dos casos de pacientes operadas de bocio endotorácico en el hospital Dr. Gustavo Aldereguía Lima de Cienfuegos. El tratamiento quirúrgico aplicado fue la hemitiroidectomía derecha, con istmectomía y resección de la prolongación mediastínica del tumor. Se trata de una entidad poco frecuente, por lo que se considera de interés su publicación.

El adenoma paratiroideo es un tumor no canceroso de las glándulas paratiroides, que aumenta los niveles de parathormona. Esta hormona regula los niveles de calcio, fósforo y vitamina D en sangre y huesos. Su triada clásica se caracteriza por aumento de los niveles de parathormona, hipercalcemia e hipofosfatemia. Esta entidad afecta a uno entre 500-1000 habitantes y es la causa principal de hiperparatiroidismo primario en un 80- 85 % de los pacientes. Se presenta el caso de una paciente femenina de 69 años de edad, ingresada por fracturas patológicas de cadera, clavícula y dedos de las manos, causada por hiperparatiroidismo primario originado por adenoma paratiroideo. Por la baja incidencia esta entidad, su publicación se considera de interés para el personal científico.

Foundation: Breast cancer is considered a health problem worldwide. In Cuba it is a prioritized line of research and treatment. Objective: To characterize the survival of patients with breast cancer at ten years of surgery. Methods: Descriptive Cohort retrospective study developed at the Surgery Service of the General Teaching Hospital Dr. Gustavo Aldereguía Lima, of the Cienfuegos Province within the period from January 2005 to December 2007. A number of 196 patients operated for breast cancer were analyzed by the Kaplan-Meier method over a period of ten years of survival after surgery. Besides the socio-demographic variables, it was analyzed: Affected breast, Tumor location, Histological type, Clinical state at the moment of the operation and surgical technique used. Results: The highest average survival was found in patients aged between 71-80 and over 80 years who had a lobular carcinoma, who had tumors in clinical stage IIa and who were subject to radical mastectomies. Conclusion: The group of patients object of study showed an elevated global survival, which was mainly associated to older ages, the early diagnosis of the disease and the performance of radical surgery.