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El linfoma extranodal de células T/NK extranasal (NKTL) primario del tracto gastrointestinal es poco frecuente y tiene carácter agresivo. Presentamos el caso de un paciente inmunocompetente de 51 años que ingresa por dolor abdominal de dos meses de evolución. En la colonoscopía, se hallaron ulceraciones ileales, por lo que se le realizaron estudios para descartar enfermedad de Crohn y tuberculosis intestinal, posteriormente presentó obstrucción intestinal. En la laparotomía exploratoria, se encontró un conglomerado ganglionar en mesenterio. La anatomía patológica confirmó el diagnóstico de NKTL primario en íleon. Se inició quimioterapia y el paciente pidió alta voluntaria dada su precaria condición. Dos meses después del alta el paciente fallece. Este linfoma ha sido reportado principalmente en Asia y posiblemente sea el primer caso reportado en Perú. Tiene un pronóstico funesto con una supervivencia global de ocho meses. Por ello, es necesario un diagnóstico precoz e iniciar la terapia oportunamente.

The ongoing COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global public health crisis. Many reports indicate disappointing results in cancer patients compared to the general population. Therefore, experts in the management of oncohematological malignancies from the National Institute of Neoplastic Diseases, national hospitals and a private clinic in Metropolitan Lima have developed recommendations obtained by consensus to continue with the management of patients with oncohematological neoplasms safely in the face of the pandemic., La pandemia COVID-19 originado por el Coronavirus 2, agente causal del síndrome respiratorio agudo severo (SARS-CoV-2) ha desencadenado una crisis de salud pública a nivel global. Muchos reportes indican resultados desalentadores en pacientes con cáncer respecto a la población general. Por ello, los expertos en el manejo de neoplasias oncohematológicas del Instituto Nacional de Enfermedades Neoplásicas, hospitales nacionales y una clínica privada de Lima Metropolitana han desarrollado recomendaciones obtenidas por consenso para continuar con el manejo de pacientes con neoplasias oncohematológicas en forma segura ante la coyuntura de pandemia.

espanolPaciente mujer de 22 anos, con tiempo de enfermedad de 2 meses, presento epifora, eritema conjuntival leve, prurito en ojo derecho y aparicion de pequena tumoracion verdosa a nivel del canto interno asociada a edema bipalpebral leve. El edema progreso limitando la vision en dicho ojo, asociandose la protrusion del globo ocular derecho. Se realizo estudio anatomopatologico del tumor naso sinusal presentando nidos celulares hipercromaticos de aspecto infiltrativo y el estudio inmunohistoquimico concluyo como rabdomiosarcoma embrionario. Se realizo quimioterapia EnglishA 22-year-old female patient, with 2-month disease time, presented with epiphora, mild conjunctival erythema and pruritus in the right eye. A small greenish-colored tumor appeared at the level of the internal canthus associated with mild bipalpebral edema. The edema progresses limiting the vision in said eye, associating the protrusion of the right eyeball. An anatomopathological study of the nasosinusal tumor was performed, presenting hyperchromatic cellular nests with an infiltrative aspect and the immunohistochemical study concluded as embryonic rhabdomyosarcoma. Chemotherapy was performed

A 48 year-old patient with abdominal pain associated and weight loss is shown. Endoscopy shows an ulcerated, friable, circumferential infiltratory lesion that compromises the pyloric canal and duodenal bulb The histopathological study reveals intestinal type adenocarcinoma with area of differentiation in coriocarcinoma. A partial distal gastrectomy and subsequent chemotherapy were performed aimed at the lineage of the coriocarcinoma, with good clinical response to the first course. Paciente de 48 años que cursa con dolor abdominal asociado a perdida ponderal. En la endoscopía se evidencia una lesión una lesión infiltrativa ulcerada, friable y circunferencial que compromete el canal pilórico y bulbo duodenal Al estudio histopatológico se revela un adenocarcinoma tipo intestinal con área de diferenciación en coriocarcinoma. Se realizó una gastrectomía parcial distal y posteriormente quimioterapia dirigida a la estirpe del coriocarcinoma, con buena respuesta clínica al primer curso.

Background:Plasmablastic lymphoma (PBL) is an aggressive lymphoma associated mainly to HIV infection, although cases in immunocompetent patients are described as well. Objective:To describe the clinicopathologic features and determine the overall survival of lymphoma patients according human immunodeficiency virus (HIV) status in Peruvian patients. Methods:We reviewed the pathology databases of 2 cancer centers and a general hospital from Peru. Forty cases were documented between 2005 and 2020. Categorical variables were compared using Fisher's exact test. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Statistical analysis was based on SPSS Program version 23. All cases were reviewed by two pathologists. Results:32 patients (80%) were HIV-positive. The median age for the whole cohort was 40 years (range, 22-86). The median age for HIV-positive and HIV-negative PBL patients were 37 years (range 22-67 years) and 57 years (range 27-86 years), respectively. The proportion of patients ≥60 years was lower in HIV-positive than in HIV-negative patients (8% and 37%, respectively; p= 0.046). 80% of patients in the whole cohort were female, and 84% and 62% in the HIV-positive and HIV-negative group, respectively. Extra-oral primary sites were the most frequent primary sites in both groups (66% and 88%, respectively). There were no statistically significant differences in Ann Arbor stage, Ki-67 expression, LDH levels, IPI scores, albumin levels, and neutrophil/lymphocyte ratio between HIV-positive and HIV-negative patients. All cases showed large lymphoid cells, of plasmablastic morphology with expression of at least one plasma cell marker (CD138, CD38, MUM1), CD45 positivity, variable expression of EMA, CD79 and CD30 and absence of expression of CD20, CD3, CD68 and LMP1; the proliferative index Ki67 varied between 60 and 90%. A small proportion of patients (18%) did not receive chemotherapy because of poor performance status or a personal decision. DA-EPOCH regimen was used in 52% and 25% of HIV+ and HIV- patients, respectively and CHOP/CHOEP regimen in 48 % and 75%, respectively. The overall response rate was 68% and 57% in HIV+ and HIV- patients with complete response (CR) in 32% and 14%, respectively. In the HIV-positive group, 66% of patients were antiretroviral therapy (ART)-naïve. The median progression-free survival (PFS) was 38 months and 7 months for HIV+ and HIV- patients, and the 1-year PFS was 74% and 0%, respectively. The median overall survival (OS) was 43 months (range 0.2-86.5) in HIV-positive patients and 10 months (range 0.5-19.0 months) in HIV-negative patients and the 1-year OS were 59% y 38%, respectively (p=0.27). Conclusions: PBL is a rare lymphoma, specially, if not related to HIV infection. In this study, 60 years or older was the only variable that showed significant difference. In our cohort, HIV-positive patients had better prognosis than HIV-negative PBL patients. Disclosures No relevant conflicts of interest to declare.

Non-Hodgkin lymphoma (NHL) is a type of blood cancer and 25% of NHL patients present with a primary extranodal tumor. Primary NHL of the vagina is extremely rare with only a few cases reported. We present the case of a 79-year-old, grand multipara, Peruvian woman with an eleven-month history of symptoms of pelvic and vaginal pain and vaginal bleeding. Vaginal examination revealed an exophytic tumor that involved the labia, right vaginal wall, cervix, parametrium, and pelvic bone. A computed tomography (CT) image showed a 10 x 10 x 9-cm solid tumor in the pelvic cavity with irregular edges in the pelvic floor, parametrium, and the perineal soft tissues. Bilateral pelvic and inguinal adenomegalies were found. No signs of metastases were found. Marrow and bone biopsy studies were negative. The diagnosis was NHL type diffuse large B-cell lymphoma (DLBCL) of vagina stage one. The patient was treated with six courses of CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab). She showed a complete response and remained in remission in follow-up control visits. NHL of the female genital tract is rare. CHOP-R is the first line of treatment for this type of cancer. However, less is known about the follow-up protocol and relapse management. Vaginal lymphoma has an extremely low prevalence, and collaborative studies are required to study the same.

e597 Background: The standard treatment for metastatic castration-resistant prostate cancer (MCRPC) is Docetaxel (DTX); however, it has serious adverse effects. It is necessary to know the prognostic factors for overall survival (OS) of patients with MCRPC treated with DTX. The aim of this study was to determine the prognostic factors for OS in patients with MCRPC treated with DTX. Methods: This study is a secondary analysis of the control arms of the clinical trials NTC00273338, NCT00519285 and NCT00988208. 1600 patients aged 18 years or older with MCPRC that received DTX and prednisone were included. Survival curves were estimated by Kaplan-Meier and comparison was done by log-rank test. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model. Results: The median OS time was 14.64 months. The 1-yr-OS and 2-yrs-OS were 86.2% and 28.6%, respectively. Patients with an ECOG score greater than 0 lived significantly less than the rest of patients (p = 0.00). The patients with an alkaline phosphate level (ALP) > 200 had significantly lower OS (p = 0.00). In the multivariate analysis, the factors that influenced OS were ECOG, ALP, HB, LDH and number of metastases. Conclusions: Poor performance status, high alkaline phosphatase level, low hemoglobin level, high LDH and more than 2 metastases were the main prognostic factors in patients with metastatic castration resistant prostate cancer. [Table: see text]

Introducción: Las pacientes con cáncer de mama tienden a desarrollar algún tipo de trastorno psiquiátrico, principalmente depresión. Una manera de evaluar cómo las pacientes conllevan su enfermedad es a través de la calidad de vida. Objetivos: Determinar la prevalencia de sintomatología depresiva y calidad de vida y sus asociaciones con el tiempo desde el diagnóstico y el estado menopáusico. Diseño: Estudio analítico, observacional y transversal. Lugar: Servicio de Oncología del Hospital Arzobispo Loayza. Participantes: Mujeres con diagnóstico clínico e histológico de cáncer de mama que acudieron para tratamiento con quimioterapia. Intervenciones: Se utilizó el inventario de depresión de Beck, la escala de calidad de vida de Mezzich y Cohen y un cuestionario demográfico. El análisis fue realizado con la prueba exacta de Fisher, t de student y regresión lineal. Principales medidas de resultados: Sintomatología depresiva, calidad de vida. Resultados: Se encuestó 24 pacientes, encontrándose una prevalencia de 38% de sintomatología depresiva y 38% de baja calidad de vida. No se halló asociación significativa de sintomatología depresiva y nivel de calidad de vida con alguno de los factores asociados, excepto en la relación de este último con el grado de instrucción de la paciente, con un OR de 11,2 (p= 0,047, IC 95% 0,99 a 125,6). Conclusiones: Se encontró una prevalencia de 38% de sintomatología depresiva y 38% de baja calidad de vida. El tiempo desde el diagnóstico y estado menopáusico no tuvieron una asociación significativa con la sintomatología depresiva y la calidad de vida. El único factor asociado significativamente con la calidad de vida fue el grado de instrucción., Background: Breast cancer women have a tendency to develop psychiatric symptomatology, mainly depressive. A way to evaluate how the patient entails her disease is by quality of life. Objectives: To determine the prevalence of depressive symptoms and quality of life and their associations with time since diagnosis and the menopausal status. Design: Analytical, observational and transversal study. Setting: Arzobispo Loayza Hospital Oncology Service. Participants: Women with clinical and histological diagnosis of breast cancer and seeking chemotherapy. Interventions: The Beck depression inventory, the Mezzich and Cohen quality of life scale and a demographic questionnaire were used. The Fisher test, student’s T-test and lineal regression analysis were used. Main outcome measures: Depression symptoms, quality of life. Results: In 24 women studied the prevalence of depressive symptoms and low level of quality of life was 38%. We did not find a significant association between depressive symptoms and quality of life, except with education level, OR 11,2 (p= 0,047, 95%CI 0,99 to 125,6). Conclusions: We found a prevalence of 38% of both depressive symptoms and low level of quality of life. Time from diagnosis and menopausal status did not have a significant association with both depressive symptoms and quality of life. The only factor significantly associated to quality of life was patient’s education level.