This is a retrospective study that evaluates de associated risk)actors for ovarian malignancy using the terminology of "malignancy prediction". It was used in the gynecological service of the HNGAMPSS (1994 to 1995) in patients with a diagnosis of adnexal mass, in whom laparoscopy or laparotomy was done according to negative or positive malignancy prediction. The use of laparoscopy is becoming more frequent in the diagnosis of adnexal masses although there is still concern on  whether this kind of approach is ideal for the proper oncological management. In our cases the incidence of ovarian malignancy was 0,8%, as in other reported series.

Retrospective study of 950 biopsies of breast at Guillermo Almenara National during 1990-1995 There were, 950 benign lesions of breast (74,21%) Fibroadenomas ocurr in the first half of reproductive age whereas fibrocys in the perimenopausal period. Sensivity of breast ultrasound (87,5%) and of BAAF (85,8%) indicate that methods are adequate for the diagnosis of breast benign disorders. Use of the Page modified classification for the histopathologic registry is recommended.

OBJECTIVE: To determine the frequency of gynecological cancer during perimenopause, and then establish which types of cancer can benefit with cancer screening. MATERIAL AND METHODS: Age andfrequency oftervix, breast, ovary, endometrium and vulvar cancer were determined inpatients between 45 and 50 years at Guillermo Almenara Hospital. RESULTS: Mammarian and ovarian cancer were diagnosed predominantly during the Perimenopause and cervical cancer was diagnosed 5 years later. In thepostreproductive period the agefrequency of cervical, mammary and ojorumv cancer were 64,5%, 63,6%; and 64,3%, respectively. Endometrium cancer was diagnosed one decade later. All patients with vulvar cancer (100%) were posmenopausal. CONCLUSION: Gynecological cancer must be diagnosed during the perimenopause when consultation about climacteric symptoms increase.

OBJECTIVE: To determine the clinical, diagnostic and surgicopatbological aspects of ovarian tumors of low malignant potencial or borderline malignancy. MATERIAL AND METHODS: 12 cases of ovarian tumors of LMP are reviewed at Guillermo Almenara Hospital (1990-1997). These tumors constitute 11 896 of all ovarian cancer. The average age of the patients was 42,5 years, one decade earlier than the mean age at diagnosis for invasive ovarian cancer. Pelvic tumor and pain were predominant characteristics. Average greatest diameter was 21 cm; 83,3% (p < 0,001) of these tumors bad complex ecoestructure (thick or thin wall, septae, and some internal ecos). CA-125 tumor marker was determined in 5 cases, and all bad <35 U/mL levels. All tumors were epithelials, and the majority mucinous 83,3%. FIGO's stages were stage I, 8,3% stage II, and 16,6% stage III (p>0,05). Management was according in to ovari...

OBJECTIVE: To determine the frequency of gynecological cancer during perimenopause, and then establish which types of cancer can benefit with cancer screening. MATERIAL AND METHODS: Age andfrequency oftervix, breast, ovary, endometrium and vulvar cancer were determined inpatients between 45 and 50 years at Guillermo Almenara Hospital. RESULTS: Mammarian and ovarian cancer were diagnosed predominantly during the Perimenopause and cervical cancer was diagnosed 5 years later. In thepostreproductive period the agefrequency of cervical, mammary and ojorumv cancer were 64,5%, 63,6%; and 64,3%, respectively. Endometrium cancer was diagnosed one decade later. All patients with vulvar cancer (100%) were posmenopausal. CONCLUSION: Gynecological cancer must be diagnosed during the perimenopause when consultation about climacteric symptoms increase.

OBJECTIVE: To determine the clinical, diagnostic and surgicopatbological aspects of ovarian tumors of low malignant potencial or borderline malignancy. MATERIAL AND METHODS: 12 cases of ovarian tumors of LMP are reviewed at Guillermo Almenara Hospital (1990-1997). These tumors constitute 11 896 of all ovarian cancer. The average age of the patients was 42,5 years, one decade earlier than the mean age at diagnosis for invasive ovarian cancer. Pelvic tumor and pain were predominant characteristics. Average greatest diameter was 21 cm; 83,3% (p < 0,001) of these tumors bad complex ecoestructure (thick or thin wall, septae, and some internal ecos). CA-125 tumor marker was determined in 5 cases, and all bad <35 U/mL levels. All tumors were epithelials, and the majority mucinous 83,3%. FIGO's stages were stage I, 8,3% stage II, and 16,6% stage III (p>0,05). Management was according in...

Retrospective study of 950 biopsies of breast at Guillermo Almenara National during 1990-1995 There were, 950 benign lesions of breast (74,21%) Fibroadenomas ocurr in the first half of reproductive age whereas fibrocys in the perimenopausal period. Sensivity of breast ultrasound (87,5%) and of BAAF (85,8%) indicate that methods are adequate for the diagnosis of breast benign disorders. Use of the Page modified classification for the histopathologic registry is recommended.

El carcinoma papilar de tiroides (CPT) es la neoplasia tiroidea más frecuente, mientras que la tiroiditis subaguda (TSA) es un trastorno inflamatorio autolimitado. Su coexistencia representa un desafío diagnóstico. Presentamos el caso de una mujer de 34 años con 6 semanas de fiebre y dolor cervical. Presentó taquicardia, bocio doloroso y nódulo tiroideo derecho. Los exámenes mostraron velocidad de sedimentación globular y tiroglobulina elevadas. La ecografía reveló un nódulo sólido subcapsular y la gammagrafía mostró ausencia de captación. La biopsia confirmó CPT. Se realizó tiroidectomía total, que evidenció CPT variante clásica y folicular sin invasión. Recibió terapia ablativa con I-131 y se encuentra en seguimiento sin recurrencia. Este caso subraya la necesidad de una evaluación exhaustiva en casos de TSA con nódulos, pues la inflamación puede enmascarar mal...

Se presenta el caso de un varón de 54 años con tirotoxicosis de dos meses de evolución, en quien se identificó un nódulo tiroideo de 1,5 cm, TSH suprimida, T4L elevada, anticuerpos antitiroideos positivos y calcitonina aumentada. La gammagrafía mostró bocio difuso hipercaptante y la biopsia confirmó carcinoma medular de tiroides (CMT), coexistiendo con enfermedad de Graves-Basedow (EGB). Fue sometido a tiroidectomía total con disección central y tratamiento con levotiroxina, sin recurrencia hasta la fecha. Este caso es único por la rara asociación entre EGB y CMT, entidades con fisiopatologías distintas, y destaca la importancia de una evaluación integral ante hallazgos atípicos. Aporta a la literatura al evidenciar la necesidad de considerar diagnósticos diferenciales incluso en contextos clínicos aparentemente claros, subrayando el valor del diagnóstico temprano en el...

El hipotiroidismo puede asociarse con pancitopenia en casos raros. Se presenta el caso de una mujer de 33 años con edema durante los últimos seis meses, asociado a fatiga, hiporexia, intolerancia al frío y parestesias. Los exámenes revelaron pancitopenia e hipotiroidismo primario autoinmune, además de niveles bajos de vitamina B12, asociados a gastritis atrófica. Se inició tratamiento con levotiroxina y prednisona por púrpura trombocitopénica autoinmune. Cuatro semanas después, la pancitopenia se resolvió. El diagnóstico final fue síndrome poliglandular autoinmune tipo 3B. De los 12 casos reportados de pancitopenia asociada a hipotiroidismo primario, se observa una afectación predominante en mujeres (75%), con una edad promedio de 55 años, y su resolución con levotiroxina en un promedio de 47 días. Su fisiopatología implica una disfunción medular por la deficiencia de ...

Up to 80% of patients with hypothyroidism present with neuromuscular symptoms. We report the case of a 56-year-old male with a two-year history of symptoms suggestive of hypothyroidism, which worsened over the last five months, with difficulty walking, muscle rigidity, and cramps. Laboratory tests confirmed primary hypothyroidism with elevated creatine kinase (CK) and lactate dehydrogenase (LDH) levels. Following treatment with levothyroxine, the clinical and biochemical response was favorable. Hoffmann syndrome, an atypical form of hypothyroid myopathy, is rare and primarily affects males with long-standing hypothyroidism. It is characterized by pseudohypertrophy and progressive muscle weakness, affecting less than 10% of hypothyroid patients. The pathogenesis is thought to involve alterations in the IGF1–PI3K–Akt/mTOR and myostatin-Smad3 pathways. Treatment with levothyroxine norma...