Cecilia Castillo

Gastrointestinal bleeding as the first manifestation of a burned-out tumour of the testis

We discuss the clinical presentation and course of the disease of a 25-year-old male who had gastro-in-testinal (GIT) symptoms secondary to retroperitoneal lymph node proliferation of a germ-cell tumour of the testis. The pathology evaluation of the orchiectomy specimen classified it as a burned-out tumour of the testis, given the lack of tumour elements and the presence of typical scarring tissue. Biological issues leading to tumour regression are discussed, as well.

Características del cáncer de mama masculino en una población uruguaya

Breast cancer (BC) in men (MBC) is an uncommon clinical entity. Even though it shares some similarities with female BC, it has a distinctive profile. The objective of this study is to identify the characteristics of MBC and learn how it is managed in our setting.Material and methods: retrospective study including patients diagnosed with MBC in three centers in Uruguay for a period of 15 years.Results: 12 patients were enrolled; the median age was 68xa0years; a third of whom had a family history (FH).Clinical and pathological characteristics: all of the tumors were ductal carcinomas of histological grade (HG) 2-3, 1/4 were stage (S) I, half (6) were SII, 6 had axillary metastases, 2/3 were estrogen receptor (ER) / progesterone receptor (PR) +. Three biological subtypes were defined: I) HER2- ER/PR+: 2/3 of patients; II) HER2+: 1/6; and III) triple-negative: 1/6. All patients with localized cancer underwent a mastectomy and most were treated with chemotherapy (CHT). All of those who presented with localized, ER/PR+ cancer received adjuvant hormone therapy, with good adherence and tolerance. Two of the eleven patients treated with radical surgery recurred during evolution; the rest remain in follow-up or treatment without evidence of recurrence.Conclusion: we presented a series of patients with MBC, with a profile similar to the one reported in the literature. Age at presentation was higher than that of female BC, and most were ER/PR +, HER 2-. However, patients in this series presented with breast cancer in the localized stage and high-grade tumors in a higher proportion than is described in the literature.

Trastuzumab-induced cardiotoxicity in Uruguayan HER2-positive breast cancer patients.

143 Background: To evaluate the incidence, severity and outcome of Trastuzumab-induced cardiotoxicity in HER2 positive Uruguayan breast cancer (BC) patients.nnnMETHODSnRetrospective observational analysis of HER2 positive BC patients who were treated with Trastuzumab (TTZ) from January 2007 to December 2013 at two Uruguayan centers. Cardiac monitoring included physical examination and assessment of left ventricular ejection fraction (LVEF) by echocardiography that was evaluated before TTZ administration and every 12 weeks thereafter during the duration of therapy. Cardiovascular risk factors analyzed were: obesity (BMI ≥ 30 kg/m2), hypertension, diabetes, sedentary lifestyle and high cholesterol.nnnRESULTSnSixty nine female patients were found in the databases of our institutions. Median age was 48 years (range: 27-73). Stage at diagnosis was as detailed: 19 % EI, 46 % EII, 29 % EIII and 4 % EIV. Eighty nine percent of patients received adjuvant TTZ , 4 % neoadjuvant TTZ and 7 % received it as a palliative therapy. Thirty patients (43, 5%) had at least one cardiovascular risk factors: 26% hypertension, 16% obesity, 9% sedentary lifestyle, and 4% high cholesterol. Median number of TTZ cycles was 15. Cycles were administered every 3 weeks at standard dose. Nineteen patients (27%) developed cardiotoxicity, of whom 12 had a transient suspension because of a reversible fall in LVEF, 2 had a irreversible reduction in LVEF, and 5 had a symptomatic heart failure. Eighty-nine percent of our patients (62 patients) completed treatment and the rest had a definitive suspension due to a irreversible reduction in LVEF or symptomatic heart failure. Most patients that developed cardiotoxicity (15 out of 19) had cardiovascular risk factors and also most of them (16 out of 19) had received anthracyclines before TTZ.nnnCONCLUSIONSnCardiotoxicity incidence was similar to the incidence reported in the literature and when it was present, in most cases was transient, asymptomatic, and reversible.