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CASO I

CASO I. VARON DE 58 AÑOS. APENDICITIS AGUDA. NO ANTECEDENTES DE INTERES. MACROSCOPICO: APENDICE CECAL ALTERACIONES FLEMONOSAS. AZUL ALCIAN. CEA. CROMOGRANINA. ADENOCARCINOIDE DE CELULAS CALICIFORMES ( OMS ). LUIS POLO H. U. VIRGEN DE LA ARRIXACA. NOMENCLATURA. CARCINOIDE MUCINOSO.

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CASO I

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  1. CASO I • VARON DE 58 AÑOS. • APENDICITIS AGUDA. • NO ANTECEDENTES DE INTERES. • MACROSCOPICO: APENDICE CECAL ALTERACIONES FLEMONOSAS.

  2. AZUL ALCIAN

  3. CEA

  4. CROMOGRANINA

  5. ADENOCARCINOIDEDE CELULAS CALICIFORMES (OMS) LUIS POLO H. U. VIRGEN DE LA ARRIXACA

  6. NOMENCLATURA • CARCINOIDE MUCINOSO. • ADENOCARCINOIDE. • Ca. MICROGLANDULAR DE CEL. CALICIFORMES. • CARCINOMA DE CEL. DE LAS CRIPTAS.

  7. EPIDEMIOLOGIA I • DESCRITO EN 1974 (Cáncer 34: 338-344) • 6% CARCINOIDES APENDICULAR, <5% TUMORES APENDICULAR. 600 CASOS PUBLICADOS • PRESENTACION VARIABLE COMO APENDICITIS (22%), ASINTOMATICO...

  8. EPIDEMIOLOGIA II • DIFERENCIACION GLANDULAR Y NEUROENDOCRINA. • ORIGEN: Cel. PLURIPOTENCIAL DEL SISTEMA APUD (CARCINOIDE Cel. NEUROENDOCRINAS ESTROMA MUCOSA)

  9. EPIDEMIOLOGIA III • EDAD: 60a (CARCINOIDE 36a) • METASTASIS 15-30% (CARCINOIDE 2-5%) • SUPERVIVENCIA ENTRE 60 Y 84% 5a (16% RECURRENCIA) • PRONOSTICO: ENTRE CARCINOIDE Y ADENOCARCINOMA.

  10. PATRON CARCINOIDE • DISPOSICION INTRAMURAL. • CONTINUIDAD BASE GLANDULAS. • BUENA DIFERENCIACION. • Cel. CON ARGENTO Y ARGIROFILIA, PANETH.

  11. INDICACION HEMICOLECTOMIA • PATRON CARCINOMATOSO(>50%): -GLAND. FUSIONADAS O CRIBIFOR. -INFILT. DIFUSA Cel. ANILLO SELLO. ->2 MIT/ 10CGA. • EXTENSION FUERA DE APENDICE. • RESECCION INCOMPLETA. • METASTASIS GANGLIONAR.

  12. PREGUNTAS?

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