Ventajas De La Cirugía Oncoplástica En El Tratamiento Del Fibroadenoma Gigante De La Mujer Adulta: A Propósito De Un Caso.

Inmaculada Lendínez, Juan Alfredo Ubiña, Saturnino De Reyes, Enrique Calcerrada

Resumen


[Advantages of Oncoplastic Surgery in the Treatment of Adult Female Giant Fibroadenoma: A Case in Point.]

Resumen
Los fibroadenomas gigantes corresponden a menos del 4% de los fibroadenomas. Suponen un efecto psicológico grave en la mujer por la deformidad mamaria que provoca. Su tratamiento quirúrgico es controvertido. Nuestro objetivo es exponer los resultados postoperatorios de la cirugía oncoplástica de la mama aplicada al tratamiento del fibroadenoma gigante como una opción de tratamiento factible y reproducible. Se presenta el caso de una mujer de 53 años derivada a la Unidad de Mama por una masa palpable de 10 cm en la mama derecha de 3 años de evolución que provocaba asimetría mamaria y repercusión psicológica. La biopsia informó de lesión fibroepitelial. Se intervino realizándose enucleación de la lesión y mamoplastia de reducción con patrón de doble rama en T invertida, y trasposición del complejo areola-pezón. La histopatología confirmó la sospecha de fibroadenoma gigante. La cirugía oncoplástica es útil en grandes tumores de mama permitiendo preservar la mama siendo oncológicamente seguras, y restablecer la simetría mamaria. Sin embargo, aunque es una herramienta útil, es necesario individualizar el tratamiento de los fibroadenomas gigantes.

Debe individualizarse en función del tamaño y forma de los senos, el tamaño y ubicación del tumor, y el potencial de crecimiento de la mama en pacientes jóvenes.

Abstract
The giant fibroadenomas correspond to less than 4% of the fibroadenomas. They suppose a serious psychological effect in the woman by the mammary deformity that causes. Its surgical treatment is controversial. Our objective is to expose the postoperative results of breast oncoplastic surgery applied to the treatment of giant fibroadenoma as a feasible and reproducible treatment option. We present the case of a 53-year-old woman was referred to the Mama Unit due to palpable mass of 10 cm in the right breast done 3 years ago. It becomes a cosmetic problem for the affected patient. The biopsy was reported as fibroepithelial lesion. The patient underwent total excision of the lesion with enucleation technique and reduction mamoplasty with an inverted T-incision technique and positioning the nipple-areola complex. Histopathology confirmed the suspicion of giant fibroadenoma. Oncoplastic techniques are a valuable component of breast surgery in patients with large breast tumors who desire breast preservation. However, the treatment of giant fibroadenomas should be individualized according to the size and shape of the breasts, the size and location of the tumor, and the growth potential of the breast in young patients.stages in children with acute lymphoblastic leukemia; especially in those of "high risk" of recurrence.

There is a world of options and ways to investigate with the cellular adoptive therapy including not only the CAR-T, but the "tumor infiltrating lymphocytes" (TIL) and the T cells with specific receptors (TCR) and not only in hematological neoplasias but also in solid tumors.


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Referencias


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