Cáncer de vesícula biliar, a propósito de un caso
Palabras clave:
neoplasias de la vesícula biliar, neoplasias de la vesicula biliarResumen
El cáncer de vesícula biliar es una enfermedad poco frecuente a nivel mundial. Existen distintos factores de riesgo asociados a la misma, como la edad mayor de 50 años y la presencia de litiasis vesicular. La litiasis desencadena una respuesta inflamatoria continua con liberación de promotores tumorales que ejercen su efecto nocivo sobre el epitelio dañado previamente. El adenocarcinoma es el tipo histológico más frecuente, constituyendo los carcinomas escamosos, adenoescamosos y otros, los de menor frecuencia. Se presenta un paciente adulto masculino, de la raza blanca, con antecedentes de litiasis vesicular, que presentó al ingreso un síndrome ictérico con signos de colangitis; al que se le realiza diagnóstico imagenológico, histopatológico y
endoscópico de una neoplasia adenoescamosa de vesícula biliar. Es fundamental identificar los factores de riesgo que favorecen la aparición de esta tumoración, para determinar las medidas de prevención y control, ya que la detección temprana y resección oportuna, son de vital importancia
en la sobrevida de estos pacientes.
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Aparicio S, Gentile A. Análisis de las tasas de mortalidad por cáncer año 2001: programa de estadísticas. Buenos Aires: Ministerio de Salud de la Provincia de Salta; 2001.
Matos E, García C, Vilensky M. Nuevos datos sobre mortalidad por cáncer en Argentina (años 1989 a 1992). Buenos Aires: Ministerio de Salud y Asociación Social; 1996.
Curley SA. The gallbaladder in cancer medicine. 5.ed. London : Holland and Frei, B.C. Decker Inc.; 2000. p. 1415-21.
Gallardo J, Rubio B, Harbs H. Avances en cáncer de vesícula biliar. Rev Chil Cancerol Hematol 2000; 10:79-86.
Arroyo GF. Cáncer de vesícula biliar. Oncología Clínica. 2003; 8(1):831-837.
Albores Saavedra J, Acantra Vázquez A, Cruz Ortiz, H. The precursor lesions of invasive gallbladder carcinoma: hyperplasia, atypical hyperplasia, and carcinoma in situ. Cancer. 1980; 45:919-27.
Pitt HA, Grochow LB, Abrams RA. Cáncer of the biliary tree in cancer: principles and practice of Oncology. 5 ed. New York : DeVita, Hellman, and Rosenberg; 1997.
Mikami T, Yanagisawa N, Baba H. Association of Bcl-2 protein expression with gallbladder carcinoma differentiation and progression and its relation to apoptosis. Cancer. 1999; 85:318-25.
Itoi T, Takei K, Shinohara Y. K-ras codon 12 and p53 mutations in biopsy specimens and bile from biliary tract cancer. Pathol Int 1999; 49:307.
Itoi T, Shinohara Y, Takeda K. Nuclear cyclin D overexpression is a critical event associated with cell proliferation and invasive growth in gallbladder carcinogenesis. J 74 Gastroenterol 2000; 35:142-9.
Quan ZW, Wu K, Wang J. Association of p53, p16, and vascular endothelial growth factor protein expression with the prognosis and metastasis of gallbladder cancer. J Am Coll Surg; 2001; 193:380-3.
Matsubara T, Jinno O. P53 gene mutations and overexpresion of p53 product in cancerous and noncancerous biliary epithelium in patients with pancreaticobiliar maljunctions. J Hepatobiliary Pancreat Surg 1999; 6:286-93.
Yokoyama N, Watanabe HH, Ajioka Y.Genetic alterations in gallbladder carcinoma: a review. Nippon Geka Gakkai Zasshi; 1998; 99:687-95.
Khan ZR, Neugut AI, Absan H, Chabot JA. Risk Factors for biliary tract cancers. Am J Gastroenterol 1999;94:149-152
Shi WZ, Hvi AM, Li X. Overexpression of retinoblastoma protein predicts decreased survival and correlates with loss of p161NK4 protein in gallbladder cancer. Clin Cancer Res 2000; 6:4096-100.
Lee C.S Ras p21 protein immunoreactivity and its relationship to p53 expression and prognosis in gallbladder and extrahepatic biliary carcinoma. Eur J Surg Oncol 1997; 23:233-7.
Cubertafond P, Gainant A, Cuchiaro G. Surgical treatment of 724 carcinomas of the gallbladder: results of the French Surgical Association Survey. Ann Surg 1994; 219:275-80.
Todoroki T, Kawamoto T, Takahashi H. Treatment of gallbladder cancer by radical resection. Brit J Surg 1999; 86:622-7.
Ogura Y, Mizumoto R, Isaji S. Radical operations carcinoma of the gallbladder: present status in Japan . World J Surg 1991; 15:337-43.
Farland EG, Mayo Smith WW, Saint S. Hepatic hemangiomas and malignant tumors; improved differentiation with heavily T2- weighted conventional spin-echo MR imaging. Radiology. 1994; 193:43.
Jiron MI, Silvia H, Whittle C. Gallbladder polyps: second consensus workshop of the Chilean hepatology association. Rev Med Chi l 1994; 122:1316.
Fong Y, Brennen MF, Turnbull A. World cancer discovered during laparoscopic surgery: potential for iantrogenic tumor dissemination. Arch Surg 1993; 128:1054-6.
Kim HJ, Kim MH, Myung SJ. A new strategy for the application of CA19- 9 in the differentiation of pancreatobiliary cancer: analysis using a receiver: operating characteristic curve. Am J Gastroenterol 1999; 94:1941-6.
Matsuda M, Shimizu Y, Chikamatsu E. Role of carcinoembrionic antigen, carbohydrate antigen 19-9 and cytology of bile in diagnosis of biliary and pancreatic cancer. Nippon Geka Gakkai Zasshi 1991; 92:716
Lynch O. Cáncer avanzado de la vesícula biliar: tratamiento combinado de cirugía y radioterapia: estudio prospectivo de 34 casos. Rev Chilena Cirugía 1998; 50:404-10.
Jones RS. Palliative operative procedures for carcinoma of the gallbladder. World J Surg; 1991; 15:348-54.
Fong Y, Jarnagin W, Blumgart L. Gallbladder cancer: comparision of patients presenting initially for definitive operation with those presenting after prior non curative intervention. Ann Surg 2000; 232:557-69.
Todoroki T, Iwasaki Y, Iri K. Resection combined with intra-operative radiation therapy (IORT) for stage IV (TNM) gallbladder carcinoma. World J Surg 1991;15:357-62.
Aretxabala X, Roa I., Burgos L. Preoperative chemoradiotherapy in the t treatment of gallbladder cancer. Am Surg 1999; 65:241-6.
Gallardo JO, Rubio B, Fodor M.A phase II study of gemcitabine in gallbladder carcinoma. Ann Oncol 2001; 12:1403-6.
Arroyo G, Gallardo J, Rubio B. Gemcitabine (GEM) in adnance biliary trac cancer (ABTC): experience from Chile and Argentina in phase II trials. Proc Am Soc Clin Oncol 2001; 626.
Gebbia V, Giuliani F, Maiello E. Treatment of inoperable and/or metastic biliary tree carcinomas with levofolinic acid and infusional fluorouracil: results of a multicenter phase II study. J Clin Oncol 2000; 19:4089-90.
Doval DC, Sekhon JS, Fuloria J.Gemcitabine and cisplatin in chemotherapy–naive, unresectable gallbladder cancer: a large multicenter, phase II study. Proc Am Soc Ciln Oncol 2001; 622.
Carraro S, Servienti PJ, Bruno MF.Gemcitabine and cisplatin in advanced or metastatic gallbladder and bile duct adenocarcinomas. Pro Am Soc Clin Oncol 2001; 2333.
Jani CR, Bhargava P, Stuart KE. Multicenter phase II trial of gemcitabine in patients with advanced or metastatic biliary cancer. Proc Am Soc Clin Oncol 2002; 2313.
