Abstract: BACKGROUND: PEComa is a perivascular epithelioid cell tumor of mesenchymal origin that expresses melanocytic and myogenic markers. These tumors are a rare group of neoplasms. There are about 100 reported cases of which 30% are gynecologic and the uterine body is the most frequent site. Due to the low frequency of occurrence, there is no established medical management and treatment. CLINICAL CASE: A 47-year-old female patient attended the Hospital Universitario Dr. José Eleuterio González due to dysmenorrhea and alteration of the menstrual cycle characterized by an increase in quantity, of one year of evolution. The pelvic ultrasound showed uterine myomatosis; abdominal hysterectomy was decided. The anatomopathological report was perivascular epitheloid cell tumor (PEComa) with which the diagnosis of PEComa of malignant potential was established. CONCLUSION: PEComa is a rare neoplasm since only a few gynecologic cases have been reported. It is important to know its macro and microscopic characteristics to establish an adequate diagnosis and treatment.

Resumen: ANTECEDENTES: El PEComa es un tumor de células epitelioides, perivascular, de origen mesenquimatoso que expresa marcadores melanocíticos y miogénicos. Estos tumores son un grupo raro de neoplasias. Hay cerca de 100 casos reportados de los que el 30% son ginecológicos y el cuerpo uterino es el sitio más frecuente. Debido a la baja frecuencia de aparición no hay una conducta médica y tratamiento establecidos. CASO CLÍNICO: Paciente de 47 años que acudió al Hospital Universitario Dr. José Eleuterio González debido a dismenorrea y alteración del ciclo menstrual caracterizado por aumento en cantidad, de un año de evolución. En el ultrasonido pélvico se observó miomatosis uterina; se decidió la histerectomía abdominal. El reporte anatomopatológico fue: tumor de células epitelioides perivasculares (PEComa) con el que se estableció el diagnóstico de PEComa de potencial maligno. CONCLUSIÓN: El PEComa es una neoplasia rara, pues solo hay pocos casos ginecológicos reportados. Es importante conocer sus características macro y microscópicas para establecer un diagnóstico y tratamiento adecuados.

BACKGROUND: Chemerin, encoded by the retinoic acid receptor responder 2 (RARRES2) gene is an adipocytesecreted protein with autocrine/paracrine functions in adipose tissue, metabolism and inflammation with a recently described function in vascular tone regulation, liver, steatosis, etc. This molecule is believed to represent a critical endocrine signal linking obesity to diabetes. There are no data available regarding evolution of RARRES2 in non-human primates and great apes. Expression profile and orthology in RARRES2 genes are unknown aspects in the biology of this multigene family in primates. Thus; we attempt to describe expression profile and phylogenetic relationship as complementary knowledge in the function of this gene in primates. To do that, we performed A RT-PCR from different tissues obtained during necropsies. Also we tested the hypotheses of positive evolution, purifying selection, and neutrality. And finally a phylogenetic analysis was made between primates RARRES2 protein. RESULTS: RARRES2 transcripts were present in liver, lung, adipose tissue, ovary, pancreas, heart, hypothalamus and pituitary tissues. Expression in kidney and leukocytes were not detectable in either species. It was determined that the studied genes are orthologous. CONCLUSIONS: RARRES2 evolution fits the hypothesis of purifying selection. Expression profiles of the RARRES2 gene are similar in baboons and chimpanzees and are also phylogenetically related.

BACKGROUND: Pure mucinous adenocarcinoma of the breast is a rare entity characterized by the production of variable amounts of mucin comprising 1% to 6% of breast carcinomas. Some mucinous adenocarcinomas have shown expression of intestinal differentiation markers such as MUC-2. This study examines the expression of intestinal differentiation markers in this type of breast carcinoma. RESULTS: Twenty-two cases of pure mucinous adenocarcinoma of the breast were assessed. Immunochemistry was performed for beta-catenin, CDX-2 and MUC-2. All cases were positive for B-catenin. MUC-2 positivity was observed in all cases; 63. 6% were 3 plus positive. All cases were negative for CDX-2. CONCLUSIONS: These results suggest that mucinous breast carcinomas express some markers of intestinal differentiation, such as MUC-2 and beta-catenin; however, future studies with a larger series of cases and using molecular techniques that help affirm these results are needed.

Background: The incidence of ectopic pregnancy is 20 per 1,000 pregnancies. The cornual ectopic pregnancy is found in 2-4%. Hydatidiform moles occur in 1 per 1000 pregnancies in USA and 1 per 500 in Mexico. Thus, the incidence of the two occurring together is very rare. Only 40 cases have been reported in the medical literature, the incidence estimate is 0.04%. Clinic case: We analyzed a 30 year old woman patient case, gravida 1, with 8 weeks’ gestation by last menstrual period, came at the Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Nuevo León, with complaints of nausea and vomiting for 1 day and abdominal pain, and transvaginal bleeding. A cualitative pregnancy test was positive. Physical examination revealed diffuse abdominal tenderness and peritoneal signs. The transvaginal ultrasonography showed a multicystic echogenic mass within the uterus near cornual region consistent with a molar pregnancy. A cornual resection was performed followed by dilation and curettage. Pathologic diagnosis was confrmed. The monitoring of ß-hGC titers was negative 7 weeks after surgery.

Antecedentes: La incidencia de embarazo ectópico es 20/1000 embarazos y en la región cornual se presentan en el 2-4%. La mola hidatiforme ocurre en 1/1000 embarazos en EEUU y 1/500 en México. La presentación simultánea es muy rara. Se han descrito solamente 40 casos en la literatura médica, con una incidencia estimada de 0,04% de localización cornual. Caso clínico: Primigesta de 30 años, que cursando un embarazo de 8 semanas, acude de urgencia por presentar náuseas y vómitos de 1 día de evolución, con dolor abdominal y sangrado vaginal. Prueba de embarazo positiva. A la exploración física presenta dolor abdominal difuso y signos de irritación peritoneal. El ultrasonido transvaginal mostró imagen ecogénica multiquística intrauterina cercana a la región cornual, por lo que se sospecha embarazo molar. En la laparotomía exploradora se realizó resección cornual y posteriormente dilatación y curetaje de la cavidad uterina. La anatomía patológica confrmó el diagnóstico. Negativizó ß-hGC a las 7 semanas después de la cirugía.

Objective. To investigate the possible association among MTHFR polymorfhisms, environmental factors and cervical cancer (CC) in the Mexican population. Methods. Seventy patients with CC and 89 control women were questioned about clinical data and their 677 and 1298 genotypes of MTHFR gene were analized. Results. Multipregnancies (0-2 vs. > 3, OR 2.1), an early age of first intercourse (IVS) (17 < vs. > 18 years, OR 4.3) or both factors (OR 3.5) were significantly associated with CC. MTHFR 677, 1298 polymorphisms and their combinations were not different between cases and controls. However, a significant association between pregnancies, TVS and MTHFR polymorphisms (presence of 1298C allele or 677TT genotype) was observed. The 1298C allele plus multipregnancies and IVS < 17 years, or both factors, increased 4.3, 5.3, and 11.8 times the risk for CC, respectively, while 677TT genotype changed the risk 2.0, 1.9, and 4.2 times, respectively. Conclusion. The 1298C allele increases the risk of CC strongly in women with multipregnancies and early age of IVS, while 677TT genotype has a lower risk without becoming a protection factor.

Objetivo. Buscar la asociación entre polimorfismos de la enzima metilentetrahidrofolato reductasa (MTHFR), factores ambientales y cáncer cérvico-uterino (CaCU) en mujeres del noreste de México. Métodos. Setenta pacientes con CaCU y 89 mujeres controles se sometieron a un interrogatorio clínico y a genotipificación de los polimorfismos 677C<img border=0 id="_x0000_i1025" src="../../../../../img/revistas/ric/v58n5/a7s1.jpg">T y 1298A<img border=0 id="_x0000_i1026" src="../../../../../img/revistas/ric/v58n5/a7s1.jpg">C del gen MTHFR. Resultados. La multigestación (0-2 vs.> 3, OR 2.1), un temprano inicio de vida sexual (IVS) (17 < vs. > 18 años, OR 4.3) o la combinación de ambos factores (OR 3.5), estuvieron asociados significativamente al CaCU. Los polimorfismos de MTHFR 677, 1298 y sus combinaciones no fueron diferentes entre casos y controles. Sin embargo, se observó una interacción significativa entre las gestaciones, el IVS y los polimorfismos de MTHFR (presencia del alelo 1298C o del genotipo 677TT). El alelo 1298C combinado con multigestación, con un IVS < 17 años, o con ambos factores, incrementó el riesgo para CaCU en 4.3, 5.3 y 11.8 veces, respectivamente, en tanto que el genotipo 677TT modificó este riesgo a 2.0, 1.9, y 4.2 veces, respectivamente. Conclusión. El alelo 1298C incrementa considerablemente el riesgo para CaCU en mujeres multigestas y con un IVS temprano, en tanto que el genotipo 677TT disminuye este riesgo, pero sin llegar a convertirse en un factor protector.

Objective. To determine the quality of the Early Cervical Cancer Detection Program in the state of Nuevo León. Material and methods. A random selection of 4 791 cytologic reports were analyzed, emitted by the State Ministry of Health, the University Hospital and the Mexican Institute for Social Security early cervical cancer detection modules. Pap tests of women with hysterectomy, current pregnancy, menopause or positive result were excluded. Quality was measured with previously defined standards. Analysis included, besides univariate statistics, tests of significance for proportions and means. Results. The quality of the program was fairly satisfactory at the level of the State. The quality of the sampling procedure was low; 39.9% of the tests contained endocervical cells. Quality of coverage was low; 15.6% were women 25 + years with first time Pap test. Quality of opportunity was high; 8.5 ± 7 weekdays between the date of the pap smear and the interpretation date. Conclusions. Strategies are needed to increase the impact of the state program, such as improving the sampling procedure and the coverage quality levels.

Objetivo. Determinar la calidad del Programa de Detección Oportuna de Cáncer Cervicouterino en Nuevo León. Material y métodos. Se analizaron 4 791 informes citológicos emitidos por los módulos de detección oportuna de la Secretaría de Salud Estatal, el Hospital Universitario y el Instituto Mexicano del Seguro Social, seleccionados al azar. Se excluyeron aquellos que pertenecían a mujeres con histerectomía, embarazo actual, menopausia o resultado citológico positivo. La calidad se midió con apego a estándares. El análisis incluyó, además de la estadística descriptiva, pruebas para diferencias de proporciones y de medias. Resultados. La calidad del Programa fue moderadamente satisfactoria en el ámbito estatal. La calidad de la toma de la muestra fue poco satisfactoria; 39.9% presentó células endocervicales. La calidad en términos de la cobertura fue poco satisfactoria; 15.6% correspondió a mujeres de 25 y más años atendidas por primera vez. La calidad en términos de la oportunidad fue muy satisfactoria; 8.5 ± .7 días hábiles entre las fechas de toma e interpretación. Conclusiones. Se requiere de estrategias para incrementar el impacto del Programa en el estado, tales como el mejoramiento en la calidad de la toma de la muestra y de la cobertura.