Pвncreas heterotуpico Neoplбsicos. Adenomas tubulo-vilosos. Adenomas sгo neoplasias benignas, constituнdas por cйlulas epiteliais que se dispхem formando glвndulas. Quando o adenoma й classificado de tubular й porque as cйlulas epiteliais formam glвndulas tubulares. Nos adenomas vilosos as cйlulas epiteliais formam projeзхes digitiformes, chamadas vilosidades, na superfнcie do pуlipo.

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A celularidade era leve em cinco casos e moderada em um. They arise in the muscle coats of the bowel as leiomyomas or leiomyosarcomas. Histologically the differentiation between benign and malignant may be difficult and causes problem to choose the best treatment. Recently, immunohistochemical techniques showed that many of these tumours had no smooth muscle differentiation and are actually GISTs. Gastrointestinal Stromal Tumours, GISTs, are histologically, immunohistochemically and genetically different from leiomyomas and leiomyosarcomas.

Five leiomyomas were in the muscularis mucosae. By the application of the immunohistochemical technique in tumours of the circular and longitudinal layers with the markers CD, CD34, PTN S- , smooth muscle actine and desmin, only one leiomyoma from the mural layer was confirmed and other five lesions were proved to be GISTs.

Surgery is the best treatment because radiotherapy or chemotherapy are not effective. The Imatinibe mesylate, selective inhibitor of the tirosina kinase expressed in GISTs, can be the therapeutic option for metastatic GISTs or for those impossible to resect.

The diagnosis and differentiation between leiomyomas, leiomyosarcomas and GISTs can only be made with the use of immunohistochemical thecnique, and a larger number of patients is necessary to define the best surgical treatment and the prognosis of these lesions. AkwarI, O. Leiomyosarcoma of the small and large bowel. Cancer, v. Appelman, H. Mesenchymal tumors of the gut: histological perspectives, new approaches, new results, and does it make any difference?

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Mutations in exon 11 of c-Kit occur preferentially in malignant versus benign gastrointestinal stromal tumors and do not occur in leiomyomas or leiomyosarcomas. Am J Pathol, v. Lee, S. Radiological Features of Leiomyomatous tumors of the colon and rectum.

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Miettinem, M. Mod Pathol, v. Miettinen, M.


Resección transgástrica laparoscópica de leiomioma localizado en unión esofagogástrica

Glaz and Grunebaum 6 recommended that asymptomatic and mildly symptomatic patients should not undergo leiomiomaa but be regularly monitored using radiography and endoscopy every years instead. We used vicryl or ethibond to suture myotomy. The advent of minimally invasive techniques has produced an increase in endoscopic approaches to the detriment of open surgery. Consensus meeting for the management of gastrointestinal stromal tumors. Thoracoscopic resection of benign tumours of the esophagus. Thoracoscopic enucleation of liomioma tumors of the esophagus under simultaneous flexible esophagoscopy.





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