RESUMO
A nineteen years old woman with ambiguous external genitalia was studied. This condition had been previously identified as a newborn, but her parents refused medical attention and it was reared as a girl. At 12-years, she began spontaneous mammary development, appearing pubic and axillary hair, and clitoral enlargement. The menarche occurred at 15-years and it was followed by irregular periods. Physical examination, showed absence of hirsutism and acne, normal mammary development equivalent to grade V of Tanner. The external genitalia showed fused labio-scrotal folds with an small introitus. The urethral meatus was absent and was later located inside the introitus. There was a big phallus similar to an adult penis with a normal glans, flexed by a chordee. Hormonal determinations discarded congenital adrenal hyperplasia. The karyotype was 46,XX and testosterone levels were in adult male range. Pelvic ultrasonography disclosed a normal uterus and both gonads in confirmed by laparoscopy identifying bilateral ovotestis. Testicular tissue was removed and plastic reconstruction of female genitals was done.
Assuntos
Transtornos do Desenvolvimento Sexual , Adulto , Transtornos do Desenvolvimento Sexual/diagnóstico , Transtornos do Desenvolvimento Sexual/cirurgia , Feminino , Genitália Feminina/cirurgia , Humanos , Laparoscopia , Cirurgia PlásticaRESUMO
OBJECTIVE: To analyze the descriptive epidemiology of cancer at the Instituto Nacional de Cancerología of Mexico, and describe the characteristics of the growing demand for medical care. MATERIAL AND METHODS: A review of the 10 year experience of the Hospital Cancer Registry from 1985 to 1994 was done. RESULTS: During the study period a total of 28591 patients was registered with the histological confirmation of cancer. There were 8984 (31.4%) men, being the testicle (8.3%), the lung (7.4%), non-Hodgkin's lymphoma (7.1%) and the prostate (5.5%) the more frequent malignancies. In women a total of 19597 (68.6%) cases were seen; together, invasive cervical cancer (30.6%) and breast cancers (20.6%) represent more than 50% of all patients. In 1996, 108876 outpatient services were given, 6492 hospitalizations, 36388 sessions of radiotherapy and 9116 of chemotherapy. Only 30% of this population comes from Mexico City, the remaining lives in the 31 different states of Mexico. CONCLUSIONS: Supporting the development of the Centros Estatales de Cancerología for the referral of patients is necessary, this will avoid the rapid saturation of medical care at the institute. Also, stimulate the development of hospital registries and collaborate with the Ministry of Health to improve the early cancer detection programmes in Mexico.
Assuntos
Neoplasias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Distribuição por SexoRESUMO
La combinación de mitoxantrona (M), 5-fluorouracilo (F) y ciclofosfamida (C), se administró como tratamiento inicial a 180 pacintes con cáncer avanzado de la glándula mamaria. Este estudio no comparativo se llevó a cabo en 7 diferentes instituciones médicas de Argentina, Brasil y México. Las dosis utilizadas fueron: mitoxantrona 12 mg/m2 i.v. día 1-21; 5-fluorouracilo 500 mg'm2 i.v. días 1-8-21 y ciclofosfamida 500 mg/m2 i.v. día 1-21. Las dosis se modificaron de acuerdo a la toxicidad presentada. En el 37% de los 1026 ciclos se presentó leucopenia <2000/mm3 y trombocitopenia <100,000/mm3 en el 16%. Náusea y vómito se presentaron en 82%, diarrea en el 27% y alopecia en el 74%. Respuesta global se observó en 88 de 147 pacientes valorables (60%); respuesta completa en 32 (21.8%) y respuesta parcial en 56 (38%), nos e observaron cambios en 38 (25.9%) y progresión en 21 (14.3%). La sobrevida promedio en este grupo fue de 25 meses; actualmente continúan con vida y sin evidencia de actividad tumoral, a más de 6 años, 24 (16.3%) de las pacientes. Aparte de la mielosupesión, en su mayoría neutropenia, la combinación MFC generalmente fue efectiva y bien tolerada con una baja incidencia de efectos secundarios. Se concluye que mitoxantrona en combinación con 5-fluorouracilo y ciclofosfamida, contribuyen a prolongar la sobrevida de las enfermas con cáncer mamario avanzado, mejorando la calidad de vida en un número importante de ellas. Se recomienda la combinación de MFC como esquema de priemra línea.