RESUMO
BACKGROUND: Colorectal liver metastasis has a high incidence, and RAS oncogene mutation status carries significant prognostic information. We aimed to assess whether RAS-mutated patients present more or less frequently with positive margins in their hepatic metastasectomy. METHODS: We performed a systematic review and meta-analysis of studies from PubMed, Embase, and Lilacs databases. We analyzed liver metastatic colorectal cancer studies, which included information on RAS status and had surgical margin analysis of the liver metastasis. Odds ratios were computed using a random-effect model due to anticipated heterogeneity. We further performed a subanalysis limited to studies that included only patients with KRAS instead of all-RAS mutations. RESULTS: From the 2,705 studies screened, 19 articles were included in the meta-analysis. There were 7,391 patients. The prevalence of positive resection margin was not significantly different between patients carrier vs non-carrier for the all-RAS mutations (OR .99; 95% CI 0.83-1.18; P = .87), and for only KRAS mutation (OR .93; 95% CI 0.73-1.19; P = .57). CONCLUSIONS: Despite the strong correlation between colorectal liver metastasis prognosis and RAS mutation status, our meta-analysis's results suggest no correlation between the RAS status and the prevalence of positive resection margins. The findings contribute to a better understanding of the RAS mutation's role in the surgical resections of colorectal liver metastasis.
Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Humanos , Genes ras , Hepatectomia/métodos , Margens de Excisão , Prevalência , Proteínas Proto-Oncogênicas p21(ras)/genética , Neoplasias Colorretais/patologia , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/patologia , Mutação , PrognósticoRESUMO
Mielolipomas são tumores benignos raros compostos por tecido adiposo maduro e por elementos hematopoiéticos. Geralmente são menores que 5 cm e assintomáticos, embora lesões maiores podem apresentar-se com dor ou hemorragia retroperitoneal. Descrevemos um caso de mielolipoma gigante, associado à hemorragia retroperitoneal após biópsia por punção com agulha fina