{"id":33975,"date":"2013-12-20T12:09:08","date_gmt":"2013-12-20T16:39:08","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=33975"},"modified":"2013-12-21T15:29:19","modified_gmt":"2013-12-21T19:59:19","slug":"tumor-de-celulas-gigantes-de-la-vaina-tendinosa","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/33975","title":{"rendered":"Tumor de c\u00e9lulas gigantes de la vaina tendinosa"},"content":{"rendered":"<p><em><strong>De La Torre A, Sandoval R, Hern\u00e1ndez M, Ortiz W, Oliver M, Ortega J <\/strong><\/em><br \/><em><strong>Hospital Vargas Instituto de Biomedicina UCV Caracas Venezuela<\/strong><\/em><\/p>\n<p><!--more--><\/p>\n<p>Paciente femenino de 28 a\u00f1os. Natural y procedentede Caracas<\/p>\n<p>Antecedentes Personales y familiares: No contributorios<\/p>\n<p>Refiere que en Junio 2011 Aumento de volumen con coloraci\u00f3n viol\u00e1cea subungueal en falange distal dedo \u00edndice de mano izquierda . En Enero 2012 Aumento progresivo de volumen en falange distal Junio 2012 Acude a nuestro centro y se ingresa con la presunci\u00f3n diagnostica de Tumor gl\u00f3mico Vs. Tumor de c\u00e9lulas gigantes de la vaina tendinosa<\/p>\n<p>\u2022 Plan de trabajo: Foto cl\u00ednica. Perfil de laboratorio. Ciprofloxacina 500 mg BID VO. Rx AP y lateral de mano izquierda. Biopsia<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33976\" alt=\"laboratorio-343-semana\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/laboratorio-343-semana.jpg\" width=\"390\" height=\"344\" \/><\/p>\n<div id='gallery-1' class='gallery galleryid-33975 gallery-columns-3 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/laboratorio-343-semana.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/laboratorio-343-semana-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/laboratorio-343-semana-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/laboratorio-343-semana-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/laboratorio-343-semana-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.001.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.001-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.001-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.001-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.001-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.002.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.002-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.002-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.002-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.002-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.003.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.003-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.003-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.003-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.003-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.004.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.004-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.004-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.004-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.004-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.005.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.005-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.005-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.005-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.005-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.006.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/Caso-semana-343.006-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.006-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.006-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/Caso-semana-343.006-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/caso-semana-featured-343.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2013\/12\/caso-semana-featured-343-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/caso-semana-featured-343-150x150.jpg 150w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/caso-semana-featured-343-25x25.jpg 25w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2013\/12\/caso-semana-featured-343-260x260.jpg 260w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p><strong>Diagnostico definitivo: Tumor de c\u00e9lulas gigantes de la vaina tendinosa.<\/strong><\/p>\n<p>\u2022 <strong>Discusion<\/strong><\/p>\n<p>Tumores benignos de tejidos blandos. Tumores no epiteliales. Pacientes 30-50 an?os, sexo femenino 2:1. Segundo en frecuencia de neoplasias benignas manos . 80% se localizan en dedos. Variantes Cl\u00ednicas: Forma difusa: en rodillas, caderas y tobillos. M\u00faltiples tumores. Tipo 2. Forma localizada: en cara anterior de los dedos pr\u00f3ximo a articulaciones interfal\u00e1ngicas, solitarias. Tipo 1. Neoformaciones subcut\u00e1neas, bien circunscritas consistencia firme, color de la piel, adherida a planos profundos. Evoluci\u00f3n lenta, asintom\u00e1tico<\/p>\n<p><span style=\"font-size: x-small;\"><em>&#8211; Fotiadis E et al. Giant cell tumour of tendon sheath of the digits. A systematic review. Hand 2011;6:244-9<br \/>&#8211; Suresh SS et al. Giant cell tumor of tendon sheath: case series and review of literature. J Hand Microsurg. 2010;2:67-71<\/em><\/span><\/p>\n<p>\u2022 <strong>Patogenia<\/strong>: traumatismo previo, inflamatorias, alteraciones metab\u00f3licas, infecciosas Mapeo citogene?tico, translocaciones en el cromosoma 1 (1p11-13) y cromosoma 2 (2q35-37) r10. Erosi\u00f3n \u00f3sea, 10-20 % Presi\u00f3n del tumor sobre cortical \u00f3sea, radiograf\u00eda e histopatolog\u00eda son claves en el diagn\u00f3stico Diagn\u00f3stico diferencial: xantomas tendinosos, condromatosis sinovial, fibromas de la vaina tendinosa, sarcoma sinovial, sarcoma epitelioide<\/p>\n<p><span style=\"font-size: x-small;\"><em>&#8211; Garg B et al. Giant cell tumour of the tendon sheath of the hand. J Orthop Surg 2011;19:218-20.<br \/>&#8211; Darwish FM et al. Giant cell tumour of tendon sheath: experience with 52 cases. Singapore Med J. 2008;49:879-82<\/em><\/span><\/p>\n<p>\u2022 <strong>Pron\u00f3stico<\/strong>: controversia, 10 -20% pueden malignizarse. Excepcional malignizaci\u00f3n<\/p>\n<p>\u2022 <strong>Tratamiento<\/strong>:<\/p>\n<ul>\n<li>Extirpaci\u00f3n quir\u00fargica, de elecci\u00f3n, incisiones en Z, bayoneta o T<\/li>\n<li>Adherencia a la piel excisio?n eli?ptica para completa extirpacio?n<\/li>\n<li>Radioterapia, en casos excisi\u00f3n inadecuada, alta actividad mit\u00f3tica, evitar recurrencias<\/li>\n<li>Recidivas: 7-45%, tras una extirpaci\u00f3n incompleta<\/li>\n<\/ul>\n<p><span style=\"font-size: x-small;\"><em>&#8211; Wan JM et al. Imaging of giant cell tumour of the tendon sheat Radiol Med 2010;115:141-51<\/em><\/span><br \/><span style=\"font-size: x-small;\"><em>&#8211; Ricart JM et al. Abordaje quir\u00fargico del tumor de c\u00e9lulas gigantes de la vaina tendinosa Piel 2004;19:163-7<\/em><\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>De La Torre A, Sandoval R, Hern\u00e1ndez M, Ortiz W, Oliver M, Ortega J . Instituto de Biomedicina: Refiere que en Junio 2011 Aumento de volumen con coloraci\u00f3n viol\u00e1cea subungueal en falange distal dedo \u00edndice de mano izquierda . En Enero 2012 Aumento progresivo de volumen en falange distal Junio 2012 Acude a nuestro centro y se ingresa con la presunci\u00f3n diagnostica de Tumor gl\u00f3mico Vs. Tumor de c\u00e9lulas gigantes de la vaina tendinosa. Plan de trabajo: Foto cl\u00ednica. Perfil de laboratorio. Ciprofloxacina 500 mg BID VO. Rx AP y lateral de mano izquierda. Biopsia<\/p>\n","protected":false},"author":16,"featured_media":33983,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29,574],"tags":[],"class_list":["post-33975","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-caso-de-la-semana","category-seccion-inicial"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/33975","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=33975"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/33975\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media\/33983"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=33975"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=33975"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=33975"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}