{"id":5176,"date":"2008-12-05T23:19:09","date_gmt":"2008-12-06T03:19:09","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=5176"},"modified":"2008-12-05T23:22:32","modified_gmt":"2008-12-06T03:22:32","slug":"caso-de-la-semana-n218","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/5176","title":{"rendered":"Caso de la semana N\u00ba218"},"content":{"rendered":"<p><strong>Presentado   por Carmen Bastidas montilla (dermat\u00f3logo),&nbsp; Marisela Acosta Casanova (anatomopat\u00f3logo), <br \/>\nHospital General Dr. Luis   Razetti\/Barinas\/Venezuela<\/strong><\/p>\n<p>&nbsp;Paciente   de 41 a\u00f1os de edad quien refiere la aparici\u00f3n de n\u00f3dulo duro, ovalado de   2 cm de   longitud mayor,superficie querat\u00f3sica, en la piel de la regi\u00f3n lumbar derecha   con 2 a\u00f1os de evoluci\u00f3n aproximadamente. Refiere que todo comenz\u00f3 como una   picada de insecto, la cual fue aumentando r\u00e1pidamente. Insiste que \u00e9l no ten\u00eda   nada en esa regi\u00f3n anat\u00f3mica (de novo)<\/p>\n<p><!--more--><\/p>\n<p>Favor   ver foto cl\u00ednica:<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-1.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"292\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-1-300x292.jpg\" alt=\"\" title=\"melanoma-1\" class=\"alignnone size-medium wp-image-5177\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-1-300x292.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-1.jpg 419w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-2.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"300\" width=\"287\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-2-287x300.jpg\" alt=\"\" title=\"melanoma-2\" class=\"alignnone size-medium wp-image-5178\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-2-287x300.jpg 287w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-2.jpg 422w\" sizes=\"auto, (max-width: 287px) 100vw, 287px\" \/><\/a><\/p>\n<p>Extirpaci\u00f3n   con margen oncol\u00f3gicos (margen 2   cm cm) Reconstrucci\u00f3n con dos colgajos   laterales.<\/p>\n<p>Favor   ver foto histopatol\u00f3gica:<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-3.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"240\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-3-300x240.jpg\" alt=\"\" title=\"melanoma-3\" class=\"alignnone size-medium wp-image-5179\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-3-300x240.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-3.jpg 588w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-4.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"268\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-4-300x268.jpg\" alt=\"\" title=\"melanoma-4\" class=\"alignnone size-medium wp-image-5180\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-4-300x268.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-4.jpg 448w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-5.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"269\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-5-300x269.jpg\" alt=\"\" title=\"melanoma-5\" class=\"alignnone size-medium wp-image-5181\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-5-300x269.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-5.jpg 453w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-6.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"265\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-6-300x265.jpg\" alt=\"\" title=\"melanoma-6\" class=\"alignnone size-medium wp-image-5182\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-6-300x265.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-6.jpg 462w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-7.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"262\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/melanoma-7-300x262.jpg\" alt=\"\" title=\"melanoma-7\" class=\"alignnone size-medium wp-image-5183\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-7-300x262.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/melanoma-7.jpg 466w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Melanoma cut\u00e1neo en fase de crecimiento vertical,   nivel IV de Clark, Breslow de 6   mm, con dos mitosis por 10 campos<\/p>\n<p>Inmunohistoqu\u00edmica: Anatatomopatol\u00f3gicamentea   (H&amp;E) e Imunohistoqu\u00edmica<\/p>\n<p>&nbsp;(Melan-A,   HMB-45 y Prote\u00edna S-100)<\/p>\n<p>Laboratorio   convencional dentro de la normalidad.<\/p>\n<p>RX   t\u00f3rax sin metastasis.<\/p>\n<p>ECO   abdomino-p\u00e9lvico: sin lesiones patol\u00f3gicas aparente.<\/p>\n<p>Evaluaci\u00f3n   por medicina interna: Hipertensi\u00f3n arterial severa<\/p>\n<p><strong>Cu\u00e1l   al es su conducta?<\/strong><\/p>\n<p><strong>C\u00f3mo   lo manejar\u00eda usted?<\/strong><\/p>\n<p><strong>Ganglio   centinela en esa regi\u00f3n   anat\u00f3mica?<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Presentado por Carmen Bastidas montilla (dermat\u00f3logo),&nbsp; Marisela Acosta Casanova (anatomopat\u00f3logo), Hospital General Dr. Luis Razetti\/Barinas\/Venezuela &nbsp;Paciente de 41 a\u00f1os de edad quien refiere la aparici\u00f3n de n\u00f3dulo duro, ovalado de 2 cm de longitud mayor,superficie querat\u00f3sica, en la piel de la regi\u00f3n lumbar derecha con 2 a\u00f1os de evoluci\u00f3n aproximadamente. Refiere que todo comenz\u00f3 como &hellip;<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[],"class_list":["post-5176","post","type-post","status-publish","format-standard","","category-caso-de-la-semana"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/5176","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=5176"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/5176\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=5176"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=5176"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=5176"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}