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"documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2018;151:41-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Primary colo-colic intussusception as cause of intestinal obstruction" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "41" "paginaFinal" => "42" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Intususcepción colo-cólica primaria como causa de oclusión intestinal" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "David Ambrona-Zafra, Juan José Segura-Sampedro, Myriam Fernández Isart" "autores" => array:3 [ 0 => array:2 [ "nombre" => "David" "apellidos" => "Ambrona-Zafra" ] 1 => array:2 [ "nombre" => "Juan José" "apellidos" => "Segura-Sampedro" ] 2 => array:2 [ "nombre" => "Myriam" "apellidos" => "Fernández Isart" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775317308825" "doi" => "10.1016/j.medcli.2017.11.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775317308825?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618301992?idApp=UINPBA00004N" "url" => "/23870206/0000015100000001/v1_201807170422/S2387020618301992/v1_201807170422/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020618302055" "issn" => "23870206" "doi" => "10.1016/j.medcle.2018.05.014" "estado" => "S300" "fechaPublicacion" => "2018-07-13" "aid" => "4372" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "pgl" "cita" => "Med Clin. 2018;151:39.e1-39.e17" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Consensus statement</span>" "titulo" => "GESIDA/PETHEMA recommendations on the diagnosis and treatment of lymphomas in patients infected by the human immunodeficiency virus" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "39.e1" "paginaFinal" => "39.e17" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Recomendaciones de GESIDA/PETHEMA sobre el diagnóstico y tratamiento de los linfomas en pacientes infectados por el virus de la inmunodeficiencia humana" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pilar Miralles, José Tomás Navarro, Juan Berenguer, José Gómez Codina, Mi Kwon, David Serrano, José Luis Díez-Martín, Salvador Villà, Rafael Rubio, Javier Menárguez, José-María Ribera Santasusana" "autores" => array:11 [ 0 => array:2 [ "nombre" => "Pilar" "apellidos" => "Miralles" ] 1 => array:2 [ "nombre" => "José Tomás" "apellidos" => "Navarro" ] 2 => array:2 [ "nombre" => "Juan" "apellidos" => "Berenguer" ] 3 => array:2 [ "nombre" => "José" "apellidos" => "Gómez Codina" ] 4 => array:2 [ "nombre" => "Mi" "apellidos" => "Kwon" ] 5 => array:2 [ "nombre" => "David" "apellidos" => "Serrano" ] 6 => array:2 [ "nombre" => "José Luis" "apellidos" => "Díez-Martín" ] 7 => array:2 [ "nombre" => "Salvador" "apellidos" => "Villà" ] 8 => array:2 [ "nombre" => "Rafael" "apellidos" => "Rubio" ] 9 => array:2 [ "nombre" => "Javier" "apellidos" => "Menárguez" ] 10 => array:2 [ "nombre" => "José-María" "apellidos" => "Ribera Santasusana" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775317309211" "doi" => "10.1016/j.medcli.2017.11.037" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775317309211?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618302055?idApp=UINPBA00004N" "url" => "/23870206/0000015100000001/v1_201807170422/S2387020618302055/v1_201807170422/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Association between melanoma, lymphoma and thyroid cancer. Case report and review of the literature" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "40" "paginaFinal" => "41" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Monserrat Franco-Muñoz, Mónica García-Arpa, Belén Lozano-Masdemont" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Monserrat" "apellidos" => "Franco-Muñoz" "email" => array:1 [ 0 => "monse.franco.m@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Mónica" "apellidos" => "García-Arpa" ] 2 => array:2 [ "nombre" => "Belén" "apellidos" => "Lozano-Masdemont" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Asociación entre melanoma, linfoma y cáncer de tiroides. Descripción de un caso y revisión de la literatura" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Several studies have shown an increased risk of developing a second neoplasm after certain tumours. Although the specific biological mechanisms have not yet been clarified, both cutaneous melanoma (CM) and lymphohematopoietic neoplasms show a higher risk of a second neoplasm; besides, a bi-directional association has also been described. On the other hand, it has been shown that there is an increased risk of thyroid carcinoma following a diagnosis of melanoma. We report the case of a male patient who suffered from a non-Hodgkin lymphoma (NHL) and years later developed melanoma and papillary thyroid cancer (PTC).</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 22-year-old male with a history of diffuse large B cell NHL at the age of 15, treated with chemotherapy, in complete remission. He reported a family history of NHL and melanoma (2 siblings of his paternal grandfather). At age 21, he was diagnosed with a 2.23<span class="elsevierStyleHsp" style=""></span>mm Breslow's depth melanoma in the right cervical region. The sentinel lymph node biopsy was negative, so close monitoring was decided. One year later, a right supraclavicular lymphadenopathy was observed in the examination, confirming melanoma metastasis by fine needle aspiration. PET/CT also showed left laterocervical lymphadenopathies, with no other findings. A bilateral cervical lymphadenectomy was performed, which revealed melanoma metastasis in right cervical lymphadenopathies and PTC metastasis in bilateral lymphadenopathies. In the subsequent thyroid ultrasound, a node was observed in the left lobe, so total thyroidectomy was performed, which confirmed the PTC, and treatment was completed with radioactive iodine ablation. The melanoma BRAF study was negative; finally, a high-dose treatment with interferon alfa was decided. The patient was lost to follow-up when changing his place of residence.</p><p id="par0015" class="elsevierStylePara elsevierViewall">There are many studies that show an increase in the frequency of a second primary neoplasm, after an CM, both <span class="elsevierStyleItalic">in situ</span> as well as invasive. The risk of a second melanoma is 9 times higher than the general population.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The non-cutaneous neoplasms most frequently associated with melanoma are: NHL, chronic lymphocytic leukaemia, thyroid carcinoma and breast cancer in women.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It has been estimated after an CM, there is an increase in the risk of NHL from 1.22 to 1.57,<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> depending on whether the melanoma was invasive or not, respectively, with the risk being higher during the first 5 years after diagnosis and when the melanoma had developed before the age of 30.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> The most frequent lymphoma subtypes after CM are small lymphocytic NHL, follicular lymphoma and diffuse large cell lymphoma.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Likewise, the association between NHL and melanoma is bi-directional, since patients with a history of NHL have an increased risk of melanoma, with a relative risk of 2.4, compared with a risk of 1.65 for a subsequent solid non-cutaneous neoplasm.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The highest risk of melanoma is in the first 3 years after diagnosis of NHL, remaining significant up to 10 years later.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> In addition, it has been observed in some studies that the association between NHL and melanoma affects the prognosis, with significant differences in mortality, with this being higher in those who had previously had NHL, compared to those who had not (31.4% <span class="elsevierStyleItalic">vs</span> 14.4%, respectively).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The cause of the association between these 2 neoplasms is unknown. Patients with lymphoma have immunodeficiency mediated by the tumour itself, which would be a risk factor for melanoma, and several studies have described that some chemotherapeutic agents, such as fludarabine, used in the treatment of NHL are associated with an increased risk of melanoma. In the case of localized CM, the main treatment is surgery, which does not explain the increased risk of NHL. UV radiation has been proposed as a common risk factor, but although it has effects on the immune system, its association with the NHL development has not been demonstrated.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Another hypothesis, which we believe is the most probable, would be the genetic susceptibility that could predispose the same patient to the development of both neoplasms. In fact, alterations in the CDKN2A gene and retinoblastoma have been described in both melanoma and NHL, but a specific genetic connection has not been demonstrated.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">On the other hand, it has been shown that patients with melanoma have a 2.17 relative risk of developing thyroid carcinoma, with PTC being the most common.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> 50% of the genetic alterations in PTC are in the BRAF gene, which could explain the association of these 2 tumors.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">We report the first case of a patient with NHL, CM and PTC, an association not described in the literature. Although the specific pathogenic mechanisms of this association have not been established to date, the patient's family history, which includes the same tumours, supports the possible genetic role. More studies with molecular analysis are needed to define the common genetic disorders underlying the development of these neoplasms.</p><p id="par0045" class="elsevierStylePara elsevierViewall">We strongly believe that the association between these tumours should be considered. Regular skin exams in patients with a history of NHL could contribute to an early detection of melanoma. Likewise, patients diagnosed with melanoma should remain under continuous surveillance, with follow-up visits that include complete history-taking and a rigorous physical examination, including thyroid and lymphadenopathy palpation, not only to detect recurrence, but also to timely diagnose the development of other tumours.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Franco-Muñoz M, García-Arpa M, Lozano-Masdemont B. Asociación entre melanoma, linfoma y cáncer de tiroides. Descripción de un caso y revisión de la literatura. Med Clin (Barc). 2018;151:40–41.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subsequent primary cancers among men and women with in situ and invasive melanoma of the skin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Balamurugan" 1 => "J.R. 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Disanto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/dc.23060" "Revista" => array:6 [ "tituloSerie" => "Diagn Cytopathol" "fecha" => "2014" "volumen" => "42" "paginaInicial" => "877" "paginaFinal" => "879" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24574369" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015100000001/v1_201807170422/S2387020618301980/v1_201807170422/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015100000001/v1_201807170422/S2387020618301980/v1_201807170422/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618301980?idApp=UINPBA00004N" ]
