Papillary thyroid cancer is the most common endocrine malignancy, and due to its favorable prognosis, the extent of surgery has been a matter of debate. About 10% of these tumors are located in the thyroid isthmus, with no specific management in current guidelines. In the last decades, isthmusectomy has been proposed as a therapeutic option for isthmic papillary thyroid carcinoma, although there is no consensus on its management. We present two cases of patients from our institution with solitary isthmic papillary thyroid carcinoma without clinical macroscopic extrathyroidal extension or clinical-radiological lymph node involvement who were treated with isthmusectomy without prophylactic lymph node dissection. Neither of them had any postoperative complications. Both had an intermediate risk of recurrence due to aggressive variants. None of them had signs of recurrence during follow-up. We intend to show that isthmusectomy seems to be an effective and safe surgical alternative in selected patients through these cases.
El cáncer de mama (CM) es la principal causa de muerte por cáncer en mujeres chilenas. Es una enfermedad heterogénea, en la cual se han identificado cuatro subtipos básicos, determinados según características clínicas, histológicas y moleculares, los que se relacionan a estrategias terapéuticas. El CM triple negativo (CMTN) se caracteriza por su agresividad, recaída temprana y mayor tendencia a presentarse en etapas avanzadas. Frecuentemente afecta a mujeres jóvenes o con antecedentes familiares de CM u ovario. La única terapia sistémica aprobada para el CMTN es la quimioterapia; sin embargo, recientemente terapias moleculares con inhibidores de puntos de control inmune e inhibidores de la poli-adenosina difosfato ribosa polimerasa, han mostrado eficacia en pacientes seleccionados, y se han agregado al arsenal terapéutico para CMTN. Dada la aparición de estas nuevas estrategias, parece relevante entender la heterogeneidad de esta enfermedad, los mecanismos de acción de las nuevas terapias, resultados clínicos y criterios de selección de pacientes para terapias moleculares. Presentamos una revisión de la terapia sistémica actual del CMTN.
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