Tejido mamario ectópico en vulva: reporte de caso y revisión sistemática de la literatura
DOI:
https://doi.org/10.18597/rcog.3593Resumen
Objetivo: reportar el caso de una paciente con diagnóstico de tejido mamario ectópico en vulva, y realizar una revisión de la literatura acerca del diagnóstico, tratamiento y pronóstico de esta condición en esta localización.
Materiales y métodos: paciente de 49 años consulta por masa vulvar dolorosa a un centro privado de nivel medio de complejidad ubicado en Bogotá, Colombia. Se realizó ecografía de la lesión y posteriormente escisión quirúrgica; la histopatología mostró tejido mamario ectópico sin malignidad. Se realizó una búsqueda en las bases de datos PubMed, Embase, Cochrane, LILACS y Scielo, con las palabras clave “Vulva”, “Glándulas mamarias”, “ectópico”, “Vulva”, “Breast” y “Ectopic”, y se incluyeron reportes y series de caso de mujeres con tejido mamario en vulva confirmado por histopatología.
Resultados: se identificaron 184 títulos, de los cuales 94 fueron finalmente incluidos para un total de 126 casos. El 57,9% eran tumores benignos, con un 95% en mujeres menores de 50 años; y el 42,06% eran tumores malignos, el 92 % en mujeres mayores de 50 años. El diagnóstico se realizó por clínica, con imágenes diagnósticas complementarias, marcadores tumorales e inmunohistoquímica en algunos casos. Se realizó escisión local en el 91% de los casos de patología benigna y 43% de patología maligna, siendo el método diagnóstico y terapéutico.
Conclusión: el tejido mamario ectópico en vulva debe ser considerado como parte del diagnóstico diferencial de masas a nivel vulvar con diferente pronóstico en mujeres pre y posmenopáusicas. Se requieren más estudios para una mejor caracterización de la patología y definir el tratamiento ideal en términos de recaída y supervivencia.
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