HighlightsEccrine spiradenomas are rare adnexal tumors of the skin. Malignant transformation of benign forms is even more unfrequent.We report a case of malignant breast eccrine spiradenoma diagnosed on the basis of breast cancer prevention programme.Imaging findings of these tumors have not been clearly demonstrated because of the rare incidence and lack of workup.The MRI findings of epidermal inclusion cysts and eccrine spiradenomas are different and so these findings might be used in making the differential diagnosis.

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INTRODUCCIÓN: Se han descrito múltiples técnicas quirúrgicas para el tratamiento de las hernias incisionales buscando reducir las complicaciones postoperatorias y la tasa de recurrencia, siendo la de Rives-Stoppa una de las más empleadas actualmente. Se presentan los resultados obtenidos con esta técnica para el tratamiento de las eventraciones de línea media.MÉTODOS: Se intervinieron 10 pacientes con hernias incisionales  (Abril 2009-Octubre 2016), recopilando datos epidemiológicos, características de las hernias y técnica quirúrgica. Se evaluó el grado de satisfacción y el dolor postoperatorio mediante una escala visual analógica (EVA), siendo controlados al mes y al año postquirúrgico.RESULTADOS. Se incluyeron 58 mujeres y 42 hombres con una edad media de 62,32±12,6 años. 38 pacientes presentaban eventroplastias previas. Las localizaciones y tamaños más frecuentes, según la European Hernia Society (EHS) fueron M3 (23%) y M4 (21%), y W2 (49%) y W3 (40%). Se empleó malla de polipropileno de baja densidad en el 93%, con overlap de 5 cm (RIQ: 4-6). La estancia hospitalaria fue de 2 días (RIQ: 2-4), morbilidad del 20% y mortalidad del 4%. La puntuación álgica el primer día postoperatorio fue 5 (RIQ: 2-7), reduciéndose a 0 (RIQ: 0-2) al mes. La tasa de infección de herida fue de un 8% y de recidiva al año del 13,2%. El 91% resultaron satisfechos tras la cirugía.CONCLUSIONES: En los pacientes intervenidos de hernia incisional de línea media mediante la técnica de Rives-Stoppa se obtienen buenos resultados de dolor, grado de satisfacción, tasa de recurrencia y complicaciones de herida.

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Major outpatient surgery of the thyroid and parathyroid glands. Results after 6 years experience Objetive: Ambulatory or overnight stay surgery have been consolidated in many different procedures. However, its use in thyroid and parathyroid surgery is still controversial. The aim of this report is to present the results of 6 years of ambulatory patients undergoing surgery of the thyroid or parathyroid glands. Material and Methods: Prospective observational study of patients who underwent hemithyroidectomy or selective parathyroidectomy in the ambulatory program from January 2011 to December 2016. All patients included met the general criteria of ambulatory surgery. During the first years nodules bigger than 3cm and patients classified as ASA III were excluded. Patients arrive at hospital the morning of surgery. After the operation, patients pass to the post-anesthesia care unit and then to the hospitalization room. 8 hours after surgery patients are discharged home if they meet the criteria. Results: 270 patients were operated, 159 of them met the inclusion criteria. The overall applicability rate was 59%. The acceptance rate was 83.6% and the substitution index was 49.2%. The unwanted hospital admission was 10.4% for the parathyroidectomy and 17.6% for the hemithyroidectomy. Any patient presented major complications at home. The satisfaction rate was high or very high for 94% of the patients. Conclusion: Selective parathyroidectomy and hemithyroidectomy performed by experienced surgeons in selected patients can be safely and effectively carried out in ambulatory surgery (outpatient). It would be possible to improve the substitution index by increasing the application and acceptability ratios.