Intraductal papillary carcinoma, also known as papillary ductal carcinoma in situ, forms part of a heterogeneous group of breast lesions, the reported incidence rates are very low and occurs in 27.7/100,000 in women, although the percentage of mortality is only 1%. This carcinoma is characterized because it can affect the inside portion of the mammary ducts, respecting the basement membrane, with proliferation of neoplasic cells, and since it is not in contact with the lymphatic vessels the possibility of metastasis is almost null. However, the risk of progressing to invasive cancer is nevertheless multifactorial as well as its size, histology, and resection margin. Clinically, it can be characterized by the presence of a single or multiple mass of moderate size, and on a mammograph it’s seen as nodular lesions with irregular edges. The case of an older adult female patient with a mammary nodule with 5 months of evolution, until it forms into a mass and later the execution of routine and laboratory examinations, allowing the diagnosis of intraductal papillary carcinoma to be confirmed. Due to the complexity of the clinical presentation and the age of the patient, a radical mastectomy and physiotherapy of the right upper limb was performed. intraductal papillary carcinoma represents less than 1% of all mammary carcinomas, and has a good prognosis. Keywords: carcinoma, mom, papillary. RESUMEN El carcinoma papilar intraductal, también conocido como carcinoma ductal in situ papilar, forma parte de un grupo heterogéneo de lesiones de la mama, la tasa de incidencia es muy baja y se presenta en 27,7/100.000 en mujeres, aunque el porcentaje de mortalidad es de tan solo el 1%. Se caracteriza porque en el interior de los ductos mamarios y respetando la membrana basal hay proliferación de células neoplasias, y al no encontrarse en contacto con los vasos linfáticos la posibilidad de metástasis es casi nula, más sin embargo el riesgo de progresar a cáncer invasor es multifactorial como su tamaño su histología y el margen de resección. Clínicamente se caracteriza por ser masas únicas o múltiples de tamaño moderado y en la mamografía se observan como lesiones nodulares de bordes irregulares. Se presenta el caso de una paciente adulta mayor que presenta un nódulo mamario de 5 meses de evolución, hasta tornarse en una masa y posterior a la ejecución de exámenes de gabinete y de laboratorio se confirma el diagnóstico de carcinoma papilar intraductal, por la complejidad del cuadro y por la edad de la paciente, se realiza como tratamiento mastectomía radical y fisioterapia del miembro superior derecho. El carcinoma papilar intraductal representa menos del 1% de todos los carcinomas mamarios, y es de buen pronóstico. Palabras claves: carcinoma, mama, papilar.

Arteriovenous malformations, also known as arteriovenous fistulas (AVF), are rare pathologies characterized by abnormal connections between the arterial and venous systems. It has a higher incidence in the right kidney, predominantly affecting women in the third and fourth decade of life. Its clinical manifestations vary according to its size, its etiology, its evolution time, as well as its location, and can be characterized by the presence of micro or macroscopic hematuria, lumbar or flank pain, nausea, vomiting and arterial hypertension. The case is presented of a 39-year-old patient who presented right lumbar pain approximately 96 hours ago, accompanied by hematuria that has increased sharply in the subsequent 24 hours.

Squamous cell metastasis from cervical cancer to breast is an extremely rare entity, approximately 29 cases have been documented worldwide since 1947 and it is the second documented case in Ecuador, the incidence is very low, it represents only 1,2 of all malignant neoplasms of the breast, which limits the expertise in the diagnosis and treatment of this metastasis, with the outermost quadrant of the breasts being the most frequent site of presentation. We present the clinical case of a 46-year-old married woman with a history of stage IVB squamous cell cancer of the cervix, who received chemotherapy, a Paclitaxel/Carboplatin regimen for 6 cycles. There was no good response and we had radiotherapy and brachytherapy treatment. The second line of chemotherapy with monodroga Gemcitab is proposed, the scheme is completed for 8 cycles. There is no favorable response, so a second-line chemotherapy treatment with Ifosfomide is proposed. The same metastases are present in the breast as after imaging and pathology examinations, it is concluded that the patient presents cervical Ca squamous cell metastases (cancer) from the cervix, 6 months after the diagnosis of the deceased patient. Metastasis to the breast from a neoplasm of other organs is very rare, the incidence of which is very low and the prognosis is gloomy. Keywords: metastasis, squamous cells, cancer of the cervix. RESUMEN La metástasis de células escamosas de cáncer de cérvix a mama es una entidad extremadamente rara, se ha documentado a nivel mundial aproximadamente 29 casos desde 1947 y es el segundo caso documentado en el Ecuador, la incidencia es muy baja, representa tan solo el 1,2 de todas las neoplasias malignas de la mama, lo que limita la experticia en el diagnóstico y tratamiento de esta metástasis, siendo el sitio más frecuente de presentación el cuadrante superior externo de las mamas. Se presenta el caso clínico de una paciente de 46 años, casada, con antecedentes de cáncer de cérvix de células escamosas en estadio IVB por lo que recibió tratamiento de quimioterapia, esquema Paclitaxel/Carboplatino por 6 ciclos. No hubo buena respuesta y recibió tratamiento de radioterapia y braquiterapia. Se propone segunda línea de quimioterapia con monodroga Gemcitab, se completa el esquema por 8 ciclos. No existió respuesta favorable por lo que se propone tratamiento de segunda línea de quimioterapia con Ifosfomida. Presenta metástasis en mama la misma que posterior a exámenes de imagen y patología se concluye que la paciente presenta metástasis de células escamosas de Ca (cáncer) de Cérvix a mama, 6 meses posterior al diagnóstico la paciente fallece. La metástasis en la mama de una neoplasia de otros órganos es muy raro cuya incidencia es muy baja y de pronóstico sombrío. Palabras claves: metástasis, células escamosas, cáncer de cérvix.