ca ovario dx y tx dr. hernández ene 2013

7/22/2019 CA Ovario Dx y TX Dr. Hernndez Ene 2013

1/86

Nr . ZDNXA FDXEEND[ @AXE

GLXTKMEA AEGCAOA

OLEDGCAOA AEGCAOA

Kdid Wdrvl gl a O ledgaca om Aegacolgm

LXDE EAX^D - 8:=7


2/86

Gegdr nd AvmrlaZrdgaz a Mvmezmna1

Wdrvlgla Oledgacaom Aegacolgm LXDE EAX^D.

Nr. ZDNXA FDXEEND[@AXE


3/86


4/86

GM AYMXLA

9% tanas gegdrdsoledgacolgas.

>-4 de irdgudeglmDnmn; >4-?:Zast `deapuslgms.Eucpmrms Leglndeglm; 4.4

=/?: `ukdrds


5/86


6/86


7/86

GEGDX ND AYMXLA - ^LZAW

DZL^DCLMC; 94-?:%

ODX@LEMC =4-8:%

Nr. ZDNXA FDXEEND[ @AXE

DW^XA@MC 4-=:%

@D^MW^WLGA 4%


8/86

^LZAWNDGEGDXNDAYMXLA

^lpas nd Edapcmslms



9/86


10/86

=. Nlsodr`lea`m.8. ûàr ndc sdea denanr`lga.7. Zacld`hrla`m.>. Gmrglea`m d`hrlaemrla.4. Garlagmrglea`m ea odstmglaemc.

9. ^drmta`m le`mnura.?. ûàrds `lxtas.



11/86


12/86

Gumnra gcelga; Zrdgaz;

Ea gmusme seta`ms. Cas seta`ms ledspdgilgas2 legcuyde flegfmze ndc mhna`de

(ndhlna m uem `msm a mgu`ucmgle nd cqulna) prdsle de cm pdcvls a nacar mhna`lemc y/a seta`ms urlemrlas

IAX@M ^MXNM ;

a Nlstdesletu`ar mhna`lemc ?4%

a Nacar mhna`lemc 8:%

a ^rmstarea urlemrla =9%

a Zrnlnm nd pdsa

a Wmeormna vmolemc

Waspdgfmr`mcloelnmn;

Nr.ZDNX

AFDXEEND[@AX

E


13/86

Dgaormim ^rmesvmolemc gae Nappcdr; @ms didgtlvm de Nx. Wdeslhlclnmn; gdrgm mc =::% Dspdglilglnmn; 67% Ea pdr`ltd dstunla nd ormends qulstds

@MXGMNAXDW ^T@AXMCDW; Zar tlpa

flstacolga

^MG; nd dcdggle de dstunla nd dxtdesle

X@; gmrmgtdrlzmgle nd cdslaeds, l`pcmetds ^.Mnlglaemcds; ZD^. ^D@, dstunlas dxtdesle.


Nr.ZDNX

AFDXEEND[@AX

E


14/86

Dgaormim ^rmesvmolemc Nappcdr; @ms didgtlvm de Nlmoestlga prdgaz.

Wdeslhlclnmn; gdrgm mc aLZ enlgd nd pucsmtlclnmn ; 3 =

@lxtms/ga`pcdkms@uctlcagucmrWfuet mrtdrlavdeasas^m`ma;

5 =:g`

`ukdr irtlc.5 4g`

past`deapuslgm.

Nr.ZDNX

AFDXEEND[@AX

E


15/86

Dgaormim ^rmesvmolemc Nappcdr;


MsgltlsMspdgta sclna.Dxgrdgdeglms 50 4``.^mhlquds 50 7``.

Gpsucm orudsm 50 7``.Harnds lrrdoucmrdsHlcmtdrmcEdaiar`mgle vmsgucmr

aLX enlgd nd rdslstdeglm nappcdr ; 3 :,>aLZ enlgd nd pucsmtlclnmn ; 3 =

@lxtms/ga`pcdkms@uctlcagucmrWfuet mrtdrlavdeasas^m`ma;

5 =:g``ukdr irtlc.

5 4g`

past`deapuslgm.

Nr.ZDNX

AFDXEEND[@AX

E


16/86

@mrgmnards tu`armcds

^fd sdru` cdvdcs ai GM=84 odedrmccy rdicdgttfd vacu`d ai tfd nlsdmsd.

Dcdvmtdn GM=84 prlar ta surodry ls usdiuc iariaccawleo tfd praordss ai tfd pmtldet nurleo

men mitdr trdmt`det. GM=4-7, GM=


17/86


18/86


Gm Avmrla

HDELOEMW; Dena`dtrlasls,

qulstds avrlgasfd`arrolgas, pmegrdmtltls,glrrasls, edirapmtms amctdrmglaeds pdrltaedmcds.

Gm =84 Nx; ?4-


19/86

Gm nd AYMXLA

@^ DZL^DCLMCDW;

GM =84

GM ?8->GM =


20/86


21/86

Gegdr nd Avmrla

DZL^DCLMCDW;

MG^LYLEM;Gmrglea`m lenlidrdeglmna

DW^XA@MCDW; LEFLHLEM;^u`ar nd gcucms nd cm

ormeucasm.

DW^XODEA



22/86


23/86


24/86

@moedtlg rdsaemegd l`moleo sgmeeleo(@XL)

^fls `anmclty sdd`s ta hd m `ard mggurmtdwmy ai ndtdgtleo pdrltaedmc `dtmstmsdsutslnd tfd trud pdcvls.

Wdeslhlclnmn 6?% Dspdglilglnmn


25/86


26/86

ZD^

Xdgdet stunlds fmvd nd`aestrmtdn flofsdesltlvlty men m pasltlvd prdnlgtlvd vmcud lelndetliyleo patdetlmccy rdsdgtmhcd rdgurrdet

avmrlme gmegdr wltf edomtlvd G^ ilenleos. Wdeslhlclnmn 67-69%

Dspdglilglnmn 4>-69%



27/86

NlmoeastlgAtfdrs

Gacaeasgapy men `m``aormpfy ^fasddxgcund m prl`mry gacaelg ar hrdmst cdslaewltf avmrlme `dtmstmsls.

Cmpmrasgapy Lt gme hd usdn le tfd`memod`det ai me avmrlme `mss mt`andrmtd/flof rlsb iar `mcloemegy.



28/86


29/86

MKGG Gmegdr Wtmoleo @meumc, Wlxtf Dnltlae

Gdrvlx Ttdrl

MKGG Gmegdr Wtmoleo @meumc ?tf Dnltlae, 8:=:.

Avmry


30/86


31/86


Gdrvlx Ttdrl


Avmry

Eatd ; Clvdr gmpsucd `dtmstmsls ^7/Wtmod LLL2 clvdr pmrdegfy`mc

`dtmstmsls @=/Wtmod LY. Zcdurmc diiuslae `ust fmvd pasltlvdgytacaoy iar @=/Wtmod LY.


32/86


33/86


Gdrvlx Ttdrl


Avmry


34/86

AYMXLA

NX. FDXE END[ 7>


Gdrvlx Ttdrl


Avmry

G?


35/86

Dstmnlilgmgle Gm Avmrla

ZXDGA[

Cagmc`detd

mvmezmna

MYME[MNA

L

LY

LLL

LL

Nr. ZDNXA FDXEEND[

@AXE


36/86

LM

LG

Gpsucm ratm^u`ar sahrd cm supdrilgld ndcavmrla

DW^ NLILG GLE G ND AY XLA


37/86


38/86


39/86

GM ND AYMXLA - DW^MNLAW

Cagmc`detd mvmezmna

LYLLL

N X . Z D N X A F D X E E N D [ @ A X E

Mvmezmna


40/86


41/86

ûàr nd gcucms odr`lemcdsGcelgm - Nlmoestlga

@msm mhna`leapcvlgm pmcpmhcd Nacar Grdgl`ldeta rplna (dxgdpta dc tdrmta`m

`mnura). Zudnd sdr dxmgdrhmna par cm rupturm atarsle ndc tuàr.

@uy irdgudetd nurmetd dc d`hmrmza. elga tuàr nd gcucms odr`lemcds gae hlcmtdrm-

clnmn; =: =4%. Nlsd`lemgle cleitlgm. @uy rmnlasdeslhcd. Fdàpdrltaeda; de gmsa nd rupturm nd cm gpsucm ndc

tuàr.



42/86

ûàr nd gcucms odr`lemcdsNLWODX@LEA@M

^rmtm`ldeta Glruom + Xmnlgmgle; ^msm nd gurmgle dxgdcdetd.

Cm paclqul`latdrmplm fm nmna hudeas rdsuctmnas.

^rmtm`ldeta gaesdrvmnar; ùkdr kavde, gae tuàrdegmpsucmna, uelcmtdrmc y gae ndsda nd pmrlnmn.



43/86

NLWODX@LEA@M; ^rmtm`ldeta

- De gmsa nd glruom gaesdrvmnarm rdmclzmr gulnmnasmdxpcarmgle ndc avmrla gaetrmcmtdrmc ^a`m nd hlap-

slm de gmsa nd cdslaeds saspdgfasms.- Dc


44/86

NLWODX@LEA@M; ^rmtm`ldeta

Wd ga`uelgme rdspudstms ga`pcdtms ndc arnde nd6: =::% de pmgldetds gae dstmnas LL y LY trmtmnms gaequl`latdrmplm.

Dc trmtm`ldeta, de odedrmc, ndhd sdr GAEWDXYMNAX,sld`prd qud sdm paslhcd.

^rmtm`ldeta nd dcdggle pmrm pmgldetds gae deidr`dnmnmvmezmnm; glruom + rmnlatdrmplm.

Wl dc Nlsodr`lea`m EA ds pura, dc praestlga dstmrnmna par cas atras tlpas flstacolgas.



45/86

^T@AX NDC WDEADENANX@LGA

Wleta`mtacaom; ?4% nd gmsas prdsdetme

nacar mhna-`lemc + `msm pcvlgm.

@mrgmnar tu`armc; elvdcds srlgas ndMcimidtapra-tdlem.



46/86


47/86

ûàr nd gcucms odr`lemcds^T@AX NDC WDEA DENANX@LGA

]ul`latdrmplm; YMG, YHZ y HDZ

Xdol`de Zmutms nd naslilgmgle

YMGYlegrlstlem (=.4ò / `8)

Mgtlea`lglem-N (:.4 o)Glgcaiasim`lnm ( 4 ? ò/bo)

Mpclgmgle LY g/ sd`mem x =8 sd`mems

Glgcas nd 4 nms

LY

g/ > sd`memsGmnm > sd`mems LY

YHZYlehcmstlem (=8 o/`8)Hcda`lglem (8: TL/`8)

Glspcmtlea (8: ò/ `8)

G/ 7 sd`mems - > glgcas LYWd`memc`detd ? glgcas LY

6glgca; sd`mem =:Nlmrla par 4 nms g/ 7 sd`mems 7 > glgcas

HDZHcda`lglem ( 8: TL/`8)Dtapslna (=:: o/`8)Glspcmtlea (8: o/`8)

Wd`memc par 7 glgcas LYNms = 4, g/ 7 sd`mems 7 glgcasNms = 4, g/ 7 sd`mems 7 glgcas



48/86

ûàr ùy MOXDWLYA. Wd msaglm m prdgaglnmn sdxumc. Zudnd prdsdetmrsd de 7 iar`ms;

- Garlagmrglea`m odstmglaemc prl`mrla, msaglmna m

d`hmrmza avrlga.- Garlagmrglea`m `dtmstslga nd uea odstmglaemc prl-

`mrla arlolemna de dc mpmrmta odeltmc (tdra).- ûàr nd gcucms odr`lemcds nlidrdeglmna fmglm ds-

trugturms traiahcstlgms.



49/86

ûàr nd Gcucms nd cm Ormeucasm; @s irdgudetd

ûàrds ^dga`m-Ilhra`m

ûàrds Ndrlvmnas Nd Cms Gcucmsnd Wdrtacl Cdynlo; Mrrdeahcmsta`m a Menrahcmsta`m

Olemenrahcmsta`m a Oledgahcmsta`m

ûàr Gcucms Clpalndms



50/86

^u`ar Gcucms nd cm ormeucasm

Mnuctas kvdeds @mrgmnar Leflhlem

Wdgrdtm Dstrodeas

Hmka patdeglmc `mcloea

Msaglm 4% gae Gm dena`dtrla.

Msaglm 84-4:% gae Flpdrpcmslm

dena`dtrlmc.

^x ]^ gae HDZ

^x X^



51/86

ûàrds garne sdxumc

Irdgudeglm; 4-=:%

ânas sae nd hmka patdeglmc nd`mcloelnmn y tldede Hude praestlgagae rdsdggle ga`pcdtm.

Glruom gaesdrvmnarm LM-G.

Dstmnlmkd ga`pcdta dstm lenlgmna.

Cm cleimndedgta`lm pudnd a`ltlrsd.

@medka gae ]^ (Zcmtlea) a X^.



52/86

ûàr nd gcucms odr`lemcds^drmta`m qustlga `mnura

Edapcmslm nd avmrla ùy irdgudetd (


53/86

^rmtm`ldeta;Wurodry Avmrlme Gmegdr



54/86

GLXTOM @LE@M@DE^D LEYMWLYM

CMZMXAWGAZLM DE GEGDX OLEDGACOLGA;Gm nd GrvlxGm nd AvmrlaGm nd Dena`dtrla yGm nd ^ra`pm nd imcapla


DCDG^XAGLXTOM;HLW^TX MX@AELGA; WAEAWTXOCLOMWTXD (ZLE[MW ZMXM

WDCCMNA ND YMWAW).DXHD; Wlstd`m Dcdgtraqulrrolgas (WD])

ga`hlemna gae Oms Mroe


55/86

Glruom de Gegdr nd avmrla

GMEGDX ZXDGA[; L y LL DW^MNLMKD ND AYMXLA

GEGDX MYME[MNA; LLL-LY GL^AXDNTGGLE ND AYMXLA.

ZXL@MXLM

WDGTENMXLM

^DXGLMXLM

Hdrdb men Fmgbdr' s Oyedgacaolg Aegacaoy, 4tf Dnltlae 8:=: Clpplegatt _lcclm`s & _lcbles



56/86

Glruom gae Gaeodcmgle/L`praetm

GMEGDX ZXDGA[; L y LL. FLW^DXDGÂ@LM M@ZCLMNM M

YMOLEM

CLEIMNDEDGÂ@LM ZDCYLGM

CLEIMNDEDGÂ@LM ZMXMMAX^LGM HLAZWLMW @TC^LZCDW

ZDXLÂEDMCDW

A@DE^DGÂ@LM

HLAZWLM NATOCMW

HLAZWLM YDWLGMCHdrdb men Fmgbdr' s Oyedgacaolg Aegacaoy, 4tf Dnltlae 8:=: Clpplegatt _lcclm`s & _lcbles



57/86

WAEAWTXO; D]TLZA TC^XMWELGA \CLOMWTXD

^lssud Iuslae Wystd`

HLW^TX MX@ELGA



58/86

GLXTO GLÂXXDNTGÂXY EGDW DE DCDG^XAGLXTO

Hlstur mrèlgaClomsurd; Wdccmnar nd vmsas


Wdrvlg la nd Ole dgaca om Aega colg m, LXDE EAX^D.

GLÂXXDNTGGLE


59/86

GL^AXXDNTGGLE

MYMEGDW DCDG^XAGLXTOM

A@DE^DG^A@M LEIXMGCLGMN X . Z D N X A F D X E E N D [ @ A X E

Clomsurd;MtcmsL`pmgtMnvmegd



60/86

CLOMWTXD \ MX@ELGAMYMEGDW DE DCDG^XAGLXTOM



AWGA O W G


61/86

CMZMXAWGAZLM NLMOEW^LGM


LenlgmtlaesGegdr prdgaz; DG L y LL Dvmcumgle y `medka nd `msm medxlmc Dstmnlilgmgle Gegdr harndcled y gegdr levmslva Xddstmnlmkd pmrm gegdr prdgaz nd avmrla ytra`pm nd imcapla

Dstmnlas mvmezmnas; LLL y LY; Dvmcumgle Cmpmrasgplgm pmrm ndtdr`lemrapdrmtlvlnmn

Wdgaen caab Ndhucbleo cl`ltmna/ `mea mslstlnm

Baestmetle [mbmsems, @.N. 864-8


62/86

GEGDX ND AYMXLA MYME[MNA

Cmpmrasgaplm nlmoestlgm]^ mnyuvmetd


DXHD KD^8 MXOE ZCMW@M


63/86

DXHD KD^8 MXOE ZCMW@M

Odedrmnar nd MI y XIWlstd`m nd sdccmna nd vmsas.Dxtdesms zaems grudetms.Gltardnugglaeds


Wdrvlg la n d Oledga cao m Aega colg m, LXDE EAX^D.

GEGDX ZXDGA[ CMZ


64/86

GEGDX ZXDGA[ - CMZ


WLW^D@M

XT@L BAF


DW^MNLMKD ND AYMXLA CMZ


65/86

N X . Z D N X A F D X E E N D [ @ A X EWdrvlg la n d Oledga cao m Aega colg m, LXDE EAX^D.

GLXTOM CMZ

GLXTOM CMZMXAWGZLGM \


66/86

GLXTOM CMZMXAWGZLGM \

GEGDX


Wdrvlg la n d Oledga caom Aega colg m, LXDE EAX^D.

GLXTOM CMZMXAWGZLGM DE GEGDX


67/86

GLXTOM CMZMXAWGZLGM DE GEGDX



DW^MNLMKD ND AYMXLA CMZ


68/86

GLXTOM CMZMXAWGZLGM




69/86


70/86

CLEI NDEDG^A@L ZCYLG \ Z X X^LGC Z

GEGDX ZXDGA[Gm Avmrla


CMZ ZF@ Xd`lx =4-==-=:.X`x
http://localhost/var/www/apps/conversion/tmp/scratch_5/LAP%20PHM%20Remix%2015-11-10.Rmxhttp://localhost/var/www/apps/conversion/tmp/scratch_5/LAP%20PHM%20Remix%2015-11-10.Rmxhttp://localhost/var/www/apps/conversion/tmp/scratch_5/LAP%20PHM%20Remix%2015-11-10.Rmxhttp://localhost/var/www/apps/conversion/tmp/scratch_5/LAP%20PHM%20Remix%2015-11-10.Rmxhttp://localhost/var/www/apps/conversion/tmp/scratch_5/LAP%20PHM%20Remix%2015-11-10.Rmxhttp://localhost/var/www/apps/conversion/tmp/scratch_5/LAP%20PHM%20Remix%2015-11-10.Rmx


71/86

Nr. ZDNXA FDXEEND[ @AXE ?=

Wdrvlgla nd Oledgacaom Aegacolgm LXDE EAX^D


72/86

Wdgaenmry Gytardnugtlae

Wdgaenmry gytardnugtlae `myhd ndiledn ms memttd`pt mt gytardnugtlvd surodry mt sa`d stmodiaccawleo ga`pcdtlae ai ilrst-cled gfd`atfdrmpy(749).

Zmtldets wltf praordsslvd nlsdmsd aegfd`atfdrmpy mrd eat sultmhcd gmenlnmtds iarsdgaenmry gytardnugtlae, hut pmtldets wfa mrdgclelgmccy irdd ai nlsdmsd men uendroa sdgaen-

caab cmpmrata`y `my hdedilt li mcc `mgrasgaplgrdslnumc nlsdmsd gme hd rdsdgtdn (74?).




73/86

Wdgaenmry Gytardnugtlae

Zmtldets wltf rdgurrdet nlsdmsd mrd sa`dtl`dsgmenlnmtds iar surolgmc dxglslae ai tfdlr nlsdmsd.

ûàr rdsdgtlae uendr tfdsd glrgu`stmegdssfaucn hd rdstrlgtdn ta tfasd wfa fmvd m

nlsdmsd-irdd letdrvmc ai mt cdmst =8, hutprdidrmhcy 8> àetfs, ar tfasd le wfa` mcc`mgrasgaplg nlsdmsd gme hd rdsdgtdn,rdomrncdss ai tfd nlsdmsd-irdd letdrvmc.




74/86

GLÂXXDNTGGLE DE GEGDX ND AYMXLA

Ca lndmcGa`pcdtm sle dvlndeglm nd tuàr rdslnumc.Cm sahrdvlnm ds `myar m `dear tuàr

rdslnumc X:)Aptl`m; Dc l`pcmetd rdslnumc, dear a loumc m =g`.Wuhptl`m; Dc l`pcmetd `myar m =g`.


Oyedgacaolg aegacaoy, Hdrdb men Fmgbdr,4tf dnltlae, 8:=:.

Mcdttl (8::9)

GLÂXDNTGGLE ND AYMXLA


75/86

GL^AXDNTGGLE ND AYMXLA

GL^AXDNTGGLE ZXL@MXLM, WDGTENMXLM y ^DXGLMXLMN X . Z D N X A F D X E E N D [ @ A X E

Wdrvlgla nd Oledgacaom Aegacolgm LXDE EAX^D


76/86

^u`ar nd gcucms odr`lemcds


77/86

^u`ar nd gcucms odr`lemcdsGltardnuggle qulrrolgm

Zudnd tdedr ue pmpdc de dc `medka nd cmsrdgurrdeglms.

Ndpdend ndc tlpa flstacolga y deidr`dnmn rdslnumc`mya a `dear nd = g`.

Nr. ZDNXA FDXEEND[

@AXE


78/86

^XM^M@LDE^A MN\TYME^D




79/86



80/86



81/86


G A


82/86

Gm Avmrla - Xdgurrdeglm

Cm rdgurrdeglm sd prdsdetm de cas prl`dras 8 m 7mas;

Gm Dmrcy L-LL 84%

Gm LLL-LY 6:%nas prl`dras mas

^MG;

Ndtdgtm 64% nd deidr`dnmn Hucby

Ea ndtdgtm dei `el`m a gmrglea`mtasls`lgraeanucmr.

Wdeslhlclnmn; 4:-6:%


Gm Harndcled-Zraordsle


83/86

Gm Harndcled-Zraordsle

^fd survlvmc ai pmtldets wltf harndrcled tuàrs lsflofdr tfme prdvlauscy ndsgrlhdn le sa`drdtraspdgtlvd stunlds.

Gaesdrvmtlvd surodry ls smid men `my hd

prapasdn ta sdvdrmc pmtldets wltf dmrcy mennlssd`lemtdn nlsdmsd mitdr tfarauof nlsgusslaeai mcc tfdrmpdutlg aptlaes.

Zraordsslae ta gmrglea`m ls mppraxl`mtdcy 8%

men `my hd ahsdrvdn le hatf ùgleaus mensdraus tuàrs.


W lhlcln n ^MG/ZD^ X l


84/86

Wdeslhlclnmn ^MG/ZD^-Xdgurrdeglm



85/86

ILOTXD 7?.=.Ahsdrvdn survlvmc rmtds iar ==,?76 gmsds wltf prl`mry avmrlme dpltfdclmc gmegdr. Nmtm ira` tfd Emtlaemc

Gmegdr Nmtm Hmsd (Ga``lsslae ae Gmegdr ai tfd M`drlgme Gaccdod ai Wurodaes men tfd M`drlgme Gmegdr Wagldty)

nlmoeasdn le ydmrs =2 Wtmod LLG, >?72 Wtmod LLLM, 86>2 Wtmod LLLH, >842 Wtmod LLLG, 7,6=42 men Wtmod LY, 7,??7.

?tf Dnl t lae

8:=:


86/86

LEDE

ca ovario dx y tx dr. hernández ene 2013

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