RESUMEN
This communication reports the second known case of oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip. The patient, an 82-year-old black woman, a former smoker (for more than 30 years), suffering from an ulcerous vegetative lesion in the middle third of the lower lip for approximately 12 months. The result of the histopathological analysis indicated carcinoma, with well-differentiated keratinized squamous cells and the presence of septate mycelial filaments. In the direct mycological examination, thick and dematiaceous septate mycelial filaments were observed. After the resection surgery, the patient did not need to use an antifungal drug to treat the phaeohyphomycosis, and no follow-up radiotherapy was needed to treat the squamocellular carcinoma. We stress that the presence of the squamocellular lesion of the lip was a possible contributing factor to the infection.
Asunto(s)
Carcinoma de Células Escamosas/complicaciones , Neoplasias de los Labios/complicaciones , Labio/patología , Feohifomicosis/diagnóstico , Feohifomicosis/patología , Anciano de 80 o más Años , Brasil , Carcinoma de Células Escamosas/cirugía , Femenino , Histocitoquímica , Humanos , Labio/cirugía , Neoplasias de los Labios/cirugía , Técnicas Microbiológicas , Microscopía , Feohifomicosis/cirugía , Resultado del TratamientoRESUMEN
Abstract This communication reports the second known case of oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip. The patient, an 82-year-old black woman, a former smoker (for more than 30 years), suffering from an ulcerous vegetative lesion in the middle third of the lower lip for approximately 12 months. The result of the histopathological analysis indicated carcinoma, with well-differentiated keratinized squamous cells and the presence of septate mycelial filaments. In the direct mycological examination, thick and dematiaceous septate mycelial filaments were observed. After the resection surgery, the patient did not need to use an antifungal drug to treat the phaeohyphomycosis, and no follow-up radiotherapy was needed to treat the squamocellular carcinoma. We stress that the presence of the squamocellular lesion of the lip was a possible contributing factor to the infection.
Asunto(s)
Humanos , Femenino , Anciano de 80 o más Años , Neoplasias de los Labios/complicaciones , Carcinoma de Células Escamosas/complicaciones , Feohifomicosis/diagnóstico , Feohifomicosis/patología , Labio/patología , Brasil , Neoplasias de los Labios/cirugía , Carcinoma de Células Escamosas/cirugía , Técnicas Microbiológicas , Resultado del Tratamiento , Feohifomicosis/cirugía , Histocitoquímica , Labio/cirugía , MicroscopíaRESUMEN
Introdução: Fungos podem infectar secundariamente carcinoma de cabeça e pescoço, diante da imunossupressão local e de tratamentos invasivos. Objetivo: Detectar fungos em tumor de cabeça e pescoço. Métodos: Foram submetidos à biópsia 81 pacientes, atendidos no ambulatório de cirurgia de cabeça e pescoço do Hospital do Câncer de Pernambuco, obtendo-se 83 amostras teciduais, segmentadas para exame histopatológico e micológico. Foram preparados exames diretos com KOH a 20% e cultura em ágar infusão de cérebro e coração e ágar Sabouraud, adicionados de cloranfenicol mantidos em duplicata a 30°C e 37°C, respectivamente. Resultados: Foram detectadas leveduras e/ou pseudomicélio com isolamento de Candida albicans (três), C. tropicalis (uma), C. parapsilosis (quatro), C. guillermondii (duas) acometendo áreas de cavidade bucal, lábio e pele na região da cabeça e pescoço. No diagnóstico histológico, foi confirmado que 60% dos pacientes apresentavam carcinoma de células escamosas. Os tumores malignos ocorreram no estádio I em 50%, seguido de estádio II e IV. Em apenas um caso foi verificado tumor de língua benígno. Conclusão: Fungos ocorrem em tumores de cabeça e pescoço e, devido à gravidade de seus danos, torna-se indispensável o diagnóstico preciso e precoce.
Introduction: Fungi can secondarily infect head and neck carcinoma, due to the local immunosuppression and invasive treatments. Objective: To detect fungi in head and neck tumor. Methods: 81 patients had been submitted to biopsy, attended the clinic of surgery of head and neck of the Cancer Hospital of Pernambuco getting 83 clinical specimens, which had been fragmented, for histopathologic and mycological examination. They were prepared for direct examination with potassium hydroxide solution 20% and culture in agar brain heart infusion and Sabouraud agar added with cloranphenicol, kept at 30°C and 37°C. Results: Yeasts were detected and/or pseudomicelium with isolation of Candida albicans (3), C. tropicalis (1), C. parapsilosis (4), C. guillermondii (2) affecting areas of the oral cavity, lip and skin in the head and neck region. On histological diagnosis it was confirmed that 60% of the patients presented squamous cells carcinoma. The malignant tumors occurred in stadium I in 50%, followed by stadium II and IV. Only one case of tongue benign tumor was verified. Conclusion: Fungi occur in head and neck tumors and, due to the severity of his injury, it is essential to the accurate early diagnosis.