ABSTRACT
O melanoma cervical primário é um diagnóstico raro e frequentemente desafiador, especialmente na presença de lesões amelanóticas, cuja confirmação deve ser feita por métodos imuno-histoquímicos. Apesar do tratamento agressivo, o prognóstico para essa doença costuma ser ruim. Relato do caso: Mulher, 79 anos, com histórico de sangramento vaginal decorrente de uma lesão cervical maligna. Inicialmente, a colposcopia revelou uma lesão ulcerada no exocérvix e a biópsia confirmou ser um tumor maligno. No entanto, após uma histerectomia abdominal radical, o exame histopatológico mostrou tratar-se de uma neoplasia maligna epitelioide, confirmada como um melanoma maligno do colo do útero por meio de exame imuno-histoquímico. A paciente recebeu quimioterapia adjuvante e radioterapia, mas eventualmente apresentou recorrência e veio a óbito. Conclusão: O presente relato avalia uma paciente com um diagnóstico incomum de melanoma cervical que, apesar do tratamento agressivo, teve um desfecho desfavorável. No entanto, uma vigilância cutânea minuciosa deve ser realizada para diagnosticá-lo corretamente como primário.
Primary cervical melanoma is a rare and often challenging diagnosis, particularly in the presence of amelanotic lesions, where confirmation should be made through immunohistochemical methods. Despite aggressive treatment, the prognosis for this disease is typically poor. Case Report: A 79-year-old woman with a history of vaginal bleeding from a malignant cervical lesion. Initially, colposcopy examination revealed an ulcerated lesion of the exocervix, and biopsy confirmed a malignant neoplasm. However, following a radical abdominal hysterectomy, histopathological examination displayed a malignant epithelioid neoplasm, confirmed a malignant melanoma of the cervix through immunohistochemical assays. The patient received adjuvant chemotherapy and radiation therapy, but eventually experienced recurrence and died. Conclusion: The present report assesses a patient with an uncommon diagnosis of cervical melanoma, which, despite aggressive treatment, had an unfavorable outcome. However, thorough skin surveillance should be performed to correctly diagnose it as primary
Subject(s)
Uterine Cervical Neoplasms , Cervix Uteri , MelanomaABSTRACT
SUMMARY OBJECTIVE: The aim of this study was to evaluate the perception of the aesthetic result of breast reconstruction surgery from the perspective of plastic surgeons compared with physicians who are not specialists in plastic surgery. METHODS: Twenty patients who underwent breast reconstruction after mastectomy had their aesthetic results evaluated by 16 plastic surgeons and 16 nonplastic physicians, yielding a total of 620 ratings (320 ratings from plastic surgeons and 320 ratings from other specialists). For all analyses, the level of rejection adopted for the null hypothesis was 5% (p-value <0.05). RESULTS: Significant differences were observed between the two groups. On average, medical professionals who specialized in plastic surgery always obtained higher scores than other physicians. However, no significant differences were found in the assessment of the aesthetic outcome of breast reconstruction according to the sex of the rating medical professional for any of the assessments considered in this study. A strong positive linear correlation between the time since training in the medical specialty of plastic surgery (r=0.750, p=0.001) and the mean aesthetic outcome score was observed in this study. CONCLUSION: Plastic surgeons assessed the aesthetic results of breast reconstruction more positively than nonplastic physicians.