RESUMEN
Granulomatosis with polyangiitis (GPA) is a rare, immunologically mediated systemic vasculitis that presents as an aseptic necrotizing granulomatous inflammation of the small and medium vessels. Case presentation: The authors report the case of a 47-year-old Syrian female smoker who was admitted to the hospital due to painless palpable masses in her left cheek and left upper lip. Her medical and family histories were unremarkable. Physical examination demonstrated facial asymmetry and bulging in the left cheek and left suborbital region, with marked limitation of the mouth opening and notable oozing from the maxillary sinus seen within the area of the extracted second premolar, in addition to swelling in the parotid gland region, which caused facial nerve weakness. Lab findings were significant for an elevated neutrophil count (16 400/mm3) and positivity of Cytoplasmic- Antineutrophil Cytoplasmic Autoantibody (c-ANCA). Microscopic examination revealed noncaseating necrotizing granulomas surrounded by histocytes and multinucleated giant cells. The disease kept its local invasion going despite the treatment with cyclophosphamide. Thus, surgical debridement was considered a notable improvement. Discussion: GPA is a systemic disease that usually affects multiple organs, especially the kidneys and the upper and lower respiratory tracts. The diagnosis of GPA is made based on a biopsy and the presence of c-ANCA. The treatment of GPA is patient-adjusted, and it usually consists of two major phases: induction and maintenance. However, surgery is preferred for patients who do not respond to pharmacotherapy. Conclusion: This article demonstrates a rare case of GPA in the head and neck region; that highlights the significant role of c-ANCA and histological exam in confirming the diagnosis as well as the importance of surgery when the disease is intractable.
RESUMEN
Burkitt's lymphoma (BL), an aggressive kind of non-Hodgkin's B-cell lymphoma. On the other hand, appendiceal carcinoid tumors are uncommon neuroendocrine neoplasms. Case presentation: The authors report a case of a 15-year-old Syrian adolescent who was admitted to our hospital due to a persistent, severe generalized abdomen pain accompanied by nausea, vomiting, loss of appetite, and inability to pass stool or gas. An abdominal radiograph revealed dilated intestinal loops with air-fluid levels. The patient underwent emergency surgery through which a retroperitoneal mass was removed as well as part of the ileum and the appendix. The final diagnosis was consistent with intestinal BL associated with an appendiceal carcinoid tumor. Discussion: The correlation between gastrointestinal carcinoids and other types of tumors was frequently reported. However, there have been few reports of carcinoid tumors being associated with lymphoreticular system cancers. BLs were classified into three variants: endemic, sporadic, and acquired immunodeficiency-associated BL while appendiceal neuroendocrine tumors were classified as the following: well-differentiated neuroendocrine tumors with benign or uncertain malignant potential; well-differentiated neuroendocrine carcinoma with low malignant potential; and mixed exocrine-neuroendocrine carcinoma. Conclusion: Our article demonstrates an unusual association between BL and an appendiceal carcinoid tumor that highlights the significant role of histological and immunohistochemical staining in confirming the diagnosis, as well as the role of surgery in treating the complications of intestinal BLs.
RESUMEN
Breast cancer is the most common malignancy in women and represents a leading cause of cancer-related mortalities. Females' awareness toward breast cancer is essential for the early diagnosis and detection especially in low and middle-income countries. This study aims to assess the awareness of breast cancer risk factors among females in the Syrian Coast. Methodology: An online cross-sectional survey was conducted among Syrian females during the COVID-19 pandemic. The questionnaire used in the study was derived from the Cancer Research UK questionnaire and modified to fit the perspective of the study. Statistical Package for Social Sciences (SPSS) was used for data analysis. The independent samples t-test and the one-way analysis of variance (ANOVA) were applied to determine whether there is statistical evidence or any statistically significant differences between the variables. Results: A total of 1305 females participated in the study. The majority aged between 18 and 25, (28.8%) of the participants obtained their information related to breast cancer from internet, (36.7%) of were smokers and (82.8%) had a family member with breast cancer. These results suggested a significant correlation between smoking, family history of cancer, marital status, and breast cancer awareness. Conclusion: This study showed which factors are significantly related to women's awareness of breast cancer risk factors. These results can contribute in the implementation of awareness programs and campaigns, thus raising the level of awareness among women.