ABSTRACT
Rosai-Dorfman Disease (RDD) is a rare non-Langerhans histiocytosis, usually self-limited and presenting with massive, painless, bilateral cervical lymphadenopathy, with or without constitutional symptoms. Extranodal disease is frequently present, and may happen in the absence of lymph node involvement, symptomatology and differential diagnosis will depend on the site affected and fatal cases may occur. The authors present two cases of Rosai-Dorfman disease (RDD), diagnosed through immunohistochemistry, with different progressions, one with complete remission and one culminating in death, highlighting the variety of presentations and the diagnostic difficulty. RDD is a rare condition with clinical presentations similar to several diseases, and should be considered in the differential diagnosis of lymphadenopathy with extranodal lesions.
ABSTRACT
OBJECTIVE: Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility-sparing treatment of cervical cancer. METHODS: The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants. RESULTS: The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti-stenosis device, and uterine transposition). CONCLUSIONS: As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.
Subject(s)
Fertility Preservation , Surgical Oncology , Trachelectomy , Uterine Cervical Neoplasms , Brazil , Consensus , Female , Humans , Neoplasm Staging , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/surgeryABSTRACT
ABSTRACT Introduction: Angiosarcomas are rare pathologies, and their appearance in the small intestine is extremely unusual. Case report: Female patient presenting vomiting, colic, abdominal distension and peritoneal irritation. An exploratory laparotomy and an enterectomy were performed. Histopathology revealed vascular neoplasm; immunohistochemistry, markers CD31, p53 and cell proliferation antigen Ki-67. The patient developed diffuse sarcomatosis and died two months after the onset of symptoms. Conclusion: This case demonstrates the difficulty in early diagnosing this pathology, due to its nonspecific clinical presentation. The disease aggressiveness, its unestablished predisposing factors and the controversy around the adequate treatment engender the poor prognosis.
RESUMO Introdução: Angiossarcomas são patologias raras, e o aparecimento deles no intestino delgado é extremamente incomum. Relato de caso: Paciente do sexo feminino apresentando vômitos, cólica, distensão abdominal e irritação peritoneal. Foram realizadas laparotomia exploratória e enterectomia, evidenciando-se neoplasia vascular ao anatomopatológico e marcadores CD31, p53 e antígeno de proliferação celular Ki-67 à imuno-histoquímica. A paciente evoluiu com sarcomatose difusa e faleceu dois meses após o início dos sintomas. Conclusão: Demonstra-se a dificuldade em diagnosticar precocemente essa patologia devido à sua clínica inespecífica. A agressividade da doença, seus fatores predisponentes indeterminados e a controvérsia referente ao tratamento adequado suscitam seu péssimo prognóstico.
ABSTRACT
Spontaneous esophageal rupture carries high morbidity and mortality. The main prognostic factor is early diagnosis, before 12 hours, and appropriate treatment. This is a case report of a 41-years-old man with late esophageal rupture diagnosis treated successfully with transmediatinal esophagectomy and esophageal-gastric tube cervical anastomosis.
Subject(s)
Esophageal Perforation , Mediastinal Diseases , Adult , Humans , MaleABSTRACT
Spontaneous esophageal rupture carries high morbidity and mortality. The main prognostic factor is early diagnosis, before 12 hours, and appropriate treatment. This is a case report of a 41-years-old man with late esophageal rupture diagnosis treated successfully with transmediatinal esophagectomy and esophageal-gastric tube cervical anastomosis.
Subject(s)
Adult , Humans , Male , Esophageal Perforation , Mediastinal DiseasesABSTRACT
Foram investigados cinco casos de carcinoma espinocelular (CEC) da mama e um tumor raro, e foram descritos menos de 150 casos na literatura médica. Foram analisadas as características clínicas, anatomopatológicas e terapêuticas das pacientes portadoras de CEC da mama, atendidas no Hospital de Câncer de Barretos. Quatro pacientes chegaram ao hospital com tumores volumosos e localmente avançados (pT4b), sendo submetidas a mastectomia e esvaziamento axilar, e, ao contrário da literatura, todas apresentavam metástase axilar. A radioterapia foi realizada em todas as pacientes, e a quimioterapia com antracíclicos foi realizada em três pacientes. Os receptores de estrogênio, progesterona e c-erb B2 foram negativos. Todas as pacientes encontram-se vivas e sem doença em um período de seguimento mediano de 55,6 meses; fato superior ao observado para o carcinoma ductal. Esses casos vêm a contribuir para melhor conhecimento da biologia desse raro tumor.
The authors report five cases of breast squamous cell carcinoma, a very rare tumor, whose there were described lower than 150 cases in medical literature. We analyze the clinical, pathologic and therapeutic aspects of breast squamous cell carcinoma. Pour patients had large and locally advanced tumors (PT4b), and they were submitted to mastectomy and axillary dissection; whose were noted axillary metastases, uncommon fact. Radiotherapy was done in all patients, and three patients received antraciclic chemotherapy. The receptors of estrogen, progesterone and c-erb B2 were negative. The patients are live without disease in a median period of 55,6 months which is superior to invasive ductal carcinoma. This report of a case represents a contribution to better knowledge of biology of this rare tumor.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged, 80 and over , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/therapy , Carcinoma, Squamous Cell/pathology , Immunohistochemistry , PrognosisABSTRACT
Os autores analisaram quatro casos de carcinoma espinocelular da mama, um tumor raro, no qual foram descritos menos de cem casos na literatura médica. Analisaram-se as características clínicas, anatomopatológicas, terapêuticas das pacientes portadoras de carcinoma espinocelular da mama atendidas no Hospital de Câncer de Barretos. Todas as pacientes chegaram ao hospital com tumores volumosos e localmente avançados (pT4b). Os receptores de estrogênio, progesterona e c-erb B2 foram negativos. Todas as pacientes se submeteram a mastectomia e esvaziamento axilar e, ao contrário do que diz a literatura, todas apresentavam metástase axilar. Radioterapia foi realizada em todas as pacientes e quimioterapia com antracíclicos foi realizada em três pacientes. As pacientes encontram-se vivas e sem doença num período de seguimento mediano de 14,8 meses. Esses casos vêm a contribuir para melhor conhecimento da biologia desse raro tumor.
The authors report four cases of breast squamous cell carcinoma, a very rare tumor, whose with less than one hundred cases in described medical literature. We analyse the clinical, pathologic and therapeutic aspects of breast squamous cell carcinoma. All four patients had large e locally advanced tumors (pT4b). The receptors of estrogen, progesterone and c-erb B2 were negative. All patients were submitted to mastectomy and axillary dissection; whose were noted axillary metastases, uncommon fact. Radiotherapy was done in all patients, and three patients received antraciclic chemotherapy. The patients are alive without disease in a median period of 14,8 months. These cases represent a contribution to better knowledge of the biology of this rare tumor.
