The lucky polyp: an unusual manifestation of chronic schistosomiasis.

A 23-year-old male from Brazil presented with bright red hematochezia. Proctological examination revealed grade II internal hemorrhoids, but flexible sigmoidoscopy uncovered a 6 mm-pedunculated polyp in the sigmoid colon, which was found to result from inflammatory reaction to Schistosoma mansoni egg deposition. The patient had no signs of portal hypertension and was successfully treated with praziquantel. This case underscores a rare presentation of chronic intestinal schistosomiasis and emphasizes the role of early diagnosis in preventing severe hepatic sequelae of chronic Schistosoma infection.

Neoplasm of uncertain behaviour of the breast-a retrospective study in a breast unit.

INTRODUCTION: Breast lesions include a heterogeneous group of entities with variable clinical behaviour and morphological presentation, mostly classified as benign or malignant, with predictable behaviour. However, there are lesions with clinical, breast imaging and/or biopsy characteristics that do not clarify their nature. These lesions have an uncertain behaviour regarding their malignant potential at diagnosis.We intend to relate the preoperative diagnosis of neoplasm of uncertain behaviour of the breast (NUnBB) regarding the core needle biopsy and the histological result after excisional biopsy. METHODS: This is a retrospective study of patients submitted to local excision of breast lesions with a perioperative diagnosis of NUnBB, classified as 2383 at 'International Statistical Classification of Diseases and Related Health Problems' (ICD 9), between January 2007 and October 2016 in a breast unit. RESULTS: Ninety-two cases with the diagnosis of NUnBB were analysed: 91 females with a mean age of 59 ± 14 years. All were submitted to local excision of breast lesion as ambulatory surgery with the following histology: 64% benign, 3% malignant potential and 33% malignant. Of those who presented malignant results, 69% underwent a surgical re-intervention for local control of the disease. DISCUSSION: Regarding the considerable number of malignant lesions at final histology and the high percentage of which are re-operated, NUnBB should be treated with the same priority as a confirmed malignant neoplasm and whenever possible, using the most appropriate surgical technique.

Paratesticular Leiomyosarcoma: A Case Report and Review of the Literature.

Paratesticular sarcomas are rare. Most cases reported in the literature are depending on retrospective analysis of case reports, small series, literature reviews, and expert opinion and they show different outcomes depending on several variables. The majority indicate that this may be an indolent tumor with a potential for cure if treated early. We present a case of a 58 year old man with a history of painless enlargement of the right testis. The ultrasound showed an extratesticular lesion and a right excisional of the mass was performed. The pathological examination revealed a leiomyosarcoma, and was then completed with a right radical inguinal orchiectomy. A review of the literature regarding paratesticular sarcomas presentation, diagnosis and treatment is presented in this article.

Isolated abdominal wall metastasis of endometrial carcinoma.

A woman in her mid-60s presented with a bulky mass on the anterior abdominal wall. She had a previous incidental diagnosis of endometrial adenocarcinoma FIGO stage IB following a vaginal hysterectomy. Physical exam and imaging revealed a well circumscribed bulging tumour at the umbilical region, measuring 10 × 9 × 9 cm, with overlying intact skin and subcutaneous tissue. Surgical resection was undertaken, and histological examination showed features of endometrial carcinoma. She began chemotherapy and is alive with no signs of recurrent disease one year after surgery. This case brings up to light an atypical location of a solitary metastasis of endometrial carcinoma.

Echinococcus granulosus in Portugal: the first report of the G7 genotype in cattle.

Although cystic echinococcosis (CE) has been a recognized public health problem in Portugal, molecular data regarding the types and prevalence of infecting strains of its etiological agent (Echinococcus granulosus) are still scarce. Over the last years we have been evaluating the prevalence of CE in the country, and in this report we determined the parasite genotypes infecting sheep, goats, cattle and human in Portugal, based on 209 hydatid cysts recovered from liver (n=96), lung (n=95), pancreas (n=17) and kidney (n=1) samples obtained between 2008 and 2011. Protoscoleces or germinal layers were collected from individual cysts, DNA was extracted, and a part of the mitochondrial DNA encoding the cytochrome c oxidase subunit 1 was amplified by PCR. Overall, the results confirm the overall dominance of the G1-G3 cluster of strains, which are particularly prevalent in southern Portugal in livestock ruminants. Unexpectedly, one parasite sequence with cattle origin was found to correspond to E. granulosus G7 genotype (also known as E. intermedius), here reported for the first time in bovine, in Portugal.

Occult hepatitis B infection in Portuguese patients with chronic hepatitis C liver disease: prevalence and clinical significance.

INTRODUCTION: Occult hepatitis B virus (HBV) infection, defined as the presence of HBV DNA in the liver (with detectable or undetectable HBV DNA in the serum), has been reported in patients with chronic hepatitis C. Some data suggest its association with a more severe liver disease and a worse response to interferon therapy in this subgroup of patients. However, the clinical significance of this condition is still under debate. AIM: To determine the prevalence of occult HBV infection and its clinical significance in patients with chronic hepatitis C liver disease. MATERIALS AND METHODS: A prospective analysis of consecutive outpatients with chronic hepatitis C who underwent a liver biopsy recruited between January 2008 and June 2011 was carried out. Data included patient's sex and age, source of hepatitis C virus (HCV) infection, HCV genotype and viral load, presence of serologic markers of previous HBV infection, HBV DNA presence in the liver, histologic findings, and response to interferon and ribavirin treatment. HBV DNA and HCV RNA detection were carried out using a sensitive commercially available PCR kit. HBV DNA was tested in liver samples using a nested PCR procedure. RESULTS: One hundred patients were included, 73% men, mean age 49 ± 11.9 years. Most patients had a genotype 1, with a high viral load, HCV infection. Of the patients, 33% had HBV serologic markers of past infection. The presence of HBV DNA in liver samples was found in 57% of the patients. No statistically significant difference in the epidemiological, histological, or virological or response to therapy data was found in patients with occult HBV infection. CONCLUSION: Occult HBV infection occurred in a high percentage of patients but was not clinically significant.

Amamentaçäo no peito e cárie dentária: revisäo da literatura e relato de caso clínico / Breast feeding and dental caries: literature review and clinical case report

Este trabalho tem como objetivo enfocar o aparecimento de cáries em crianças muito jovens, devido a amamentaçäo no peito. Faz-se uma breve revisäo da literatura sobre o assunto e apresenta-se um caso clínico, atendido no Departamento de Odontopediatria e Ortodontia da FO-UFRJ