Clinicopathological analysis of head and neck rhabdomyosarcoma: A series of 10 cases and literature review.

BACKGROUND: To describe the clinicopathological characteristics of a series of head and neck rhabdomyosarcoma (RMS) and to review the literature. MATERIAL AND METHODS: Cases diagnosed as RMS affecting the head and neck region were retrospectively retrieved from the files of two Brazilian institutions from January 2006 to January 2017. Data on clinical features (sex, age and affected site), microscopic subtype, immunohistochemical results, treatment employed and follow-up status were obtained from the patient's medical charts. RESULTS: During the period considered, 10 cases of RMS were identified. Females predominated (4M:6F), the mean age at diagnosis was 16.5 years-old and the orbit was the most affected site (4 cases). Microscopically, most cases were classified as embryonal RMS (6 cases) and the Desmin/Myogenin/Myo-D1 immunohistochemical positivity was useful to confirm the diagnosis. Chemotherapy and radiotherapy were applied to 9 and 8 patients respectively, whereas 2 patients were treated by surgery. Recurrences occurred in 3 patients and distant metastasis in 2 cases. Nine patients were alive in their last follow-up, 3 of them with disease, whereas 1 patient died due to the disease. CONCLUSION: Head and neck RMS is an aggressive malignant neoplasm which demands especial concern to achieve early diagnosis and successful treatment.

Hantavirus Pulmonary Syndrome: An Alert to Latin American Countries.

Approximately 400 cases of Hantavirus Pulmonary Syndrome (HPS) have been reported on the North American continent since the first epidemic in 1993, in New Mexico, USA. In Brazil, 12 cases were confirmed before 1998. Infection results from inhalation of rodent blood, saliva or waste. Clinical findings of the disease are characterized by a nonspecific febrile illness, followed by rapid progression to pulmonary edema which may lead to a shock-like state or renal failure. Mortality is high and emergency measures are necessary, including ECMO (extracorporeal membrane oxygenation) in those patients with cardiopulmonary failure. Each virus strain is carried by a specific species of rodent. This leads to an overlapping geographic distribution of the rodent and virus. Public health authorities emphasize prevention of the disease. Guidelines have been prepared by the CDC (Centers for Disease Control) for use by Latin American countries. Vaccines against hantavirus are under development and clinical trails are ongoing in Korea, China and the United States.