ABSTRACT
Chronic lymphedema presents as interstitial fluid retention due to a failure in the lymphatic system drainage. The affected region becomes more vulnerable immunologically and predisposed to the onset of neoplasms. Basal Cell Carcinoma is the most common sort of neoplasm, nevertheless it rarely metastisizes. Sarcomas are malignant mesenchymal neoplasms, locally aggressive, which can spread. Here is reported an infrequent case of multiple basal cell carcinoma, synchronous to a poorly differentiated pleomorphic sarcoma, both spreading to lymph nodes and arising from tissue compromised by chronic lymphedema.
Subject(s)
Carcinoma, Basal Cell/secondary , Lymphedema/complications , Neoplasms, Multiple Primary/pathology , Sarcoma/secondary , Aged , Chronic Disease , Female , Hamartoma Syndrome, Multiple , Humans , Immunohistochemistry , Lymphatic MetastasisABSTRACT
Chronic lymphedema presents as interstitial fluid retention due to a failure in the lymphatic system drainage. The affected region becomes more vulnerable immunologically and predisposed to the onset of neoplasms. Basal Cell Carcinoma is the most common sort of neoplasm, nevertheless it rarely metastisizes. Sarcomas are malignant mesenchymal neoplasms, locally aggressive, which can spread. Here is reported an infrequent case of multiple basal cell carcinoma, synchronous to a poorly differentiated pleomorphic sarcoma, both spreading to lymph nodes and arising from tissue compromised by chronic lymphedema.
Linfedema crônico se manifesta pelo acúmulo de líquido intersticial por falha da drenagem linfática. A região afetada torna-se imunologicamente vulnerável e predisposta ao desenvolvimento de neoplasias. Carcinoma basocelular é a neoplasia maligna mais comum, entretanto raramente metastatiza. Sarcomas são neoplasias mesenquimais malignas, localmente agressivas e capazes de metastatizar. Apresentamos um caso raro de múltiplos carcinomas basocelulares concomitantes a sarcoma pleomórfico pouco diferenciado, metastáticos para linfonodos, originando-se em área de linfedema crônico.
Subject(s)
Aged , Female , Humans , Carcinoma, Basal Cell/secondary , Lymphedema/complications , Neoplasms, Multiple Primary/pathology , Sarcoma/secondary , Chronic Disease , Hamartoma Syndrome, Multiple , Immunohistochemistry , Lymphatic MetastasisABSTRACT
BACKGROUND: Some skin carcinomas may be very aggressive. Increased expression of the protein p53 has been associated with tumor aggressiveness. In this study, p53 expression was evaluated in basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) with skull base invasion, and was compared to tumors with good outcome. STUDY DESIGN AND SETTING: Expression of p53 was immunohistochemically analyzed and it was reported as present or absent in 24 BCC and 11 SCC with skull base invasion. Control group (good outcome) included 23 BCC and 10 SCC. RESULTS: Expression of p53 was noted in 70.83% of BCC with skull base invasion, compared to 43.48% in the control group (P = 0.058). Regarding SCC, p53 positivity was noted in only 9.09% of SCC with skull base invasion, compared to 40.00% in the control group (P = 0.149). CONCLUSIONS: In this study, p53 expression was more common among BCC with skull base invasion, compared to controls with good outcome, and the difference was considered marginally significant. This proportion was reversed in SCC, but the difference was not statistically significant. EBM RATING: B-3b.
Subject(s)
Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/pathology , Skin Neoplasms/pathology , Skull Base Neoplasms/pathology , Tumor Suppressor Protein p53/analysis , Carcinoma, Basal Cell/secondary , Carcinoma, Squamous Cell/secondary , Case-Control Studies , Disease-Free Survival , Female , Follow-Up Studies , Humans , Immunohistochemistry , Lymphatic Metastasis/pathology , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local/pathology , Prognosis , Retrospective Studies , Survival RateABSTRACT
Some skin carcinomas may be very aggressive. Breached of basement membrane (BM) has been in some situations associated with tumor aggressiveness. In this study, the status of BM in invasion was evaluated in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) with skull base invasion, and it was compared with tumor's good outcome. Integrity or breached of BM was visualized using immunohistochemistry technique with anti-type IV collagen antibody. The pattern of BM was classified as intact, breached, or absent in 24 BCCs and 11 SCCs with skull base invasion. Control group (good outcome) included 23 BCCs and 10 SCCs. Breached BM and absence of BM were respectively noted in 33.33% and 45.83% of BCCs with skull base invasion, compared with 8.33% and 17.395% in the control group ( P < .001). Regarding SCCs, ruptured and absent BMs were, respectively, noted in 36.36% and 63.64% of BCCs with skull base invasion, compared with 30% and 30% in the control group ( P = .075). In this study, destruction of BM was significantly more common in BCCs with skull base invasion, in comparison with those with good outcome. In SCC, this difference was not statistically significant.
Subject(s)
Basement Membrane/pathology , Carcinoma, Basal Cell/secondary , Carcinoma, Squamous Cell/secondary , Skin Neoplasms/pathology , Skull Base Neoplasms/pathology , Skull Base/pathology , Basement Membrane/metabolism , Biomarkers, Tumor/metabolism , Carcinoma, Basal Cell/metabolism , Carcinoma, Basal Cell/therapy , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/therapy , Collagen Type IV/metabolism , Combined Modality Therapy , Head and Neck Neoplasms/pathology , Humans , Immunohistochemistry , Neoplasm Invasiveness , Retrospective Studies , Single-Blind Method , Skin Neoplasms/metabolism , Skin Neoplasms/therapy , Skull Base Neoplasms/metabolism , Skull Base Neoplasms/therapyABSTRACT
BACKGROUND: Some skin carcinomas may be very aggressive. Intensity of angiogenesis, measured by intratumoral vessel density using expression of CD34, has been associated with tumor aggressiveness. In this study, the expression of CD34 in basal cell carcinomas ( BCCs) and squamous cell carcinomas (SCCs) with skull base invasion was compared with that in tumors with good outcome. METHODS: Expression of CD34 was graded as mild, moderate, and intense, in 24 BCCs and 11 SCCs with skull base invasion. The control group included 23 BCCs and 10 SCCs. RESULTS: Intense expression of CD34 was noted in 25.00% of BCCs with skull base invasion, compared with 4.35% in the control group (p =.058). Regarding SCCs, intense expression of CD34 was found in 54.55% of aggressive tumors, compared with 10.00% in the control group (p =.133). CONCLUSIONS: A trend toward denser microvascular angiogenesis was observed in both BCCs and SCCs with skull base invasion compared with less aggressive controls.
Subject(s)
Brain Neoplasms/secondary , Carcinoma, Basal Cell/secondary , Carcinoma, Squamous Cell/secondary , Neoplasm Invasiveness/pathology , Neovascularization, Pathologic/pathology , Skin Neoplasms/pathology , Biopsy, Needle , Brain Neoplasms/pathology , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/pathology , Case-Control Studies , Female , Humans , Immunohistochemistry , Male , Prognosis , Reference Values , Retrospective Studies , Risk Assessment , Skull BaseABSTRACT
Antecedentes: Los cirujanos de cabeza y cuello se enfrentan al dilema de enuclear el ojo para asegurar la curación de la enfermedad neoplásica. La reconstrucción en las décadas del 60 y 70 se hacía con colgajos de vecindad, actualmente se prefieren los colgajos microquirúrgicos o la rotación del músculo temporal e injerto de piel, dependiendo de la extensión de la resección. Objetivo: Analizar la conducta con el órgano de la visión, en pacientes portadores de tumores vecinos a la órbita. Diseño: Prospectivo. Población: 37 pacientes, 20 pertenecían al sexo masculino, la mayor incidencia se registró en la 5º y 6º década. Método: El tipo de cirugía fue local en 27/37 pacientes y craneofacial en 10. La cirugía se asoció a la exenteración orbitaria en 24/37 (64,8 por ciento). Resultados: Se produjeron 12 recurrencias: 5 locales, 5 regionales y 2 locorregionales
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aged , Skin Neoplasms/pathology , Paranasal Sinus Neoplasms/pathology , Mouth Neoplasms/pathology , Orbit Evisceration/methods , Orbital Neoplasms/surgery , Prospective Studies , Carcinoma, Squamous Cell/secondary , Carcinoma, Basal Cell/secondary , Practice Guidelines as Topic , Orbital Neoplasms/secondary , Orbital Neoplasms/complicationsSubject(s)
Humans , Carcinoma, Basal Cell/genetics , Angiogenesis Inhibitors/physiology , Carcinoma, Basal Cell/immunology , Carcinoma, Basal Cell/secondary , Hyaluronan Receptors/adverse effects , Basal Cell Nevus Syndrome/diagnosis , Basal Cell Nevus Syndrome/pathology , Chromosomes, Human, Pair 9 , Telomerase/physiologySubject(s)
Humans , Carcinoma, Basal Cell/genetics , /adverse effects , Carcinoma, Basal Cell/immunology , Carcinoma, Basal Cell/secondary , Chromosomes, Human, Pair 9 , Angiogenesis Inhibitors/physiology , Basal Cell Nevus Syndrome/diagnosis , Basal Cell Nevus Syndrome/pathology , Telomerase/physiologyABSTRACT
Se presentaron 368 cánceres basocelulares tratados por resección quirúrgica en 216 pacientes entre los años 1983 y 1986. Se identificaron 44 tumores recidivantes, con una recidiva global de 11,9 por ciento. La recidiva en presencia de borde microscópico de resección sano fue de 10,6 por ciento, y con borde microscópico comprometido fue de 27,6 por ciento. El análisis de los factores de riesgo de recidiva mostró que ésta no está asociada a la localización del tumor primario (p= 0,92), el tiempo de exposición previa al sol (p= 0,89), al tipo de piel según la clasificación de Fitzpatrick (p= 0,62), al aspecto clínico (homogéneo, erosionado, ulcerado) (p= 0,10), al tamaño del tumor inicial (p= 0,56), ni a la edad de los pacientes (p= 0,33). En cambio, en este estudio constituyen factores de riesgo de recidiva los siguientes factores: variedad histológica superficial invasora (p= 0,001), borde de sección quirúrgico comprometido con tumor (p= 0,01) y reacción linfocitaria ausente o escasa (p= 0,008). Para prevenir la recidiva proponemos el uso de biopsia contemporánea para asegurar resección completa en la primera intervención y verificar variedad histológica de alto riesgo que requiere de resección de seguridad de mayor tamaño
Subject(s)
Humans , Male , Female , Carcinoma, Basal Cell/secondary , Neoplasm Recurrence, Local/epidemiology , Carcinoma, Basal Cell/surgery , Neoplasm Invasiveness/pathology , Risk FactorsABSTRACT
Describimos un caso de carcinoma de células basales (CCB) con metástasis viscerales en un varón de 51 años que presentó dificultad respiratoria y derrame pleural. En la autopsia las metástasis de CCB infiltraban ambas pleuras y pulmones, pericardio, hueso, hígado y suprarrenales. La revisión del tumor cutáneo resecado 11 años antes mostró un CCB infiltrante con similares características histológicas a las metástasis (AU)
Subject(s)
Humans , Male , Middle Aged , Skin Neoplasms/secondary , Carcinoma, Basal Cell/secondary , Neoplasm Metastasis , Otorhinolaryngologic Neoplasms/complications , Otorhinolaryngologic Neoplasms/secondary , Carcinoma, Basal Cell/complications , Carcinoma, Basal Cell/pathology , Lung Neoplasms/complications , Lung Neoplasms/secondary , PrognosisABSTRACT
Describimos un caso de carcinoma de células basales (CCB) con metástasis viscerales en un varón de 51 años que presentó dificultad respiratoria y derrame pleural. En la autopsia las metástasis de CCB infiltraban ambas pleuras y pulmones, pericardio, hueso, hígado y suprarrenales. La revisión del tumor cutáneo resecado 11 años antes mostró un CCB infiltrante con similares características histológicas a las metástasis
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Basal Cell/secondary , Neoplasm Metastasis , Skin Neoplasms/secondary , Carcinoma, Basal Cell/complications , Carcinoma, Basal Cell/pathology , Lung Neoplasms/complications , Lung Neoplasms/secondary , Otorhinolaryngologic Neoplasms/complications , Otorhinolaryngologic Neoplasms/secondary , PrognosisABSTRACT
One to two per cent of the GI tract cancers have its origin in the anal canal. The purpose of this publication, is to report a case of a patient with the unusual complication of brain and bone metastases which is believed to be due to hematogenous spreading.
Subject(s)
Bone Neoplasms/secondary , Brain Neoplasms/secondary , Carcinoma, Basal Cell/secondary , Rectal Neoplasms/pathology , Antineoplastic Agents/therapeutic use , Carcinoma, Basal Cell/drug therapy , Humans , Male , Middle Aged , Neoplasm Staging , Rectal Neoplasms/drug therapy , Rectal Neoplasms/radiotherapyABSTRACT
Entre 1 y 2 por ciento de los c nceres digestivos lo constituyen neoplasias del canal anal. El propósito de este trabajo es comunicar la ocurrencia de un caso del tal patología con la poco frecuente ocurrencia de met stasis óseas y cerebrales, que se cree son debidas a diseminación hematógena. (AU)
Subject(s)
Middle Aged , Humans , Male , Rectal Neoplasms/pathology , Carcinoma, Basal Cell/secondary , Brain Neoplasms/secondary , Bone Neoplasms/secondary , Rectal Neoplasms/radiotherapy , Rectal Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Neoplasm StagingABSTRACT
Entre 1 y 2 por ciento de los c nceres digestivos lo constituyen neoplasias del canal anal. El propósito de este trabajo es comunicar la ocurrencia de un caso del tal patología con la poco frecuente ocurrencia de met stasis óseas y cerebrales, que se cree son debidas a diseminación hematógena.
Subject(s)
Middle Aged , Humans , Male , Bone Neoplasms/secondary , Brain Neoplasms/secondary , Carcinoma, Basal Cell/secondary , Rectal Neoplasms/pathology , Antineoplastic Agents/therapeutic use , Neoplasm Staging , Rectal Neoplasms/drug therapy , Rectal Neoplasms/radiotherapyABSTRACT
Apresenta-se o caso de um paciente de carcinoma basocelular com acometimento neoplásico tardio da segunda vértebra lombar, cujo diagnóstico foi de carcinoma baso-epidermóide
Subject(s)
Middle Aged , Humans , Male , Carcinoma, Basal Cell/secondary , Skin Neoplasms/secondary , Bone Neoplasms/pathology , Carcinoma, Squamous Cell/pathologyABSTRACT
Metástase tem sido considerada um raro fenômeno no curso do desenvolvimento e crescimento do carcinoma basocelular. Descreve-se um caso de carcinoma basocelular localizado primariamente na regiäo pre-auricular, determinando metástases para linfonodos cervicais regionais. Digno de nota foi a demonstraçäo de uma extensa infiltraçäo neoplásica perineural no tumor primitivo. Muito embora näo existam provas definitivas de que os espaços perineurais representem linfáticos, sugere-se a possibilidade destes espaços contribuírem para a disseminaçäo a distância de células neoplásicas, seguindo um plano de menor resistência