Aggressive behavior of papillary microcarcinoma in a patient with Graves' disease initially presenting as cystic neck mass.

Prognosis of papillary carcinoma of the thyroid associated with Graves' disease is controversial; nevertheless, tumors smaller than 1 cm (microcarcinoma) are usually considered to render a good prognosis. We describe a patient with Graves' disease who developed a lateral cystic neck mass that was later confirmed to be a metastatic lymph node from papillary thyroid microcarcinoma. Contrary to having a good prognosis with a microcarcinoma, our patient developed bilateral lung metastases. The possible role of thyroid stimulating immunoglobulins in the aggressive course of the tumor is discussed.

Perinatal factors associated with neural tube defects (anencephaly [correction of anancephaly], spina bifida and encephalocele).

The objective of the present study was to determine the presence of risk factors for the occurrence of neural tube defects. Data for 33,535 births which occurred at Hospital do Servidor Público Estadual de São Paulo from July 1973 to December 1986 were collected in a prospective manner as recommended by "Estudo Colaborativo Latino-Americano de Malformações Congênitas" (ECLAMC, Collaborative Latin American Study on Congenital Malformations). Twenty-six cases of neural tube defects were detected (0.77/1000 births). Of these, 11 were cases of spina bifida (0.39/1000 births), 9 of anencephaly (0.27/1000 births) and 6 of encephalocele (0.18/1000 births). We observed a higher frequency of polyhydramnios, premature labor, Apgar scores of less than 7 at the first and fifth minutes, low birth weight and intrauterine growth retardation.

[Myasthenia gravis and pregnancy: review of the literature and report of 6 cases occurring in 5 patients]. / "Miastenia gravis" e gestação: revisão da literatura e relato de seis casos ocorridos em cinco pacientes.

The authors report six cases of myasthenia gravis during pregnancy. Three patients experienced increasing severity of their disease and one death occurred in the puerperium. The infants were born with no evidence of neonatal myasthenia. The patients should be closely monitored during labor and puerperium. This disease is characterized by unpredictable exacerbations, and the association of myasthenia gravis and pregnancy increases the risk for the patient.

[Cerclage of the cervix uteri via a transabdominal route: report of 2 cases]. / Circlagem do colo uterino por via transabdominal: relato de dois casos.

The authors present two cases of transabdominal cervicouterine cerclage using Benson and Durfee's technique. In both cases the surgery was successful and the patients gave birth at 37 and 40 weeks, respectively, to healthy newborns. The technique is recommended by the authors since technical details are observed.