Large mirror brain metastases from primary undifferentiated sarcoma of the breast: case report and review of the literature.

Primary breast sarcomas are rare high-grade tumors with a reported incidence of <1% of breast malignancies. Its dissemination to the CNS is exceptional and only one is found in the literature. The authors described the case of a 22-year-old female with history of a breast undifferentiated sarcoma that present with two large bilateral retrolenticular brain metastases. Both lesions were excised in the same procedure and she underwent adjuvant therapy. She died 24 months after surgery. Despite being aggressive lesions, aggressive treatment of primary breast sarcomas including brain metastases excision, should be considered in order to improve overall survival.

HIPTCN: Prospective Observational Study of Hypocoagulated Head Trauma Patients with Normal Admission Computed Tomography Scan.

INTRODUCTION: Our national protocol for traumatic brain injury dictates that hypocoagulated patients with mild trauma and initial tomography scan with no intracranial traumatic changes must be hospitalized for 24 hours and do a post-surveillance tomography scan. The main goal of this study was to evaluate the clinical relevance of these measures. MATERIAL AND METHODS: A prospective observational study was undertaken in four hospitals. Adult hypocoagulated traumatic brain injury patients with a normal tomography scan were included. The main outcomes evaluated were rate of delayed intracranial hemorrhage, rate of admission in a neurosurgical department, rate of complications related with surveillance and rate of prolonged hospitalization due to complications. An analysis combining data from a previously published report was also done. RESULTS: A total of 178 patients were included. Four patients (2.3%) had a delayed hemorrhage and three (1.7%) were hospitalized in a neurosurgery ward. No cases of symptomatic hemorrhage were identified. No surgery was needed, and all patients had their anticoagulation stopped. Complications during surveillance were reported in seven patients (3.9%), of which two required prolonged hospitalization. DISCUSSION: The rate of complications related with surveillance was higher than the rate of delayed hemorrhages. The initial period of in-hospital surveillance did not convey any advantage since the management of patients was never dictated by neurological changes. Post-surveillance tomography played a role in deciding about anticoagulation suspension and prolongation of hospitalization. CONCLUSION: Delayed hemorrhage is a rare event and the need for surgery even rarer. The need for in-hospital surveillance should be reassessed.

Introdução: O nosso protocolo nacional para traumatismos cranioencefálicos recomenda que doentes hipocoagulados com trauma craniano ligeiro e tomografia inicial sem alterações traumáticas intracranianas sejam hospitalizados 24 horas e façam uma tomografia computorizada pós-vigilância. O principal objetivo deste estudo foi avaliar a relevância clínica dessas medidas. Material e Métodos: Foi realizado em quatro hospitais um estudo prospetivo e observacional. Foram incluídos adultos hipocoagulados com trauma craniano e tomografia normal. Os principais outcomes avaliados foram: taxa de hemorragia intracraniana tardia, taxa de internamento numa enfermaria de neurocirurgia, taxa de complicações relacionadas com a vigilância e taxa de hospitalização prolongada por complicações. Resultados: Foram incluídos um total de 178 doentes. Quatro doentes (2,3%) apresentaram hemorragia tardia e três (1,7%) foram mantidos hospitalizados numa enfermaria de Neurocirurgia. Não foram documentados casos de hemorragia tardia sintomática. Nenhuma cirurgia foi necessária e em todos estes doentes a anticoagulação foi interrompida. Durante a vigilância, foram relatadas complicações em sete doentes (3,9%), dos quais dois exigiram hospitalização prolongada. Discussão: A taxa de complicações relacionadas com a vigilância foi maior do que a taxa de hemorragia tardia. O período inicial de vigilância intra-hospitalar não trouxe qualquer vantagem, já que o manejo dos doentes nunca foi ditado por alterações neurológicas. A tomografia pós-vigilância desempenhou um papel importante na decisão sobre a suspensão da anticoagulação e o prolongamento da hospitalização. Conclusão: A hemorragia tardia é um evento raro e a necessidade de cirurgia ainda mais. Deve ser reavaliada a necessidade de vigilância intra-hospitalar.

PANCOAST TUMOUR WITH SPINE RESECTION - CASE REPORT.

Pancoast tumours are defined as tumours arising from the upper lobe and invading the thoracic inlet,representing less than 5% of all lung cancers. Clinical features depend on the involved structures. For many years invasion of the spine was considered unresectable and fatal. Due to the progress in spine surgery, en bloc resection including the spine is nowadays possible. We report the first case of a successful en bloc vertebral resection of a Pancoast tumour in a 66 year-old male, with a squamous cell carcinoma, treated at our department in a multidisciplinary setting, after induction chemoradiotherapy. An en bloc resection including the left upper lobe, the first three ribs and the vertebral body of D2, was performed through a Paulson incision after posterior cervico-dorsal arthrodesis. A complete R0 resection was confirmed on the pathology specimen. Currently, one year after surgery, although no local recurrence has occurred, the patient is being treated with immunotherapy due to disease progression in the right acetabulum which was irradiated (20Gy) and then submitted to iliac resection and prothesis reconstruction.

Assessing soil contamination in automobile scrap yards by portable X-ray fluorescence spectrometry and magnetic susceptibility.

A by-product of industrialization and population growth, automobile scrap yards are a potential source of metal contamination in soil. This study evaluated the use of portable X-ray fluorescence (pXRF) spectrometry and magnetic susceptibility (χ) analysis in assessing metal soil contamination in scrap yards located in Brazil. Five automobile scrap yards were selected in Curitiba, Paraná State (CB1, CB2, and CB3) and Lavras, Minas Gerais State (LV1 and LV2). By evaluating metal concentrations and geoaccumulation index values, we verified moderate Cu, Pb, and Zr contamination and moderate to high Zn contamination, primarily in the topsoil (0-10 cm). Soil Zn concentrations in automobile scrap yards were on average four times higher than in reference soils, suggesting that galvanized automobile parts may be the primary source of this soil contaminant. Although other elements (i.e., As, Cr, Fe, Nb, Ni, and Y) were slightly increased compared to reference values in one or more soils, concentrations did not constitute contamination. Automobile scrap yard topsoil had higher χ values (5.8 to 52.9 × 10-7 m3 kg-1) at low frequency (χlf) compared to reference soil (3.6 to 7.5 × 10-7 m3 kg-1). The highest values of χlf occurred in LV soils, which also represented the highest Zn contamination. Magnetic multidomain characteristics (percent frequency-dependent susceptibility between 2 and 10) indicated magnetic particle contributions of anthropogenic origin. The use of pXRF and χlf as non-destructive techniques displays potential for identifying soil contamination in automobile scrap yards.

Contribuição ao estudo do magmatismo Paleo e Mesoproterozóico do SW do Craton Amazônico através da aplicação de isótopos estáveis de O, H e S / Contribution to the study of the Paleo and Mesoproterozoic magmatism of the SW Amazonian craton based on stable isotopes of O, H and S

Os isótopos estáveis de O, H e S foram utilizados para investigar a origem das rochas magmáticas nos Terrenos Jauru e Pontes e Lacerda do SW do Craton Amazônico, estado de Mato Grosso, Brasil. No Terreno Jauru as rochas granitóides do Greenstone belt Alto Jauru e da Suíte Cachoeirinha apresentam valores de δ18O entre +9,0‰ e +6,3‰ que indicam derivação a partir de magmas juvenis. Na Suíte Intrusiva Rio Branco valores de δ18O para rochas básicas estão entre +5,4‰ e +5,8‰ e para rochas félsicas entre +8,7‰ e +9,0‰; rochas intermediárias apresentam valores entre +7,3‰ e +8,3‰. Os valores mais baixos de δ18O, obtidos nas rochas básicas, são compatíveis com derivação mantélica, porém as rochas félsicas apresentam valores de δ18O compatíveis com origem crustais. Análises de isótopos estáveis de H (rocha total) forneceram valores de δD entre - 83‰ e -92‰, diferente das assinaturas de rochas metamórficas e de águas meteóricas. Resultados em sulfetos para isótopos estáveis de S em rochas básicas e intermediárias desta suíte apresentam valores de δ34S coerentes com uma fonte mantélica (entre + 0,7‰ e +3,8‰), enquanto os valores de δ34S (entre +5,2‰ e +6,1‰) obtidos nas rochas félsicas sugerem participação crustal na sua gênese. Na Suíte Santa Helena (Terreno Pontes e Lacerda) os resultados obtidos para δ18O se agrupam entre +4,4‰ e +8,9‰ indicando uma origem mantélica. O presente estudo confirma a importância da aplicação de isótopos estáveis para a compreensão de processos magmáticos e evolução crustal.

Stable isotopes of O, H and S were used to investigate the origin of magmatic rocks of the Jauru and the Pontes e Lacerda Terrains, SW portion of the Amazonian craton, Mato Grosso state, Brazil. Granitic rocks of the Alto Jauru Greenstone belt and Cachoeirinha Suite, Jauru terrain, present δ18O values between +9.0‰ and +6.3‰, indicative of derivation from juvenile magmas. The Rio Branco Intrusive Suite basic and felsic rocks' δ18O values fall, respectively, within +5.4‰ to +5.8‰ and +8.7‰ to +9.0‰ ranges; the intermediate rocks present δ18O between +7.3‰ and +8.3‰. The lower values of δ18O, obtained from basic rocks, are compatible with a mantle source, however the felsic rocks present δ18O values indicative of crustal source. The stable isotopes of hydrogen yielded δD values between - 83‰ and - 92‰, different from the δD signatures of metamorphic rocks and rain water. Sulphur isotopes in sulfides from basic and intermediate rocks of the Rio Branco suite presented δ34S values coherent with a mantle source (between + 0.7‰ and +3.8‰), whereas δ34S values between + 5.2‰ and + 6.1‰, obtained from the felsic rocks, suggest crustal participation in their genesis. For the Santa Helena Suite (Pontes e Lacerda Terrain) the δ18O values fall between +4.4‰ and +8.9‰. The present study confirms the advantages of using stable isotopes to understand magmatic processes and crustal evolution.

The Glória quartz-monzodiorite: isotopic and chemical evidence of arc-related magmatism in the central part of the Paleoproterozoic Mineiro belt, Minas Gerais State, Brazil.

The Glória quartz-monzodiorite, one of the mafic plutons of the Paleoproterozoic Mineiro belt, is intrusive into banded gneisses, amphibolites, schists and phyllites of the Rio das Mortes greenstone belt, in the southern portion of the São Francisco Craton, State of Minas Gerais, Brazil. The Glória quartz-monzodiorite yields a SHRIMP U-Pb zircon age of 2188 +/- 29 Ma, suggesting a tectonic relationship with the pre-collisional phase of the Mineiro belt. According to the Nd isotopic evidence (epsilonNd(T) = -3.4; T DM = 2.68 Ga) the original magmas was formed by a mixture among Archean crustal material and Paleoproterozoic juvenile magma. The Glória quartz-monzodiorite shows metaluminous and calc-alkaline tendency with intermediate K content, comparable to that of volcanic-arc rocks. The primary mineralogical assemblage was partly modified by metamorphism, dated between 2131-2121 Ma in nearby coeval plutons. Such metamorphism is significantly older than the reported metamorphic episodes of the Mineiro belt in the Quadrilátero Ferrífero region (2059-2041 Ma) in the eastern portion of the study area. This evidence, together with chemical and isotopic data from other mafic and felsic plutons coeval with the Glória quartz-monzodiorite, indicate a tectonic and magmatic migration within the Mineiro belt from west to east.