Anaplastic thyroid carcinoma with unusual long-term survival: a case report.

BACKGROUND: Anaplastic thyroid carcinoma is a rare, rapidly progressive, and highly aggressive tumor. It has a global annual incidence of 1-2 per million people. It mostly affects older adults and women. The median survival duration after diagnosis does not exceed 6-8 months. CASE PRESENTATION: A 60-year-old female patient of mixed race (Honduran) presented to the local medical service with dysphonia that had started approximately 2 months earlier, accompanied by orthopnea that had started 1 month earlier. On physical examination, a soft mass was palpated within the anterior neck region; it was approximately 4 cm in diameter, painless, and mobile on swallowing, and had irregular margins. Ultrasound and computed tomography of the neck were performed. Subsequently, fine needle aspiration biopsy was performed. The histological diagnosis was anaplastic thyroid carcinoma (stage IVB). She underwent total thyroidectomy and chemotherapy. She is currently in her fifth year of remission after diagnosis and remains under oncologic surveillance. DISCUSSION: Anaplastic thyroid carcinoma demonstrates a lethal behavior. Approximately 18% survive for more than a year after diagnosis, and 0-10% survive for 5 years. Different pretherapeutic prognostic factors may affect survival, including age < 70 years, the absence of distant metastases, and complete local resection. CONCLUSION: Conventional treatment improves the quality of life of the patient, but the results are not encouraging for the medium and long term. Only a few patients manage to exceed the average life expectancy of 3-6 months, despite undergoing the currently available therapeutic regimen.

Liposarcoma vulvar desdiferenciado con diferenciación homóloga a liposarcoma pleomórfico: reporte de caso / Dedifferentiated vulvar liposarcoma with homologous differentiation to pleomorphic liposarcoma: case report

Resumen ANTECEDENTES: Los liposarcomas son un tipo de tumor de partes blandas. El subtipo desdiferenciado es una de las variantes más comunes junto con el liposarcoma bien diferenciado. CASO CLÍNICO: Paciente de 68 años que acudió a consulta por aparición de una masa en la zona vaginal que clínicamente se diagnosticó como hernia inguinal directa. Se procedió a la resección quirúrgica de la masa. El reporte histopatológico fue de miofibrolipoma, sin atipias y con bordes libres de neoplasia. Tres años después, la paciente retornó a la consulta por reaparición de la masa y se negó a una nueva biopsia. Posteriormente, en el 2020, la paciente aceptó la resección de la masa; el reporte histopatológico fue: liposarcoma desdiferenciado con diferenciación lipoblástica homóloga a liposarcoma pleomórfico. CONCLUSIÓN: Los estudios histopatológicos son necesarios para la confirmación del diagnóstico y la resección quirúrgica es el tratamiento de elección.

Abstract BACKGROUND: Liposarcomas are a type of soft tissue tumor. The dedifferentiated subtype is one of the most common variants along with well-differentiated liposarcoma. CLINICAL CASE: A 68-year-old female patient presented for consultation due to the appearance of a mass in the vaginal area which was clinically diagnosed as a direct inguinal hernia. Surgical resection of the mass was performed. The histopathological report was myofibrolipoma, without atypia and with borders free of neoplasia. Three years later, the patient returned to the office for recurrence of the mass and refused a new biopsy. Subsequently, in 2020, the patient accepted the resection of the mass; the histopathologic report was: dedifferentiated liposarcoma with lipoblastic differentiation homologous to pleomorphic liposarcoma. CONCLUSION: Histopathological studies are necessary for confirmation of the diagnosis and surgical resection is the treatment of choice.

A review of the main histopathological findings in coronavirus disease 2019.

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, has been declared by the World Health Organization as an emerging public health problem of global importance and classified as a pandemic. SARS-CoV-2 infection can result in diverse, multiorgan pathology, the most significant being in the lungs (diffuse alveolar damage in its different phases, microthrombi, bronchopneumonia, necrotizing bronchiolitis, viral pneumonia), heart (lymphocytic myocarditis), kidney (acute tubular injury), central nervous system (microthrombi, ischemic necrosis, acute hemorrhagic infarction, congestion, and vascular edema), lymph nodes (hemophagocytosis and histiocytosis), bone marrow (hemophagocytosis), and vasculature (deep vein thrombosis). An understanding of the spectrum and frequency of histologic findings in COVID-19 is essential for gaining a better understanding of disease pathophysiology and its ongoing impact on public health. To this end, we conducted a systematic meta-analysis of histopathologic observations to date and review the reported findings.

Tuberculosis en estudios post mortem: estudio observacional de 10 años en el Hospital General San Juan de Dios, Guatemala / Post mortem examination in tuberculosis: A 10 year observational study in the San Juan de Dios General Hospital, Guatemala

Introducción: La tuberculosis constituye un problema importante de salud a nivel mundial y más aún, la detección temprana y el tratamiento adecuado de la misma en países subdesarrollados. Los estudios post mortem (EPM) han permitido el diagnóstico de tuberculosis, aún en casos sin diagnóstico clínico de la enfermedad. Objetivo: Conocer el número de casos con diagnóstico de tuberculosis en EPM, durante un período de 10 años, en el Hospital General San Juan de Dios (HGSJDD) de Guatemala. Material y métodos: Se revisaron los informes finales de EPM del HGSJDD de Guatemala, de abril del 2006 a marzo del 2016. Se identificaron los casos con diagnóstico de tuberculosis y se revisaron cortes histológicos y tinciones especiales de los mismos. Resultados: En los 10 años revisados, se realizaron 859 EPM, en 21 casos se diagnosticó tuberculosis, 18 en adultos y 3 en niños. La mayoría correspondió a tuberculosis pulmonar (80,95%). En ninguno de los casos se había realizado el diagnóstico clínico de tuberculosis y solo en 5 se tuvo sospecha clínica de la enfermedad, pero ninguno fue investigado. Ningún paciente tenía documentado VIH/sida. Conclusión: El EPM sigue siendo de importancia en el estudio de las enfermedades. En el presente estudio se encontró el diagnóstico de 21 casos de tuberculosis, que no se habían diagnosticado en las evaluaciones clínicas

Introduction: Tuberculosis is a very important health problem worldwide. Early detection and adequate treatment of this disease is also a problem in low income countries. Post mortem examination has enabled tuberculosis to be diagnosed, even in cases without a clinical diagnosis of the disease. Objective: To determine the number of tuberculosis cases diagnosed on autopsy during a period of 10 years, at the San Juan de Dios General Hospital, Guatemala (SJDGH). Material and methods: The final autopsy reports at the between April 2006 and March 2016 were reviewed. H&E and special stains in cases with a diagnosis of tuberculosis were revised for confirmation. Results: During the 10 years reviewed, 859 autopsies had been carried out, 21 of which had the diagnosis of tuberculosis; 18 were adults and 3 were children and the majority (80.95%) were cases of pulmonary tuberculosis. However, in only 5 cases had there been a clinical suspicion, but without further investigation and none had a confirmed clinical diagnosis of tuberculosis. No patients had documented HIV/AIDS. Conclusion: Autopsy continues to be important in the study of disease. In this retrospective study, 21 cases of tuberculosis in 21 cases were found in patients with no clinical diagnosis of the disease

[Post mortem examination in tuberculosis: A 10 year observational study in the San Juan de Dios General Hospital, Guatemala]. / Tuberculosis en estudios post mortem: estudio observacional de 10 años en el Hospital General San Juan de Dios, Guatemala.

INTRODUCTION: Tuberculosis is a very important health problem worldwide. Early detection and adequate treatment of this disease is also a problem in low income countries. Post mortem examination has enabled tuberculosis to be diagnosed, even in cases without a clinical diagnosis of the disease. OBJECTIVE: To determine the number of tuberculosis cases diagnosed on autopsy during a period of 10 years, at the San Juan de Dios General Hospital, Guatemala (SJDGH). MATERIAL AND METHODS: The final autopsy reports at the between April 2006 and March 2016 were reviewed. H&E and special stains in cases with a diagnosis of tuberculosis were revised for confirmation. RESULTS: During the 10 years reviewed, 859 autopsies had been carried out, 21 of which had the diagnosis of tuberculosis; 18 were adults and 3 were children and the majority (80.95%) were cases of pulmonary tuberculosis. However, in only 5 cases had there been a clinical suspicion, but without further investigation and none had a confirmed clinical diagnosis of tuberculosis. No patients had documented HIV/AIDS. CONCLUSION: Autopsy continues to be important in the study of disease. In this retrospective study, 21 cases of tuberculosis in 21 cases were found in patients with no clinical diagnosis of the disease.

Spatial distribution of Zika in Honduras during 2016-2017 using geographic information systems (GIS) - Implications for public health and travel medicine.

BACKGROUND: Zika virus (ZIKV) infection has significantly affected Latin America in 2015-2017. Most studies have been reported from Brazil and Colombia, and only a few from Central America. For these reasons, we analyzed the incidence, incidence rates and evolution of cases in Honduras from 2016 to 2017. METHODS: Using epidemiological weeks (EW) surveillance data on the ZIKV epidemics in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental and municipal levels. RESULTS: From 1 January 2016 to 31 December 2017, a total of 32,607 cases of ZIKV were reported (98.5% in 2016 for an incidence rate of 36.85 cases/100,000 pop; 1% confirmed by RT-PCR). The highest peak was reached on the EW 6°, 2016 (2559 cases; 29.34 cases/100,000 pop). The department with the highest number of cases and incidence rate was Cortés (13,128 cases, 791.08 cases/100,000 pop in 2016). DISCUSSION: The pattern and evolution of ZIKV infection in Honduras have been similar to that which occurred for chikungunya in 2015. As previously reported, infection with chikungunya involved predominantly the central and capital area of the country, reaching incidences there >750 cases/100,000 pop. Studies using geographical information systems linked with clinical disease characteristics are necessary to attain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.