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1.
Medicine (Baltimore) ; 100(7): e24806, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607843

RESUMO

RATIONALE: Oral cancer often causes secondary primary cancers in the upper gastrointestinal tract. However, there are no reports of secondary primary cancers in patients with oral squamous cell carcinoma and malignant lymphoma of the small intestine. This report describes a case of metachronous multiple primary cancers of the tongue and small intestine malignant lymphoma. PATIENTS CONCERNS: The patient was admitted to our department with the chief complaint of pain in the right tongue. Partial tongue resection and supraomohyoid neck dissection were performed. One year after surgery, the patient experienced abdominal pain and bloody stools. DIAGNOSIS: Diffuse large B-cell lymphoma (DLBCL) was diagnosed via histological examination. INTERVENTIONS: A terminal ileum resection was performed. Postoperatively, the patient received 6 courses of rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP). OUTCOMES: Five years after his initial diagnosis, there is no evidence of recurrence, metastasis, or other primary cancer. LESSONS: Oral cancer patients should always be followed up owing to a possibility of malignant tumors in other areas.


Assuntos
Carcinoma de Células Escamosas/complicações , Intestino Delgado/patologia , Linfoma Difuso de Grandes Células B/patologia , Neoplasias da Língua/patologia , Assistência ao Convalescente , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/administração & dosagem , Ciclofosfamida/uso terapêutico , Doxorrubicina/administração & dosagem , Doxorrubicina/uso terapêutico , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Segunda Neoplasia Primária/patologia , Prednisona/administração & dosagem , Prednisona/uso terapêutico , Rituximab/administração & dosagem , Rituximab/uso terapêutico , Resultado do Tratamento , Vincristina/administração & dosagem , Vincristina/uso terapêutico
2.
BMJ Case Rep ; 14(2)2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33558378

RESUMO

Few cases of pouch-related cancers have been reported in inflammatory bowel disease, and squamous cell carcinoma (SCC) is very rare. We have reviewed the published literature searching the online databases PubMed and Medline. Since 1979, there have been eight cases of SCC developing after restorative proctocolectomy in ulcerative colitis. To date, there have been no reported cases of SCC of the ileo-anal pouch in Crohn's disease. We present the case of a 59-year-old woman who underwent colectomy with ileal pouch-anal anastomosis for Crohn's disease during the 1990s. The patient was noted to be anaemic and was experiencing significant weight loss with poor pouch function in 2019. Endoscopy with histology and radiological investigation revealed the presence of SCC of the pouch. This was subsequently treated with surgical therapy and chemoradiotherapy.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias do Colo/patologia , Bolsas Cólicas/patologia , Doença de Crohn/patologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia Adjuvante , Neoplasias do Colo/complicações , Neoplasias do Colo/terapia , Doença de Crohn/complicações , Doença de Crohn/cirurgia , Feminino , Humanos , Ileostomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Proctocolectomia Restauradora
3.
Anticancer Res ; 41(1): 71-79, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33419800

RESUMO

BACKGROUND: The genetic basis of sinonasal inverted papilloma (SNIP)-derived squamous cell carcinoma (SCC) has not yet been well characterized. AIM: To characterize the genetic abnormalities of SNIP and SNIP-derived SCC and to uncover their differences. MATERIALS AND METHODS: Mutations of 409 genes were analyzed using amplicon targeted sequencing in a total of six papilloma/carcinoma samples from four patients with SNIP-derived SCC. RESULTS: The genes that were mutated in multiple cases were epidermal growth factor receptor (EGFR) (3/6), cyclin-dependent kinase inhibitor 2A (CDKN2A) (3/6), lysine methyltransferase 2D (KMT2D) (3/6), tumor protein p53 (TP53) (3/6), neurofibromin 1 (NF1) (3/6), phosphodiesterase 4D interacting protein (PDE4DIP) (3/6), cytochrome P450 family 2 subfamily D member 6 (CYP2D6) (2/6), fms-related receptor tyrosine kinase 4 (FLT4) (2/6) and myosin heavy chain 9 (MYH9) (2/6). Of the two cases analyzed in the papilloma-oncology carcinoma pair, one did not have any common mutations; the other showed a staged functional deletion of TP53 during the process of malignant transformation from SNIP to SCC. CONCLUSION: CDKN2A, KMT2D, NF1, PDE4DIP, CYP2D6, FLT4, and MYH9 were identified as candidate novel SNIP-derived SCC-related genes.


Assuntos
Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/genética , Genômica , Oncogenes , Papiloma Invertido/complicações , Papiloma Invertido/genética , Neoplasias dos Seios Paranasais/complicações , Neoplasias dos Seios Paranasais/genética , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Feminino , Expressão Gênica , Genômica/métodos , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Mutação , Polimorfismo de Nucleotídeo Único
4.
BMJ Case Rep ; 14(1)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33500301

RESUMO

A 75-year-old man was hospitalised for bronchoscopy with biopsy due to a suspicious pulmonary mass at chest tomography. He had significant dyspnoea, constipation, nausea, vomiting, anorexia and a 33% loss of weight in the past 3 months. Biopsy revealed a pulmonary squamous cell carcinoma, which was inoperable. Tramadol used at home for 3 months was replaced by morphine on admission. The patient remained constipated despite prokinetics and laxatives, leading to the diagnostic hypothesis of paraneoplastic motility disorder and opioid-induced constipation. Abdominal tomography ruled out the possibility of mechanical obstruction. As complications, the patient presented superior vena cava syndrome and opioid (morphine) intoxication. The patient died a few days later. The management of this case highlights the importance of multidisciplinary care and the challenges of palliative oncology care. Paraneoplastic motility disorder must always be considered among the mechanisms of intestinal dysfunction in patients with advanced oncological disease.


Assuntos
Carcinoma de Células Escamosas/complicações , Constipação Intestinal/etiologia , Gastroparesia/etiologia , Neoplasias Pulmonares/complicações , Síndromes Paraneoplásicas do Sistema Nervoso/etiologia , Idoso , Antieméticos/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico por imagem , Constipação Intestinal/diagnóstico , Constipação Intestinal/tratamento farmacológico , Constipação Intestinal/fisiopatologia , Fármacos Gastrointestinais/uso terapêutico , Gastroenteropatias/diagnóstico , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/etiologia , Gastroenteropatias/fisiopatologia , Motilidade Gastrointestinal , Gastroparesia/diagnóstico , Gastroparesia/tratamento farmacológico , Gastroparesia/fisiopatologia , Glicerol/uso terapêutico , Humanos , Lactulose/uso terapêutico , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Metoclopramida/análogos & derivados , Metoclopramida/uso terapêutico , Morfina/efeitos adversos , Constipação Induzida por Opioides/diagnóstico , Cuidados Paliativos , Síndromes Paraneoplásicas do Sistema Nervoso/diagnóstico , Síndromes Paraneoplásicas do Sistema Nervoso/fisiopatologia , Tramadol/efeitos adversos
5.
Rio de Janeiro; s.n; 2021. ilus.
Tese em Português | Coleciona SUS | ID: biblio-1148238

RESUMO

Introdução: O pênfigo paraneoplásico é uma doença autoimune caracterizada pela produção de autoanticorpos por células tumorais neoplásicas. O primeiro sinal da doença são úlceras orais em 45% dos casos. Sua persistência e progressão são características de malignidade, reconhecida ou oculta. O difícil manejo dessa complicação, devido à doença de base não controlada, leva à piora dos sintomas e perda da qualidade de vida do doente. Objetivos: Relato de uma patologia rara, pouco relacionada a neoplasias sólidas, refratária a maioria dos tratamentos e com alta taxa de morbimortalidade. Métodos: Relato de caso de uma paciente com diagnóstico de carcinoma epidermoide de colo do útero, estadio IVa, com doença fora de controle e manifestações de pênfigo paraneoplásico cutâneo e mucoso. Resultados: A paciente apresentou o pênfigo paraneoplásico como complicação do câncer, com dificuldade de diagnóstico pela raridade da doença. Atualmente, sintomática com pouca resposta à corticoterapia. Conclusões: A raridade de algumas doenças torna o atraso no diagnóstico uma dificuldade ao tratamento. Assim como, o padrão de apresentação e a pouca experiência com patologias raras leva, muitas vezes, ao subdiagnóstico e subtratamento de nossos doentes, com perda da qualidade de vida


Background: Paraneoplastic pemphigus is an autoimmune disease characterized by autoantibody production by malignant tumor cells. The first sign of the disease is oral ulcer in 45% of cases. Their persistence and progression are features of malignancy, recognized or hidden. The difficult management of this complication due to uncontrolled underlying disease leads to the worsening of symptoms and loss of the patients' quality of life. Objective: Report a rare pathology, uncommonly related to solid neoplasms, refractory to most procedures and with high rates of morbidity and mortality. Methods: Case report of a patient diagnosed with squamous cell carcinoma of the cervix, stage IVa, with disease out of control and manifestations of skin and mucous paraneoplastic pemphigus. Results: The patient presented paraneoplastic pemphigus as a complication of the cancer, with a difficult diagnosis because of the rarity of the disease. Currently, symptomatic with little response to corticosteroid therapy. Conclusions: The uncommonness of some diseases makes the delay in diagnosing an obstacle to treatment. The presentation pattern and the little experience in rare diseases often lead to the underdiagnosis and undertreatment of our patients and loss of quality of life.


Assuntos
Humanos , Feminino , Adulto , Carcinoma de Células Escamosas/complicações , Pênfigo , Neoplasia Intraepitelial Cervical/complicações , Neoplasias
6.
Clin Nucl Med ; 46(1): e13-e15, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32701799

RESUMO

Constrictive pericarditis refers to focal or global thickening of pericardium causing impedance to diastolic filling and increased systemic venous pressure. We discuss a case of thymic carcinoma presenting as constrictive pericarditis. A 70-year-old man experiencing shortness of breath underwent Doppler echocardiography for further evaluation. Echocardiography was suggestive of thickened nodular pericardium with minimal pericardial effusion, and Doppler features were suggestive of constrictive pericarditis. F-FDG PET/CT done to exclude malignancy reveals locally advanced thymic carcinoma spreading along the pericardial sheath with metabolically active rib metastases.


Assuntos
Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico por imagem , Fluordesoxiglucose F18 , Pericardite Constritiva/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico por imagem , Idoso , Carcinoma de Células Escamosas/patologia , Ecocardiografia , Humanos , Masculino , Neoplasias do Timo/patologia
7.
J Infect Chemother ; 27(1): 99-102, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33023821

RESUMO

We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Neoplasias/complicações , Pneumonia Viral/tratamento farmacológico , Ritonavir/uso terapêutico , Idoso , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/tratamento farmacológico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Quimioterapia Combinada , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamento farmacológico , Evolução Fatal , Humanos , Itália , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento
8.
Medicine (Baltimore) ; 99(52): e23860, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350779

RESUMO

ABSTRACT: Malnutrition is common among patients who have oral cavity squamous cell carcinoma (OSCC), but its effect on the incidence of postoperative complications remains uncertain. Validated nutrition and complication assessment tools were used to evaluate the effects of nutrition on the likelihood of postoperative complications after curative surgery for OSCC.A retrospective study that spanned January 2014 to December 2018 enrolled 70 patients who received curative surgery for OSCC. Nutritional status before surgery was evaluated with the scored Patient-Generated Subjective Global Assessment (PG-SGA), and patients were classified as either well-nourished (rating A) or malnourished (ratings B and C). Complications 30 days after the operation were graded using Clavien-Dindo classification. The perioperative clinicopathological characteristics of the groups were compared, and risk factors for postoperative complications were identified through logistic regression.A total of 44 (62.8%) patients formed the malnourished group, and they tended to be older (P = .03), weigh less (P = .001), have lower Body Mass Index (P = .003), higher PG-SGA scores (P < .001), higher neutrophil-to-lymphocyte ratio (P = .034), more postoperative complications (P < .001), and longer hospital stays (P = .021). Major complications (Clavien-Dindo classification ≥ IIIa) were experienced by 18.5% (n = 13) of patients and were more common in the malnourished group (P = .007). Multivariate logistic regression demonstrated that PG-SGA score ≥4 was an independent risk factor for postoperative complications (hazard ratio = 4.929, P = .008).Malnutrition defined using the PG-SGA is an independent risk factor for postoperative complications of curative surgery in patients with OSCC. More prospective studies are warranted to confirm our findings.


Assuntos
Desnutrição , Estado Nutricional , Procedimentos Cirúrgicos Bucais/efeitos adversos , Complicações Pós-Operatórias , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/etiologia , Pessoa de Meia-Idade , Neoplasias Bucais/complicações , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Avaliação Nutricional , Procedimentos Cirúrgicos Bucais/métodos , Complicações Pós-Operatórias/classificação , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Medição de Risco , Fatores de Risco
9.
Medicine (Baltimore) ; 99(39): e22252, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991421

RESUMO

A 31-year-old male patient with psoriasis received administration of traditional Chinese medicine (TCM) during a disease course of 14 years. He showed multiple keratoma together with squamous cell carcinoma (SCC) in left lower limbs. After admission, the conditions were stable after treatment, and received surgery for treating SCC. The skin defect was treated using full-thickness skin graft. The postoperative survival of the flap was satisfactory, and the conditions of psoriasis were well controlled. In this case, we presented the feasibility of graft in the donor site from a psoriatic lesion. Besides, we analyzed the possibility of SCC and keratinizing lesions.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Cutâneas/cirurgia , Transplante de Pele/métodos , Retalhos Cirúrgicos/transplante , Adulto , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Humanos , Masculino , Medicina Tradicional Chinesa , Psoríase/complicações , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/patologia
10.
Medicine (Baltimore) ; 99(32): e21521, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769890

RESUMO

RATIONALE: The establishment of lung isolation is often particularly challenging for the anesthesiologist in patients with difficult airway. Usually, orotracheal intubation with double lumen tube is the commonly used technique for achieving 1 lung anesthesia. Whereas, in patients with limited mouth opening and restricted cervical mobility, this technique becomes extremely difficult and hazardous. We report a case in which bronchial blocker placement was succeeded via both nostrils in a difficult airway due to restricted mouth opening. PATIENT CONCERNS: A 50-year-old, non-smoking female with a painless mass in the left upper lobe. She had a 10-year history of ankylosing spondylitis and squamous cell carcinoma of the floor of the mouth after 5 operations 4 years previously. DIAGNOSES: Left upper lobe adenocarcinoma, ankylosing spondylitis and oral squamous cell carcinoma. INTERVENTIONS: To achieve 1 lung anesthesia, both nostrils were used for extraluminal bronchial blocker placement. OUTCOMES: Initially, oral intubation was selected for establishing a patent airway but failed. Then switched to nasal canal for insertion, after several attempts, a conventional nasal intubation tube (internal diameter 6.0 mm) was placed via 1 nostril under topical anesthesia, with the aid of a flexible fiberoptic bronchoscope, and a bronchial blocker was advanced to the desired position via the other nostril. LESSONS: In difficult airway with limited mouth opening and restricted cervical mobility, multidisciplinary experts participated discussion is a prerequisite for contemplating a scientific plan. Preoperative computed tomography scan and 3-dimensional computed tomography reconstruction would be helpful in detecting the narrowest part of airway conduit and determining a safe, reliable, and feasible airway program.


Assuntos
Adenocarcinoma de Pulmão/terapia , Obstrução das Vias Respiratórias/terapia , Intubação/métodos , Neoplasias Pulmonares/terapia , Nariz , Ventilação Monopulmonar/métodos , Adenocarcinoma de Pulmão/complicações , Obstrução das Vias Respiratórias/complicações , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/terapia , Feminino , Humanos , Neoplasias Pulmonares/complicações , Pessoa de Meia-Idade , Boca/patologia , Neoplasias Bucais/complicações , Neoplasias Bucais/terapia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/terapia
11.
Med Hypotheses ; 143: 110089, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32673940

RESUMO

Extracellular matrix metalloproteinase inducer (EMMPRIN), which is also called BASIGIN/CD147, is a cell surface glycoprotein that belongs to the immunoglobulin superfamily and plays a significant role in intercellular recognition in immunology, cellular differentiation and development. Apart from ACE-2, recently EMMPRIN, has been regarded as a target for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attachment and entry into the host cell. Since one of the routes of entry for the virus is the oral cavity, it becomes imperative to percept oral comorbidities such oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs) in terms of EMMPRIN as a target for SARS-CoV-2. In the present paper, it is proposed that OSCC, by the virtue of upregulation of EMMPRIN expression, increases the susceptibility to coronavirus disease (COVID-19). In turn, COVID-19 in OSCC patients causes exhaustion of EMMPRIN receptor due to binding with 'S' receptor leading to a downregulation of related carcinogenesis events. We proposed that in the ACE-2 depleted situation in OSCC, EMMPRIN receptor might get high jacked by the COVID-19 virus for the entry into the host cells. Apart from the anti-monoclonal antibody, it is recommended to explore the use of grape seed and skin containing mouthwash as an adjunct, which could also have anti EMMPRIN effects in patients with OSCC and OPMDs.


Assuntos
Basigina/metabolismo , Infecções por Coronavirus/metabolismo , Regulação Neoplásica da Expressão Gênica , Neoplasias Bucais/metabolismo , Pneumonia Viral/metabolismo , Anticorpos Monoclonais , Betacoronavirus , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/metabolismo , Infecções por Coronavirus/complicações , Suscetibilidade a Doenças , Extrato de Sementes de Uva , Humanos , Neoplasias Bucais/complicações , Antissépticos Bucais , Pandemias , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/complicações , Ligação Proteica
12.
In Vivo ; 34(3 Suppl): 1681-1684, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32503829

RESUMO

AIM: To describe the incidental detection of COVID-19 disease on positron-emission tomography/computed tomography (PET/CT) in a patient with cancer despite initial negative swab by polymerase chain reaction (PCR). CASE REPORT: Clinical and radiographic data were obtained from the electronic medical record. Nasopharyngeal swabs were obtained and evaluated for COVID-19 by the Food and Drug Administration-approved reverse transcription-PCR assays. On radiographic examination, PET/CT was consistent with COVID-19-related pneumonia not seen on prior imaging. Initial nasopharyngeal swab 2 days after PET/CT imaging was negative for COVID-19. Subsequent repeat swab 10 days later was positive for COVID-19, while the patient was febrile on screening assessment. The patient remained COVID-19-positive until 1 month after abnormal PET/CT imaging. CONCLUSION: PET/CT can be sensitive for early COVID-19 detection, even in the setting of a negative confirmatory PCR test. This highlights the importance of continued patient surveillance and use of appropriate personal protective equipment to minimize COVID-19 transmission.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Tonsilares/diagnóstico por imagem , Doenças Assintomáticas , Betacoronavirus/genética , Carcinoma de Células Escamosas/complicações , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Reações Falso-Negativas , Humanos , Achados Incidentais , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Cidade de Nova Iorque , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Equipamentos de Proteção , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sensibilidade e Especificidade , Neoplasias Tonsilares/complicações
13.
J Glaucoma ; 29(6): 448-455, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32487970

RESUMO

PRECIS: In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk. PURPOSE: The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG. METHODS: We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations. From 1984 (women)/1988 (men), we asked about basal cell carcinoma or squamous cell carcinoma history separately; in prior years, we asked about any NMSC history in a single question. Squamous cell carcinoma was confirmed with histopathology reports while basal cell carcinoma and any early (<1984/<1988) NMSC history was self-reported. Incident XFG cases (362 women and 83 men) were confirmed with medical records. Using pooled data, we estimated multivariable-adjusted relative risks [MVRRs; 95% confidence intervals (CIs)] with Cox proportional hazards models that were stratified by age (in mo), 2-year time period at risk and average lifetime residential latitude. RESULTS: In multivariable-adjusted analyses, we observed a 40% higher XFG risk with any NMSC history (MVRR=1.40; 95% CI=1.08-1.82); the association was observed even with 4 and 8-year lags in NMSC history. Also, the NMSC association was stronger in younger (below 65 y; MVRR=2.56; 95% CI=1.62-4.05) versus older participants (65 y and above; MVRR=1.25; 95% CI=0.94-1.66; P for interaction=0.01) and those living in the northern latitudes (≥42°N; MVRR=1.92; 95% CI=1.28-2.88) versus more southern latitudes (<42°N; MVRR=1.19; 95% CI=0.86-1.66; P for interaction=0.04). CONCLUSION: NMSC was associated with higher XFG risk, particularly among younger participants and those living in the Northern US.


Assuntos
Síndrome de Exfoliação/epidemiologia , Glaucoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/complicações , Carcinoma Basocelular/epidemiologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Estudos de Coortes , Síndrome de Exfoliação/complicações , Feminino , Seguimentos , Glaucoma/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Exposição à Radiação/efeitos adversos , Exposição à Radiação/estatística & dados numéricos , Fatores de Risco , Neoplasias Cutâneas/complicações , Raios Ultravioleta/efeitos adversos
15.
J Clin Pathol ; 73(11): 754-757, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32366599

RESUMO

In the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, pathologists can be exposed to infection handling surgical specimens. Guidelines related to safety procedures in the laboratory have been released. However, there is a lack of studies performed on biopsy and surgical resection specimens. Here we report the detection of SARS-CoV-2 in formalin-fixed paraffin-embedded samples from surgical resection of tongue squamous cell carcinoma of a patient who developed COVID-19 postsurgery. RNA of SARS-CoV-2 strain was detected in the tumour and the normal submandibular gland samples using real-time PCR-based assay. No viral RNA was found in metastatic and reactive lymph nodes. We demonstrated that SARS-CoV-2 RNA can be detected in routine histopathological samples even before COVID-19 disease development. These findings may give important information on the possible sites of infection or virus reservoir, and highlight the necessity of proper handling and fixation before sample processing.


Assuntos
Betacoronavirus/isolamento & purificação , Carcinoma de Células Escamosas/cirurgia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Preservação de Tecido/métodos , Neoplasias da Língua/cirurgia , Betacoronavirus/genética , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/virologia , Infecções por Coronavirus/etiologia , Infecções por Coronavirus/virologia , Fixadores , Formaldeído , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Inclusão em Parafina , Pneumonia Viral/etiologia , Pneumonia Viral/virologia , Complicações Pós-Operatórias/virologia , RNA Viral/análise , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fixação de Tecidos/métodos , Neoplasias da Língua/complicações , Neoplasias da Língua/patologia , Neoplasias da Língua/virologia
16.
Medicine (Baltimore) ; 99(20): e20220, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443352

RESUMO

RATIONALE: Chilaiditi syndrome is a rare disorder characterized by a broad spectrum of (gastro-intestinal) symptoms caused by interposition of a segment of bowel between the liver and the diaphragm. Most cases present with abdominal symptoms and the morbidity tend to increase with age. PATIENT CONCERNS: Here we present a rare case of Chilaiditi syndrome. An elderly postmenopausal woman developed unresolved postoperative respiratory symptoms and chest pain. Chest auscultation revealed considerable attenuation of respiratory sounds. She showed postoperative increase in D-dimer level and sudden onset of dyspnea. DIAGNOSES: Considering the presence of atelectasis in the middle and lower lobes of the right lung, bedside fiberoptic bronchoscopy was performed immediately to rule out bronchial phlegm embolism. However, no phlegm embolism was found in the left lung, and a small amount of yellow-white mucus was seen in the upper lobe of the right lung. Due to external pressure, the lumen of the middle and lower lobes of the right lung was obviously narrowed. INTERVENTIONS: The patient was placed in a semi-sitting position and a tube was passed through the anus to decompress the intestinal cavity; in addition, she received potassium supplementation. OUTCOMES: The patient's symptoms improved markedly. Chest and semi-supine abdominal plain radiographs showed enhanced lung markings, shadows in the left lower lung lobes, elevation of the right diaphragm, and small amount of pneumoperitoneum. The patient recovered after 5 days of continuous treatment and was discharged. LESSONS: Emergency computed tomographic pulmonary angiography may facilitate the diagnosis of Chilaiditi syndrome, especially in the postoperative setting. Occurrence of Chilaiditi syndrome in this patient was likely associated with surgical factors. Appropriate investigations and clear identification of etiology are essential for successful treatment.


Assuntos
Síndrome de Chilaiditi/complicações , Neoplasias do Colo do Útero/cirurgia , Idoso , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/cirurgia , Dor no Peito/etiologia , Dispneia/etiologia , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Complicações Pós-Operatórias/etiologia , Tomografia Computadorizada por Raios X/métodos , Neoplasias do Colo do Útero/complicações
18.
Mol Cancer ; 19(1): 80, 2020 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-32345328

RESUMO

Recent studies have reported that COVID-19 patients with lung cancer have a higher risk of severe events than patients without cancer. In this study, we investigated the gene expression of angiotensin I-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) with prognosis in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC). Lung cancer patients in each age stage, subtype, and pathological stage are susceptible to SARS-CoV-2 infection, except for the primitive subtype of LUSC. LUAD patients are more susceptible to SARS-CoV-2 infection than LUSC patients. The findings are unanimous on tissue expression in gene and protein levels.


Assuntos
Adenocarcinoma de Pulmão/complicações , Betacoronavirus , Carcinoma de Células Escamosas/complicações , Infecções por Coronavirus/etiologia , Neoplasias Pulmonares/complicações , Peptidil Dipeptidase A/genética , Pneumonia Viral/etiologia , Serina Endopeptidases/genética , Adenocarcinoma de Pulmão/genética , Animais , Carcinoma de Células Escamosas/genética , Linhagem Celular , Infecções por Coronavirus/genética , Suscetibilidade a Doenças , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Pulmonares/genética , Camundongos , Camundongos Transgênicos , Pandemias , Peptidil Dipeptidase A/biossíntese , Pneumonia Viral/genética , Serina Endopeptidases/biossíntese
19.
J Laparoendosc Adv Surg Tech A ; 30(5): 477-480, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32311303

RESUMO

Background: The current global COVID-19 pandemic is caused by the novel coronavirus Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Given that SARS-CoV-2 is highly transmissible, surgical societies have recommended that procedures with a high risk of aerosolization be avoided or delayed. However, some high-risk procedures, such as those related to head and neck malignancies, cannot always be delayed. Care must be taken during aerosol-generating procedures to minimize viral transmission as much as possible. Preoperative testing for COVID-19, limited operating room personnel, adequate personal protective equipment, and surgical technique are factors to consider for high-risk procedures. Methods: This article presents the case of an awake tracheotomy performed for a transglottic mass causing airway obstruction. Results: With detailed planning and specific techniques, the amount of aerosolization was reduced, and the procedure was performed as safely as possible. Conclusion: This case provides a template for future aerosol-generating procedures during respiratory pandemics.


Assuntos
Obstrução das Vias Respiratórias/cirurgia , Infecções por Coronavirus/diagnóstico , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pneumonia Viral/diagnóstico , Insuficiência Respiratória/cirurgia , Traqueotomia/métodos , Aerossóis/efeitos adversos , Obstrução das Vias Respiratórias/etiologia , Betacoronavirus/isolamento & purificação , Carcinoma de Células Escamosas/complicações , Infecções por Coronavirus/complicações , Infecções por Coronavirus/virologia , Glote , Humanos , Controle de Infecções/normas , Neoplasias Laríngeas/complicações , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Insuficiência Respiratória/etiologia , Traqueotomia/efeitos adversos , Vigília
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