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1.
Anticancer Res ; 40(11): 6563-6570, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33109598

RESUMO

BACKGROUND/AIM: In this study, we investigated the locations and surgical complications of schwannomas. PATIENTS AND METHODS: Data of 130 patients with schwannomas were retrospectively reviewed. Pre- and post-operative neurological symptoms, tumor locations, and nerves of origin (sensory, motor, or mixed) were reviewed. RESULTS: Before surgery, 69 patients had Tinel-like signs, 56 patients had pain, 32 patients had numbness, four patients had motor deficits. After surgery, 20 patients had developed a new neurological deficit; 11 patients had motor deficits, ten patients had sensory deficits, and one patient had both motor and sensory deficits. Most schwannomas occurred in mixed nerves, including the median nerve in 17 patients and tibial nerve in 13 patients. CONCLUSION: The most common site of schwannoma was the median nerve. Although the nerve of origin of the schwannoma could be identified in only 26.0% of cases, the data suggest that schwannomas occur in both sensory and motor nerves.


Assuntos
Nervo Mediano/cirurgia , Neurilemoma/cirurgia , Neoplasias do Sistema Nervoso Periférico/cirurgia , Neoplasias Cutâneas/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Neurilemoma/complicações , Neurilemoma/tratamento farmacológico , Neurilemoma/fisiopatologia , Neoplasias do Sistema Nervoso Periférico/fisiopatologia , Período Pós-Operatório , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/fisiopatologia , Resultado do Tratamento , Adulto Jovem
2.
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
3.
Immunotherapy ; 12(15): 1133-1138, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32900245

RESUMO

Background: Little is known about the 2019 novel coronavirus disease (COVID-19) course and outcomes in patients receiving immunotherapy. Here we describe a metastatic Merkel cell carcinoma patient with a severe acute respiratory syndrome coronavirus 2 infection while receiving pembrolizumab. Case presentation: A 66-year-old man, with a metastatic Merkel cell carcinoma receiving pembrolizumab, presented with fever. Chest computed tomography (CT) showed pulmonary ground-glass opacities, suggesting viral or immuno-related etiology. On day 7, the patient was hospitalized due to dyspnea and worsening of the radiological findings. Real time polymerase chain reaction (RT-PCR) testing confirmed COVID-19. The patient developed acute respiratory distress syndrome and acute kidney injury. Hydroxychloroquine was administered for 5 days, but discontinued after supraventricular extrasystoles. Clinical improvement allowed the patient's discharge after 81 days of hospitalization. Conclusion: A careful evaluation of oncologic patients receiving immunotherapy during the COVID-19 pandemic is of utmost importance.


Assuntos
Carcinoma de Célula de Merkel/terapia , Infecções por Coronavirus/diagnóstico , Imunoterapia , Pneumonia Viral/diagnóstico , Neoplasias Cutâneas/terapia , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Betacoronavirus , Carcinoma de Célula de Merkel/complicações , Carcinoma de Célula de Merkel/patologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Infecções por Coronavirus/terapia , Humanos , Imunoterapia/efeitos adversos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Pneumonia Viral/terapia , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
4.
Medicine (Baltimore) ; 99(31): e21529, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756200

RESUMO

RATIONALE: Tetanus is usually caused by wound infection with Clostridium tetani after acute injuries. Skin cancer wound is a rarely reported cause of tetani infection. It is difficult to be diagnosed and mistaken for other brain lesions. PATIENT CONCERNS: A 49-year-old man presenting with the only symptom of repeated convulsions was admitted to our department. He had an ulcerated skin cancer on the right buttock that had been excised in another hospital 1 month before admission, leaving the wound unhealed. He was suspected of having a metastatic brain tumor early, but exhibited a negative cranial CT-scan. DIAGNOSIS: Tetanus was diagnosed when he was observed to have sudden convulsions after sensory stimulation such as noise, light, or touch. INTERVENTIONS: Despite administration of a high dose of diazepam and phenobarbitone, continuous generalized rigidity with laryngospasm still occurred. Instead, when propofol was intravenously infused, the spastic convulsion completely stopped. Tracheotomy and mechanical ventilation were performed. OUTCOMES: The patient gradually recovered in 2 weeks. LESSONS: Tetanus is rarely infected through the wound of an ulcerated skin cancer. Early diagnosis can only be based on accurate assessment of clinical manifestations, and propofol infusion appears to be more effective in anti-convulsion management for patients with tetanus. Routine vaccination to prevent tetanus in patients with ulcerated skin cancer should be considered in the future clinical work.


Assuntos
Neoplasias Cutâneas/complicações , Tétano/etiologia , Úlcera/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Dermatopatias/complicações , Tétano/fisiopatologia
6.
Medicine (Baltimore) ; 99(28): e21199, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664167

RESUMO

RATIONALE: Blue rubber bleb nevus syndrome (BRBNS) is an extremely rare disorder characterized by multifocal venous malformations involving various organs such as the skin and gastrointestinal tract. Severe complications of BRBNS, such as intussusception, volvulus, and intestinal infarction are rarer and require surgery. This report describes a 33-year-old male of BRBNS complicated with intussusception that was successfully diagnosed and treated with surgery. PATIENT CONCERNS: A 33-year-old Chinese man presented with persistent, colicky pain accompanied by nausea, abdominal distension, and dizziness. The patient presented with sporadic bluish nodules on his skin involving his head, neck, thorax, abdomen, and planta pedis. DIAGNOSES: BRBNS with the complication of intussusception. INTERVENTIONS: An emergency laparotomy was performed, and postoperative management included blood transfusions and oral iron supplementation for 2 weeks. OUTCOMES: The patient's postoperative course of hospitalization was uneventful. During the 4-month follow-up, the patient showed no signs of intussusception recurrence. LESSONS: Patients diagnosed with BRBNS who present with acute abdominal pain and distension should raise suspicion for the presence of intussusception, which requires emergent surgical intervention.


Assuntos
Neoplasias Gastrointestinais/complicações , Intussuscepção/etiologia , Nevo Azul/complicações , Neoplasias Cutâneas/complicações , Adulto , Humanos , Masculino
7.
Dermatol Online J ; 26(4)2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32621681

RESUMO

Sézary syndrome is a rare leukemic subtype of cutaneous T cell lymphoma that is characterized by erythroderma, lymphadenopathy, and malignant T cells in the peripheral blood. Poor prognostic factors of Sézary syndrome include advanced disease stage, older age at onset, and large cell transformation. Presentation with bullous lesions, though rare, has been reported in a few patients. We present an elderly woman with bullous Sézary syndrome who presented with a two-month history of progressive rash. Upon admission, the patient had pruritic, erythematous, edematous plaques with overlying flaccid bullae and erosions involving the scalp, neck, torso, and extremities. Despite treatment, the patient died two months after presentation. Although rare, bullous lesions associated with Sézary syndrome may indicate poor prognosis.


Assuntos
Síndrome de Sézary/complicações , Dermatopatias Vesiculobolhosas/etiologia , Neoplasias Cutâneas/complicações , Idoso , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Prognóstico , Síndrome de Sézary/diagnóstico , Síndrome de Sézary/patologia , Dermatopatias Vesiculobolhosas/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia
8.
Dermatol Online J ; 26(5)2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32621707

RESUMO

Oculocutaneous albinism is a genetically heterogeneous, autosomal recessive group of disorders characterized by a generalized decreased or absence of melanin pigment in the eyes, hair, and skin. These patients have a greater sensitivity to UV radiation and a predisposition to skin tumors, mainly squamous cell carcinoma and basal cell carcinomas, and to a lesser extent malignant melanomas. Melanoma can be one of the most challenging cancers to diagnose in patients with albinism. We report an uncommon clinical presentation of melanoma, an amelanotic melanoma in the right supraciliar region in a patient with oculocutaneous albinism. The clinical presentation was an erythematous, scaly and ill-defined plaque. The skin biopsy revealed a lentigo maligna melanoma. Amelanotic melanomas are one of the two most difficult to diagnose subtypes of melanoma, together with the nevoid type. Melanoma in oculocutaneous albinism patients are often amelanotic, which makes their clinical diagnosis very difficult. These patients should be examined in the dermatology department at least once a year and it is recommended to have a high index of suspicion.


Assuntos
Albinismo Oculocutâneo/complicações , Melanoma Amelanótico/patologia , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Dermoscopia , Feminino , Humanos , Lactente , Masculino , Melanoma Amelanótico/complicações , Melanoma Amelanótico/diagnóstico , Pessoa de Meia-Idade , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnóstico
12.
Invest Ophthalmol Vis Sci ; 61(5): 48, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32460312

RESUMO

Purpose: Ultraviolet radiation from sunlight contributes to age-related cataract and skin cancer. The EPHA2 gene is implicated in both these diseases. The purpose of this study was to determine whether age-related cataract and skin cancer are associated in a cohort of older Australians. Methods: A cross-sectional study was performed using the Historical Cohort of the Registry of Senior Australians. Individuals aged ≥65 years or aged ≥50 years and of Aboriginal or Torres Strait Islander descent, who had an aged care eligibility assessment between July 2005 and June 2015, and had a history of cataract surgery and/or skin cancer according to the Australian Government Medicare Benefits Schedule dataset, during the 3-year period prior, were evaluated (N = 599,316). A multivariable logistic regression model was used to determine association and multiple hypothesis correction was employed. Results: Of the evaluated individuals, 87,097 (14.5%) had a history of cataract and 170,251 (28.4%) a history of skin cancer. Among those with a history of cataract, 20,497 (23.5%), 1127 (1.3%), and 14,730 (16.9%) individuals had a concurrent history of keratinocyte, melanoma, and premalignant/solar keratosis, respectively. Those with a history of cataract were 19% more likely to have a history of skin cancer (odds ratio [OR], 1.19; 95% confidence interval [CI], (1.17-1.21). Co-occurrence of keratinocyte skin cancer was 16% (OR, 1.16; 95% CI, 1.14-1.18), melanoma 21% (OR, 1.21; 95% CI, 1.13-1.29), and premalignant/solar keratosis 19% (OR, 1.19; 95% CI, 1.17-1.22) more in the presence than absence of history of cataract. Conclusions: Age-related cataract is positively associated with skin cancer and its subtypes, including premalignant lesions in an older Australian population.


Assuntos
Catarata/complicações , Catarata/epidemiologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino
15.
Am J Kidney Dis ; 76(2): 299-302, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32417401
16.
Eur J Cancer ; 133: 94-103, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32470710

RESUMO

BACKGROUND: Subgroup analyses of two large EORTC adjuvant interferon-alpha2b (IFNα-2b) vs observation randomised trials demonstrated that a treatment benefit was observed only in patients with an ulcerated melanoma without palpable nodes (hazard ratio [HR] for recurrence-free survival [RFS] was 0.69). This was confirmed by a meta-analysis of 15 adjuvant IFN trials (HR: 0.79). PATIENTS AND METHODS: In the EORTC 18081 trial, sentinel node-negative stage II patients with an ulcerated primary melanoma were 1:1 randomised between pegylated (PEG)-IFNα-2b at 3 µg/kg/week subcutaneously and observation, for 2 years, or until disease recurrence or unacceptable toxicity in spite of dose adjustments to maintain an Eastern Cooperative Oncology Group performance status of 0 or 1. Main end-point was RFS. Secondary end-points included distant metastasis-free survival (DMFS), overall survival, and safety (EudraCT Number: 2009-010273-20). RESULTS: Between February 2013 and January 2017, only 112 patients were randomised, 56 in each arm. The trial was stopped early for lack of recruitment. At a 3.4-year median follow-up, the estimated HR for the PEG-IFNα-2b group compared with the observation group regarding RFS was 0.66 (95% confidence interval [CI]: 0.32-1.37), and the 3-year RFS rate was 80.0% (95% CI: 65.7-88.8%) and 72.9% (95% CI: 58.3-83.0%), respectively. DMFS was prolonged: HR: 0.39 (95% CI: 0.15-0.97), and the 3-year DMFS rate was 90.6% (95% CI: 78.9-96.0%) vs 76.4% (95% CI: 62.1-85.9%). One patient in the PEG-IFNα-2b group died compared with 4 in the observation group. Fifty-four patients started PEG-IFNα-2b treatment, 16 (29%) completed 2 years of treatment, 2 (4%) stopped due to recurrence, 23 (43%) due to toxicity and 14 (25%) due to other reasons. CONCLUSIONS: The EORTC 18081 PEG-IFNα-2b randomised trial, observed a similar HR (0.69) for RFS as the previous EORTC trials (0.69). In countries without access to new drugs, adjuvant (PEG)-IFNα-2b treatment is an option for patients with ulcerated melanomas without palpable nodes.


Assuntos
Interferon alfa-2/administração & dosagem , Interferon-alfa/administração & dosagem , Melanoma/terapia , Polietilenoglicóis/administração & dosagem , Neoplasias Cutâneas/terapia , Úlcera Cutânea/terapia , Conduta Expectante , Adulto , Idoso , Quimioterapia Adjuvante , Terapia Combinada , Esquema de Medicação , Europa (Continente)/epidemiologia , Feminino , Humanos , Injeções Subcutâneas , Masculino , Oncologia/organização & administração , Melanoma/complicações , Melanoma/mortalidade , Melanoma/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Proteínas Recombinantes/administração & dosagem , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Úlcera Cutânea/complicações , Úlcera Cutânea/mortalidade , Úlcera Cutânea/patologia , Sociedades Médicas/organização & administração , Análise de Sobrevida , Conduta Expectante/métodos
20.
J Am Acad Dermatol ; 83(2): 703-704, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32305443
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