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1.
J Drugs Dermatol ; 20(5): 552-554, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33938701

RESUMO

Locally-advanced periocular basal cell carcinoma (BCC) pose many therapeutic challenges due to the need to preserve functionality and cosmesis of the orbit and periocular area. Surgical excision and subsequent orbital exenteration are two recognized modalities of treatment. Vismodegib is currently an FDA-approved monotherapy for locally-advanced and metastatic BCC. We present a case of the use of vismodegib as neoadjuvant therapy prior to surgical excision of a locally-advanced periocular recurrent BCC in a 75-year-old male. The patient’s tumor successfully responded to vismodegib allowing surgical excision with clear margins. The orbit was saved in a patient who otherwise would have required complete orbital exenteration. J Drugs Dermatol. 20(5):552-554. doi:10.36849/JDD.5661.


Assuntos
Anilidas/administração & dosagem , Carcinoma Basocelular/terapia , Neoplasias Palpebrais/terapia , Recidiva Local de Neoplasia/terapia , Piridinas/administração & dosagem , Neoplasias Cutâneas/terapia , Administração Oral , Idoso , Anilidas/efeitos adversos , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/patologia , Pálpebras/diagnóstico por imagem , Pálpebras/patologia , Pálpebras/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Margens de Excisão , Terapia Neoadjuvante/métodos , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/patologia , Tratamentos com Preservação do Órgão/métodos , Piridinas/efeitos adversos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Resultado do Tratamento
2.
J Cutan Pathol ; 48(7): 937-942, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33660318

RESUMO

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare cutaneous adnexal neoplasm typically arising on the face of older individuals, most commonly around the eyelids. Histopathologic features include a circumscribed proliferation of low-grade epithelioid cells with areas of cystic and cribriform growth, foci of intracytoplasmic and extracellular mucin, and coexpression of endocrine, neuroendocrine, and cytokeratin markers by immunohistochemistry. Given histopathologic and immunohistochemical similarities, EMPSGC is often likened to solid papillary carcinoma of the breast and endocrine ductal carcinoma in situ, and is thought by many to represent a forme fruste of mucinous carcinoma of the skin. To date, the vast majority of reported cases of EMPSGC have been described as having indolent behavior, with no cases of distant metastasis yet reported. Here we report a unique case of EMPSGC that recurred over several years following standard surgical excision and Mohs micrographic surgery, with subsequent metastasis to the parotid gland and axial skeleton.


Assuntos
Adenocarcinoma Mucinoso/diagnóstico , Recidiva Local de Neoplasia/secundário , Neoplasias Císticas, Mucinosas e Serosas/patologia , Neoplasias Cutâneas/patologia , Adenocarcinoma Mucinoso/cirurgia , Idoso , Biomarcadores Tumorais/metabolismo , Neoplasias Palpebrais/patologia , Humanos , Imuno-Histoquímica/métodos , Masculino , Cirurgia de Mohs/métodos , Mucinas/metabolismo , Metástase Neoplásica/patologia , Recidiva Local de Neoplasia/radioterapia , Tumores Neuroendócrinos/patologia , Neoplasias Parotídeas/patologia , Radiocirurgia/métodos , Neoplasias das Glândulas Sudoríparas/patologia , Resultado do Tratamento
4.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542009

RESUMO

Proliferating trichilemmal tumours (PTTs) are rare cutaneous adnexal tumours derived from the hair shaft outer root sheath. We are reporting the first case of PTT in a young child. In this case, a 7-year-old girl presented with trichilemmal keratinisation consistent with PTT. The patient was monitored with no signs of recurrence. PTT is a rare tumour occurring primarily in adults and we present this case so that young patients with PTT can be diagnosed and treated appropriately with a painless, mobile, rapidly growing mass on the right upper eyelid. CT imaging showed well-circumscribed, heterogenous mass measuring 1.6 cm with fluid-filled appearance and no tissue invasion. Surgical excision was performed and pathology revealed an unencapsulated, well-demarcated tumour.


Assuntos
Neoplasias Palpebrais/cirurgia , Neoplasias de Anexos e de Apêndices Cutâneos , Criança , Neoplasias Palpebrais/patologia , Feminino , Humanos , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Neoplasias de Anexos e de Apêndices Cutâneos/cirurgia , Neuroimagem
5.
Ann Otol Rhinol Laryngol ; 130(9): 1016-1023, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33514267

RESUMO

OBJECTIVES: Advanced cutaneous squamous cell carcinoma of the head and neck (CSCCHN) is associated with poor outcome despite multimodality therapy. Comprehensive risk stratification may pinpoint the most suitable adjuvant treatment. This study aimed to evaluate the outcomes of surgically treated locoregional CSCCHN and to identify prognostic indicators of treatment outcomes. METHODS: We retrospectively analyzed disease variables, pathologic characteristics, and management in association with treatment outcomes of all consecutive advanced CSCCHN patients who underwent surgical resection at Tel Aviv Sourasky Medical Center. RESULTS: From 2008 to 2018, 74 patients met the inclusion criteria. Only perineural invasion (PNI) was significantly associated with worse overall survival (OS) (P = .001). Location within the facial "mask areas" was significantly associated with pathologically negative cervical disease (P = .001). Forty-seven patients underwent adjuvant radiation therapy (RT) which significantly improved OS and disease-free survival versus surgery alone (P = .025 and P = 0.035, respectively). CONCLUSION: PNI was associated with worse OS in surgically treated advanced CSCCHN. Adjuvant RT conferred better outcomes despite high risk features.


Assuntos
Neoplasias Faciais/cirurgia , Linfonodos/patologia , Esvaziamento Cervical , Radioterapia Adjuvante , Couro Cabeludo/cirurgia , Neoplasias Cutâneas/cirurgia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Idoso , Idoso de 80 Anos ou mais , Bochecha/patologia , Bochecha/cirurgia , Quimiorradioterapia Adjuvante , Intervalo Livre de Doença , Neoplasias da Orelha/patologia , Neoplasias da Orelha/cirurgia , Extensão Extranodal/patologia , Neoplasias Palpebrais/patologia , Neoplasias Palpebrais/cirurgia , Neoplasias Faciais/patologia , Feminino , Testa/patologia , Testa/cirurgia , Humanos , Hospedeiro Imunocomprometido , Estimativa de Kaplan-Meier , Neoplasias Labiais/patologia , Neoplasias Labiais/cirurgia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Recidiva Local de Neoplasia , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos , Glândula Parótida , Modelos de Riscos Proporcionais , Procedimentos Cirúrgicos Reconstrutivos , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Taxa de Sobrevida , Resultado do Tratamento
7.
Br J Ophthalmol ; 105(7): 914-920, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32732342

RESUMO

BACKGROUND: Nationwide studies of ocular adnexal lymphoma (OAL) are very rare in the literature, and knowledge on incidence, subtype distribution and long-term survival data is limited. This is the largest national study of OAL to date. This study sought to find information on incidence, changes in incidence, clinical findings, distribution of subtypes, survival and prognostic factors. METHODS: Patients diagnosed with OAL from January 1, 1980 to December 31, 2017 were identified in Danish registers, and clinical as well as survival data were collected. The data were analysed with Kaplan-Meier plots and log-rank test. RESULTS: 387 patients were included in the study. The major lymphoma subtypes were extranodal marginal-zone B cell lymphoma (EMZL) (55%), diffuse large B cell lymphoma (DLBCL) (13%), mantle cell lymphoma (MCL) (11%) and follicular lymphoma (FL) (10%). OAL is a disease of the elderly (median age 69 years). The incidence of lymphoma of the ocular adnexal region has increased significantly throughout the time period of the study (Pearson correlation coefficient, r=0.65; P<0.001). In the period 1980-1984, the incidence was 0.086 per 100 000, which increased to 0.307 per 100 000 in the period 2013-2017. Low-grade, low-stage primary lymphomas were treated with radiotherapy, whereas patients with high-stage, high-grade and/or relapsed disease were treated with chemotherapy. Low-grade subtypes EMZL (89%) and FL (56%) had better 10-year disease-specific survival than the high-grade lymphomas DLBCL (38%) and MCL (31%)(p<0.001). CONCLUSION: OAL is increasing in incidence in the Danish population for unknown reasons. However, the prognosis for most OAL is favourable, as highlighted in this national long-term study.


Assuntos
Neoplasias da Túnica Conjuntiva/epidemiologia , Neoplasias Palpebrais/epidemiologia , Doenças do Aparelho Lacrimal/epidemiologia , Linfoma/epidemiologia , Neoplasias Orbitárias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Neoplasias da Túnica Conjuntiva/patologia , Dinamarca/epidemiologia , Intervalo Livre de Doença , Neoplasias Oculares/epidemiologia , Neoplasias Oculares/patologia , Neoplasias Palpebrais/patologia , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Doenças do Aparelho Lacrimal/patologia , Linfoma/patologia , Linfoma de Zona Marginal Tipo Células B/epidemiologia , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma Folicular/epidemiologia , Linfoma Folicular/patologia , Linfoma Difuso de Grandes Células B/epidemiologia , Linfoma Difuso de Grandes Células B/patologia , Linfoma de Célula do Manto/epidemiologia , Linfoma de Célula do Manto/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Orbitárias/patologia , Sistema de Registros , Estudos Retrospectivos , Taxa de Sobrevida
11.
Br J Ophthalmol ; 105(1): 48-56, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32277010

RESUMO

BACKGROUND: Immune checkpoint blockade strategies have gained attention in the treatment/prognosis of cancers by targeting the programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) pathway alone or in combination with cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) blockade and are currently in clinical trials. The present study investigated the expression of the PD-1, PD-L1, CTLA-4, CD4 and CD8 proteins and their prognostic value in the tumour microenvironment of sebaceous gland carcinoma (SGC). METHODS: The expression levels of PD-1, PD-L1, CTLA-4, CD4 and CD8 proteins were assessed in 52 cases of SGC by immunohistochemistry and validated by western blotting. mRNA expression was measured by quantitative real-time PCR. Kaplan-Meier curves and Cox proportional hazard models were used to analyse the correlation of protein expression with clinicopathological parameters and disease-free survival. RESULTS: The expression of PD-L1 was found to be higher in tumour cells than in stromal cells. In univariate analysis, the expression of PD-1 in tumour-infiltrating lymphocytes (tPD-1) and PD-L1 in tumour cells was associated with reduced disease-free survival, whereas PD-L1 expression in stromal lymphocyte infiltration (sPD-L1) was associated with the increased survival of patients (p<0.05). However, by multivariate analysis, the expression of tPD-1 was found to be an independent prognostic factor for poor survival. CONCLUSION: Our study highlights the prognostic outcome of PD-1 and PD-L1 protein expression in cells of tumour-stromal compartments. These results indicate that the PD-1/PD-L1 pathway mediates important interactions within the tumour microenvironment in SGC.


Assuntos
Adenocarcinoma Sebáceo/metabolismo , Neoplasias Palpebrais/metabolismo , Proteínas de Checkpoint Imunológico/metabolismo , Neoplasias das Glândulas Sebáceas/metabolismo , Células Estromais/metabolismo , Microambiente Tumoral/fisiologia , Adenocarcinoma Sebáceo/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígeno B7-H1/genética , Antígeno B7-H1/metabolismo , Western Blotting , Antígenos CD4/metabolismo , Antígenos CD8/metabolismo , Antígeno CTLA-4/genética , Antígeno CTLA-4/metabolismo , Neoplasias Palpebrais/patologia , Feminino , Humanos , Proteínas de Checkpoint Imunológico/genética , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Receptor de Morte Celular Programada 1/genética , Receptor de Morte Celular Programada 1/metabolismo , Modelos de Riscos Proporcionais , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Neoplasias das Glândulas Sebáceas/patologia
12.
Arch. Soc. Esp. Oftalmol ; 95(9): 459-462, sept. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-201789

RESUMO

El linfoma anaplásico de células grandes primario cutáneo (LACGc) forma parte del espectro de la enfermedad linfoproliferativa cutánea CD30+. Su afectación palpebral es muy rara, y en todos los casos descritos en la literatura afecta al párpado superior. En el presente caso clínico se describe un LACGc palpebral de localización atípica. Una mujer de 39 años sin antecedentes de interés presentó una lesión de crecimiento rápido en canto medio palpebral de aspecto inflamatorio-infeccioso. Tras una semana de antibioterapia oral sin respuesta, se realizó una biopsia excisional. Con análisis anatomopatológico compatible y estudio de extensión negativo, se catalogó como LACGc. Tras 2 años de seguimiento la paciente no ha presentado recidiva de la enfermedad. La afectación de los párpados por un LACGc es poco frecuente y potencialmente grave. Por ello, es necesario ampliar la información sobre el diagnóstico, tratamiento y curso de esta enfermedad


Cutaneous anaplastic large-cell lymphoma (cALCL) is a condition within CD30 lymphoid proliferations spectrum. Involving the eyelid is unusual and all cases found in the literature are located in the upper eyelid. In this case we report an cALCL atypical presentation. A 39 year-old woman with no significant medical history, presents a fast-growing mass in the medial canthus, with inflamatory-infectious appearance. After a week with antibiotics with no response, an excisional biopsy was practiced. The hystopathology analysis with a negative systemic work up confirmed the diagnosis of a cALCL. After two-year follow up, patient is asymptomatic. cALCL involving the eyelid are rare but potentially life-threatening disorders, so more information about diagnosis, treatment and follow up is needed


Assuntos
Humanos , Feminino , Adulto , Linfoma Anaplásico Cutâneo Primário de Células Grandes/patologia , Aparelho Lacrimal/patologia , Neoplasias Cutâneas/patologia , Neoplasias Palpebrais/patologia , Linfoma Anaplásico Cutâneo Primário de Células Grandes/tratamento farmacológico , Aparelho Lacrimal/efeitos dos fármacos , Neoplasias Cutâneas/tratamento farmacológico , Biópsia , Neoplasias Palpebrais/tratamento farmacológico
13.
Exp Eye Res ; 198: 108140, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32649951

RESUMO

PURPOSE: Eyelid basal cell carcinoma (BCC) is the most common eyelid malignancy. Metabolic reprogramming is critical in tumorigenesis, but the metabolic feature of eyelid BCC remains elusive. In this study, we aim to reveal the metabolic profile in eyelid BCC using targeted metabolomics. Eyelid samples were collected from patients who had removal of BCC and from control patients who underwent blepharoplasty. Multivariate analysis of metabolomics data distinguished the two groups, indicating that eyelid BCC has significantly different metabolome than the healthy tissue. We found 16 increased and 11 decreased metabolites in the BCC tissues. These metabolites were highly enriched in the metabolism of nicotinamide adenine dinucleotide (NAD), glutathione metabolism, polyamine metabolism, and the metabolism of glycine, serine, threonine, arginine and proline. amino acid metabolism. Metabolites from NAD metabolism (Nicotinamide; Nicotinamide riboside; N1-Methylnicotinamide) had the highest sensitivity, specificity, and prediction accuracy in a prediction model for eyelid BCC. In conclusion, eyelid BCC has a signature change of cell metabolome. Metabolites in NAD metabolic pathways could potentially be biomarkers or therapeutic targets for eyelid BCC.


Assuntos
Carcinoma Basocelular/metabolismo , Neoplasias Palpebrais/metabolismo , Metaboloma/fisiologia , Metabolômica/métodos , Idoso , Biomarcadores Tumorais/metabolismo , Carcinoma Basocelular/patologia , Neoplasias Palpebrais/patologia , Feminino , Humanos , Masculino
15.
Top Companion Anim Med ; 40: 100455, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32690283

RESUMO

A 12-year-old, male mongrel dog was presented for a 6-month history of a progressive eyelid mass of the right upper eyelid. The dog's medical history reported long-term bilateral topical application of 0.03% tacrolimus ophthalmic ointment for third eyelid plasmoma and treatment cycles with systemic corticosteroids for a long-standing atopic dermatitis. Complete physical and ophthalmologic examination of the dog as well as complete blood count, serum biochemical analysis, urinalysis, thoracic radiographs, and abdominal ultrasonography were performed. The mass involved the skin and the margin of the upper eyelid, which was ulcerated. Conjunctival hyperemia, and the thickening and partial depigmentation of the third eyelid due to plasmoma were present. The plasmoma was observed bilaterally. Histological examination of the eyelid mass showed an invasive proliferation of malignant epithelial cells with intermixing of both adenocarcinomatous and malignant squamous cell components. An eyelid adenosquamous carcinoma was diagnosed. To the best of the authors' knowledge, this is the first report on an adenosquamous carcinoma of the eyelid in a dog. Immunosuppression has been found to be a significant clinical risk factor for cutaneous adenosquamous carcinoma in humans and was considered a possible risk factor for this dog.


Assuntos
Carcinoma Adenoescamoso/veterinária , Doenças do Cão/patologia , Neoplasias Palpebrais/veterinária , Corticosteroides/uso terapêutico , Animais , Carcinoma Adenoescamoso/patologia , Cães , Neoplasias Palpebrais/patologia , Imunossupressores/uso terapêutico , Masculino , Plasmócitos , Tacrolimo/uso terapêutico
16.
J Cutan Pathol ; 47(9): 860-864, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32358805

RESUMO

Primary cutaneous signet-ring cell/histiocytoid carcinoma of the eyelid is a rare and aggressive neoplasm. Fewer than 50 cases have been reported in the literature, and the genetic driving mutations are unknown. Herein, we present a case of this rare disease along with the results of molecular profiling via targeted next-generation sequencing. The patient is an 85-year-old man who presented with left eyelid swelling initially thought to be a chalazion. After no response to incision and drainage and antibiotics, an incisional biopsy was performed. Histopathologic sections revealed a proliferation of cells with signet-ring and histiocytoid morphology arranged singly and in cords infiltrating the dermis, subcutaneous tissue, and muscle. The lesional cells strongly expressed cytoplasmic cytokeratin 7 and nuclear androgen receptor. Next-generation sequencing revealed a CDH1 mutation, which is known to confer signet-ring morphology in other carcinomas. Pathogenic mutations in NTRK3, CDKN1B, and PIK3CA were also detected. To our knowledge, this is the first documented genetic analysis of this rare disease with findings that offer insights into disease pathogenesis and potential therapeutic targets.


Assuntos
Antígenos CD/genética , Caderinas/genética , Carcinoma de Células em Anel de Sinete/genética , Neoplasias Palpebrais/genética , Queratina-7/metabolismo , Receptores Androgênicos/metabolismo , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/uso terapêutico , Biópsia , Carcinoma de Células em Anel de Sinete/diagnóstico , Carcinoma de Células em Anel de Sinete/terapia , Terapia Combinada , Neoplasias Palpebrais/patologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Histiócitos/patologia , Humanos , Masculino , Mutação , Radioterapia Adjuvante/métodos , Neoplasias Cutâneas/patologia , Retalhos Cirúrgicos , Resultado do Tratamento
17.
Int J Surg Pathol ; 28(8): 888-892, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32363990

RESUMO

Ocular sebaceous carcinoma is an uncommon, aggressive tumor arising from the Meibomian gland, Zeis gland, or sebaceous glands in the caruncle or eyelashes. We described a rare case of sebaceous carcinoma in situ in a 51-year-old female that was characterized by intraepithelial growth of sebaceous carcinoma cells with no invasive carcinoma in the underlying sebaceous glands. Early stromal invasion was identified that featured 2 distinctive but focally intermixed populations of sebaceous carcinoma cells and squamous carcinoma cells. The 2 populations of cells exhibited their respective distinct immunophenotype but both showed strong overexpression of p53. This case provides evidence to support the hypothesis that some ocular sebaceous carcinoma may arise from intraepithelial pluripotent stem cells.


Assuntos
Adenocarcinoma Sebáceo/diagnóstico , Carcinoma in Situ/diagnóstico , Túnica Conjuntiva/patologia , Neoplasias Palpebrais/diagnóstico , Neoplasias das Glândulas Sebáceas/diagnóstico , Adenocarcinoma Sebáceo/patologia , Carcinoma in Situ/patologia , Neoplasias Palpebrais/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias das Glândulas Sebáceas/patologia , Glândulas Sebáceas/patologia
20.
BMC Ophthalmol ; 20(1): 103, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32178641

RESUMO

BACKGROUND: The purpose was to describe the Nordic treatment practices and to reach a Nordic consensus for the treatment of sebaceous eyelid carcinoma. METHODS: The treatment practices data was collected by a questionnaire with 37 questions to the Nordic oculoplastic surgeons and analyzed. A PubMed MEDLINE database search was done to gather data on the published treatment practices and recommendations. A working group that consisted of in minimum one senior consultant from each leading Nordic University Eye Hospital was assigned. A structured interactive method was used to establish the consensus. RESULTS: Twenty-four doctors responded to the questionnaire. 23/24 (96%) of the respondents took a biopsy before surgery. Regional lymph node scanning was routinely done by 14/23 (61%) and a systemic screening of a metastatic disease by 13/23 (57%). 6/22 (27%) never took conjunctival mapping biopsies and 12/23 (52%) never screened for Muir- Torre. Respondents used Mohs surgery, frozen section or multi-stage excision with delayed closure, and 5-6 mm was the mostly preferred margin. Sentinel lymph node biopsy was a possible option for 9/22 (41%) and cryotherapy and Mitomycin C for 6/22 (27%) respondents. 50% of respondents considered radiation as a treatment option. 15/16 (94%) respondents always followed-up their patients, most for 5 years. Two thirds scanned regional lymph nodes during the follow-up. Consensus was reached for 18 statements representing three domains: preoperative work-up, treatment and follow-up. CONCLUSION: Treatment practices differ in between the five Nordic countries which have similar public health care systems. In the article the authors present a Nordic consensus for the treatment of eyelid sebaceous carcinoma.


Assuntos
Adenocarcinoma Sebáceo/terapia , Consenso , Neoplasias Palpebrais/terapia , Pálpebras/patologia , Neoplasias das Glândulas Sebáceas/terapia , Adenocarcinoma Sebáceo/patologia , Adulto , Idoso , Terapia Combinada/normas , Neoplasias Palpebrais/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Sebáceas/patologia , Biópsia de Linfonodo Sentinela , Inquéritos e Questionários
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