Pólipo fibroepitelial vulvar: una serie de casos

Los pólipos fibroepiteliales son tumores cutáneos benignos frecuentes en la población general. Sin embargo, la afectación del tracto genital es inhabitual. Su etiología no es clara, pero se han descrito asociaciones con trastornos metabólicos y fluctuaciones hormonales, lo cual explica su mayor prevalencia en mujeres. Debido a la variedad de diagnósticos diferenciales, es necesaria la evaluación histopatológica. Su manejo es habitualmente conservador; sin embargo, pueden requerir intervención quirúrgica en algunos casos. Exponemos cuatro casos de tumores fibroepiteliales vulvares de diferentes tamaños, uno de ellos clasificado como gigante, así como la aproximación de manejo. Con esta presentación, esperamos mejorar el conocimiento, la precisión del diagnóstico y contribuir al tratamiento eficaz de las pacientes con esta patología vulvar tan poco frecuente.

Fibroepithelial polyps are common benign skin tumors in the general population. However, genital tract involvement is unusual. Their etiology is unclear, but associations with metabolic disorders and hormonal fluctuations have been described, which explains their higher prevalence in women. Due to the variety of differential diagnoses, histopathological evaluation is necessary. Their management is usually conservative. However, they may require surgical intervention in some cases. We present four cases of vulvar fibroepithelial tumors of different sizes, one of them classified as giant, as well as the management approach. With this presentation, we hope to improve knowledge, diagnostic accuracy and contribute to the effective treatment of patients with this rare vulvar pathology.

Carcinomatosis meníngea secundaria a melanoma metastásico: reporte de un caso / Meningeal carcinomatosis secondary to metastatic melanoma: a case report

Resumen La carcinomatosis meníngea es una entidad poco frecuente, que puede formar parte de la historia natural de muchos procesos neoplásicos. Se presenta habitualmente con síntomas poco específicos, como cefalea, cambios en la conducta o alteraciones motoras y sensitivas. A continuación, presentamos el caso de una paciente con carcinomatosis meníngea por melanoma metastásico y su evolución clínica.

La carcinomatosis meníngea es una entidad poco frecuente, que puede formar parte de la historia natural de muchos procesos neoplásicos. Se presenta habitualmente con síntomas poco específicos, como cefalea, cambios en la conducta o alteraciones motoras y sensitivas. A continuación, presentamos el caso de una paciente con carcinomatosis meníngea por melanoma metastásico y su evolución clínica.

Associação do retalho miocutâneo de Tripier a enxerto de cartilagem da escafa: um recurso cirúrgico para reconstrução de defeitos de espessura total da pálpebra inferior / Association of the Tripier myocutaneous flap to scapha cartilage graft: a surgical resource for reconstruction of full thickness defects of lower eyelids

A reconstrução da pálpebra inferior secundária à ressecção de câncer de pele é um desafio cirúrgico e sua abordagem deve ser planejada por lamelas e extensão da ressecção. Apresentamos o caso de paciente do sexo masculino, 69 anos, que após a ressecção oncológica apresentou defeito de espessura total maior de 60% na pálpebra inferior. Para reconstrução foi indicada a associação do retalho miocutâneo unipediculado de Tripier com enxerto de cartilagem da escafa obtendo resultados favoráveis, mostrando que a associação destas técnicas é uma boa prática na hora de planejar a reconstrução da pálpebra inferior.

The reconstruction of the secondary lower eyelid to a resection of skin cancer is a challenging surgical procedure that must be carefully planned with regards to issues related to lamella and extension of the resection. We present the case of a 69-year-old male patient who, after oncologic resection, presented a total thickness defect greater than 60% in the lower eyelid. For reconstruction, it was indicated that the use of Tripier's unipedic myocutaneous flap with scapha cartilage graft produced favorable results, which confirms that it is worthwhile using these techniques when planning lower eyelid reconstruction.

Quality of life and clinical and demographic characteristics of patients with cutaneous squamous cell carcinoma submitted to tumor resection by double-bladed scalpel

Abstract: Background: Non-melanoma skin cancer accounts for a third of all malignancies registered in Brazil, with squamous cell carcinoma (SCC) being one of its subtypes. It develops in photo-exposed areas, affecting social habits and causing negative influence on quality of life (QoL). Objectives: To evaluate QoL in patients with primary cutaneous SCC. Methods: A cross-sectional study was performed in patients with clinical diagnosis of SCC, corroborated by dermoscopy and confirmed by histopathology; prior to resection of the tumor using the double-blade scalpel technique, a questionnaire on the Dermatology Life Quality Index (DLQI) was applied. Results: Among the 46 evaluated patients, mean age was 67.1 ± 16.0 years, with a predominance of males, low educational level and socioeconomic status, Fitzpatrick II phototype, history of outdoor work, and tumor location in exposed photo areas. Mean DLQI was 4.02 ± 0.63, and in the categorization, 11 (23.9%) had a moderate to severe negative effect on QoL. The skin tumor had a negative impact on daily activities (33% of cases), treatment effects (30%), and symptoms and feelings (29%). Study limitations: There is no gold standard instrument for assessing QoL in dermatological patients. Conclusion: In the study sample, one-fourth of patients with SCC had a moderate to severe negative effect on quality of life.

Melanoma cutáneo: algunas consideraciones actuales / Cutaneous melanoma: some current considerations

El melanoma cutáneo es una enfermedad grave y potencialmente mortal que afecta a la población de todo el orbe y que se encuentra condicionada por muchos factores de riesgo relacionados con algunos estilos de vida, que pueden ser modificables. El hallazgo oportuno y precoz de esta entidad clínica eleva la sobrevida de las personas afectadas y favorece el resultado terapéutico; sin embargo, en ocasiones no se diagnostica a tiempo. Actualmente ya se presenta en individuos más jóvenes de 25-29 años de edad y con gran probabilidad de generar metástasis, lo cual constituye una preocupación en el ámbito de la salud. Al respecto, se decidió efectuar esta revisión bibliográfica, con el fin de actualizar algunos elementos sobre el tema y darlos a conocer a la comunidad médica nacional y extranjera.

The cutaneous melanoma is a severe and potentially mortal disease that affects the population of the whole world and that is conditioned by many risk factors related to some lifestyles that can be modified. The opportune and early finding of this clinical entity elevates the survival of affected people and it favors the therapeutic result; however, it is not diagnosed on time occasionally. At present it is already presented in younger individuals with 25-29 years old and with great probability of generating metastasis, which constitutes a concern in the health field. In this respect, it was decided to make this literature review, with the purpose of to update some elements on the topic and to make them known in the national and foreign medical community.

Dermatofibrossarcoma protuberans: experiência e discussão numa série de casos / Dermatofibrosarcoma protuberans: experience and analysis of a clinical series

Introdução: Os dermatofibrossarcomas protuberans são tumores malignos da pele que, por serem pouco frequentes e de variadas apresentações, muitas vezes têm negligenciado o diagnóstico e a terapêutica, resultando principalmente em altas taxas de recidiva e, eventualmente, em maior mortalidade. O objetivo é avaliar dados epidemiológicos de pacientes portadores desta neoplasia e analisar os fatores determinantes da sua recidiva local. Métodos: Estudo retrospectivo de 19 casos, num período de dez anos, tratados no Hospital Santa Rita da Santa Casa de Misericórdia de Porto Alegre com tratamento estatístico. Resultados: Foi verificada a recidiva em 5 pacientes, correspondendo a 26,5% da amostra, sem registro de óbito. Foram analisadas as variáveis: localização, tamanho, estadiamento e margens cirúrgicas, sendo a última estatisticamente significativa. (p<0,03). Conclusão: Embora ainda não haja consenso na literatura quanto à extensão das margens de ressecção nos dermatofibrossarcomas protuberans, certamente margens inferiores a 1 centímetro, como as preconizadas para outros tumores cutâneos, incluindo alguns melanomas, são inadequadas.

Introduction: Dermatofibrosarcoma protuberans (DFSP) are malignant tumors of the skin. Because they are infrequent and have varied presentations, they are often underdiagnosed and remain untreated, leading to high rates of recurrence and occasionally higher mortality. The aim here is to evaluate epidemiological data of patients with this neoplasia and to analyze the determinants of its local recurrence. Methods: A retrospective study with statistical analysis of 19 patients with DFSP treated at the Hospital Santa Rita, Santa Casa de Misericordia de Porto Alegre over a period of ten years. Results: There was a recurrence in 5 patients, representing 26.5% of sample, with no record of death. We analyzed the following variables: location, size, stage and surgical margins, the latter being statistically significant (p <0.03). Conclusion: Although there is yet no consensus in the literature about the extent of resection margins in dermatofibrosarcoma protuberans, certainly margins less than 1.0 cm, as suggested for other skin tumors, including some melanomas, are inadequate.