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1.
Rev. otorrinolaringol. cir. cabeza cuello ; 82(3): 324-327, sept. 2022. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409940

ABSTRACT

Resumen La adenopatía dermatopática es una entidad histopatológica que consiste en un aumento del tamaño ganglionar en respuesta a enfermedades cutáneas crónicas. En el análisis histopatológico se observa una hiperplasia paracortical con presencia de células dendríticas, células de Langerhans e histiocitos. La presentación clínica más habitual es la aparición de adenopatías de características benignas con o sin prurito en pacientes con antecedentes de enfermedad cutánea. La aparición de masas laterocervicales es un motivo de consulta frecuente en otorrinolaringología. Presentamos el caso de un paciente exfumador de 41 años que consultó por aparición brusca de una masa cervical quística, sugestiva de quiste braquial o de una adenopatía quística. Una vez descartada malignidad, se procedió a realizar exéresis de la lesión mediante cervicotomía para diagnóstico patológico. El estudio de la muestra confirmó el diagnóstico de adenopatía dermatopática en un paciente sin antecedente de enfermedad cutánea previa.


Abstract Dermatopathic lymphadenopathy is a histopathologic entity which consists on reactive lymphadenopathy in the setting of chronic cutaneous diseases. The histologic examination is characterized by paracortical hyperplasia with presence of dendritic cells, Langerhans cells and histiocytes. The most common clinical presentation is the presence of lymphadenopathy with benign characteristics with or without pruritus in patients with prior history of cutaneous disease. The appearance of laterocervical masses is a frequent reason for consultation in otorhinolaryngology. We present the case of a 41-year-old ex-smoker who consulted due to the sudden appearance of a cystic cervical mass, suggestive of a brachial cyst or cystic adenopathy. Once malignancy had been ruled out, excision of the lesion within cervicotomy was performed in order to reach a pathological diagnosis. The histologic study confirmed the diagnosis of dermatopathic adenopathy in a patient with no history of previous skin disease.


Subject(s)
Humans , Male , Adult , Skin Diseases/complications , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Lymphadenopathy/diagnosis , Lymphadenopathy/pathology , Magnetic Resonance Spectroscopy , Cysts , Diagnosis, Differential , Lymphatic Diseases
3.
São Paulo; s.n; s.n; 2022. 56 p. tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-1396952

ABSTRACT

O câncer de pele pode ser classificado como não melanoma e melanoma. O melanoma apresenta baixa incidência entre os cânceres de pele, porém é a forma mais letal e é considerado um dos tipos mais resistentes ao tratamento. Devido à infiltração de células malignas nos tecidos, vasos linfáticos e vasos sanguíneos, o melanoma invade e se espalha rapidamente. Suas metástases são frequentemente localizadas em linfonodos, cérebro, fígado e outros órgãos. Melanomas metastáticos abrigam múltiplas mutações gênicas e muitos tumores apresentam resistência aos tratamentos, como por exemplo com inibidores BRAF, devido à mutações e ativação de vias paralelas. Ou seja, existe uma necessidade clara da busca de novas opções de tratamento. Em trabalho realizado por nosso grupo, Massaro et al mostraram que o derivado de estradiol 2- Metoxiestradiol induz apoptose em células de melanoma e senescência. Neste sentido, o composto STX140, (um análogo do estradiol com biodisponibilidade superior), que já se mostrou eficaz no combate ao câncer de mama em diversos estudos in vitro e in vivo, será então avaliado para sua ação no melanoma de forma inédita. Este trabalho teve como principal objetivo explorar a ação antitumoral em células de melanoma do composto STX140, especialmente a indução de senescência. Utilizando a cultura de células de melanoma foram realizados os ensaios de: viabilidade celular - IC50, formação de colônias, análise do ciclo celular e caracterização de morte celular por citometria de fluxo, ensaio In vitro scratch, coloração para ß-galactosidase, PCR quantitativo e ELISA. Os resultados mostraram que o composto STX140: diminui a viabilidade celular, inibe a proliferação, formação de colônias e migração em linhagens de melanoma (não resistentes e resistentes ao vemurafenibe, inibidor de BRAF). Além do mais, o composto atuou diminuindo a secreção da interleucina pró-tumoral IL-8 em células resistentes. O STX140 induziu senescência nas células de melanoma que foram positivas para ß-galactosidase, também havendo aumento da expressão de genes chave de vias de senescência (CDKN1A e GADD45A) nas células de melanoma resistentes tratadas com o composto. Em conclusão, o STX140 mostrou ter um potencial antitumoral contra o melanoma, diminuindo sua viabilidade celular, inibindo sua proliferação e migração, induzindo senescência, diminuindo a secreção de interleucina pró- tumoral, com efeito mais acentuado nas linhagens de melanoma resistente


Skin cancer can be classified as non-melanoma and melanoma. Melanoma has a low incidence among skin cancers, but it is the most lethal form and is considered one of the most resistant to treatment. Due to the infiltration of malignant cells into tissues, lymphatic vessels and blood vessels, melanoma invades and spreads rapidly. Its metastases are often located in lymph nodes, brain, liver and other organs. Metastatic melanomas presents multiple gene mutations and many tumors are resistant to treatments, such as with BRAF inhibitors, due to mutations and activation of parallel pathways. In other words, there is a clear need to search for new treatment options. In work carried out by our group, Massaro et al showed that the estradiol derivative 2- Methoxyestradiol induces apoptosis in melanoma cells and senescence. In this sense, the compound STX140, (an estradiol analogue with superior bioavailability), which has already been shown to be effective against breast cancer in vitro and in vivo studies will be then evaluated for its action on melanoma. The main objective of this work is to explore the antitumor action of the compound STX140 in melanoma cells, especially the induction of senescence. Using the melanoma cell culture the following assays were performed: cell viability - IC50, clonogenic, cell cycle analysis and cell death characterization by flow cytometry, wound assay, staining for ß-galactosidase, quantitative PCR and ELISA. Preliminary data from this work showed that the compound STX140: decreases cell viability, inhibits proliferation, colony formation and migration in melanoma cell lines (non-resistant and resistant to vemurafenib, BRAF inhibitor). It also decreased the secretion of pro-tumor interleukin IL-8 in resistant cells. STX140 induced senescence in melanoma cells, that were positive for ß-galactosidase, and there was also increased expression of key genes of senescence pathways (CDKN1A and GADD45A) in resistant melanoma cells treated with the compound. In conclusion, STX140 has been shown to have antitumor potential against melanoma, decreasing its cell viability, inhibiting its proliferation and migration, inducing senescence, decreasing pro-tumor interleukin secretion, with a more pronounced effect on resistant melanoma cell lines


Subject(s)
Estradiol/analogs & derivatives , Melanoma/pathology , Skin Neoplasms/pathology , In Vitro Techniques/methods , Aging/metabolism , Interleukin-8/adverse effects , Cell Culture Techniques/methods , Inhibitory Concentration 50 , Flow Cytometry/instrumentation , Neoplasm Metastasis
4.
Rev. bras. oftalmol ; 81: e0055, 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1394862

ABSTRACT

RESUMO Objetivo Analisar o perfil clínico de pacientes portadores de neoplasias escamosas da superfície ocular. Métodos Foram avaliados os principais fatores de risco envolvidos na gênese das neoplasias escamosas da superfície ocular, as características clínicas dos pacientes e os hábitos comportamentais associados. Foram incluídos neste trabalho de coorte histórica 80 pacientes com diagnóstico anatomopatológico de neoplasia escamosa da superfície ocular atendidos entre os anos de 2010 e 2020 em um hospital referência em oculoplástica e segmento anterior de Santa Catarina. Os dados clínicos e desfechos foram avaliados por meio da análise de prontuário e entrevista, sendo posteriormente tabulados no Excel e submetidos à analise estatística por meio do software Statistical Pakage for the Social Sciences, versão 16. Resultados Foi observado que 73,8% (n=59) eram do sexo masculino. A média de idade da amostra foi de 62 anos. Quanto ao fototipo de pele, de acordo com a escala de Fitzpatrick, constatou-se que a maioria apresentou os fototipos 1 e 2 (22; 27,5% e 44; 55%, respectivamente). Em relação à exposição ocupacional ao sol/radiação, 48% (n=60) apresentaram história de exposição ocupacional, sendo que, destes, 28 pacientes trabalhavam no setor de agricultura. Dos pacientes da amostra, 33 (41,2%) apresentavam histórico pessoal de neoplasias de pele, sendo que, destes, três apresentavam diagnóstico de xeroderma pigmentoso. Quanto ao hábito de uso de fatores de proteção solar, 61% (n=49) da amostra negou o hábito. Foi evidenciada associação estatisticamente significativa entre o hábito de usar fatores de proteção solar e histórico pessoal de neoplasias de pele. Em relação ao tipo de neoplasia escamosa, a maioria dos pacientes (72; 90%) apresentou diagnóstico anatomopatológico de carcinoma espinocelular ocular. Conclusão O perfil clínico epidemiológico dos pacientes portadores de neoplasias escamosas da superfície ocular neste estudo, predominantemente de carcinoma espinoceular ocular, foi de homens, idosos, de pele clara (fototipo 2) e com histórico importante de exposição aos raios solares ultravioleta A e B. Comorbidades imunodepressoras (HIV e transplante de órgão sólido) e doenças dermatológicas (albinismo e xeroderma pigmentoso) associaram-se ao aparecimento das neoplasias escamosas da superfície ocular em idade mais precoce. Em pacientes com histórico pessoal prévio de neoplasias de pele, foi evidenciado o hábito de uso de fatores de protetor solar mais presente em relação aos demais.


ABSTRACT Objective To analyze the clinical profile of patients with ocular surface squamous neoplasms (OSSN). Methods The main risk factors involved in the genesis of the ocular surface squamous neoplasms, the clinical features, and the behavioral habits associated were evaluated. This historical cohort study included 80 patients with anatomopathological diagnosis of OSSN who were treated between 2010-2020 at a reference hospital in oculoplastic and anterior segment in Santa Catarina. The clinical data and outcomes were evalated through the analysis of medical records and interviews, being later tabulated in Excel and analyzed using the SPSS 16 software. Results Regarding the clinical profile of the patients in the sample, 73.8% (n = 59) were male. The mean age of the sample was 62 years old. As for the skin phototype, according to the Fitzpatrick scale, most of the sample presented the phototype 1 and 2 (27.5% n = 22; and 55% n = 44 respectively). Regarding occupational exposure to the sun / radiation, 48% (n = 60) had history of occupational exposure, and of these, 28 patients worked in the agricultural area. Of the patients of the sample, 33 (41.2%) had a personal history of skin neoplasms, and of these, 3 had diagnosis of xeroderma pigmentosum. As for the habit of using sun protection factors, 61% (n = 49) of the sample denied the habit. A statistically significant association was evidenced between the habit of using sun protection factors and people's history of skin cancer. Regarding the type of squamous neoplasia, most patients in the 90% sample (n = 72) had an anatomopathological diagnosis of ocular squamous cell carcinoma. Conclusion The clinical epidemiological profile of patients with OSSN in this study, predominantly ocular squamous cell carcinoma, was men, elderly, fair-skinned (phototype 2) and with an important history of exposure to UVA and UVB rays. Immunosuppressive comorbidities (HIV, solid organ transplant) and dermatological diseases (albinism, xeroderma pigmentosum) are associated with the appearance of OSSN at an early age. In patients with a previous personal history of skin neoplasms, the habit of using sunscreen factors was more present than in the other patients.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Carcinoma, Squamous Cell/epidemiology , Conjunctival Neoplasms/epidemiology , Eye Neoplasms/epidemiology , Skin Neoplasms/pathology , Sunlight/adverse effects , Sunscreening Agents , Ultraviolet Rays/adverse effects , Carcinoma, Squamous Cell/pathology , Comorbidity , Surveys and Questionnaires , Risk Factors , Cohort Studies , Occupational Exposure , Conjunctival Neoplasms/pathology , Solar Radiation , Environmental Exposure , Eye Neoplasms/pathology , Sun Protection Factor/statistics & numerical data
5.
Chinese Journal of Pathology ; (12): 202-206, 2022.
Article in Chinese | WPRIM | ID: wpr-935505

ABSTRACT

Objective: To investigate the clinical and pathologic features, diagnosis and differential diagnosis of congenital hemangioma (CH). Methods: Forty cases of CH were diagnosed from January 2017 to December 2020 in Henan Provincial People's Hospital. The clinical and pathological and immunohistochemical data were analyzed, with review of literature. Results: There were 24 male and 16 female patients. The lesions were located in the head, neck (11 cases), limbs (14 cases), and trunk (15 cases). The clinical manifestations were congenital painless plaques or masses, the larger ones protruded on the skin surface, mostly dusky purple or bright red, with surrounding white halos. Under low magnification, the tumor was lobular and well demarcated, composed of neo-microvascular lumen of different sizes. The vascular endothelial cells were cuboidal or hobnail in appearance, forming stellar drainage vessels within the lobules. Extra-medullary hematopoiesis was seen in one case of rapidly involuting CH; there were different number of tortuous and dilated vascular lumen between the lobular structures, and some non-involuting CH cases were vascular malformations, which were devoid of lobulated structures. Immunohistochemistry showed that endothelial cells were strongly positive for CD31, CD34 and ERG, while D2-40 and GLUT-1 were negative. Conclusions: CH is a benign congenital vascular tumor with characteristic lobulated growth and abnormal blood vessels in the stroma. Pathological diagnosis often needs to be differentiated from infantile hemangioma, pyogenic granuloma, kaposiform hemangioendothelioma and vascular malformation.


Subject(s)
Endothelial Cells/pathology , Female , Hemangioendothelioma/pathology , Hemangioma/pathology , Humans , Kasabach-Merritt Syndrome/pathology , Male , Sarcoma, Kaposi/pathology , Skin Neoplasms/pathology
6.
Rev. chil. neuro-psiquiatr ; 59(4): 375-378, dic. 2021. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388408

ABSTRACT

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.


Subject(s)
Humans , Female , Aged , Skin Neoplasms/pathology , Meningeal Carcinomatosis/secondary , Melanoma/pathology , Fatal Outcome
7.
Diagn. tratamento ; 26(3): 101-4, jul-set. 2021. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1291194

ABSTRACT

Contexto: O fibrohistiocitoma maligno é um sarcoma de tecidos moles muito agressivo, com rara apresentação limitada à pele e tecido subcutâneo em face. O diagnóstico é anatomopatológico com auxílio da imuno-histoquímica. Descrição do caso: Este artigo relata o caso de um paciente com diagnóstico de fibrohistiocitoma maligno restrito à face com boa resposta terapêutica após exérese cirúrgica. Discussão: Tendo em vista a raridade dessa afecção, dificuldade diagnóstica devido ao quadro inespecífico e com rápida evolução, é importante lembrar desse possível diagnóstico e atuar precocemente. Conclusões: O diagnóstico precoce interfere de forma significativa na evolução do quadro, sendo necessária a manutenção do acompanhamento oncológico e dermatológico com o intuito de detectar precocemente recidivas locais e metástases a distância.


Subject(s)
Humans , Male , Aged , Skin Neoplasms/pathology , Histiocytoma, Malignant Fibrous/pathology , Face , Skin Neoplasms/surgery , Immunohistochemistry , Histiocytoma, Malignant Fibrous/surgery
8.
Rev. méd. Chile ; 149(8): 1236-1240, ago. 2021. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1389575

ABSTRACT

Digestive tract primary melanoma is uncommon. However, metastatic lesions are more frequent and occur mainly in the small intestine. We report a 69-year-old male patient who consulted for a hyperpigmented skin lesion on the left thigh associated with multiple subcutaneous nodules. The biopsy was compatible with melanoma and PET/CT was positive for metastases in nodules and in an inguinal lymph node. Radiotherapy and chemotherapy with pembrolizumab were performed with good response, associated with posterior resection of the inguinal lymph node and melanocytic lesions. At three years of follow-up, a new hypermetabolic focus in the proximal jejunum was found in a control PET/CT. An endoscopic biopsy confirmed that it was a recurrence of the melanoma. Laparoscopic resection with primary anastomosis was performed with good clinical evolution. The definitive biopsy showed a melanoma metastasis with two of three lymph nodes positive for metastasis and a non-mutated BRAF gene. In conclusion, a single intestinal recurrence of melanoma is rare and requires an active search, since it can be resected using minimally invasive techniques.


Subject(s)
Humans , Male , Aged , Skin Neoplasms/surgery , Skin Neoplasms/pathology , Melanoma/surgery , Recurrence , Positron Emission Tomography Computed Tomography , Lymph Nodes/pathology
9.
Braz. j. otorhinolaryngol. (Impr.) ; 87(4): 389-395, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1285703

ABSTRACT

Abstract Introduction Regional metastases of cutaneous head and neck squamous cell carcinoma occur in approximately 5 % of cases, being the most important prognostic factor in survival, currently with no distinction between parotid and neck metastasis. Objective The purpose of this study was to evaluate the prognostic features among patients with head and neck cutaneous squamous cell carcinoma exhibiting regional metastasis. Methods A retrospective analysis of patients with cutaneous squamous cell carcinoma who underwent parotidectomy and/or neck dissection from 2011 to 2018 at a single institution tertiary center was performed. Patient demographics, clinical, surgical and pathological information, adjuvant treatments, and outcome at last follow-up were collected. Outcomes included disease recurrence and death due to the disease. Prognostic value of clinic pathological features associated with disease-specific survival was obtained. Results Thirty-eight cases of head and neck cutaneous squamous cell carcinoma with parotid and/or neck metastasis were identified. Overall, 18 (47.3 %) patients showed parotid metastasis alone, 12 (31.5 %) exhibited neck metastasis alone and 8 (21.0 %) had both. A primary tumor in the parotid zone (Hazard Ratio ‒ HR = 5.53; p = 0.02) was associated with improved disease-specific survival. Poorer disease-specific survival was observed in patients with higher primary tumor diameter (HR = 1.54; p = 0.002), higher depth of invasion (HR = 2.89; p = 0.02), invasion beyond the subcutaneous fat (HR = 5.05; p = 0.002), neck metastasis at first presentation (HR = 8.74; p < 0.001), number of positive lymph nodes (HR = 1.25; p = 0.004), and higher TNM stages (HR = 7.13; p = 0.009). Patients presenting with isolated parotid metastasis during all follow-ups had better disease-specific survival than those with neck metastasis or both (HR = 3.12; p = 0.02). Conclusion Head and neck cutaneous squamous cell carcinoma with parotid lymph node metastasis demonstrated better outcomes than cases with neck metastasis.


Resumo Introdução As metástases regionais do carcinoma espinocelular cutâneo de cabeça e pescoço ocorrem em aproximadamente 5% dos casos, sendo esse o fator prognóstico mais importante na sobrevida, atualmente sem distinção entre metástases de parótida e cervicais. Objetivo Avaliar as características prognósticas em pacientes com carcinoma espinocelular cutâneo de cabeça e pescoço com metástase regional. Método Foi feita uma análise retrospectiva de pacientes com carcinoma espinocelular cutâneo submetidos à parotidectomia e/ou esvaziamento cervical entre 2011 e 2018 em um único centro terciário de uma única instituição. Dados demográficos dos pacientes, informações clínicas, cirúrgicas e patológicas, tratamentos adjuvantes e desfechos no último acompanhamento foram coletados. Os desfechos incluíram recorrência e morte devido à doença. O valor prognóstico das características clínico-patológicas associadas à sobrevida específica da doença foi obtido. Resultados Foram identificados 38 casos de carcinoma espinocelular cutâneo de cabeça e pescoço com metástase de parótida e/ou pescoço. No geral, 18 (47,3%) pacientes apresentaram metástase da parótida isolada, 12 (31,5%) apresentaram metástase cervical isolada e 8 (21,0%) apresentaram ambos. Um tumor primário na região da parótida (Hazard ratio [HR] = 5,53; p = 0,02) foi associado a melhor sobrevida específica. Pior sobrevida específica foi observada em pacientes com maior diâmetro do tumor primário (HR = 1,54; p = 0,002), maior profundidade de invasão (HR = 2,89; p = 0,02), invasão além da gordura subcutânea (HR = 5,05; p = 0,002), metástase cervical na primeira apresentação (HR = 8,74; p < 0,001), conforme maior número de linfonodos positivos (HR = 1,25; p = 0,004) e estágios TNM mais elevados (HR = 7,13; p = 0,009). Os pacientes que apresentaram metástase da parótida isolada durante todo o acompanhamento apresentaram melhor sobrevida específica do que aqueles com metástase cervical ou ambos (HR = 3,12; p = 0,02). Conclusão Os casos de carcinoma espinocelular cutâneo de cabeça e pescoço com metástase intraparotídea demonstraram melhores desfechos do que aqueles com metástase cervical.


Subject(s)
Humans , Skin Neoplasms/pathology , Parotid Neoplasms/surgery , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/surgery , Prognosis , Retrospective Studies , Squamous Cell Carcinoma of Head and Neck , Neoplasm Recurrence, Local/pathology , Neoplasm Staging
11.
Dermatol. argent ; 27(2): 59-63, abr-jun 2021. il, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1366196

ABSTRACT

Los tumores de colisión consisten en neoplasias compuestas por dos poblaciones celulares distintas que mantienen una clara diferenciación de sus bordes y que se encuentran adyacentes una de otra en la misma muestra histopatológica. Esta asociación puede corresponder a dos tumores malignos, dos benignos o uno maligno y uno benigno. Son infrecuentes y, en ocasiones, representan un desafío clínico para la detección correcta de ambas neoplasias. Se presenan los casos de tres pacientes con tumores cutáneos de colisión, de estirpe melanocítica combinada con queratinocítica; en dos de ellos ambas neoplasias fueron malignas y en uno, se asociaron una lesión maligna y una benigna.


Collision tumors consist of neoplasms composed of two different cell populations that maintain a clear differentiation of their borders, and that are adjacent to each other in the same histopathological sample. This association can correspond to two malignant tumors, two benign, or one malignant and one benign. They are infrequent and, at times, represent a clinical challenge for the correct detection of both neoplasms. Three cases of cutaneous collision tumors of a melanocytic line combined with a keratinocytic line are presented, two of them in which both neoplasms were malignant and one that associated a malignant and a benign lesion.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Skin Neoplasms/diagnosis , Carcinoma, Basal Cell/diagnosis , Melanoma/diagnosis , Neoplasms, Multiple Primary/diagnosis , Skin Neoplasms/surgery , Skin Neoplasms/pathology , Carcinoma, Basal Cell/surgery , Carcinoma, Basal Cell/pathology , Melanoma/surgery , Melanoma/pathology , Neoplasms, Multiple Primary/surgery , Neoplasms, Multiple Primary/pathology
12.
Gac. méd. Méx ; 157(2): 215-219, mar.-abr. 2021. tab
Article in Spanish | LILACS | ID: biblio-1279104

ABSTRACT

Resumen Antecedentes: Los estudios sobre factores pronóstico de melanoma están basados en poblaciones caucásicas, con predominio de melanomas delgados (Breslow < 3 mm). Los pacientes mexicanos muestran predominio de melanomas gruesos (Breslow ≥ 3 mm). Objetivo: Identificar factores asociados al pronóstico de pacientes con melanomas gruesos. Material y métodos: Se analizó la influencia pronóstica de factores clinicopatológicos en 362 melanomas gruesos. Resultados: La mediana de Breslow fue de 7 mm, 271 (74.9 %) pacientes tuvieron melanoma acral y 49 (13.5 %) melanoma nodular. El 56.6 % de los pacientes se encontró en etapa clínica [EC] III), 269 (74.3 %) tenía ulceración y 15 (4.1 %) márgenes positivos. Las variables asociadas con menor supervivencia global [SG] fueron la EC (p < 0.001), Breslow (p = 0.044), ulceración (p = 0.004), mitosis (p < 0.001) y margen < 2 cm (p < 0.001) . En el análisis multivariante los factores que influyen en SG fueron la EC, mitosis y el margen quirúrgico. Conclusiones: En pacientes con melanomas gruesos la SG es influida por un margen positive, mitosis y EC.


Abstract Background: Studies on prognostic factors in melanoma are based on Caucasian populations, with a predominance of thin melanomas (Breslow <3 mm). Mexican patients show a predominance of thick melanomas (Breslow ≥ 3 mm). Objective: To identify factors associated with the prognosis of patients with thick melanomas. Material and methods: The prognostic influence of clinicopathological factors was analyzed in 362 thick melanomas. Results: The Breslow median was 7 mm, 271 (74.9 %) patients had acral melanoma and 49 (13.5 %) nodular melanoma. The 56.6 % of patients were found in clinical stage [CS] III), 269 (74.3 %) had ulceration, and 15 (4.1 %) had positive margins. The variables associated with lower overall survival [OS] were CS (p < 0.001), Breslow (p = 0.044), ulceration (p = 0.004), mitosis (p < 0.001) and margin < 2 cm (p < 0.001). In the multivariate analysis, the factors influencing OS were CD, mitosis, and the surgical margin. Conclusions: In patients with thick melanomas, OS is influenced by a positive margin, mitosis and CS.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Skin Neoplasms/mortality , Skin Neoplasms/pathology , Tumor Burden , Melanoma/mortality , Melanoma/pathology , Prognosis , Ulcer/pathology , Margins of Excision , Lymphatic Metastasis , Melanoma/classification , Mexico , Mitosis
13.
Gac. méd. Méx ; 157(1): 43-49, ene.-feb. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1279072

ABSTRACT

Resumen Introducción: La micosis fungoide es el linfoma primario de células T en piel más frecuente, con expresividad clínica heterogénea. Objetivo: Reportar las variedades clínicas y las características sociodemográficas de pacientes con micosis fungoide tratados en un hospital dermatológico. Métodos: Se incluyeron 290 pacientes con diagnóstico clínico e histopatológico de micosis fungoide atendidos en el transcurso de 11 años. Se realizó descripción sociodemográfica de los pacientes, quienes se clasificaron conforme las variantes clínicas e histopatológicas. Resultados: 58 % de los casos de micosis fungoide se presentó en mujeres y 42 % en hombres. La variedad clínica más común fue la clásica en 46.2 %; la discrómica representó 35.2 %, del cual la hipopigmentada fue la más representativa (7.6 %); la poiquilodérmica constituyó 4.1 % y la foliculotrópica, 3.1 %. La variedad papular se presentó en seis pacientes (2.1 %), la de placa única en tres (1 %) y la ictiosiforme, siringotrópica y la piel laxa granulomatosa, en un paciente cada una. La variedad granulomatosa se encontró en 0.7 % y 1.4 % presentó eritrodermia. Conclusiones: La variedad clínica más frecuente de micosis fungoide fue la clásica en fase de placa, seguida de las variedades discrómicas. Otras variedades clínicas representaron 18.6 %.


Abstract Introduction: Mycosis fungoides (MF) is the most common primary skin T-cell lymphoma, which is characterized for a heterogeneous clinical expressivity. Objective: To report clinical variants and sociodemographic characteristics in patients with MF under the care of a dermatological hospital. Methods: 290 patients with MF clinical and histopathological diagnosis attended to over the course of 11 years were included. Sociodemographic description of patients was made, who were classified according to clinical and histopathological variants. Results: MF was recorded in 57.9 % of women and 42 % of men. The most common clinical variant was the classic type in 46.2 %; dyschromic variants accounted for 35.2 %, out of which hypopigmented MF was the most representative (17.6 %); poikilodermatous MF accounted for 4.1 %, and folliculotropic, for 3.1%. The papular variant occurred in six patients (2.1 %), the single-plaque variety in three (1%), and the ichthyosiform, syringotropic and granulomatous slack skin varieties occurred in one patient each. The granulomatous variant was found in 0.7 %, and 1.4 % had erythroderma. Conclusions: The most common MF clinical variant was classic plaque stage, followed by dyschromic variants. Other clinical variants accounted for 18.6 %.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Skin Neoplasms/pathology , Mycosis Fungoides/pathology , Skin Neoplasms/classification , Skin Neoplasms/therapy , Retrospective Studies , Cohort Studies , Mycosis Fungoides/classification , Mycosis Fungoides/therapy , Treatment Outcome
14.
Arq. bras. oftalmol ; 83(6): 485-489, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1153089

ABSTRACT

ABSTRACT Purpose: The purpose of this study was to report a series of cases of solitary fibrofolliculoma, a lesion seldom observed in the lids. Demographics, as well as clinical and histological aspects of the lesion were evaluated. Methods: This was a retrospective case series spanning a period of 18 years. All the included patients were diagnosed with solitary fibrofolliculoma confirmed by histological examination. Data regarding patient demographics, signs, and symptoms, course of the disease, location of the lesion, clinical and histological diagnosis, and outcome were collected. Results: Eleven cases of solitary fibrofolliculoma were diagnosed in the study period. The median age of patients was 51 ± 16.3 years (range: 27-78 years). Most patients were females (7/11; 64%). Five of the patients (45%) were asymptomatic; four (36%) reported bleeding, one (9%) had referred itching, and one (9%) rubbing of the lesion. The lesion occurred in a wide range of locations; one of them was located in the lids. The diagnosis for all lesions was histological based on characteristic findings of a hair follicle occasionally dilated and containing keratin material surrounded by a moderately well-circumscribed thick mantle of fibrous tissue. The infundibular follicular epithelium extended out into this fibrous mantle forming epithelial strands or cords. There were no relapses after exeresis. Conclusion: Solitary fibrofolliculoma is a rare lesion, seldom affecting the eyelids. We reported 11 cases, and the third case reported thus far in the literature affecting the lids. Diagnosis may be easily missed due to the nonspecific symptoms and clinical appearance. Therefore, it is necessary to perform excisional biopsy and histological examination for the recognition of this lesion.


RESUMO Objetivo: o objetivo deste estudo foi relatar uma série de casos de fibrofoliculoma solitário, uma lesão raramente observada nas pálpebras. Demografia, bem como aspectos clínicos e histológicos da lesão foram avaliados. Métodos: Trata-se de uma série de casos retrospectivos, com um período de 18 anos. Todos os pacientes incluídos foram diagnosticados com fibrofoliculoma solitário confirmado por exame histológico. Foram coletados dados referentes à demografia, sinais e sintomas dos pacientes, evolução da doença, localização da lesão, diagnóstico clínico e histológico e desfecho. Resultados: Onze casos de fibrofoliculoma solitário foram diagnosticados no período do estudo. A média de idade dos pacientes de 51 ± 16,3 anos (variação: 27-78 anos). A maioria dos pacientes era do sexo feminino (7/11, 64%). Cinco dos pacientes (45%) eram assintomáticos; quatro (36%) relataram sangramento, um (9%) referiu coceira e um (9%) fricção da lesão. A lesão ocorreu em luma ampla variedade de locais; um deles sendo nas pálpebras. O diagnóstico de todas as lesões foi histológico com base nos achados característicos de um folículo piloso ocasionalmente dilatado e contendo material de queratina, cercado por um manto espesso de tecido fibroso moderadamente bem circunscrito. O epitélio infundibular folicular se estendeu até esse manto fibroso, formando cordões ou cordões epiteliais. Não houve recaídas após exérese. Conclusão: Fibrofoliculoma solitário é uma lesão rara, mais ainda quando afeta as pálpebras. Relatamos 11 casos, e o terceiro relatado até o momento na literatura que afeta as pálpebras. O diagnóstico pode ser facilmente esquecido devido a sintomas inespecíficos e aparência clínica. Portanto, é necessário realizar biópsia excisional e exame histológico para o reconhecimento dessa lesão.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Skin Neoplasms , Hair Follicle , Hair Diseases , Skin , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Retrospective Studies , Neoplasm Recurrence, Local
15.
An. bras. dermatol ; 95(6): 691-695, Nov.-Dec. 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1142133

ABSTRACT

Abstract Background: The mitotic index is no longer used to classify T1 melanoma patients into T1a and T1b, so it should not be used to indicate sentinel node biopsy in these patients. Objectives: To evaluate patients with T1 melanoma who underwent sentinel lymph node biopsy and to compare those who were classified as T1a with those classified T1b, according to the 7th and 8th Edition of the melanoma staging system, regarding a positive biopsy result. The authors also aimed to assess whether there is any difference in the results in both staging systems. Material and methods: This was a retrospective analysis of 1213 patients who underwent sentinel lymph node biopsy for melanoma, from 2000 to 2015, in a single institution. Results: Of 399 patients with thin melanomas, 27 (6.7%) presented positive sentinel lymph nodes; there was no difference in positivity for sentinel node biopsy when comparing T1a vs. T1b in both staging systems. Furthermore, the clinical results were also similar between the two groups. However, in the complete cohort analysis, the mitotic index was associated with positivity for sentinel lymph node biopsy (p < 0.0001), positivity for non-sentinel lymph node (p < 0.0001), recurrence-free survival (p < 0.0001), and specific melanoma survival (p = 0.023). Study limitation: Unicentric study. Conclusion: The mitotic index was shown to be a very important prognostic factor in the present study, but it was not observed in patients classified as T1. The mitotic index should no longer be used as the only reason to refer sentinel lymph node biopsy in patients with thin melanoma.


Subject(s)
Humans , Skin Neoplasms/pathology , Melanoma/pathology , Prognosis , United States , Retrospective Studies , Sentinel Lymph Node Biopsy , Lymphatic Metastasis , Mitotic Index , Neoplasm Staging
16.
Más Vita ; 2(3,Extraord): 97-103, dic. 2020.
Article in Spanish | LILACS, LIVECS | ID: biblio-1373575

ABSTRACT

Los tumores malignos de la piel son los más frecuentes y, aunque no se hallan entre las diez primeras causas de muerte por cáncer, sí ocasionan deformidades y afectación funcional. Ello se debe a que la mayoría aparece en sitios de la piel expuestos al sol (la cara, alrededor de los ojos y la boca, las orejas, entre otros). Objetivo: Determinar los factores de riesgos que predisponen a la aparición del cáncer de piel. Metodología: Se constituye en una investigación de carácter documental, tanto bibliográfica como digital. Resultados: la predisposición de padecer cáncer de piel subyace en factores endógenos (factores internos del individuo) raza, alimentación, hábitos, sexo, antecedentes familiares y personales, fototipo, lunares y factores exógenos (factores externos al individuo), exposición a rayos ultravioleta, productos químicos y hábito de fumar. Conclusión: El principal factor de riesgo para desarrollar un cáncer de piel son los llamados rayos ultravioletas procedentes de la luz solar, que producen mutaciones en el ADN de las células que se acumulan durante años. El cáncer de piel es la forma más frecuente de cáncer en la población de piel blanca(AU)


Malignant skin tumors are the most frequent and, although they are not among the top ten causes of death from cancer, they do cause deformities and functional impairment. This is because most appear in places on the skin exposed to the sun (the face, around the eyes and mouth, the ears, among others). Objective: To determine the risk factors that predispose to the appearance of skin cancer. Methodology: It constitutes a documentary research, both bibliographic and digital. Results: the predisposition to suffer from skin cancer underlies endogenous factors (internal factors of the individual) race, diet, habits, sex, family and personal history, phototype, moles and exogenous factors (factors external to the individual), exposure to ultraviolet rays, chemicals and smoking. Conclusion: The main risk factor for developing skin cancer are the so-called ultraviolet rays from sunlight, which produce mutations in the DNA of cells that accumulate over years. Skin cancer is the most common form of cancer in the fair-skinned population(AU)


Subject(s)
Skin Neoplasms/pathology , Sunlight , Ultraviolet Rays , Risk Factors , Tobacco Use , Medical History Taking , Medical Oncology
17.
Rev. cir. (Impr.) ; 72(5): 464-467, oct. 2020. graf
Article in Spanish | LILACS | ID: biblio-1138740

ABSTRACT

Resumen Objetivos: El melanoma cutáneo presenta un alto potencial metastásico y constituye la fuente extraabdominal más frecuente de lesión del intestino delgado. El diagnóstico de metástasis gastrointestinales es a menudo una expresión de enfermedad avanzada, con una supervivencia media de entre 6 y 9 meses. Materiales y Método: Presentamos el caso de un paciente varón de 63 años diagnosticado de melanoma cutáneo que acudió a urgencias por dolor abdominal y estreñimiento. Se realizó una TC abdominal donde se informó de la existencia de 2 lesiones metastásicas a nivel de intestino delgado que condicionaban oclusión intestinal. Resultados: El paciente fue intervenido quirúrgicamente bajo abordaje laparoscópico con resección de los dos segmentos intestinales afectos y anastomosis intracorpórea. El informe histopatológico confirmó que se trataban de metástasis de melanoma. Discusión: La oclusión intestinal por metástasis de melanoma maligno es muy infrecuente. La cirugía es el tratamiento de elección en pacientes con metástasis intestinales de melanoma. El tratamiento quirúrgico puede mejorar el pronóstico y estaría indicado casos de metástasis únicas o pacientes sintomáticos con intención paliativa. El abordaje mínimamente invasivo ofrece resultados oncológicos similares a la laparotomía.


Aim: Cutaneous melanoma has a high metastatic potential, being the most frequent extra-abdominal source of small bowel metastasis. The diagnosis of gastrointestinal metastases is often an expression of advanced disease, with an average survival of 6-9 months. Materials and Method: We herein present the case of a 63-year-old male patient diagnosed with cutaneous melanoma who arrived to the emergency department complaining of abdominal pain and constipation. An abdominal CT scan was performed, it revealed two metastatic lesions in the small bowel which marked the mechanical obstruction. Results: Patient underwent a laparoscopy and both involved segments were removed. Pathology exam confirmed the diagnosis of melanoma metastases. Discussion: Surgery excision is the treatment of choice in patients with small bowel metastases from melanoma. Surgical management can improve the prognosis and it would be indicated in cases of single metastases or symptomatic patients with a palliative intention. Minimally invasive approach provides similar oncological results as conventional laparotomy. Small bowel obstruction due to metastases of malignant melanoma is extremely rare.


Subject(s)
Humans , Male , Middle Aged , Skin Neoplasms/diagnosis , Melanoma/diagnosis , Skin Neoplasms/pathology , Biopsy , Tomography, X-Ray Computed , Laparoscopy , Gastrointestinal Neoplasms/secondary , Intestinal Obstruction/surgery , Melanoma/pathology
18.
Rev. inf. cient ; 99(3): 200-208, mayo.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126938

ABSTRACT

RESUMEN Introducción: En Guantánamo no se ha caracterizado el cáncer de piel en los adultos mayores. Objetivo: Caracterizar a los pacientes ingresados en los hogares de ancianos "Caridad Jaca" y "San José" de la ciudad de Guantánamo con diagnóstico de cáncer de piel en el periodo 2017-2019. Método: Se realizó un estudio observacional, prospectivo y transversal con todos los ancianos (n=256) con cáncer de piel (n=15). Se estudiaron las siguientes variables: edad, sexo, lugar de nacimiento y donde vivió, antecedentes patológicos personales, fototipo cutáneo, características de la lesión, diagnóstico clínico, dermatoscópico e histopatológico. Resultados: En el 5,9 % de los ancianos se diagnosticó un cáncer de piel. Fue más común en hombres (53,4 %), con 60 a 79 años (53,4 %), nacidos o que vivieron en áreas urbanas y fototipo cutáneo III (40,0 %). El 100,0 % se expuso a la luz solar, el 86,7 % sin medios de fotoprotección. El cáncer se localizó más en la cara (66,7 %), tenían entre 3 y 4 años de evolución (60,0 %) y el carcinoma basocelular (46,6 %) fue el más frecuente. En el 80,0 % de los casos se apreció correlación diagnóstico clínico, dermatoscópico e histopatológico. Conclusiones: Es baja la frecuencia del cáncer de piel en los ancianos, sin embargo, se requiere prestar más atención al aseguramiento del diagnóstico precoz de esta enfermedad.


ABSTRACT Introduction: Skin cancer in elderly has not been characterized in Guantanamo. Objective: Characterize the patients admitted to the nursing homes "Caridad Jaca" and "San José" in the city of Guantánamo with a diagnosis of skin cancer in the period 2017-2019. Method: It was conducted an observational, prospective and cross-sectional study with all the elderly (n=256) with skin cancer (n=15). Studied variables: age, sex, place of birth and lived, personal pathological history, skin phototype, characteristics of the lesion, clinical dermatoscopic and histopathological diagnosis. Results: 5.9% of the elderly were diagnosed with skin cancer. It was more common in men (53.4%), range age from 60 to 79 (53.4%), were born or lived in urban areas and with skin phototype III (40.0%). 100.0% of the patients were exposed to sunlight, 86.7% without photo-protection means. The cancer was more localized in the face area (66.7%), had between 3 and 4 years of evolution (60.0%) and basal cell carcinoma (46.6%) was the most frequent. Clinical, dermatoscopic and histopathological diagnosis correlation was observed in 80.0 % of the cases. Conclusions: The rate of skin cancers in erderly is low, however, more attention is needed to ensure early diagnosis of this disease.


Subject(s)
Humans , Aged , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/epidemiology , Carcinoma, Squamous Cell/epidemiology , Prospective Studies , Longitudinal Studies , Observational Study , Homes for the Aged/organization & administration
19.
Medicina (B.Aires) ; 80(3): 280-284, jun. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1125080

ABSTRACT

El melanoma desmoplásico es una variedad infrecuente de melanoma que se distingue por su presentación clínico-patológica y su comportamiento biológico. El diagnóstico temprano es un desafío por su presentación clínica variable, con predominio del componente dérmico y la frecuente ausencia de pigmento. En la histología se lo divide en puro y mixto y esta clasificación tiene importantes implicancias pronósticas. El espesor de Breslow promedio al momento del diagnóstico es mayor que en otras variantes de melanoma, sin embargo, la tendencia a generar metástasis ganglionares es menor.


Desmoplastic melanoma is a rare presentation of melanoma with a different clinical behavior compared to other histological variants. Its diagnosis in early stages is a challenge due to its variable clinical presentation, with a predominant dermal component and the frequent absence of pigment. Its histology is divided into pure and mixed type, and this classification has important prognostic implications. The average Breslow thickness at diagnosis is higher than in other melanoma variants. However, the tendency to lymph node metastasis is low.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Melanoma/diagnosis , Melanoma/pathology , Biopsy , Diagnosis, Differential
20.
An. bras. dermatol ; 95(3): 379-382, May-June 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130887

ABSTRACT

Abstract In situations in when a dermoscopic record of a large lesion is desirable, the resulting images are usually restricted to a small field of view due to the limited diameter of dermatoscope lenses. This limitation often produces several photographs separately, thus losing the possibility of a single-image global evaluation. In these case reports, we show examples of a recently published image montage technique called Wide Area Digital Dermoscopy, in this case, applied to basal cell carcinomas.


Subject(s)
Humans , Male , Skin Neoplasms/diagnostic imaging , Image Processing, Computer-Assisted/methods , Carcinoma, Basal Cell/diagnostic imaging , Dermoscopy/methods , Skin Neoplasms/pathology , Software , Carcinoma, Basal Cell/pathology , Reproducibility of Results , Middle Aged
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