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Introdução: O carcinoma basocelular (CBC) de vulva é uma condição rara que corresponde a menos de 0,4% dos casos de CBC e de 2% a 4% das neoplasias de vulva. O CBC de vulva é mais comum entre mulheres brancas, multíparas e na pósmenopausa, especialmente na sétima década de vida. O objetivo é relatar um caso de CBC de vulva no qual discutiram-se os aspectos do diagnóstico e tratamento. Relato de Caso: Mulher de 63 anos de idade, G1P1A0, chega ao consultório em janeiro de 2022 para tratamento de lesão persistente em vulva. Realizou-se biópsia incisional que mostrou tratar-se de provável carcinoma basocelular nodular com invasão da derme. A paciente submeteu-se a uma ressecção do tumor com margens macroscópicas livres e sutura primária. A cirurgia não teve complicações no pré-operatório e no pós-operatório. O histopatológico da peça cirúrgica mostrou tratar-se de carcinoma basocelular nodular com área irregular, plana, branco, medindo 0,7x0,4cm, com as margens laterais distando 7,0 e 5,0mm e profundas, 5,9mm; todas livres. Conclusão: O caso relatado é raro, tendo sido o tratamento de ressecção cirúrgica do CBC de vulva com margens bem-sucedido. Catorze meses após a cirurgia, a paciente encontra-se sem evidências de recidiva local ou regional.
Introduction: Basal cell carcinoma (BCC) of the vulva is a rare condition that accounts for less than 0.4% of BCC cases and 2% to 4% of vulvar neoplasms. BCC of the vulva is more common among white, multiparous and postmenopausal women, especially in the seventh decade of life. The aim is to report a case of BCC of the vulva in which aspects of diagnosis and treatment were discussed. Case report: A 63-year-old woman, G1P1A0, arrives at the office in January 2022 for treatment of a persistent lesion on her vulva. An incisional biopsy was performed and showed that it was likely nodular basal cell carcinoma with invasion of the dermis. The patient underwent tumor resection with free macroscopic margins and primary suture. The surgery had no complications preoperatively or postoperatively. The histopathology of the surgical specimen showed that it was a nodular basal cell carcinoma with an irregular, flat, white area, measuring 0.7x0.4cm, with the lateral margins 7.0 and 5.0mm apart and 5.9mm deep; all free. Conclusion: The reported case is rare, with surgical resection of BCC of the vulva with margins being successful. Fourteen months after surgery, the patient has no evidence of local or regional recurrence.
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O tumor filoide é uma neoplasia fibroepitelial rara que representa 0,3 a 1% de todas as neoplasias mamárias. De acordo com a classificação histopatológica, 12 a 26% são do tipo borderline e aproximadamente 15% desses tumores recorrem após excisão cirúrgica. O tratamento recomendado para todos os tipos de tumor filoide é a excisão cirúrgica, e no caso de tumores gigantes o tratamento deve ser multidisciplinar. Apresentamos o caso de uma mulher de 46 anos com tumor filoide na mama esquerda que recorreu 4 anos após a excisão cirúrgica. O estudo anatomopatológico qualificou-o como tumor gigante e o estudo histopatológico relatou tumor filoide borderline. Foi submetida a excisão cirúrgica com mastectomia esquerda e reconstrução mamária com retalho de grande dorsal mais enxerto de gordura. A paciente apresentou evolução favorável sem recidiva. Concluindo, o tumor filoide gigante borderline recorrente é raro e seu manejo cirúrgico representa um desafio tanto na excisão quanto na reconstrução mamária.
Phyllodes tumor is a rare fibroepithelial neoplasm that represents 0.3 to 1% of all breast neoplasms. According to histopathologic classification, 12 to 26% are borderline type and approximately 15% of these tumors recur after surgical excision. The recommended treatment for all types of phyllodes tumor is surgical excision, and in the case of giant tumors the treatment should be multidisciplinary. We present the case of a 46-yearold woman with a phyllodes tumor in the left breast that recurred 4 years after surgical excision. The anatomopathological study qualified it as a giant tumor and the histopathological study reported a borderline phyllodes tumor. She underwent surgical excision with left mastectomy and breast reconstruction by means of a latissimus dorsi flap plus fat graft. The patient presented a favorable evolution without recurrence. In conclusion, the recurrent giant borderline phyllodes tumor is rare and its surgical management represents a challenge both in breast excision and reconstruction.
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Introdução: Em 1977, a partir dos estudos anatômicos de McCraw et al., passou-se a utilizar o músculo peitoral maior como retalho miocutâneo em ilha. O presente artigo descreve um caso de reconstrução de um defeito da parede anterior do hemitórax direito através do retalho miocutâneo peitoral maior em ilha ipsilateral. Relato do Caso: A.E.S., de 66 anos, sexo masculino foi submetido a ressecção ampla de um carcinoma basocelular infiltrativo recidivante de 13,0 x 8,0cm da região paraesternal direita. O retalho miocutâneo foi transposto através de tunelização subcutânea e as cicatrizes posicionadas em forma de mamaplastia em T invertido. Conclusão: A presente tática cirúrgica é de fácil execução para cirurgiões habituados com reconstrução mamária, apresenta tempo cirúrgico curto e resultado estético-funcional satisfatório.
Introduction: In 1977, based on anatomical studies by McCraw et al., the pectoralis major muscle began to be used as an island myocutaneous flap. The present article describes a case of reconstruction of a defect in the anterior wall of the right hemithorax using the pectoralis major myocutaneous flap in an ipsilateral island. Case Report: AES, 66 years old, male, underwent wide resection of a recurrent infiltrative basal cell carcinoma measuring 13.0 x 8.0 cm in the right parasternal region. The myocutaneous flap was transposed through subcutaneous tunneling and the scars were positioned in the shape of an inverted T mammoplasty. Conclusion: This surgical tactic is easy to perform for surgeons accustomed to breast reconstruction, has a short surgical time, and has satisfactory aesthetic-functional results.
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Objective@#To explore the clinical manifestations, histopathological characteristics, diagnosis, treatment, and prognosis of simultaneous unilateral primary tumors of different pathological types in the parotid gland.@*Methods@#A case of simultaneous unilateral primary parotid gland tumors, i.e., adenolymphoma and basal cell adenoma, was reviewed and analyzed in combination with the literature.@*Results@#The patient discovered a lump in the right parotid gland area one month prior to presentation, and a tumor was palpated in the shallow lobe of the right parotid gland before surgery. According to MR images, the initial diagnoses were tumors of the shallow and deep lobes of the right parotid gland. The tumors of the deep and shallow lobes were excised with part of the gland, and the facial nerves were dissected under general anesthesia. Postoperative pathology revealed an adenolymphoma in the shallow lobe of the right parotid gland and a basal cell adenoma with cystic transformation in the deep lobe. The surgical effect was good, with no complications, and there was no recurrence after 1 year of follow-up. A review of the relevant literature showed that multiple primary tumors of the parotid gland can manifest as the simultaneous presence of two or more types of tumors on both sides or on one side, and the disease is mainly treated with surgery.@*Conclusion@#Multiple unilateral primary parotid gland tumors are rare. Imaging examinations need to be combined with clinical evaluations to prevent missed diagnoses. Surgery is the first treatment option, and patients with benign tumors have a good prognosis.
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ABSTRACT We present a rare case of primary caruncle basal cell carcinoma (BCC), a condition with limited occurrences. Our patient, an 80-year-old woman without prior ocular pathological history, presented a 2x2mm pedunculated blackish nodular lesion on the caruncle of her left eye, without local conjunctival or cutaneous involvement. Histological analysis following complete excision confirmed the presence of basal cell carcinoma within the caruncle. Over a span of 30 months, no recurrence has been observed. While scant cases are documented in the literature, we conducted a review of these instances. Despite its infrequent manifestation, this condition should be taken into account when evaluating caruncular tumors, given its tendency to invade the orbit. Complete excision with free surgical margins is the treatment of choice, and adjuvant radiotherapy or chemotherapy might be considered.
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Introducción: El carcinoma basocelular constituye uno de los tipos de cáncer cutáneo de mayor incidencia. El uso del HeberFERON® ha demostrado una efectiva respuesta clínica. Objetivo: Evaluar la respuesta del HeberFERON® en pacientes con carcinoma basocelular asociado a la COVID-19, y su comportamiento en pacientes con igual diagnóstico dermatológico sin tratamiento previo con dicho fármaco, atendidos con cirugía. Materiales y métodos: Se realizó un estudio observacional descriptivo y retrospectivo en un universo de 184 pacientes adultos con carcinoma basocelular. Se analizaron las variables edad, sexo, fototipo de piel, comorbilidades asociadas, infección con SARS-CoV-2 asociada con tratamiento previo con HeberFERON® o cirugía; tiempo entre tratamiento recibido y padecimiento de COVID-19, y severidad de los síntomas. Los resultados se expresan en tablas. Resultados: Se estudiaron 94 pacientes tratados con HeberFERON® para el carcinoma basocelular, y 90 pacientes tratados con cirugía. Predominaron los masculinos, mayores de 60 años, fototipo de piel II-III, con comorbilidades cardiovasculares. De ellos, 24 (25,5 %) resultaron positivos a la COVID-19, y el 83,3 % desarrollaron síntomas leves. De los tratados con cirugía para el carcinoma basocelular, 61 resultaron positivos a la COVID-19 (67,7 %), y el 55,7 % tuvo sintomatología severa. Durante el ciclo de tratamiento con HeberFERON para el carcinoma basocelular, el 66,7 % enfermó con COVID-19 entre las 16 y 32 semanas. Posterior a las 32 semanas, se reportó un fallecido. Conclusiones: Los pacientes tratados con cirugía sin previo HeberFERON tuvieron más contagios con COVID-19, predominando los decesos asociados a ello, siendo menor en los que lo recibieron. De los tratados previamente con HeberFERON® para el carcinoma basocelular, el 74,5 % no enfermó de COVID-19, a pesar de haber sido el 52,8 % contactos de positivos al SARS-CoV-2.
Introduction: Basal cell carcinoma is one of the types of skin cancer with the highest incidence. The use of HeberFERON® has shown an effective clinical response. Objective: To evaluate the response of HeberFERON® in patients with BCC associated with COVID-19 and its behavior in patients with the same dermatological diagnosis without previous treatment with that drug, treated with surgery. Materials and methods: A descriptive and retrospective observational study was conducted in a universe of 184 adult patients with basal cell carcinoma. The variables analyzed were age, sex, skin phototype, associated comorbidities, SARS-CoV-2 infection, associated to previously treatment with HeberFERON® or surgery; time between treatment received and suffering from COVID-19; severity of symptoms. The results were expressed in tables. Results: 94 patients were treated with HeberFERON® for basal cell carcinoma, and 90 were treated with surgery. There was a predominance of male patients, aged over 60 years, skin phototype II-III, with cardiovascular morbidities. Of them, 24 (25.5%) were positive to COVID-19 (67.7%), and 83.3% developed mild symptoms. Of those treated with surgery for basal cell carcinoma, 61 were positive to COVID-19 (67,7%), and 55.7% had severe symptoms. During the HeberFERON® treatment cycle for basal cell carcinoma, 66.7% became ill with COVID-19 between 16 and 32 weeks. After 32 weeks one deceased was reported. Conclusions: Patients treated with surgery without prior HeberFERON® had more infections with Covid-19, the deaths associated with it predominating, being less in those who received it. Of those previously treated with HeberFERON® for basal cell carcinoma, 74.5% did not become ill with COVID-19, despite having been 52.8% contacts to SARS-CoV-2 positive people.
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ABSTRACT BACKGROUND: The prevalence of chronic kidney disease (CKD) has increased in the recent decades, along with the number of patients in the terminal stages of this disease, requiring transplantation. Some skin disorders are more frequent in patients with CKD and in renal transplant recipients (RTR). OBJECTIVES: To evaluate the frequency of skin diseases in RTR and patients with CKD receiving conservative treatment. DESIGN AND SETTING: This observational cross-sectional study recruited consecutive patients with CKD and RTR from a nephrology clinic at a teaching hospital in Brazil between 2015 and 2020. METHODS: Quantitative, descriptive, and analytical approaches were used. The sample was selected based on convenience sampling. Data were collected from dermatological visits and participants' medical records. RESULTS: Overall, 308 participants were included: 206 RTR (66.9%, median age: 48 years, interquartile range [IQR] 38.0-56.0, 63.6% men) and 102 patients with CKD (33.1%, median age: 61.0 years, IQR 50.0-71.2, 48% men). The frequency of infectious skin diseases (39.3% vs. 21.6% P = 0.002) were higher in RTR than in patients with CKD. Neoplastic skin lesions were present in nine (4.4%) RTR and in only one (1.0%) patient with CKD. Among the RTR, the ratio of basal cell carcinoma to squamous cell carcinoma was 2:1. CONCLUSIONS: This study revealed that an increased frequency of infectious skin diseases may be expected in patients who have undergone kidney transplantation. Among skin cancers, BCC is more frequently observed in RTR, especially in those using azathioprine.
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Fundamento: El carcinoma basocelular es infrecuente en la piel cabelluda. Es un tumor de invasión local y crecimiento lento, puede ser agresivo, destruir tejidos vecinos, causar ulceración e invadir en profundidad cartílago y hueso. Objetivo: Evaluar los resultados de la aplicación del HeberFERON y el seguimiento con ecografía cutánea en pacientes con carcinoma basocelular en la piel cabelluda. Metodología: Se realizó un estudio observacional, descriptivo y longitudinal en una serie de casos con diagnóstico de carcinoma basocelular de la piel cabelluda en el Policlínico Centro de la ciudad Sancti Spíritus, durante el período de 10 de julio del 2018 a 29 de julio del 2022. Se incluyeron 6 casos. Las variables estudiadas fueron la respuesta al tratamiento mediante la clínica, la ecografía cutánea e histopatología y presencia de eventos adversos. Resultados: Predominó el sexo masculino, subtipo histológico sólido, subtipo clínico nódulo ulcerativo, tamaño del tumor mayor de 30 mm y tiempo de evolución de más de 12 meses; la respuesta al tratamiento en la mayoría de los casos fue parcial. Los eventos adversos fueron dolor y ardor en el sitio de inyección, fiebre, edema y eritema perilesional. Conclusiones: El HeberFERON resultó de utilidad en los pacientes con carcinoma basocelular del cuero cabelludo ya que redujo el tumor en unos casos y en otros lo eliminó. La ecografía permitió la evaluación en tiempo real de la neoplasia; los eventos adversos más frecuentes fueron la fiebre y el dolor en el sitio de inyección, a pesar de ello ningún paciente abandonó el tratamiento.
Background: Basal cell carcinoma is uncommon in the scalp. It is a slow-growing locally invasive tumor, it can be aggressive in destroying neighboring tissues, cause ulceration and invade deep into the cartilage and bone. Objective: To evaluate the results of HeberFERON application and follow-up with cutaneous echographical in patients with scalp basal cell carcinoma. Methodology: An observational, descriptive and longitudinal study was conducted in a series of cases diagnosed with scalp basal cell carcinoma at the Center Polyclinic in Sancti Spíritus city during the period from July 10, 2018 to July 29, 2022. Six clinical cases were included. The studied variables were the answer to the treatment by clinical, cutaneous echographical and histopathology and the presence of adverse events. Results: Male sex predominated, solid histologic subtype, clinical subtype ulcerative nodule, tumor size greater than 30 mm and evolution time of over 12 months; the treatment response in most cases was partial; adverse events were pain and burning at the injection site, fever, edema and perilesional erythema. Conclusion: It was observed that in patients with scalp basal cell carcinoma, the HeberFERON treatment reduced in some cases and eliminated the tumor in others. Echography allowed real-time evaluation of the neoplasm, fever and pain at the injection site were the most frequent adverse events. In spite of this, none of the patients abandoned the therapy.
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Introducción: El cáncer de piel es la más frecuente de todas las neoplasias. Su incidencia mundial ha aumentado en proporción epidémica, y existe un predominio en países tropicales debido a la constante exposición solar. El carcinoma basocelular es el que más afecta a la población y predomina en hombres de más de 60 años. Existen criterios para clasificar esta entidad en alto riesgo, basándose, sobre todo, en la localización y extensión de la lesión. Una opción novedosa y terapéutica de elección es el uso del HeberFERON®. Objetivo: Describir la respuesta clínica al tratamiento con HeberFERON® en pacientes con carcinoma basocelular de alto riego en Matanzas, en el período de febrero de 2019 a julio de 2021. Materiales y métodos: Se realizó un estudio descriptivo prospectivo en pacientes atendidos en la Consulta Provincial de Tumores Periféricos, de Matanzas, que presentaron carcinoma basocelular de alto riesgo en el período mencionado. Resultado: La población estuvo constituida por 55 pacientes, predominando los hombres y el grupo etario de 60 a 69 años. Las variantes ulceradas localizadas en la nariz constituyeron las formas clínicas agresivas de mayor incidencia. Conclusiones: Imperaron las respuestas completas en tumores mayores de 2 cm, evitando cirugías mutilantes, con lo que se evidencia la seguridad y eficacia del HeberFERON®.
Introduction: Skin cancer is the most frequent of all neoplasms. Its worldwide incidence has increased in epidemic proportions, and there is predominance in tropical countries due to constant sun exposition. Basal cell carcinoma is the one that most affects the population and predominates in men over 60 years of age. There are criteria to classify this entity as high risk, based, above all, in the location and extent of the lesion. A novel and therapeutic option of election is the use of HeberFERON™. Objective: To describe the clinical response to treatment with HeberFERON™ in patients with high-risk basal cell carcinoma in Matanzas, from February 2019 to July 2021. Materials and methods: Prospective, descriptive study was carried out in patients treated at the Provincial Clinic of Peripheral Tumors, of Matanzas, who presented high-risk basal cell carcinoma in the aforementioned period. Results: The population consisted of 55 patients, predominating men and the age group from 60 to 69 years. The ulcerative forms located in the nose constituted the aggressive clinical forms of highest incidence. Conclusions: Complete responses prevailed in tumors larger than 2 cm, avoiding mutilating surgeries, thus demonstrating the safety and efficacy of HeberFERON™.
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Introducción: El carcinoma basocelular es un tumor de invasión local de crecimiento; se origina en las células epidérmicas de los folículos pilosos o las células basales de la epidermis, cuando se localizan en zona de alto riesgo en la cara tienen un mayor índice de recurrencia tumoral y de invasión a estructuras adyacentes y subyacentes. Objetivo: Evaluar los resultados de la aplicación del HeberFERON en pacientes con carcinoma basocelular en zona de alto riesgo. Métodos: Se realizó un estudio observacional, descriptivo y prospectivo en pacientes con diagnóstico clínico, dermatoscópico e histopatológico de carcinoma basocelular en zona de alto riesgo, tratados con HeberFERON en la consulta del Policlínico Centro de Sancti Spíritus desde el 12 de enero de 2016 hasta el 25 de marzo de 2022. La muestra quedó conformada por 62 pacientes Las principales variables estudiadas fueron la respuesta al tratamiento y los eventos adversos. Resultados: Predominó el sexo masculino, el área urbana, fototipocutáneo III y la edad mayor de 40 años. La localización más frecuente fue la nasal; el subtipo clínico el nódulo ulcerativo; el histológico, el sólido; el tumor primitivo y menor de 2 cm; la respuesta al tratamiento fue completa en la mayoría de los pacientes. Los eventos adversos más comunes fueron dolor y ardor en el sitio de inyección, edema y eritema perilesional, fiebre y cefalea. Conclusiones: La mayoría de los pacientes tratados con HeberFERON tuvieron una respuesta completa, los eventos adversos fueron los descritos en la literatura por el uso de interferones, sin cambio en la actitud farmacológica(AU)
Introduction: Basal cell carcinoma is a growing and locally invasive tumor; it originates in the epidermal cells of hair follicles or the basal cells of the epidermis. When located in a high-risk facial zone, they present a higher rate of tumor recurrence and invasion to adjacent and underlying structures. Objective: To evaluate the results of HeberFERON application in patients with basal cell carcinoma on a high-risk zone. Methods: An observational, descriptive and prospective study was conducted in patients with a clinical, dermatoscopic and histopathological diagnosis of basal cell carcinoma on a high-risk zone, treated with HeberFERON in the consultation of Policlínico Centro of Sancti Spíritus, from January 12, 2016 to March 25, 2022. The sample was made up of 62 patients. The main variables studied were response to treatment and adverse events. Results: There was a predominance of the male sex, the urban area, skin phototype III and age over 40 years. The most frequent localization was nasal; the clinical subtype, ulcerative nodule; the histological subtype, solid. The response to treatment was complete in most patients. The most common adverse events were pain and burning at the injection site, perilesional erythema and edema, fever and headache. Conclusions: Most patients treated with HeberFERON had a complete response; the adverse events were those described in the literature due to the use of interferons, with no change in pharmacological behavior(AU)
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Humanos , Masculino , Femenino , Neoplasias Cutáneas/epidemiología , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/tratamiento farmacológico , Interferones/uso terapéutico , Epidemiología Descriptiva , Estudios Prospectivos , Estudio ObservacionalRESUMEN
Abstract Background: Achieving adequate surgical margins and preventing recurrence are important in the treatment of basal cell carcinoma (BCC). Objectives: The objectives of this study were to evaluate the adequacy of surgical margins and the re-excision rates in patients with primary BCC who underwent standard surgical treatment using our proposed algorithm and to define the risk factors in patients with recurrent BCC. Methods: The medical records of patients who were histopathologically diagnosed with BCC were reviewed. An algorithm created based on previous literature was used to determine the distribution of optimal surgical margins adequacy and re-excision rates. Results: Statistically significant differences were observed between the cases with and without recurrence in age at diagnosis (p = 0.004), tumor size (p = 0.023), tumor location in the H zone of the face (p = 0.005), and aggressive histopathological subtype (p = 0.000). When the tumors were evaluated for adequacy of deep and lateral surgical margins and re-excision rates, higher rates of adequate excision (457 cases, 68.0%) and re-excision (43 cases, 33.9%) were noted for tumors in the H or M zone. Study limitations: Inadequate follow-up of newly diagnosed patients in terms of recurrence and metastasis and the retrospective application of our proposed algorithm are the limitations of the present study. Conclusions: Our results showed that if BCC was detected at an early age and at an early stage, recurrence was lower. The H and M zones were the regions with the highest rates of optimal surgical outcomes.
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Fundamento: El carcinoma basocelular de la región auricular es considerado uno de los más agresivos y con peor pronóstico, suele ser destructivo y mutilante por lo que el tratamiento conservador, como es el uso de los interferones, es importante en la práctica médica habitual. Objetivo: Evaluar los resultados de la aplicación del HeberFERON en una serie de pacientes con carcinoma basocelular en la región auricular. Metodología: Se realizó un estudio observacional, descriptivo y longitudinal en una serie de casos con diagnóstico clínico, dermatoscópico e histopatológico de carcinoma basocelular de la oreja que recibieron tratamiento con HeberFERON en el Policlínico Centro de la ciudad Sancti Spíritus, durante el período del 20 de febrero de 2017 a 20 de diciembre de 2022. En total se incluyeron 29 pacientes. Se realizó una evaluación inicial, durante y 16 semanas después del tratamiento; se les inyectó 10.5 UI de HeberFERON 3 veces por semana perilesional e intradérmico hasta completar 9 dosis. Las variables fueron la respuesta al tratamiento y presencia o no de eventos adversos. Resultados: Predominó el sexo masculino, la localización en la concha de la oreja, subtipo clínico nódulo ulcerativo y el histológico sólido, con respuesta completa en la mayoría de los pacientes. Como eventos adversos más comunes se presentaron dolor en el sitio de inyección, fiebre, edema y eritema perilesional. Conclusiones: La respuesta al tratamiento fue favorable en la mayoría de los pacientes y los eventos adversos que se observaron fueron los descritos en la literatura sin cambio en la actitud farmacológica.
Background: Basal cell carcinoma of the auricular region is one of the most aggressive cancers and with the worst prognosis, is usually destructive and mutilating, therefore conservative treatment, such as the use of interferons, is important in routine medical practice. Objective: To evaluate the results of HeberFERON application in a series of patients with basal cell carcinoma in the auricular region. Methodology: An observational, descriptive and longitudinal study was conducted on a series of cases with clinical, dermoscopic and histopathologic diagnosis of basal cell carcinoma of the ear treated with HeberFERON at the Center Polyclinic in Sancti Spíritus city, during the period from February 20, 2017 through December 20, 2022. A total of 29 patients were included in the study. An evaluation was conducted at the start of treatment, during treatment, and 16 weeks after treatment; the patients were treated with 10.5 IU of HeberFERON by perilesional and intradermal injections three times a week until completing nine doses. The variables were the response to the treatment and the presence or absence of any adverse events. Results: The male sex predominated, location in the ear turbinate, clinical subtype ulcerative nodule and solid histologic subtype, with a complete response in the majority of patients. The most common adverse events were injection site pain, fever, edema, and perilesional erythema. Conclusions: The response to treatment was favorable in most patients, and the adverse events observed were those described in the literature, with no change in pharmacologic attitude.
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Carcinoma Basocelular , Pabellón AuricularRESUMEN
El carcinoma basal palpebral representa un 90 % de los tumores malignos oculares con una alta morbilidad. Su incidencia tiene un comportamiento diferente en las distintas partes del mundo y, por lo general, aumenta con la edad. El diagnóstico positivo se realiza por la evaluación histológica de la muestra mediante biopsia escisional. El tratamiento ideal es el quirúrgico, aunque existen otras opciones de tratamiento. El no quirúrgico tiene como objetivo la eliminación del tumor, así como evitar las complicaciones o las secuelas funcionales y estéticas por la cirugía. Se reconocen numerosas opciones dentro de la modalidad terapéutica no quirúrgica; imiquimod, 5-fluorouracilo, inhibidores de la vía de Hedgehog y los interferones. Diversos estudios han demostrado la utilidad de los interferones en monoterapia o como terapia combinada, en pacientes no susceptibles de actuaciones quirúrgicas. Por esta razón, se decidió revisar la literatura científica actual sobre la eficacia y seguridad del HeberFERON® en el tratamiento del carcinoma basal palpebral. Se realizó una búsqueda actualizada teniendo en cuenta los descriptores correspondientes a las palabras clave relacionadas con la temática a investigar, en las bases de datos bibliográficas Medline (buscador PubMed), SciELO, Ebsco, Clinical Key y en Google Académico. Se recuperaron 35 artículos que su contenido respondía al tema de estudio.
Palpebral basal carcinoma represents 90% of ocular malignant tumors with high morbidity. Its incidence has a different behavior in different parts of the world and generally increases with age. Positive diagnosis is made by histological evaluation of the specimen by excisional biopsy. The ideal treatment is surgical, although other treatment options are available. Non-surgical treatment is aimed at eliminating the tumor, as well as avoiding the complications or functional and esthetic sequelae of surgery. Numerous options are recognized within the non-surgical therapeutic modality; imiquimod, 5-fluorouracil, Hedgehog pathway inhibitors and interferons. Several studies have demonstrated the usefulness of interferons in monotherapy or as combination therapy in patients not amenable to surgery. For this reason, it was decided to review the current scientific literature on the efficacy and safety of HeberFERON® in the treatment of palpebral basal cell carcinoma. An updated search was carried out taking into account the descriptors corresponding to the key words related to the subject under investigation, in the bibliographic databases Medline (PubMed search engine), SciELO, Ebsco, Clinical Key and Google Scholar. Thirty-five articles were retrieved whose content corresponded to the subject of the study.
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Introduction: The columella is an important subunit of the nose, essential for nasal architecture and facial aesthetics. The total reconstruction of the nasal columella becomes a great challenge after repairing trauma, carcinomas, and necrosis in this region. There are descriptions in the literature of numerous reconstruction techniques using different flaps, such as a frontal region flap, an infraclavicular region flap, and a unilateral and bilateral nasolabial flap. Case Report: A total reconstruction of the nasal columella after resection of basal cell carcinoma (BCC) using a bilateral nasolabial flap is reported. Conclusion: The technique proved effective for correcting the complex defect after BCC resection, with technical ease for resolution and good aesthetic and functional results.
Introdução: A columela é uma importante subunidade do nariz, sendo essencial para a arquitetura nasal e estética facial. A reconstrução total da columela nasal torna-se, portanto, um grande desafio após reparação de traumas, carcinomas e necroses nesta região. Há na literatura a descrição de inúmeras técnicas de reconstrução com uso de diferentes retalhos, como retalho da região frontal, retalho da região infraclavicular, retalho nasolabial unilateral e bilateral. Relato de Caso: Reporta-se uma reconstrução total da columela nasal pós-ressecção de carcinoma basocelular (CBC) utilizando retalho nasolabial bilateral. Conclusão: A técnica utilizada mostrou-se eficaz para correção do defeito complexo pós-ressecção de CBC, apresentando facilidade técnica para resolução e bom resultado estético-funcional.
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Introduction: Basal cell adenocarcinoma is a rare well recognized low grade malignant salivary gland tumor often resembles basal cell adenoma. the infiltrating growth pattern and likelihood of vascular and perineural involvement distinguishes basal cell adenocarcinoma with basal cell adenoma. Case presentation: Here we present histopathological and immune histochemical analysis of two such rare cases of basal cell adenocarcinoma and review of literature is discussed. Conclusion: Basal cell adeno carcinoma is a low grade malignancy and doesn’t metastasize. With only few hundreds of cases that has been reported in literature, basal cell adeno carcinoma should be included as differential diagnosis in salivary gland tumors in order not to miss the diagnosis
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Background: Dermoscopy is useful in the diagnosis of basal cell carcinoma (BCC). However, most descriptions of the dermoscopic features of BCCs are in Caucasians (skin types I-III) and there is a paucity of data in dark-skinned Indian patients. Aims: The aim of this study was to describe the various dermoscopic features of BCC in dark-skinned patients from South India and correlate these with the histopathologic subtypes. Methods: A retrospective observational study of biopsy-proven cases of BCC was conducted at a tertiary care center in South India using nonpolarized contact dermoscopy. Results: Sixty BCCs in 35 patients predominantly of skin phototypes IV or V were studied. These included 32 nodular, 27 superficial and 1 infiltrative type of BCC. The most common dermoscopic features noted were maple leaf-like areas (61.7%), blue-white veils (53.4%), ulceration (48.4%) and short fine telangiectases (46.7%). Ulceration, blue-white veils and arborizing vessels were significantly associated with nodular BCCs, while maple leaf-like areas, red-white structureless areas, multiple small erosions and spoke wheel areas were noted with superficial BCCs. Limitations: The limitations of this study include its retrospective nature, the use of only nonpolarized light for examination, the lack of other histopathological variants of BCC as well as the lack of a comparison group. Conclusion: We report a dermoscopic study of BCC in dark-skinned patients from Puducherry, South India. The blue-white veil was observed in half of the patients and was significantly associated with nodular BCCs. The addition of the blue-white veil to the diagnostic criteria for pigmented BCC could improve the diagnostic accuracy of dermoscopy in Indian patients.
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Introduction: Non-melanoma skin cancer is the most frequent neoplasm in Brazil, with an estimated 176,930 new cases during the 2020-2022 period, with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) as the most common subtypes. Surgical treatment of the lesions is effective, with a recurrence rate varying between 3 and 23%, with compromised margins being an important prognostic factor for this recurrence, increasing the importance of complete excision of the tumor. Method: To prepare this work, 1127 lesions treated at the Hospital de Amor Amazônia were analyzed, seeking to quantify cases and analyze surgically compromised margins through a retrospective analytical descriptive study. For this, histopathological reports of the operated patients were reviewed, dividing them according to sex, age, lesion topography, date of excision, lesion diameter, lesion depth, presence of ulceration, compromised margins, and histological type. Results: Among the lesions treated, 65% were BCC and 35% SCC, both histological types presenting a low incidence of compromised margins. In cases of CPB impairment, treatment via exeresis was chosen in 100% of cases. Concerning BCC impairment, the majority opted for clinical follow-up, with reapproach in only 9% of cases. Conclusion: This study demonstrates that the cases treated at the Hospital de Amor Amazônia align with the epidemiological data in the main literature, except for finding a higher incidence of non-melanoma skin cancer in men. In addition, this work demonstrates good results in the clinical approach of compromised margins in BCC lesions.
Introdução: O câncer de pele não melanoma é a neoplasia mais frequente no Brasil, com uma estimativa de 176.930 novos casos durante o triênio 2020-2022, tendo o carcinoma basocelular (CBC) e o carcinoma espinocelular (CEC) como subtipos mais presentes. O tratamento cirúrgico das lesões é efetivo, apresentando taxa de recorrência variando entre 3 e 23%, sendo o comprometimento de margens importante fator prognóstico para essa recorrência, aumentando a importância da excisão completa do tumor. Método: Para a elaboração deste trabalho, foram analisadas 1127 lesões abordadas no Hospital de Amor Amazônia, buscando quantificar casos e analisar margens cirurgicamente comprometidas por meio de um estudo descritivo analítico retrospectivo. Para isso, foram revisados laudos histopatológicos dos pacientes operados, dividindo-os de acordo com sexo, idade, topografia da lesão, data de excisão, diâmetro da lesão, profundidade da lesão, presença de ulceração, comprometimento de margens e tipo histológico. Resultados: Dentre as lesões abordadas, 65% eram CBC e 35% CEC, ambos os tipos histológicos apresentando baixa incidência de margens comprometidas. Nos casos de comprometimento em CEC, optou-se pelo tratamento via exérese em 100% dos casos. Já em relação ao comprometimento em CBC, optou-se majoritariamente pelo acompanhamento clínico, com reabordagem em apenas 9% dos casos. Conclusão: Este estudo demonstra que os casos abordados no Hospital de Amor Amazônia vão ao encontro dos dados epidemiológicos presentes nas principais literaturas, com ressalva, apenas, ao encontrar uma maior incidência de câncer de pele não melanoma em homens. Além disso, esse trabalho demonstra bons resultados na abordagem clínica de margens comprometidas em lesões de CBC.
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Introduction: Non-melanoma tumors frequently affect the lower palpebral region and constitute a challenge for reconstructing the surgical wound without causing functional or aesthetic changes. Primary closure is generally impossible, and flaps are preferred over grafts as they generate less eyelid retraction. This article aims to describe a new surgical reconstruction technique. Method: A modified McGregor flap technique is described for correcting a surgical defect greater than 50% of the anterior lamella of a recurrent basal cell carcinoma lesion in the lower eyelid. Results: The patient was evaluated on the 7th, 14th, 21st, and 45th postoperative days. She presented a good functional and aesthetic response to the technique used. Conclusion: Using the double transposition flap, we demonstrate a new technique for closing defects larger than two-thirds in the lower eyelid.
Introdução: Os tumores não melanomas acometem frequentemente a região palpebral inferior e consistem em um desafio para a reconstrução da ferida operatória sem ocasionar alteração funcional ou estética. O fechamento primário geralmente não é possível e os retalhos são preferenciais aos enxertos por gerarem menor retração palpebral. Este artigo tem como objetivo descrever uma nova técnica de reconstrução cirúrgica. Método: Descreve-se técnica modificada do retalho de McGregor para correção de defeito cirúrgico maior que 50% da lamela anterior, de lesão recidivada de carcinoma basocelular localizada em pálpebra inferior. Resultados: Paciente foi avaliada no 7º, 14º, 21º e 45º dia de pós-operatório. Apresentou boa resposta funcional e estética com a técnica utilizada. Conclusão: Demonstramos uma nova técnica de fechamento de defeitos maiores do que dois terços na pálpebra inferior através do retalho de dupla transposição.
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Two male patients with bifid rib-basal cell nevus-jaw cyst syndrome (BCNS) were admitted to Department of Stomatology, the First Affiliated Hospital of Bengbu Medical College due to radiological findings of multiple low density shadows in the jaw. Clinical and imaging findings showed thoracic malformation, calcification of the tentorium cerebellum and falx cerebrum as well as widening of the orbital distance. Whole exon high-throughput sequencing was performed in two patients and their family members. The heterozygous mutations of c.C2541C>A(p.Y847X) and c.C1501C>T(p.Q501X) in PTCH1 gene were detected in both patients. Diagnosis of BCNS was confirmed. The heterozygous mutations of PTCH1 gene locus were also found in the mothers of the two probands. Proband 1 showed clinical manifestations of low intelligence, and heterozygous mutations of c.C2141T(p.P714L) and c.G3343A(p.V1115I) were detected in FANCD2 gene. Proband 2 had normal intelligence and no FANCD2 mutation. The fenestration decompression and curettage of jaw cyst were performed in both patients. Regular follow-up showed good bone growth at the original lesion, and no recurrence has been observed so far.
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Humanos , Masculino , Síndrome del Nevo Basocelular/diagnóstico , Mutación , Nevo , Receptor Patched-1/genética , Linaje , Costillas/anomalíasRESUMEN
A preservação do desenho das margens cirúrgicas é essencial durante a realização da cirurgia micrográfica de Mohs. Contudo, a degermação cutânea no ato da antissepsia e o uso da gaze durante a anestesia local, com frequência, promovem a remoção dessas marcações. A utilização da película protetora Cavilon® 3M, ao fixar a tinta da caneta marcadora, mostrou-se eficaz na preservação do mapa cirúrgico, permitindo uma remoção precisa do espécime cirúrgico
The preservation of the surgical margins marking is essential during Mohs micrographic surgery. However, skin degermation during antisepsis and the use of gauze during local anesthesia often remove these markings. The use of the protective film Cavilon® 3M to fix the marking pen ink was effective in preserving the surgical map, allowing an accurate removal of the surgical specimen.