Síndrome de estenose pilórica por adenocarcinoma de piloro / Pyloric stenosis due to adenocarcinoma of the pylorus

We present a case of primary malignant pylorus neoplasia, emphasizing its rarity, the difficulty of diagnosis and the importance of an adequate prepare before the endoscopic procedure. Literature shows that tumors compromising the first, third and fourth segments of duodenum are rare, especially those of the pyloric area, representing only 0.35% of all malignant tumors of the gastrointestinal tract. Adenocarcinoma is the most common histological type, representing 50% of all malignant neoplasias at this site. The most common symptoms are weight loss, nausea, vomiting, abdominal pain, abdominal mass, sudden changes in intestinal habits and iron deficiency anemia secondary to chronic intestinal hemorrhage. Survival after five years is only 18%. We report a case of a seventy-one year-old male referring early satiety, epigastric pain, retrosternal burning and dyspepsia, with unspecific results in complementary exams, since complete gastric emptying was not achieved. As symptoms worsened, the patient was submitted to laparotomy, with identification of gastric dilation and severe pyloric stenosis, macroscopically suggesting malignancy. The chosen procedure was a subtotal gastrectomy. Adjuvant radiotherapy and chemotherapy were not used. The patient is been followed-up without tumor recurrence so far.

ß-1-3 Glucan no tratamento do câncer de intestino / ß-1-3 Glucan in bowel cancer treatment

Objetivo: Avaliar a ação do ß-1-3 glucan na resposta imunológica de pacientes portadores de cáncer de intestino submetidos à cirurgia, quimioterapia e radioterapia. Método: Estudo retrospectivo de 75 pacientes, analisando as variações dos valores dos leucócitos, linfócitos e subpopulações CD4 e CD8 com o uso de ß-1-3 glucan. Resultados: Houve um aumento no número de todas as linhagens celulares estudadas, principalmente a da subpopulação de linfócitos CD4 (29,70%). A análise estatística pelo teste "t" de Student e pelo de Wilcoxon mostrou que os resultados foram significativos. Conclusão: O uso do ß-1-3 glucan foi capaz de restaurar e manter a resposta imune, reduzir os danos imunossupressores da quimioterapia e radioterapia e o seu uso não demonstrou efeitos colaterais.

Objective: To review the effectiveness of ß-1-3 glucan in the immune response of patients with intestinal cancer submitted to surgery, chemo and radiotherapy. Methods: Retrospective study on 75 patients, analyzing the variations on the leucocytes, lymphocytes and CD4/CD8 lymphocyte subpopulations using ß-1-3 glucan. Results: There was an increase in the general cellular sample, especially on CD4 lymphocyte subpopulations. Statistica analyses via Student's t-test and the Wilcoxon test have showed that the resultshave been significant. Conclusion: The use of ß-1-3 glucan was able to restore and keep the immune response in check, and to reduce the immunosupressor damages from chemo and radiotherapy. There were no side effects.

Tumor de células da granulosa / Granulosa cell tumor

Os tumores de células da granulosa säo neoplasias raras derivadas do cordäo sexual, com capacidade para feminilizar as pacientes. Säo eles, portanto, hormônio-produtores e de hábito benigno, podendo apresentar características histológicas variadas, sendo algumas vezes malignos. Este trabalho apresenta três casos desta neoplasia ovariana. Säo mostradas suas histórias clínicas, a sintomatologia, as cirurgias realizadas e respectivas complicaçöes, bem como seus diagnósticos anatomopatológicos e seus respectivos acompanhamentos.