Ressecção do tumor e colocação de enxerto de pele parcial no couro cabeludo em um paciente com neurofibromatose tipo 1 / Tumor resection and partial skin graft placement on the scalp in a patient with Neurofibromatosis type 1

A neurofibromatose tipo 1 (NF1) é um distúrbio neurocutâneo hereditário no qual se formam tumores no sistema nervoso (neurofibromas). Os neurofibromas são os tumores benignos mais comuns na NF1. O tipo, o tamanho, o número e a localização dos neurofibromas devem ser considerados para a escolha do tratamento. Apresentamos um caso de NF1, no qual foi realizada uma ampla ressecção do couro cabeludo devido à presença de múltiplos neurofibromas. Associado a isso, a reconstrução foi realizada com retalhos de avanço mais autoenxerto de pele parcial, com resultados favoráveis e boa cobertura das áreas onde os tumores foram removidos.

Neurofibromatosis type 1 (NF1) is an inherited neurocutaneous disorder in which tumors form in the nervous system (neurofibromas). Neurofibromas are the most common benign tumors in NF1. The type, size, number, and location of the neurofibromas should be considered for the choice of treatment. We present a case of NF1, in which a wide scalp resection was performed due to the presence of multiple neurofibromas. Associated with this, reconstruction was performed with advancement flaps plus partial skin autograft with favorable results and good coverage of the areas where the tumors were removed.

Tumor filoide borderline gigante e recidivante: ressecção e reconstrução da mama / Recurrent giant borderline phyllodes tumor: resection and breast reconstruction

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.

Efecto protector del aceite de plukenetia volubilis (sacha inchi) en la depresión inducida de ratones albinos / Protective effect of plukenetia volubilis (sacha inchi) oil on induced depression of albino mice

Objetivo: Evaluar el efecto protector del aceite de Plukenetia volubilis (Sacha Inchi) en la depresión inducida a ratones albinos. Materiales y métodos: Los ratones fueron divididos en 4 grupos y recibieron durante 10 días las siguientes sustancias: Grupo N°01(n=6) Vehículo 5 ml/Kg/12h, Grupo Nº 02 (n=6): Fluoxetina 10 mg/Kg/24horas, Grupo Nº 03 (n=6): Aceite de sacha inchi 1g/kg/12 horas, Grupo Nº 04 (n=6): Aceite de sacha inchi 3g/kg/12 horas. Luego, fueron sometidos a la prueba de Nado Forzado, sumergiéndolos en una piscina cilíndrica durante 6 minutos y registrando el tiempo de inmovilidad. Los ratones sometidos a la prueba de Sujeción de cola fueron distribuidos de la misma manera y administrados con las mismas sustancias para después de 10 días ser suspendidos por el tercio distal de la cola registrándose el tiempo de inmovilidad. Resultados: Los ratones que recibieron el aceite de Plukenetia volubilis a dosis de 1g/kg y 3 g/kg presentaron menor tiempo de inmovilidad respecto al control para ambas pruebas, sólo teniendo el grupo con dosis 3 g/kg significancia estadística. En el nado forzado el tiempo de inmovilidad con dosis de aceite de 1g/kg y 3 g/kg fue 184,7 s y 108,0 s, respectivamente. Para la prueba de Sujeción de cola el tiempo de inmovilidad fue 118,33 s y 63,33 s para dosis de 1g/kg y 3g/kg respectivamente. Conclusiones: El aceite de Sacha Inchi administrado por vía oral a dosis de 3g/kg demostró efecto protector similar a fluoxetina, frente a la depresión inducida en los modelos animales empleados. (AU)

Objective: Evaluate protective effect of Plukenetia volubilis oil (Sacha Inchi) on induced depression in albino mice. Materials and methods: Mice were divided into 4 groups and received the following substances during 10 days: Group N°1 (n = 6) Vehicle 5 ml/Kg/12h, Group N°2 (n = 6): Fluoxetine 10 mg/Kg/24h, Group N°3 (n = 6): Sacha inchi oil 1 g/kg /12h, Group N°4 (n = 6): Sacha inchi oil 3 g/ kg/12 h. Then, they were subject to Forced Swimming test, submerging them in a cylindrical pool for 6 minutes and the immobility time was recorded. The mice subjected to the tail suspension test were distributed in the same way and administered with the same substances, after 10 days being suspended by the distal third of the tail, recording the immobility time. Results: The mice that received the Plukenetia volubilis oil at a dose of 1 g/kg and 3 g/kg had a shorter immobility time regarding control for both tests, and only the group with a dose of 3 g/kg had statistical significance. In forced swimming the immobility time with oil doses of 1 g/kg and 3 g/kg was 184.7 s and 108.0 s, respectively. For Tail suspension test, the immobility time was 118.33 s and 63.33 s for doses of 1g/kg and 3g/kg, respectively. Conclusions: Sacha Inchi oil administered orally at a dose of 3g/kg showed a protective effect similar to fluoxetine, against induced depression in the animal model used. (AU)