Polimorfismos do gene da interleucina-13 nas posições -1055 C/T e +2044 G/A em pacientes com carcinoma espinocelular de cabeça e pescoço / Interleukin-13 gene polymorphisms at -1055 C/T and +2044 G/A positions in patients with squamous cell carcinoma of head and neck

O carcinoma espinocelular (CEC) é a neoplasia mais comum do trato aerodigestivo superior. A interleucina-13 (IL-13) é uma citocina imunorreguladora com polimorfismos relatados para seu gene associados com a mesma doença, especialmente asma e alergia. O presente estudo investigou se os polimorfismos do gene da IL-13 (posições 1055C/T no gene promotor da 1L-13 e +2044G/T exon 4) podem distinguir os pacientes com CEC de cabeça e pescoço de controles saudáveis. MÉTODO: O estudo analisou pacientes com CEC de cabeça e pescoço (n = 137) pareados por idade e sexo com um grupo de controles saudáveis (n = 127). A genotipagem do polimorfismo do gene da IL-13 foi executada pelo método de polimorfismo no comprimento de fragmentos de restrição baseado em reação em cadeia da polimerase. RESULTADOS: Não foram identificadas diferenças estatisticamente significativas nas frequências dos genótipos e alelos entre pacientes e controles em ambas as posições (p = 0,16). Além disso, não foi observada associação entre os genótipos investigados e outros fatores prognósticos, como idade, sexo, localização do tumor primário, tamanho do tumor e tabagismo. CONCLUSÃO: O presente estudo sugere que não há associação entre os polimorfismos do gene da IL-13 (nas posições -1055C/T e +2044GI A) e suscetibilidade dos pacientes a CEC de cabeça e pescoço.

Squamous cell carcinoma (SCC) is the most common malignancy that involves the upper aerodigestive tract. Interleukin-13 (IL-13) is an immunoregulatory cytokine that has been reported to have some polymorphisms in it gene associated with same disease especially asthma and allergy. The present study aimed to investigate whether the polymorphisms of IL-13 gene (at positions of 1055C/T in the promoter of1L-13 gene and +2044G/T exon-4) differ in patients with head and neck SCC from healthy controls. METHODS: This study was investigated in patient with head and neck SCC (n = 137) and age- and sex-matched healthy controls (n = 127). Genotyping of IL-13 gene polymorphism was performed using polymerase chain reaction-based restriction fragment length polymorphism method. RESULTS: No statistically significant differences were found in the frequencies of genotypes and alleles between patients and control group at both sites (p = 0.16). In addition, no association was observed between investigated genotypes and other potential prognostic factors such as age, sex, primary tumor site, tumor size and smoking. CONCLUSION: This study suggests that there is no association between IL-13 gene polymorphisms (at position -1055C/T and +2044GI A) and susceptibility of the patients to SCC of head and neck.

Melanoma primário de mucosa do trato nasossinusal: relato de 18 pacientes e análise de 1077 pacientes na literatura / Primary mucosal melanoma of the sinonasal tract: report of 18 patients and analysis of 1077 patients in the literature

O presente estudo tem por objetivo relatar as características, fatores prognósticos e desfecho de tratamento de 18 casos de melanoma da mucosa nasossinusal e conduzir uma revisão da literatura. MÉTODO: Entre 1995 e 2005, 18 pacientes consecutivos diagnosticados com melanoma da mucosa do trato nasossinusal e tratados em nossa instituição. Para encontrar as principais casuísticas de estudos relacionados, conduzimos uma revisão da literatura em PubMed e Scopus. No total, encontramos 35 casuísticas, incluindo 1.077 pacientes com melanoma da mucosa nasossinusal. RESULTADOS: Encontramos 16 homens e 2 mulheres. A idade de apresentação foi 51-80 anos (mediana de 58 anos). Todos os pacientes sofreram excisão cirúrgica seguida de radioterapia com ou sem quimioterapia. A mediana de sobrevida foi de 15 meses e a sobrevida geral de 5 anos foi de 23 por cento. Sob análise univariada, estadiamento e remissão completa após tratamento inicial foram importantes fatores prognósticos. Entretanto, sob análise multivariada, somente estágio da doença teve significância estatística. CONCLUSÃO: Melanoma nasossinusal é um tumor raro e agressivo com alto fracasso locorregional e distante e pobre desfecho de tratamento. Entretanto, em uma revisão da literatura, encontramos significativa melhora em termos de sobrevida de 5 anos para casuísticas recentes comparadas com casuísticas previamente relatadas.

The present study aimed at reporting on the characteristics, prognostic factors and treatment outcomes of 18 cases of nasosinusal mucosa melanoma, and do a literature review on the subject. METHODS: between 1995 and 2005, 18 patients consecutively diagnosed with nasosinusal mucosa melanoma were managed in our institution. We reviewed the literature in PubMed and Scopus in order to find the main series from studies associated with this topic. We found a total of 35 series, involving 1,077 patients with nasosinusal mucosa melanoma. RESULTS: we found 16 men and 2 women, with age at presentation between 51 and 80 years (median of 58 years). All these patients were submitted to surgical excision followed by radiotherapy with or without chemotherapy. The survival median was 15 months, and the 5-year general survival had a percentage value of 23 percent. Considering our univariate analysis: tumor staging and complete remission after initial treatment were deemed relevant prognostic factors. Nonetheless, considering the multivariate analysis, only disease stage was statistically significant. CONCLUSION: nasosinusal melanoma is a rare and aggressive tumor, with high loco-regional and distant failure rates, and poor treatment outcomes. Notwithstanding, in a literature review we found significant improvements considering the 5-year survival for recent series when compared to previously reported ones.

Topical betamethasone for prevention of radiation dermatitis.

BACKGROUND: Although acute radiation dermatitis (ARD) is a common side-effect of radiotherapy (RT), currently there is no general consensus about its prevention or treatment of choice. AIMS: The purpose of this study was to investigate whether prophylactic use of topical betamethasone 0.1% can prevent ARD caused by chest wall irradiation. METHODS: Fifty-one patients who underwent modified radical mastectomy for breast cancer and were going to receive RT, were randomly assigned to receive topical betamethasone 0.1%, petrolatum or none during RT. The frequency and severity of ARD (measured using Radiation Therapy Oncology Group acute radiation morbidity scoring criteria) were recorded at the end of each week during RT and two weeks after its completion. Clinical outcomes were analyzed by relevant statistical methods. RESULTS: All patients developed some degree of ARD, the frequency and severity of which increased with time and reached the maximum at the end of the seventh week for all groups. Patients receiving betamethasone had less severe ARD than the other two groups throughout the course of the study, but this difference was significant only at the end of the third week (p = 0.027). No significant difference was observed between the petrolatum and control arms. CONCLUSION: Prophylactic and ongoing use of topical betamethasone 0.1% during chest wall RT for breast cancer delays occurrence of ARD but does not prevent it. Petrolatum has no effect on the prevention of ARD in these patients.

Description of a neural sheath tumor of the trigeminal nerve: immunohistochemical and electron microscopy study

CONTEXT: Malignant neural sheath tumors of the trigeminal nerve affecting the nasal cavity and the paranasal sinuses are extremely rare. With conventional optical microscopy, their identification is difficult, and it is necessary to confirm them by means of electron microscopy and immunohistochemical techniques. CASE REPORT: The patient was a 41-year-old woman with a ten-month progressive history of pain followed by painful edema in the left facial region, and with symptoms of bleeding, secretion and nasal obstruction. Studies with imaging methods suggested the presence of an expansive process in the left nasal and paranasal cavities. In the biopsy, the histopathological findings from optical microscopy were suggestive of a tumor of neural origin in the trigeminal nerve. Immunohistochemical and electron microscopy studies confirmed that it was a malignant tumor of the neural sheath of the trigeminal nerve. We describe the clinical, radiological, and histological features of this tumor and review the literature.

CONTEXTO: O tumor maligno da bainha neural do trigêmeo que acomete a cavidade nasal e os seios paranasais é extremamente raro. A microscopia óptica habitual sua identificação é difícil, sendo necessária a confirmação através de microscopia eletrônica e de técnicas imunoistoquímicas. RELATO DE CASO: A paciente era uma mulher de 41 anos com história de 10 meses de progressiva dor seguida de edema álgico em região facial à esquerda, e de sintomas de sangramento, secreção e obstrução nasal. Estudos com métodos de imagem sugeriam a presença de processo expansivo em cavidades nasais e paranasais à esquerda. A biopsia, os achados histopatológicos à microscopia óptica foram sugestivos de tumor de origem neural no trigêmeo. Estudos imunoistoquímico e por microscopia eletrônica confirmaram se tratar de neoplasia maligna da bainha neural do trigêmeo. Descrevemos as características clínicas, radiológicas e histológicas deste tumor, e revisamos a literatura.

Role of external irradiation in high-risk resected colon cancer.

BACKGROUND / AIM: The best therapeutic modality for colon cancer "one of the most common malignancies of human being" is surgical resection of primary tumor. Adjuvant chemotherapy can help surgery to have a higher control and survival rate in high-risk resected patients, but the role of radiation therapy is the place of debate. This study was carried out to evaluate the possible role of adjuvant radiotherapy in such cases. MATERIALS AND METHODS: This retrospective trial evaluated 65 eligible patients with surgically resected high-risk colon carcinoma (serosal and/or lymph node involvement), from May 1986 to February 2000. The patients were categorized into two groups. The first group was treated with chemotherapy alone and the other with chemo-radiotherapy. Chemotherapy included 5.FU 500 mg/m2sub/5days for 6-8 courses and radiotherapy consisted 45-55 Gy with 1.5-2 Gy/fraction. Minimum follow-up was 36 months. RESULTS: Mean event-free survival was 140 and 101 months in chemotherapy and combined-therapy groups, respectively (P = 0.099). Local recurrence rate was detected as 9.7% in the chemotherapy arm and 23.5% in the combined-therapy arm (P > 0.1). Treatment-related morbidity and mortality has been significantly higher in the radiation arm (P CONCLUSION: Postoperative external radiation as adjuvant treatment does not improve local control of the patients with colon carcinoma.

Long-term pruritus as the initial and sole clinical manifestation of occult Hodgkin's disease.

Pruritus or itch is a frequent symptom of patients with Hodgkin's disease. It often occurs during the clinical course of the disease and rarely may precede the diagnosis of underlying disease. In this report, we present a 16-year-old patient who had history of generalized pruritus without any skin rash for 4 years before the diagnosis of Hodgkin's disease. Within that period, she had received symptom-oriented medications, with no significant effect. After the first cycle of chemotherapy, her pruritus resolved completely. This case suggests that long-term generalized pruritus may be indicative of a significant underlying problem like Hodgkin's disease.

Primary epidural malignant hemangiopericytoma of thoracic spinal column causing cord compression: case report

CONTEXTO: Hemangiopericitoma é uma neoplasia mensequimal incomum que raramente afeta o canal espinhal. O hemangiopericitoma maligno primário da coluna vertebral é extremamente raro. RELATO DE CASO: Relatamos um caso de hemangiopericitoma maligno epidural primário da coluna vertebral torácica que invade o osso vertebral, causando a compressão do cordão espinhal em um homem de 21 anos. O paciente apresentou-se com dor progressiva nas costas durante quatro meses, que progrediu para paraparesia, parestesia bilateral do pé e incontinência urinária. A intervenção cirúrgica com laminectomia e ressecção do tumor e fixação posterior foi executada. A radioterapia pós-operatória no campo envolvido foi realizada. Marcante melhoria neurológica foi observada subseqüentemente. Descrevemos as características clínicas, radiológicas, e histológicas deste tumor e revemos a literatura.