Fibrosarcoma infantil intestinal. Reporte de un caso con sangrado digestivo en un lactante / Infantile intestinal fibrosarcoma. Case report with digestive bleeding in an infant

El fibrosarcoma infantil es un tumor raro, perteneciente al grupo de sarcomas no rabdomiosarcoma; se presenta, preferentemente, en infantes, con localización más frecuente en extremidades.Se reporta un varón de 5 meses, con historia de sangrado digestivo desde los 3 meses, interpretados, al principio, como alergia a la proteína de leche de vaca, con evolución tórpida y anemia. Por laparoscopía exploradora, se evidenció un tumor en el intestino medio; se realizó resección y anastomosis término-terminal. Luego, se ampliaron los márgenes de resección por ser < 0,1 cm.Microscópicamente, se observó una proliferación neoplásica fusocelular con positividad difusa para vimentina, y reacción en cadena de la polimerasa con transcriptasa reversa positiva para ETV6-NTRK3. Se diagnosticó fibrosarcoma infantil intestinal. Presentó buena evolución a 24 meses del diagnóstico. Si bien es infrecuente en pediatría, se debe considerar como diagnóstico diferencial en lactantes con sangrado digestivo sin causa clara.

Infantile fibrosarcoma is a rare tumor, belonging to the non-rhabdomyosarcoma, soft tissue sarcoma. It is mostly presented in infants, most commonly involving the extremities.We report a 5-month-old boy, presenting with digestive bleeding since the age of 3 months, initially diagnosed as cow's milk allergy, with a torpid evolution and anemia. He underwent laparoscopic exploration, with evidence of a mass in the small bowel. Resection and end-to-end anastomosis were performed. Because of inadequate microscopic margins (< 1 cm), a new surgery was performed to achieve tumor free margins. Histological examination consisted of spindle cells that mainly expressed vimentin, and reverse transcriptase-polymerase chain reaction was positive for the ETV6-NTRK3 transcript, confirming the diagnosis of infantile fibrosarcoma. The patient did well after 24 months of follow-up.Although infantile intestinal fibrosarcoma is extremely uncommon in children, it should be considered as differential diagnosis for digestive bleeding in infants

Mixofibrosarcoma de bajo grado: reporte de caso / Low grade mixofibrosarcoma: case report

El mixofibrosarcoma es un subtipo de sarcoma que comúnmente se presenta en las extremidades de personas ancianas. La presentación clínica no es característica y el aspecto histológico es altamente heterogéneo, lo que frecuentemente retrasa el diagnóstico o conduce a uno equivocado. Técnicas de histoquímica e inmunohistoquímica son mandatorias para establecer el diagnóstico de MFS. Presentamos el caso de un hombre de 57 años para ilustrar lo poco sugerente de este diagnóstico dada la presentación clínica. El manejo de este tumor es con cirugía, eventualmente radioterapia y seguimiento estricto.

Myxofibrosarcoma is a subtype of sarcoma commonly found in the extremities of elderly people. The clinical presentation is not characteristic and the histological aspect is highly heterogeneous, which often delays the diagnosis or leads to the wrong one. Histochemistry and immunohistochemistry techniques are required to establish the diagnosis of SFM. We present the case of a 57-year-old man to illustrate the unimpressive nature of this diagnosis given the clinical presentation. The management of this tumor is with surgery, eventually radiotherapy and strict follow-up.

Oral fibrosarcoma in jararaca (Bothrops pubescens): anatomopathological and immunohistochemical aspects / Fibrossarcoma oral em jararaca (Bothrops pubescens): aspectos anatomopatológicos e imuno-histoquímicos

A 4-year-old female captive-bred snake of the genus Bothrops showed swelling on the left side of the oral cavity, suggesting the development of neoplasia. The mass was removed surgically and sent for pathological examination. Two months later a new increase in volume in the same site was observed, suggesting recurrence. The lesion was completely removed and sent for pathological analysis. Histologically, the two-samples consisted of a mass with highly-cell density composed of spindle-shaped anaplastic cells arranged in interwoven bundles, distributed throughout the tissue extension and, occasionally, polygonal cells arranged in irregular fascicles. The Masson trichrome staining showed modest amount of collagen supporting the neoplastic cells. PAS-positive content was not observed in the cytoplasm of neoplastic cells. Histological and histochemical findings indicated that it was a spindle cell neoplasm, but the classification was not possible. Immunohistochemistry was requested and performed using the streptavidin-biotin-peroxidase method. The markers used were anti-vimentin, anti-PCNA, anti-EMA, anti-melan A and anti-melanosome, anti-desmin, anti-actin, anti-CD68 and anti- S100protein. The neoplastic cells were immunoreactive for vimentin and PCNA and negative for the other antibodies. The morphology characterization, histochemical and immunohistochemical analysis of neoplastic cells allowed the definitive diagnosis of oral fibrosarcoma...

Uma serpente de cativeiro, fêmea, quatro anos de idade, do gênero Bothrops apresentou aumento de volume no lado esquerdo da cavidade oral, sugerindo tratar-se de neoplasma. A massa foi removida cirurgicamente e enviada para exame anatomopatológico. Dois meses depois foi observado novo aumento de volume no mesmo local, sugerindo recidiva. A lesão foi removida por completo e também enviada para análise. Histologicamente, as duas amostras consistiam de massa altamente celular, composta por células anaplásicas fusiformes organizadas em feixes entrelaçados e distribuídos por toda extensão tecidual e, ocasionalmente, células poligonais arranjadas em fascículos irregulares. A coloração de tricrômico de Masson apresentou quantidade modesta de colágeno sustentando as células neoplásicas. Não foi observado conteúdo PAS-positivo no citoplasma das células neoplásicas. Os achados histológicos e histoquímicos indicavam tratar-se de neoplasma de células fusiformes, porém não era possível sua classificação. A imuno-histoquímica foi requisitada e realizada pelo método streptavidina-biotina-peroxidase, utilizando os anticorpos anti-vimentina, anti-PCNA, Anti-EMA, anti-melan A, anti-HMB45, anti-desmina, anti-actina, anti-CD68 e anti-proteína S-100. As células neoplásicas foram imunorreativas para vimentina e PCNA e, negativas para os demais anticorpos. A caracterização morfológica, histoquímica e imuno-histoquímica das células neoplásicas permitiu o diagnóstico definitivo de fibrossarcoma oral...

Estigma e discriminação: experiências de mulheres HIV positivo nos bairros populares de Maputo, Moçambique / Stigma and discrimination: the experiences of HIV-positive women in poor neighborhoods of Maputo, Mozambique / Estigma y discriminación: las experiencias de las mujeres VIH positivas en los barrios populares de Maputo, Mozambique

A epidemia de HIV/AIDS é um sério problema de saúde pública em Moçambique, que convive com altas taxas de prevalência do HIV. O impacto da epidemia é agravado pelo forte estigma que atinge as pessoas soropositivas. O objetivo deste estudo foi investigar, com base em uma perspectiva socioantropológica, a experiência de mulheres HIV positivo nos bairros populares de Maputo e como lidam com o estigma e a discriminação. Foram realizadas entrevistas semiestruturadas com dez mulheres HIV positivo, residentes nos bairros populares de Maputo. Os resultados mostram como a desigualdade de gênero atua de forma importante na construção da vulnerabilidade das mulheres ao HIV, assim como em sua estigmatização e discriminação. No enfrentamento do estigma, as mulheres procuram preservar o sigilo do diagnóstico buscando apoio na reunião em grupos de pares HIV positivo. É fundamental que se implementem políticas públicas voltadas para o empoderamento das mulheres e redução do estigma associado ao HIV/AIDS.

The HIV/AIDS epidemic is a serious public health problem in Mozambique. The country has high prevalence rates, and the epidemic's impact is aggravated by the stigma affecting HIV-positive persons. This study takes a socio-anthropological perspective to analyze the experience of HIV-positive women in poor neighborhoods of Maputo and the ways they cope with stigma and discrimination. Semi-structured interviews were conducted with 10 HIV-positive women. The results show how gender inequalities increase women's vulnerability to HIV and contribute to their stigmatization and discrimination. In dealing with stigma, women try to keep their diagnosis confidential, seeking support in group meetings with others living with HIV. Public policies should focus on women's empowerment and the reduction of HIV/AIDS-related stigma.

El VIH/SIDA es un problema de salud pública grave en Mozambique, que convive con altas tasas de prevalencia del VIH. El impacto de la epidemia se ve agravada por el fuerte estigma que afecta a las personas con VIH. El objetivo de este estudio fue investigar, desde una perspectiva antropológica, la experiencia de las mujeres VIH positivas en los barrios populares de Maputo y cómo enfrentan el estigma y la discriminación. Se realizaron entrevistas semi-estructuradas con 10 mujeres VIH positivas que viven en barrios pobres de Maputo. Los resultados muestran cómo la desigualdad de género juega un papel importante en la construcción de la vulnerabilidad de las mujeres frente al VIH, así como en la estigmatización y discriminación. Para hacer frente el estigma, las mujeres buscan preservar la confidencialidad del diagnóstico y buscar apoyo en la reunión de grupos de pares con VIH. Es imprescindible implementar políticas públicas enfocadas al empoderamiento de las mujeres y a la reducción del estigma asociado con el VIH/SIDA.

Low-grade fibromyxoid sarcoma: a rare distinctive soft tissue tumor

A fifty-three-year-old Bahraini male presented with a painless, slow growing mass in the left gluteal region. A work-up including pelvic MRI, chest CT scan and excisional biopsy was performed. The histology was low-grade fibromyxoid sarcoma [LGFMS]. Immunohistochemistry tests confirmed the diagnosis. He received local radiotherapy as an alternative for re-resection. Changes in the liver were suspicious but an ultrasound and MRI of the liver ruled out liver metastases. The patient is maintained under close observation because the tumor has high tendency of local recurrence and possible pulmonary and liver metastases. This specific distinctive entity of soft tissue sarcoma is yet to be reported in Bahrain; it has no clear protocol regarding the best follow-up recommendations.

Fibrosarcoma nasosinusal: presentación de tres casos / Nasosinusal fibrosarcoma: presentation of three cases

Este trabajo hace referencia a tres casos de tumor nasosinusal o fibrosarcoma, entidad poco frecuente en el medio. Se presentan tres pacientes operados en el Servicio de Otorrinolaringología del Hospital Provincial Docente Dr Antonio Luaces Iraola de Ciego de Ávila, de fibrosarcoma nasosinusal con invasión orbitaria, fosa pterigomaxilar, senos etmoidales y esfenoidales; dos de ellos fallecieron, uno a los 18 meses por complicación endocraniana y el otro por fallo multiorgánico causado por anemia aguda; el otro se recuperó satisfactoriamente. Se hace una revisión del tema para apoyar el diagnóstico y manejo de los casos.

This work makes reference to three cases of nasosinusal or Fibrosarcoma tumor, an uncommon entity in our environment. It´s presented three operated patients in Otolaryngology teaching Provincial Hospital service Dr Antonio Luaces Iraola from Ciego de Avila, of nasosinusal fibrosarcoma with orbital invasion, pterygopalatine cavity, ethmoidal and sphenoid sinuses;two of them died, one 18 months after by endocraneal complication and the other by multiorgan failure caused by acute anemia; the third one was recovered successfully. A review of the topic is done to support diagnosis and case management.

Doenças da cavidade nasal em ruminantes no Brasil / Diseases of the nasal cavity of ruminants in Brazil

This paper reports diseases of the nasal cavity diagnosed in ruminants in the Veterinary Hospital of the Federal University of Campina Grande, in Patos, state of Paraiba, northeastern Brazil, from 2003 to 2009. During that period three cases or outbreaks of diseases of the nasal cavity were reported in cattle, three in goats and nine in sheep (out of 404 diseases diagnosed in cattle, 330 in goats, and 338 in sheep). At all are reported one case of atopic rhinitis in cattle, seven outbreaks of conidiobolomycosis and two outbreaks of rhinofacial pythiosis in sheep, two cases of protothecosis and one of nasal aspergillosis in goats, and a myxoma and a fibrosarcoma in cattle. Additionally, other diseases of the nasal cavity reported in Brazil are reviewed, including oestrosis, rhinosporidiosis, squamous cell carcinoma, and enzootic ethmoidal tumor.

Este trabalho descreve as doenças das fossas nasais diagnosticadas em ruminantes no Hospital Veterinário da Universidade Federal de Campina Grande, em Patos, Paraíba, nos anos de 2003-2009. No período foram registrados três diagnósticos de doenças das fossas nasais de bovinos, três em caprinos e nove em ovinos (de um total de 404 diagnósticos em bovinos, 330 em caprinos e 338 em ovinos). Descrevem-se um caso de rinite atópica em bovinos, sete surtos de conidiobolomicose e dois de pitiose rinofacial em ovinos, dois casos de prototecose e um de aspergilose nasal em caprinos e um mixoma e um fibrossarcoma em bovinos. Adicionalmente, é realizada uma revisão de outras doenças das fossas nasais de ruminantes descritas em outras regiões do Brasil, incluindo oestrose, rinosporidiose, carcinoma epidermóide e tumor etmoidal enzoótico.

Giant primary pulmonary fibrosarcoma.

A rare case of primary fibrosarcoma in a 48-year-old male is described who presented with a huge pulmonary mass on the left side. The diagnosis was established on fine needle aspiration cytology (FNAC) and percutaneous transthoracic lung biopsy, supported by immuno-histochemistry.

Vaginal fibrosarcoma in cow [A case report]

A five-year-old Holstein cow with a history of vaginal prolapse was admitted to the Large Animal Clinic, Faculty of Veterinary Medicine, University of Tabriz. According to the owner, she had a 5-month history of vaginal prolapse and frequent sanguineous discharge from the vagina. Appetite was normal and its last parturition was two months ago. Clinical examination revealed a tumor like mass that attached to the vaginal roof and partly protruded through the vagina without any vaginal prolapse. After epidural anesthesia, the mass was surgically removed with some of the surrounding tissue. The dimensions of the mass were 5.2 x 4 x 3.4 cm. Macroscopically, it was relatively well circumscribed with a lobulated and ulcerated surface. In cut section, the mass was homogenously creamy in color. There were no foci of necrosis or hemorrhage. Microscopically, the growth was composed of spindle-shaped flbroblastic type tumor cells that formed interlacing and intersecting bundles. The neoplastic cells showed pleomorphism, karyomegaly and slight nuclear hyperchromatism. The mitotic index was less than five. Based on the site, biological behavior, immunohistochemistry results, macroscopic and microscopic characteristics, the mass was diagnosed as a well-differentiated fibrosarcoma. This is the first report of cow vaginal fibrosarcoma from Iran

Aggressive fibromatosis versus low grade fibrosarcoma - a diagnostic dilemma

The fibromatosis are a group of lesions that can infiltrate widely, replacing muscle, fat and bone with fibrous tissue of varying cellularity. They do not develop distant metastases, however, locally they show an aggressive and infiltrative behaviour. The major challenge in the diagnosis lies in not over or under diagnose of fibrosarcoma and an underdiagnosis of reactive fibrosis. But this histologic differentiation is necessary owing to different treatment strategies

Dermatofibrosarcoma protuberans: comunicación de un caso y revisión de la literatura / Dermatofibrosarcoma protuberans: case report and literature review

El dermatofibrosarcoma protuberans (DFSP) es un tumor raro, de origen fibrohistiocítico y malignidad intermedia, caracterizado por su crecimiento local progresivo y su alta tasa de recidivas locales con bajo potencial metastásico. Afecta principalmente a adultos entres los 20 y 50 años, pero también se presentan casos en la niñez. Se localiza más frecuentemente en el tronco y raíz de miembros y menos del 5% de los casos afecta cuero cabelludo. Se presenta el caso de un varón de 20 años con un dermatofibrosarcoma protuberans en región frontoparietal izquierda con compromiso del cuero cabelludo, al que se le realizó tratamiento cirugía micrográfica de Mohs y se realiza una revisión de la literatura.

Fibrosarcoma gigante de ovario: a propósito de un caso / Giant ovarian fibrosacarcoma: apropos of a case

Se presenta el caso de una paciente de 62 años de edad, de la raza negra, con antecedentes de enfermedad y aumento de volumen del abdomen de varios años de evolución. Al estudiarlo, no se obtuvieron resultados concluyentes. Después de constatar el gran aumento de volumen del abdomen y de palpar un tumor que lo ocupaba casi totalmente, se le realizaron estudios imagenológicos que no definieron el lugar de procedencia del tumor, y se decidió intervenir quirúrgicamente, ya que por el crecimiento tumoral los síntomas compresivos intraabdominales aumentaban progresivamente. En el acto operatorio se encontró un tumor gigante en el ovario izquierdo, con diámetro transversal de más de 60 cm y peso superior a 12 kg. Se realizó la exéresis del tumor, histerectomía total, anexectomía derecha y omentectomía.

The case of a 62-year-old black female patient with past health history and increase of the abdomen volume of some years of evolution is presented. On studying her, no concluding results were attained. After confirming the considerable enlargement of the abdomen and palpating a tumor that occupied it almost totally, imaging studies, which did not define the place of origin of the tumor, were conducted. It was decided to carry out surgery, since the tumoral growth caused a progressive rise of the intraabdominal compressive symptoms. During the operation, it was found a giant tumor of the left ovary, with a transversal diameter of more than 60 cm and a weight over 12 kg. Tumor exeresis, total hysterectomy, right anexectomy and omentectomy were performed.

Proceder ortopédico y manejo anestésico de Fibrosarcoma de cara interna de muslo izquierdo: reporte de un caso / Orthopedia Service-traumatology and anesthesiology-resuscitation: a case presentation

El cáncer es una enfermedad causada por un crecimiento insidioso de células anormales. Por fortuna, logros recientes de terapéutica múltiple para el cáncer están aumentando netamente la supervivencia, y brindan una esperanza para el futuro control de esta enfermedad. Fibrosarcoma, entidad que nos ocupa, es frecuente en la raza negra, invasora localmente, pero no causa metástasis. La biopsia es esencial para establecer el diagnóstico. El tratamiento de elección para este tipo de sarcoma de partes blandas, es la extirpación quirúrgica adecuada, con el fin de erradicar la enfermedad. En este trabajo se presenta un caso de una mujer de 62 años de edad, de la raza negra, que ingresó en el Hospital General Docente Roberto Rodríguez Fernández con la variedad clínica de Fibrosarcoma de cara interna de muslo izquierdo. Se describen las características clínicas del paciente, los exámenes complementarios y se destaca el proceder ortopédico y manejo anestésico, mediante la técnica de peridural continua, para analgesia postoperatoria.

Cancer is a disease caused by incident growth of abnormal cells. Fortunately, recent achievements of multiple therapy for cancer is increasing the survival and offer a hope for the future control of this disease. Fibrosarcoma, is more frequent in balck race, locally invasive, but doesn´t cause metastasis. The biopsy is essential to establish the diagnosis, the elective treatment to this type of sarcoma of soft parts, is the appropiate surgical extirpation, with the purpose of eradicate the disease. In this paper it is presented a case of a 62 years old woman, black race that was admitted in General Hospital Roberto Rodríguez Fernandez with the clinic variety of fibrosarcoma of infero-internal face of left thigh. There are described clinical characteristics of the patient, the complementary exams and it´s highlighted the orthopaedic behaviour and anaesthetic management, through continuos peridural technique, for post-operated analgesia.

Cytological diagnosis of myxoinflammatory fibroblastic sarcoma: a case report and discussion of differential diagnosis.

Myxoinflammatory fibroblastic sarcoma previously known as inflammatory myxohyaline tumour of distal extremities with virocyte or Reed Sternberg like cells is a low grade tumour of the hands and feet. It is a distinctive lesion with features simulating inflammatory conditions, Hodgkin's disease and various sarcomas. It characteristically occurs in the distal extremities and has a propensity to recur locally. We describe cytological appearance of this condition with relevant differential diagnosis. A 51 year old male presented with a swelling over upper 1/3 of medial aspect of left tibia of 4 months duration. Fine needle aspiration smears showed myxoid material, epithelioid cells, spindle cells, vacuolated cells and giant cells along with scattered lymphocytes. Histopathological examination of the excision biopsy specimen was confirmatory.

[Transformation of dermatofibrosarcoma protuberans on a fibrosarcoma-A case report]

The dermatofibrosarcoma protuberans is a rare cutaneous mesenchymal tumor characterized by a low potential of malignancy with a very low rate of metastasis but an important rate of local recurrence. Its transformation on a fibrosarcoma is exceptional, responsible of a higher metastatic potential. This transformation leads to a better surveillance. With a case report and literature review we will try to remember epidemiological, physical, histological, therapeutic, and outcome particularities of this entity