Carcinoma metaplásico de mama fusocelular de alto grado con diferenciación osteoclástica / High-grade fusocellular metaplastic carcinoma with osteoclast-like cell differentiation

Presentamos el caso de una paciente de 45 años, con antecedentes familiares de cáncer de mama y sin antecedentes personales de interés, con una tumoración de mama de corta duración. El diagnóstico fue un Carcinoma metaplásico fusocelular de alto grado con diferenciación de células tipo osteoclástico. Se realizó tratamiento quimioterápico neoadyuvante, quirúrgico y quimioterapia adyuvante. Presentó diseminación metastásica 3 meses después de la cirugía y a los 8 meses de la aparición de la primera metástasis fue éxitus. Dada la baja incidencia, difícil manejo y mal pronóstico, consideramos necesario elaborar una revisión bibliográfica sobre este tipo de neoplasia de mama

We report the case of a 45-year-old patient patient with a family history of breast cancer and no relevant personal history, with a short-term breast tumor. The diagnosis was a high-grade fusocellular metaplastic carcinoma with osteoclast-like cell differentiation. Neoadjuvant chemotherapy, surgery and adjuvant chemotherapy were performed. He presented metastatic dissemination 3 months after surgery and at 8 months after the onset of the first metastasis she died. Given the rarity of this entity, difficult management and poor prognosis, we consider that a literatura review of this type of breast tumor

Flurbiprofen-induced generalized bullous fixed drug eruption.

Fixed drug eruption (FDE) is an unusual drug-related side effect that results in recurrent lesions whenever the causative drugs are used. FDEs usually occur as a single, sharply demarcated, round erythematous patch or plaque, occasionally with localized bullae. The most common offending agents include antimicrobials, nonsteroidal anti-inflammatory drugs, and antiepileptics. There are some reports where contact dermatitis and cutaneous vasculitis have been associated with the use of flurbiprofen. We present the case of a 50-year-old man with flurbiprofen-induced generalized bullous FDE. To the best of our knowledge, the most serious form of FDE, the generalized bullous FDE, to be caused by flurbiprofen has not been reported previously.

Irritable bowel syndrome in patients with chronic pruritus of undetermined origin.

BACKGROUND: Chronic pruritus is an important distressing condition that is often refractory to treatment. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that occurs without an organic cause. OBJECTIVES: We aimed to investigate the relationship between chronic pruritus of undetermined origin (CPUO) and IBS. METHODS: Eighty patients with chronic pruritus (CP) of undetermined origin and fifty healthy control subjects without pruritus were included into the study. All of the participants were examined by a gastroenterologist for concomitant IBS. RESULTS: The frequency of IBS was found higher in patients with CP of undetermined origin (P: 0.02), but we did not observe any significant association between pruritus intensity and either presence of IBS (P: 0.08) or the subtypes of the syndrome (P: 0.40). Furthermore, patients with CP of undetermined origin between 40 and 60 years, female gender and longer duration of the disease were found to be significantly associated with the presence of IBS (P: 0.02, P: 0.01 and P < 0.001). CONCLUSIONS: We found that the frequency of IBS was higher in patients with CP than in healthy controls. Our study is the first report about the relation between CP of undetermined origin and IBS. Further studies with larger numbers of the patients are needed to show association between IBS and CPUO using laboratory tests to define underlying diseases such as lactose intolerance, functional dyspepsia and emotional diseases.

Trichoscopy in paediatric patients with tinea capitis: a useful method to differentiate from alopecia areata.

OBJECTIVES: Trichoscopy (hair and scalp dermatoscopy) facilitates the diagnosis of hair and scalp disorders. The aim of our study was to identify the trichoscopic features in diagnosis of tinea capitis (TC) and to compare these findings with alopecia areata (AA). MATERIALS AND METHODS: Our study included 15 children with TC and 10 children with AA as a control group. Affected areas of the scalp on all the cases were analysed under a magnification of 20X and 40X by a digital dermatoscope (MoleMax II). RESULTS: Broken and dystrophic hairs were found in dermatological examination of all the patients with TC. In addition, corkscrew hairs, comma hairs and black dots were observed respectively. Yellow dots, exclamation mark hairs and vellus hair were observed in patients with AA. CONCLUSIONS: Broken and dystrophic hairs, corkscrew hairs, comma hairs and black dots were observed only in patients with TC; yellow dots, exclamation mark hairs and vellus hairs were observed only in patients with alopesi areata. Further studies with larger numbers of patients are needed to determine specific trichoscopic findings of TC and to access differential diagnosis.

Mean platelet volume is associated with aortic arterial stiffness in patients with Behçet's disease without significant cardiovascular involvement.

BACKGROUND: Behçet's disease (BD), is a chronic, systemic vasculitis, which may affect all types and sizes of blood vessels. BD is associated with endothelial dysfunction and chronic inflammation. Endothelial dysfunction is the critical early step in the process of atherogenesis, and it is commonly investigated by measuring arterial stiffness. Mean platelet volume (MPV) has been investigated in relation with both thrombosis and inflammation. We aimed to investigate the relationship between an increased arterial stiffness and MPV in patients with Behçet's disease without significant cardiovascular involvement. METHODS: We studied 36 patients (20 males, mean age: 37.6 ± 11.7 years) who were diagnosed by the international diagnostic criteria of BD and 35 healthy controls (15 males, mean age: 35.0 ± 10.6 years), and the two groups were matched by age and gender. MPV levels and arterial stiffness measurements were compared in these groups. RESULTS: Arterial stiffness was higher in patients with BD compared to control group. (BD and controls; 7.28 m/s, 6.64 m/s; respectively) (p: 0.02). MPV levels were also significantly higher in patients with BD compared to control group. (BD and controls; 8.86 ± 0.81 fl, 8.39 ± 0.96 fl, respectively) (p: 0.02). Additionally, arterial stiffness correlated positively with age, the duration of disease and MPV levels in patients with BD (p: 0.002, 0.03, 0.02 respectively). CONCLUSIONS: In our study, increased MPV is associated with arterial stiffness in patients with BD without significant cardiovascular involvement. It shows that there is a relationship between thrombosis and chronic inflammation in BD. Furthermore, MPV is also a moderate predictor of cardiovascular disease and represents an increase in platelet activation. These findings provide further evidence of a link between inflammation and thrombosis in patients with BD.

Elevated serum levels of endocan in patients with psoriasis vulgaris: correlations with cardiovascular risk and activity of disease.

BACKGROUND: Psoriasis vulgaris is an inflammatory disease characterized by epidermal hyperproliferation, leucocyte adhesion molecule expression and leucocyte infiltration. Psoriasis is associated with an increased risk of cardiovascular disease. Endothelial dysfunction is widely regarded as being the initial process in the development of atherosclerosis. Human endothelial cell-specific molecule-1 (endocan) is a novel human endothelial cell-specific molecule. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. OBJECTIVES: To investigate the relationship between serum levels of endocan and both cardiovascular risk and disease activity in patients with psoriasis vulgaris. METHODS: A total of 29 patients with psoriasis vulgaris and 35 control subjects were included in the study. Endocan, high-sensitivity C-reactive protein (hsCRP) and carotid artery intima-media thickness (cIMT) were measured in all subjects. RESULTS: Serum endocan levels were significantly different between the two groups (P < 0.001). In patients with psoriasis, serum endocan levels correlated with Psoriasis Area and Severity Index, hsCRP and cIMT (r = 0.477, P = 0.009; r = 0.484, P = 0.008; r = 0.408, P = 0.02, respectively). CONCLUSIONS: Circulating endocan may represent a new marker that correlates with cardiovascular risk as well as the severity of disease in patients with psoriasis vulgaris. Endocan may be a surrogate endothelial dysfunction marker and may have a functional role in endothelium-dependent pathological disorders. Whether endocan levels could become a treatment target merits further investigation.