A case of recurrent vulvar carcinoma treated with erlotinib, an EGFR inhibitor.

BACKGROUND: There is no effective therapy for patients with regional and/or distant recurrence of vulvar carcinoma. Recently two case reports about the use of erlotinib, an EGFR (epithelial growth factor receptor) inhibitor, in the context of recurrent vulvar cancer were published with a good clinical response reported. CASE: We report a case where erlotinib was used in a 67-year-old patient with recurrent and multi-treated vulvar carcinoma. Utilization of erlotinib was started with rapid clinical improvement. The treatment was well tolerated with palliation of symptoms. A CT scan also showed cutoff "net" improvement, with regression of size and number of hilar and pulmonary metastases. After one month of improvement, despite continuous treatment with erlotinib, dyspnea returned. A new CT scan showed an increased number of hilar nodes, a new hepatic lesion and increase in the size of the known pelvic lesion. CONCLUSION: EGFR inhibitors appear to be promising agents for this devastating and fatal disease. As with other studies with these agents, our patient showed a rapid response with important palliation of symptoms, however of short duration.

[Prevalence of Helicobacter pylori infection in children evaluated at "Hospital de Clínicas de Porto Alegre", RS, Brazil]. / Prevalência de infecção por, Helicobacter pylori em crianças avaliadas no Hospital de Clínicas de Porto Alegre, RS, Brasil.

OBJECTIVES: To determine prevalence of Helicobacter pylori infection in a group of symptomatic patients between 2 and 18 years old who were submitted to gastric biopsy during upper endoscopy done in the period of 1990-97. To correlate the histological findings with clinical and endoscopical data. METHODS: A cross-sectional study done after review of clinical and histopathological data. Histopathological sections were reviewed by a pathologist, who did not know the clinical information and the previous histopathological reports. RESULTS: Among 181 patients evaluated, prevalence of Helicobacter pylori infection was 24.86% (45 positive cases). In pathological analysis, gastritis was found in 38/45 of the positive Helicobacter pylori patients and in 45/136 negative Helicobacter pylori. Gastric ulceration was found in 6/45 positive Helicobacter pylori and in 3/136 negative Helicobacter pylori. CONCLUSION: This study stated a significative association between Helicobacter pylori infection and pathological abnormalities in children evaluated in the "Hospital de Clínicas de Porto Alegre", RS, Brazil.