RESUMO
Breast cancer is extremely rare in children, and consequently no consensus has been reached on the optimal treatment modalities. The medical history and treatment plan for a 7.5-year old male breast cancer patient is described. Radical mastectomy with sentinel node biopsy was performed in October 2002. As no malignant cells were detected in the sentinel node, and no BRCA1-2 mutations were detected, no further radio- or chemotherapy was performed. A "wait-and-see" policy was decided on. Further treatment will be given if this becomes necessary with the development of metastases.
Assuntos
Neoplasias da Mama Masculina/patologia , Carcinoma/patologia , Neoplasias da Mama Masculina/genética , Neoplasias da Mama Masculina/cirurgia , Carcinoma/genética , Carcinoma/cirurgia , Criança , Predisposição Genética para Doença , Humanos , MasculinoAssuntos
Neoplasias Renais , Regressão Neoplásica Espontânea , Segunda Neoplasia Primária , Nefrectomia , Tumor de Wilms , Quimioterapia Adjuvante , Humanos , Lactente , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/terapia , Masculino , Segunda Neoplasia Primária/diagnóstico por imagem , Segunda Neoplasia Primária/terapia , Tomografia Computadorizada por Raios X , Ultrassonografia , Tumor de Wilms/diagnóstico por imagem , Tumor de Wilms/terapiaRESUMO
BACKGROUND: Primary humoral deficiencies vary from complete absence of B cells and/or serum immunoglobulin to lacunar deficits involving specific antibody responses to polysaccharides. OBJECTIVES: We compared the B-cell CD5 expression in patients with selective antipolysaccharide antibody deficiencies (SPADs), common variable immunodeficiency (CVID), and IgG subclass deficiency and in normal control subjects. METHODS: Five patient populations were evaluated: (1) patients with severe SPAD (no protective serologic postvaccine response to any of 12 polysaccharide antigens tested); (2) patients with intermediate SPAD (diminished response to polysaccharide antigens and adequate response to 1 to 3 of 12 serotypes tested); (3) patients with IgG subclass deficiency; (4) patients with CVID; and (5) age-matched control subjects. Blood was collected from all patients and evaluated by using flow cytometry. Results were compared by using the Student t test. RESULTS: Patients with severe SPAD deficiencies had a marked predominance of CD5+ B cells in the peripheral blood (93% to 97% of total B cells, n = 2). The intermediate SPAD group had a mean CD5+ B-cell percentage that was significantly higher than that of the age-matched control group (87. 4%, n = 7, vs 52.5%, n = 20; P =.007). Patients with CVID and IgG subclass deficiency had mean CD5+ B-cell percentages that were similar to those of the age-matched control subjects. CONCLUSIONS: Our studies demonstrate that patients with SPAD had a markedly increased percentage of CD5+ B cells in the peripheral blood as compared with age-matched control subjects and patients with other humoral deficiencies. This observation suggests that an association may be present between CD5+ B-cell predominance and SPAD.
