Breast cancer in young women: a rising threat: A 5-year follow-up comparative study.

Introduction: Breast cancer in young women is usually considered as breast cancer occurring in women younger than 40 years and is the most frequent cancer-related cause of death in these patients. In the past few years, there seems to be an increasing trend in the prevalence of breast cancer in young women, which, associated with poorer prognosis, more aggressive histologic features, and more frequent recurrence rates, makes it a rising threat to young women. This study aimed to evaluate the biological behavior of breast cancer in young women in our institution. Material and methods: A retrospective, unicentric, cohort study was conducted between 2012 and 2016. All consecutive patients with breast cancer were enrolled in the study. Cases were divided into two groups: case group, those younger than 40 years, and control group, those 40 years or older. The exclusion criterion was nonoperative treatment. Several clinical and pathologic parameters were evaluated, as well as were overall survival time and disease-free survival time. Results: The incidence of breast cancer in young women presented a rising tendency over the study period. Significant differences were observed in the comparison of the groups according to body mass index, age at menarche, age at birth of the first child, and proliferation rate. There were no differences in overall survival and disease-free survival rates between the groups. Conclusions: Young women had a more symptomatic presentation, a greater tumor proliferation rate, but similar outcomes compared with older patients. Greater multicentric studies are needed to confirm or refute these results.

Primary breast lymphoma: A mimic of inflammatory breast cancer.

INTRODUCTION: Primary breast lymphoma (PBL) is a rare disease accounting for 0.04-0.5% of all breast malignancies. PRESENTATION OF CASE: This article reports a clinical case of a 81-year-old woman with a history of right breast erythema and edema associated to breast pain, with over two weeks duration. Physical examination demonstrated mammary asymmetry and inflammatory signs with orange peel skin. She had the right upper limb swollen and palpable axillar and supraclavicular lymph nodes. The principal suspicion was an inflammatory breast cancer. Imaging was unspecific. Core needle biopsy of an axillary lymph node and of the breast mass identified morphological and immunophenotypic features consistent with diagnosis of primary non-Hodgkin DLBCL. Patient was guided by Hematology. DISCUSSION: The clinical and imaging findings in breast lymphoma can mimic those of breast carcinoma. Sometimes, PBL presentation is suggestive of Inflammatory breast cancer. Diagnosis depends on adequate tissue sampling for histology examination and immunophenotyping. The therapeutic management of PBL is controversial and is not clearly established, but many studies support that it is not a surgical disease and can be treated successfully with combined chemotherapy and radiotherapy. CONCLUSION: Breast lymphoma must be considered in the differential diagnosis of a breast lump, even in the presence of cutaneous inflammatory changes. PBL can be treated successfully with combined therapy.

Metastatic melanoma: An unusual cause of gastrointestinal bleeding and intussusception-A case report.

INTRODUCTION: Malignant melanoma is responsible for 1-3% of all malignancies being the gastrointestinal tract one of the most common metastatic locations. PRESENTATION OF CASE: We present the case of a 71-year old male with previous history of cutaneous melanoma. Seven years later, while being studied due to suspected small bowel bleeding, he developed small bowel obstruction after being submitted to double balloon enteroscopy. Further investigation revealed small bowel intussusception. He was taken up for emergency laparotomy that confirmed ileal intussusception secondary to an intraluminal mass. We performed segmental enterectomy with primary anastomosis. Histology confirmed intestinal melanoma metastasis. DISCUSSION: Malignant melanoma frequently spreads to the gastrointestinal tract. The presentation is mainly asymptomatic and the diagnosis is often made only after complications develop. Small bowel intussusception and gastrointestinal bleeding are unusual presentations of metastatic melanoma, with few cases reported. Surgical resection not only provides symptom control but also positively affects prognosis. CONCLUSION: Although usually asymptomatic, melanoma metastasis should always be considered in a patient with intestinal symptoms or chronic anemia and personal history of melanoma. Surgical resection is the treatment of choice, leading to an increase in overall survival.

Pseudomyxoma peritonei presenting as irreducible epigastric hernia.

Abdominal wall hernia is a common and usually straightforward pathology presenting in surgery clinics. On occasion, the surgeon is faced with unexpected findings requiring difficult intraoperative decision. We present a case of pseudomyxoma peritonei incidentally found during surgery for epigastric hernia. The patient complained of a long lasting epigastric hernia with recent onset pain and growth. Surgery was limited to laparoscopic incisional biopsy of mucinous peritoneal deposit, confirming the diagnosis and suggesting an appendiceal origin. The patient was subsequently referred to a specialized peritoneal cancer unit for definitive treatment which consisted of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy, which can be compromised by previous organ resection. This case highlights the importance of maintaining a high level of suspicion before unusual clinical courses of common pathology.

Heterotopic mesenteric and abdominal wall ossification - Two case reports in one institution.

INTRODUCTION: Heterotopic ossification occurs when bone develops in tissues which usually don't undergo ossification. Heterotopic mesenteric ossification, also known as intra-abdominal myositis ossificans, is a rare and benign form of ossification, usually related with previous abdominal surgery or trauma. PRESENTATION OF CASES: We report two cases of heterotopic ossification both after multiple abdominal surgeries, with intraoperative findings of mesenteric and abdominal wall ossification. Histopathology revealed metaplastic bone deposition, without evidence of atypia or malignancy. DISCUSSION: This rare entity shares clinical and pathological characteristics of myositis ossificans. It is important to consider the differential diagnosis with sarcomas. In the cases described, the patients were proposed for elective surgery and this pathology was as an incidental finding. CONCLUSION: The simultaneous presence of mesenteric and abdominal wall ossification in both patients makes these cases even rarer.

Avaliaçäo morfométrica de neurônios secretores hormonais dos núcleos paraventriculares do Gallus domesticus, sob bloqueio do influxo de cálcio / Morphometric evaluation on hormonal secretory neurons of the paraventricular nucleus in Gallus domesticus, on obstruction of calcium influx

Parâmetros entre o transporte anterógrado e os níveis de cálcio foram demonstrados em neurônios isolados, e somam-se informaçoes que o fluxo axoplasmático pode estar relacionado com microtúbulos, miosina e actina em neurônios secretores hipotalâmicos. Neste estágio, procuramos verificar se há suscetilidade dos núcleos paraventrículares à açao do bloqueador de canais de cálcio (verapamil) e a decorrência do efeito sobre o transporte axoplasmático da neurossecreçao em Gallus domesticus aos 25 dias após eclosao. Os resultados da análise morfométrica com integralizador de imagem realizada após processamento segundo Bargmann e os da avaliaçao do teor proteico hipotalâmico pelo método de Lowry, foram analisados estatisticamente registrando consistência na hipótese de ser cálcio-dependente o transporte da neurossecreçao dos núcleos paraventriculares, nesta condiçao experimental.