Galería de imágenes de tumores malignos como herramienta didáctica en oncología / Gallery of malignancies images as didactic tool in oncology i: en

Introducción: Los tumores malignos son afecciones prevalentes que exigen un diagnóstico temprano para un tratamiento oportuno. La confección de una galería de imágenes como medio de enseñanza con la tecnología digital constituye una herramienta de aprendizaje de incuestionable valor en la especialidad de oncología. Objetivo: Confeccionar una galería de imágenes digitales de tumores malignos como medio de enseñanza alternativo para la docencia de residentes y profesionales de enfermería. Métodos: Se realizó una innovación tecnológica en el Hospital Oncológico Docente Provincial Conrado Benítez García de Santiago de Cuba, durante el bimestre enero-febrero del 2023. El objeto de estudio y el campo de acción fueron los recursos del aprendizaje y las imágenes digitalizadas sobre tumores malignos, respectivamente. Se combinaron los métodos de investigación teóricos (sistematización, vivencial y analítico sintético) y empíricos (análisis documental y encuesta en forma de cuestionario a informantes clave). Resultados: Como medio de enseñanza alternativo para la docencia médica y de enfermería, manualmente se confeccionó una galería digital con 164 imágenes de tumores malignos que incluían casi todas las localizaciones. Los expertos en informática, especialistas, residentes y enfermeras valoraron de muy adecuado el producto informático, basado en la cientificidad y la didáctica tecnológica para la formación académica integral. Conclusiones: La galería de imágenes digitales constituye una herramienta didáctica, motivacional, atractiva e interesante para el aprendizaje de las neoplasias malignas; es un recurso ilustrativo y utilitario para la docencia médica y del profesional de enfermería.

Introduction: Malignancies are prevalent affections that demand an early diagnosis for an opportune treatment. The making of an images gallery as teaching means with digital technology constitutes a learning tool of unquestionable value in the oncology specialty. Objective: To make a gallery of malignancies digital images as alternative teaching means for the residents and nursing professionals. Methods: A technological innovation was carried out in Conrado Benítez García Provincial Teaching Oncological Hospital in Santiago de Cuba, during the January-February two-month period, 2023. The study object and action field were the learning resources and the digital images on malignancies, respectively. The theoretical investigation methods (systematizing, experiential and analytic synthetic) and empiric (documental analysis and interviews in questionnaire form to key informants) were combined. Results: As alternative teaching means for medical and nursing teaching, a digital gallery was manually made with 164 malignancies images that included almost all the localizations. Computer science experts, specialists, residents and nurses valued as very appropriate the computer product, based on the scientificity and the technological didactics for the integral academic training. Conclusions: The gallery of digital images constitutes a didactic, motivational, attractive and interesting tool for learning of malignancies; it is an illustrative and utilitarian resource for medical and nursing professional teaching.

Linfoma no Hodgkin de células B primario de mama. Reporte de caso y revisión de la literatura / Primary breast B-cell non-Hodgkin's lymphoma of the breast. Case Report and review of the literature

Objetivos: Reportar un caso de linfoma no Hodgkin de células B primario de mama (LPM) y realizar una revisión de la literatura de su diagnóstico y tratamiento. Materiales y métodos: Se reporta el caso de una paciente de 80 años que acudió a una institución privada de referencia en México por un LPM. Además, se diagnosticó un melanoma primario de hígado, mediante biopsia dirigida y estudio de patología. La paciente recibió tratamiento con R-CHOP (rituximab, ciclofosfamida, doxorrubicina, vincristina y prednisona), cuadrantectomía, resección de cadenas ganglionares y radioterapia. La paciente presenta adecuada respuesta del LPM, sin embargo, el segundo tumor primario progresa llevando a la paciente a cuidados paliativos. Se realizó una búsqueda bibliográfica en Medline vía PubMed, LILACS y Google Scholar. Se incluyeron estudios de cohortes, reportes y series de casos en pacientes con LPM que abordaran el diagnóstico, tratamiento y pronóstico de esta patología, publicados en inglés y español entre los años 2000 a 2022. Resultados: Se identificaron 23 títulos, de los cuales 17 cumplieron con los criterios de inclusión, estos fueron reportes de caso y series de caso. La mayoría de las pacientes recibió un esquema quimioterapéutico R-CHOP, el cual se complementó con radioterapia. Cerca del 80 % presentó remisión completa. El sitio más frecuente de recaída fue el sistema nervioso central. La sobrevida a 5 años fue del 83,6 % en los estudios incluidos. Conclusiones: En la actualidad, el esquema CHOP -con o sin rituximab- es el más empleado y el único que ha mostrado tener un impacto positivo en la supervivencia, este suele acompañarse de radioterapia. Se requieren más estudios clínicos aleatorizados para establecer de manera más clara la efectividad y seguridad de estos tratamientos.

Objectives: To report a case of primary breast B-cell non-Hodgkin's lymphoma (PBL) and to conduct a literature review of its diagnosis and treatment. Material and methods: Case report of an 80-year-old female patient who presented to a private referral institution in Mexico, with PBL. She was also diagnosed with primary liver melanoma by means of targeted biopsy and pathology testing. The patient received treatment with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone), quadrantectomy, lymph node dissection and radiotherapy. The PBL showed good response but, because of progression of the second primary tumor, the patient went on to receive palliative care. A review of the literature was conducted in Medline via PubMed, LILACS and Google Scholar. Cohort studies, case reports and case series in patients with PBL that discussed diagnosis, treatment and prognosis of this disease, published in English and Spanish between 2000 and 2022, were included. Results: Overall, 23 titles were identified, of which 17 consisting of case reports and case series met the inclusion criteria. The majority of patients received R-CHOP as chemotherapy regimen, with irradiation as adjunct therapy. Close to 80 % went into complete remission. The most frequent site of recurrence was the central nervous system. Five-year survival was 83.6 % in the included studies. Conclusions: At present, the CHOP regimen, with or without rituximab and usually accompanied by radiotherapy, is the most widely used and the only one that has shown a positive impact on survival. Additional randomized clinical trials are needed in order to gain a clearer insight into the effectiveness and safety of these treatments.

Cáncer y COVID-19, un vínculo peligroso / Cancer and COVID-19, a dangerous association

Fundamento: La COVID-19 es una pandemia causada por el virus SARS-CoV-2 cuya asociación con el cáncer puede tener efectos adversos. Objetivo: Describir los principales vínculos entre el cáncer y la COVID-19. Metodología: Se realizó una búsqueda bibliográfica en Google Académico, SciELO y PubMed Central con los descriptores SARS-CoV-2, COVID-19 y cáncer, consultados en el DeCS. Se seleccionaron artículos a texto completo en español e inglés, principalmente de revistas arbitradas por pares. Resultados: La COVID-19 produce resultados más desfavorables en los pacientes con cáncer. Estos resultados se relacionan con altas tasas de hospitalización, complicaciones y mortalidad. La frecuente asociación de comorbilidades en pacientes con cáncer parece contribuir a este vínculo peligroso. Las vías de señalización comunes al cáncer y a la infección por el SARS-CoV-2 son citocinas proinflamatorias, interferón tipo I, receptor de andrógenos y puntos de control inmune. Este conocimiento tiene aplicación práctica en el empleo de medicamentos para combatir la COVID-19 en pacientes con cáncer. Conclusiones: El cáncer se relaciona con la COVID-19 grave, por lo que esos pacientes son más vulnerables a la infección viral.

Background: COVID-19 is a pandemic caused by the SARS-CoV-2 virus which relation with cancer may have adverse effects. Objective: To describe the main associations between cancer and COVID-19. Methodology: A literature review was conducted in Google Scholar, SciELO and PubMed Central with the descriptors SARS-CoV-2, COVID-19 and cancer, consulted in DeCS. Full-text articles in Spanish and English were selected, mainly from peer-reviewed journals. Results: COVID-19 produces more non-favorable outcomes in patients with cancer. These outcomes are related to high hospitalization rates, complications and mortality. Frequent comorbidity relations in patients with cancer seem to contribute to this dangerous association. Signaling pathways common to cancer and SARS-CoV-2 infection are proinflammatory cytokines, type I interferon, androgen receptor, and immune checkpoints. This knowledge has a practical use with drugs against COVID-19 in patients with cancer. Conclusions: Cancer is associated with severe COVID-19, making such patients more vulnerable to viral infection.

Undifferentiated embryonal liver sarcoma: case report and review of the literature. / Sarcoma hepático embrionario indiferenciado: reporte de caso y revisión de la literatura.

BACKGROUND: Undifferentiated embryonal sarcoma of the liver accounts for 9-13% of malignant tumors in the pediatric age group, and is the third primary malignant neoplasm of the liver in children. However, few cases are reported in the literature. It may manifest with fever, weight loss, pain, and abdominal tumor sensation. In addition to pathology and immunohistochemistry, imaging studies are the appropriate tools for diagnosis. CASE REPORT: We present the case of a 6-year-old female patient diagnosed with undifferentiated embryonal sarcoma of the liver by surgery and subsequent biopsy results. CONCLUSIONS: When reviewing the literature, we found that this type of malignant neoplasm is not frequent in children. However, it is important to consider this type of tumor as a cause in those cases of hepatomegaly in the pediatric age.

INTRODUCCIÓN: El sarcoma hepático embrionario indiferenciado representa el 9-13% de los tumores hepáticos malignos en la edad pediátrica y es la tercera neoplasia maligna primaria de hígado en la infancia. Sin embargo, son pocos los casos reportados en la literatura. Se puede manifestar con fiebre, pérdida de peso, dolor y sensación de tumor abdominal. Los estudios de imagen, además de los estudios anatomopatológico e inmunohistoquímico, son las herramientas adecuadas para el diagnóstico. CASO CLÍNICO: Se presenta el caso de una paciente de 6 años de edad con diagnóstico de sarcoma hepático embrionario indiferenciado mediante cirugía y posterior resultado de la biopsia. CONCLUSIONES: Al revisar la literatura se encontró que este tipo de neoplasia maligna no es frecuente en la infancia. Sin embargo, es importante considerar este tipo de tumor como causa en aquellos casos de hepatomegalia en la edad pediátrica.

Hemangiossarcoma na língua de um gato / Hemangiosarcoma in a cats tongue

Background: Hemangiosarcoma is a primary malignant neoplasm of vascular endothelial cells, common in dogs and uncommon in cats. It is characterized by being aggressive and presenting high metastatic behavior. It corresponds to 0.5% to 2% of all feline neoplasms, with more reports in shorthaired cats aged between 8 and 12.2 years old, with no predisposition for sex or breed. Among the diagnostic methods, histopathological and immunohistochemical exams stand out because they are more accurate, since the result of fine-needle aspiration biopsy is usually hidden by blood contamination. This report aims to describe a case of a hemangiosarcoma in a cats tongue. Case: A 9-year-old, female, shorthair cat with a history of weight loss, lethargy, chewing difficulty with the evolution of three months and two-day oral bleeding was attended. Physical examination revealed blood in the oral cavity, enlargement, and darkening of the tongue surface, normalized oral and ocular mucous membranes, estimated dehydration of 7%, a rectal temperature of 38.8OC, and pulmonary and cardiac auscultation without changes. The cat was hospitalized, and euthanasia was elected. Cytological and histopathological exams of the tongue were requested, which revealed a neoplastic proliferation of endothelial cells expanding and replacing the muscular layer of the tongue, forming primitive vascular structures filled with a large number of red blood cells and supported by a delicate fibrovascular stroma. There were moderate anisocytosis and anisocariosis and rare figures of mitosis. Immunohistochemical examination showed the expression of von Willebrand factor, smooth muscle vimentin, and actin in the cytoplasm of neoplastic cells, and negative staining for pancitokeratin. Discussion: According to the results of cytological, histopathological and immunohistochemical…(AU)

Hemangiossarcoma na língua de um gato / Hemangiosarcoma in a cat’s tongue

Background: Hemangiosarcoma is a primary malignant neoplasm of vascular endothelial cells, common in dogs and uncommon in cats. It is characterized by being aggressive and presenting high metastatic behavior. It corresponds to 0.5% to 2% of all feline neoplasms, with more reports in shorthaired cats aged between 8 and 12.2 years old, with no predisposition for sex or breed. Among the diagnostic methods, histopathological and immunohistochemical exams stand out because they are more accurate, since the result of fine-needle aspiration biopsy is usually hidden by blood contamination. This report aims to describe a case of a hemangiosarcoma in a cat’s tongue. Case: A 9-year-old, female, shorthair cat with a history of weight loss, lethargy, chewing difficulty with the evolution of three months and two-day oral bleeding was attended. Physical examination revealed blood in the oral cavity, enlargement, and darkening of the tongue surface, normalized oral and ocular mucous membranes, estimated dehydration of 7%, a rectal temperature of 38.8OC, and pulmonary and cardiac auscultation without changes. The cat was hospitalized, and euthanasia was elected. Cytological and histopathological exams of the tongue were requested, which revealed a neoplastic proliferation of endothelial cells expanding and replacing the muscular layer of the tongue, forming primitive vascular structures filled with a large number of red blood cells and supported by a delicate fibrovascular stroma. There were moderate anisocytosis and anisocariosis and rare figures of mitosis. Immunohistochemical examination showed the expression of von Willebrand factor, smooth muscle vimentin, and actin in the cytoplasm of neoplastic cells, and negative staining for pancitokeratin. Discussion: According to the results of cytological, histopathological and immunohistochemical

Asociación entre características de las calcificaciones mamográficas y neoplasia maligna en un hospital nacional, 2017 / Association Between Characteristics Of Mammographic Calcifications And Malignie Neoplasia In A National Hospital ­ 2017

Introducción: La presencia de calcificaciones puede ser útil para el diagnóstico de neoplasia de mama. Objetivo: Determinar la asociación entre las características de las calcificaciones mamográficas y neoplasia maligna. Métodos: Estudio observacional, analítico, retrospectivo de casos y controles. Desarrollado en la Unidad de Patología Mamaria de ginecología. Se incluyeron como casos a pacientes mujeres con mamografía sugerente de neoplasia maligna con biopsia positiva a malignidad y como controles a 67 pacientes sin evidencia histológica de neoplasia. Resultados: La edad media de los casos fue de 54,12 años, en los controles 50,34. El 50,9%(59) son mayores o iguales a 50 años, OR 2,399 IC 95% (1,125 ­ 5,114) p=0,022, de estos el 52,5% (31) tenían cáncer de mama. El 9,5%(11) presentaron calcificaciones sospechosas de malignidad, las más frecuentes, la amorfa y la fina pleomórfica. El 37,1% (43) de los casos totales correspondieron a la categoría BI-RADS 0, el 6,9% (8) a BI-RADS 1, el 8,6% (10) a BI-RADS 2, el 7,8% (9) a BI-RADS 3, el 28,4% (33)a BI-RADS 4, el 8,6% (10) a BI-RADS 5 y el 2,6% (3) a BI-RADS 6. El 72,7% (8) de pacientes con calcificaciones sospechosas de malignidad presentó cáncer de mama. En el análisis bivariado se obtuvo un OR de 4,163. IC 95% (1,043 ­ 16,606) p = 0,031. En el análisis multivariado la asociación permaneció inalterada independientemente de la edad y BI-RADS. Conclusión: La edad mayor o igual de 50 años y las calcificaciones mamográficas sospechosas de malignidad son factores asociados para el cáncer de mama.

Introduction: The presence of calcifications may be useful for the diagnosis of breast neoplasia. Objective: To determine the association between the characteristics of mammographic calcifications and malignant neoplasia. Methods: Observational, analytical, retrospective of cases and controls. Developed in the Gynecology Breast Pathology Unit. Female patients with mammogram suggestive of malignant neoplasm with a positive malignancy biopsy were included as cases, and 67 patients without histological evidence of malignancy as controls. Results: The average age of the cases was 54.12 years, in the controls 50.34. 50,.9% (59) are older than or equal to 50 years, OR 2,399 95% CI (1,125-5,114) p = 0.022, of these 52.5% (31) had breast cancer. 9.5% (11) had calcifications suspicious of malignancy, the most frequent, the amorphous and the pleomorphic fine. 37.1% (43) of the total cases have the BI-RADS 0 category, 6.9% (8) BI-RADS 1, 8.6% (10) BI-RADS 2, 7.8 % (9) BI-RADS 3, 28.4% (33) BI-RADS 4, 8.6% (10) BI-RADS 5 and 2.6% (3) BI-RADS 6. 72, 7% (8) of patients with calcifications suspected of malignancy presented breast cancer. In the bivariate analysis, an OR of 4,163 was obtained. 95% CI (1,043-16,606) p = 0,031. In the multivariate analysis the association remained unchanged regardless of age and BI-RADS. Conclusion: Age 50 years or older and mammographic calcifications suspected of malignancy are associated factors for breast cancer.

Apresentação clínica atípica de Carcinoma Espinocelular em lábio inferior / Atypical clinical presentation of squamous cell carcinoma in the lower lip

O carcinoma espinocelular (CEC) é a neoplasia maligna que mais acomete a cavidade bucal. O objetivo deste trabalho foi apresentar um caso com apresentação clínica atípica de CEC em lábio inferior num paciente HIV positivo. Paciente do gênero masculino, leucoderma, 59 anos, portador do vírus HIV, apresentava queixa de ardência no lábio inferior. Na história pregressa, relatou ter sido submetido à biópsia incisional do lábio inferior com o diagnóstico de displasia epitelial leve. Ao exame físico intrabucal apresentava o lábio inferior com um quadro compatível de queilite actínica. Na sua região central do lábio, ele se queixava de formigamento e dor do tipo "fisgada". Após duas semanas de acompanhamento, o paciente relatou piora na dor. Foi feita uma biópsia incisional da região afetada. O exame anatomopatológico foi compatível com CEC. O paciente foi encaminhado para a equipe de cirurgia de cabeça e pescoço e foi feita uma vermelhenectomia do lábio inferior. Após quatro meses, o paciente revelou ausência de sintomas e aspecto clínico normal. Pacientes HIV positivos podem apresentar maior predisposição às neoplasias malignas, diante do seu quadro de imunossupressão. O presente caso enfatiza a atenção ao exame de boca de pacientes portadores do HIV, bem como valoriza a queixa do paciente, a qual já revelava alterações sensoriais da região afetada. Vale ressaltar que os aspectos clínicos de um CEC geralmente são de uma úlcera assintomática, tendo o presente caso uma apresentação clínica atípica.

Squamous cell carcinoma (SCC) is a malignant neoplasm that most affects the oral cavity. The aim of this study was to present a case with a clinical presentation of SCC on the lower lip in an HIV positive patient. A 59-year-old male patient, leucoderma, with HIV virus, complained of burning sensation in the lower lip. In the previous history, he reported having undergone an incisional biopsy of the lower lip with the diagnosis of mild epithelial dysplasia. On intra-oral physical examination, he presented her lower lip with a compatible picture of actinic cheilitis. In his central area of the lip, he complained of tingling and "hooked" pain. After two weeks of follow-up, the patient reported worsening in pain. An incisional biopsy of the affected region was performed. The anatomopathological examination was compatible with SCC. The patient was referred to the head and neck surgery team and a lower lip vermelhenectomy was performed. After four months, the patient showed no symptoms and a normal clinical appearance. HIV positive patients may be more prone to malignant neoplasms, given their immunosuppression. The present case emphasizes the attention to the oral examination of patients with the HIV, as well as values the patient's complaint, which already revealed sensory changes in the affected region. It is worth mentioning that the clinical aspects of a SCC are usually asymptomatic ulcers, with the present case having an atypical clinical presentation.

Caracterización clínica, patológica y epidemiológica de pacientes con carcinoma diferenciado de tiroides / Clinical, pathological and epidemiological characterization of patients with thyroid differentiated carcinoma

Introducción: El diagnóstico y tratamiento de pacientes con nódulo de tiroides son un desafío clínico, instrumental, imagenológico y patológico, y a pesar de que no representan un problema de salud en Cuba, afecta a un grupo importante de la población, fundamentalmente en edad laboral. Objetivo: Determinar las características clínicas, patológicas y epidemiológicas de pacientes con carcinoma bien diferenciado de tiroides. Métodos: Se realizó un estudio descriptivo y transversal de 30 pacientes con cáncer bien diferenciado de tiroides, operados en el Hospital Oncológico Conrado Benítez García de Santiago de Cuba, desde enero de 2014 hasta julio de 2017 y que recibieron tratamiento oncoespecífico, para lo cual se revisaron las historias clínicas y los informes de biopsia de cada uno. Resultados: En la serie predominaron las mujeres de 40-49 años de edad, los afectados de piel mestiza y negra, el aumento de volumen de la glándula, los nódulos hipoecogénicos, el tumor papilar, además de la infiltración capsular y la permeabilización vascular entre los factores pronósticos histológicos más comunes. Conclusiones: Existen elementos clínicos, epidemiológicos e imagenológicos para diagnosticar un presunto carcinoma bien diferenciado de tiroides.

Introduction: The diagnosis and treatment of patients with thyroid node are a clinical, instrumental, imagenological and pathological challenge, and although they does not represent a health problem in Cuba, they affect an important populational group, fundamentally in working periods. Objective: To determine the clinical, pathological and epidemiological characteristics of patients with well differentiated carcinoma of thyroid. Method: A descriptive and cross-sectional study of 30 patients with well differentiated cancer of thyroid, operated in Conrado Benítez García Oncological Hospital belonging to Santiago de Cuba was carried out from January, 2014 to July, 2017 and who received onchospecific treatment , for which the medical records and the biopsy reports were reviewed from each patient. Results: In the series the 40-49 year-old women , those patients affected of mestizo and black skin, the increase of the gland volume, the hypoechogenic nodules and the papillary tumor prevailed, besides the capsular infiltration and the vascular permeabilization among the most common histological prognosis factors. Conclusions: Clinical, epidemiological and imagenological elements exist to diagnose a presumed well differentiated carcinoma of thyroid.

Trombosis segmentaria sigmoidea consecuente a neoplasia maligna de colon. A propósito de un caso interesante / Sigmoid segmental thrombosis consequent to colon malignant neoplasia. On the purpose of a case

RESUMEN Se presentó un caso de una paciente de 78 años de edad, procedente del municipio de Calimete, con antecedentes patológicos personales de infarto agudo miocárdico sin elevación del segmento ST e hipertensión arterial. Llegó a la Unidad de Cuidados Intensivos de Emergencia, de Colón con un estado toxico infeccioso severo. Fue intervenida quirúrgicamente con el diagnóstico presuntivo de una trombosis mesentérica. Se constató dicho diagnóstico complementario a una neoplasia maligna de colon sigmoides. Falleció producto a un shock séptico refractario a aminas. En la necropsia se reportaron hallazgos de interés (AU).

ABSTRACT The authors present the case of a 78-years-old female patient from the municipality of Calimete, with personal pathological antecedents of acute myocardial infarct without ST segment elevation and arterial hypertension. She arrived to the Emergency Intensive Care Unit of Colon with a severe toxic-infectious status. She underwent a surgery with a presumptive mesenteric thrombosis. It was stated that diagnosis, complementary to a sigmoid colon malignant neoplasia. She died as a product of an amine-refractory septic shock. The autopsy showed findings of interest (AU).

Trombosis segmentaria sigmoidea consecuente a neoplasia maligna de colon. A propósito de un caso interesante / Sigmoid segmental thrombosis consequent to colon malignant neoplasia. On the purpose of a case

RESUMEN Se presentó un caso de una paciente de 78 años de edad, procedente del municipio de Calimete, con antecedentes patológicos personales de infarto agudo miocárdico sin elevación del segmento ST e hipertensión arterial. Llegó a la Unidad de Cuidados Intensivos de Emergencia, de Colón con un estado toxico infeccioso severo. Fue intervenida quirúrgicamente con el diagnóstico presuntivo de una trombosis mesentérica. Se constató dicho diagnóstico complementario a una neoplasia maligna de colon sigmoides. Falleció producto a un shock séptico refractario a aminas. En la necropsia se reportaron hallazgos de interés.

ABSTRACT The authors present the case of a 78-years-old female patient from the municipality of Calimete, with personal pathological antecedents of acute myocardial infarct without ST segment elevation and arterial hypertension. She arrived to the Emergency Intensive Care Unit of Colon with a severe toxic-infectious status. She underwent a surgery with a presumptive mesenteric thrombosis. It was stated that diagnosis, complementary to a sigmoid colon malignant neoplasia. She died as a product of an amine-refractory septic shock. The autopsy showed findings of interest.

Carcinoma de glândulas hepatoides em caninos / Hepatoid gland carcinoma in dogs

O carcinoma de glândulas hepatoides é uma neoplasia maligna, de origem epitelial, que acomete cães machos inteiros e com idade avançada. O presente trabalho relata o caso de dois caninos machos, o primeiro da raça Teckel e o segundo sem raça definida, 13 anos e15 anos de idade respectivamente, o segundo apresentando sintomas de hematúria e piúria, com histórico de ectoparasitismo e que apresentavam nódulo em região de prepúcio. Foram realizados exames pré-operatórios e de pesquisa de metástase os quais não indicaram nada digno de nota. Houve o direcionamento para a realização de excisão cirúrgica dos nódulos os quais foram encaminhados para histopatologia e tiveram como diagnóstico morfológico o carcinoma de glândulas hepatoides. (AU)

Hepatoid gland carcinoma is a malignant neoplasm of epithelial origin that affects whole male dogs with advanced age. The present study reports the case of two male canines, the first of the Teckel breed and the second of no defined breed, 13 years and 15 years of age respectively, the second presenting symptoms of hematuria and pyuria, with a history of ectoparasitism and who presented with a nodule in foreskin region. Preoperative and metastatic research examinations were performed which indicated nothing of note. The patients were referred for surgical excision of the nodules, which were referred for histopathology and their morphological diagnosis was carcinoma of the hepatoid glands.(AU)

Utilidade da tomografia de tórax no seguimento pós-ressecção cirúrgica em pacientes com carcinoma de células não pequenas do pulmão / Usefulness of chest tomography in the follow-up after surgical resection in patients with non-small cell lung carcinoma

Introdução: O câncer de pulmão passou de uma doença rara no início do século XX para a neoplasia mais letal em todo o mundo. A maioria dos casos são diagnosticados em estágios avançados e somente cerca de 25% desses doentes são passíveis de tratamento cirúrgico no momento do diagnóstico. A cirurgia continua sendo a melhor chance de cura para o câncer de pulmão não pequenas células (CPNPC), variando suas taxas de sucesso conforme o estádio da doença. Apesar dos avanços no tratamento e detecção precoce, os pacientes submetidos a tratamento definitivo para o CPNPC permanecem em risco de recorrência ou de aparecimento de segundo câncer primário de pulmão. O risco de recorrência é estimado entre 2% e 3% por ano, por paciente, e entre 1% a 4% por ano para o aparecimento de segunda neoplasia primária de pulmão. Ainda não há consenso sobre o melhor modo de seguir esses pacientes depois de terminado o tratamento oncológico. As maiores divergências se referem a quais exames devem ser realizados e o intervalo de tempo. Objetivo Principal: Avaliar o impacto da tomografia computadorizada do tórax no seguimento de pacientes operados por câncer de pulmão de células não pequenas, na detecção de recidiva ou segunda neoplasia primária de pulmão. Materiais e métodos: Foram estudados pacientes do A.C.Camargo Cancer Center com diagnóstico de neoplasia maligna primária do pulmão, submetidos à ressecção cirúrgica completa no período de 2007 a 2015. Avaliadas todas as consultas de seguimento, quantas tomografias de tórax (TC) os pacientes realizaram e se apresentaram alterações. Os pacientes foram classificados em quatro grupos: recidiva sistêmica e locorregional da neoplasia pulmonar; segunda neoplasia primária de pulmão; segunda neoplasia primária extrapulmonar e ausência de neoplasia. Resultados: A idade mediana foi de 67 anos e a maioria eram homens (56,1%) e tabagistas (61,5%). O tipo histológico predominante foi o adenocarcinoma (67,3%) e a cirurgia mais realizada foi a lobectomia (67,6%). A maioria dos pacientes encontrava-se no estágio IA (53,4%) e algum tipo de tratamento adjuvante foi realizado em 41 pacientes (27,7%). O tempo mediano de seguimento foi de 40,1 meses. Foram identificados 65 pacientes (43,9%) com exame suspeito para recidiva ou segunda neoplasia primária sendo a maioria deles assintomáticos. Desses pacientes, 53 (81,5%) tiveram a tomografia de tórax como o exame suspeito. Em 51 pacientes (78,4%) a suspeita foi detectada na consulta de rotina. No desfecho, encontramos 26 pacientes (40%) com recidiva da doença; 17 pacientes (26%) com segunda neoplasia primária de pulmão; 10 pacientes (15%) com segunda neoplasia primária extrapulmonar e 12 pacientes (18%) sem neoplasia. Com relação ao número de tomografias realizadas, evidenciamos que 73,4% dos pacientes realizaram menor número de tomografias do que estabelecido pelo nosso protocolo de seguimento. Entretanto, o fato de realizar menos tomografias do que o preconizado não interferiu na sobrevida global (p=0,08). Conclusões: O presente estudo mostra que alterações na TC de tórax foram os primeiros sinais de recidiva e principalmente de segundas neoplasias primarias do pulmão. A maioria desses pacientes era assintomática, demostrando importância na realização do exame no seguimento. Houve uma tendência maior para o não cumprimento do protocolo da instituição quanto à periodicidade, porém isso não demonstrou impacto na sobrevida (AU)

Introduction: Lung cancer has gone from a rare disease in the early 20th century to the most lethal neoplasm worldwide. Most cases are diagnosed in advanced stages and only about 25% of these patients are eligible for surgical treatment at the time of diagnosis. Surgery remains the best chance of cure for non-small cell lung cancer, with varying success rates depending on the stage of the disease. Despite advances in treatment and early detection, patients undergoing definitive treatment for non-small cell lung cancer (NSCLC) remain at risk for recurrence and second primary lung cancer. The risk of recurrence is estimated between 2% and 3% per year per patient and between 1% and 4% per year for the appearance of second primary lung cancer. Currently, there is no consensus in the literature on the best way to follow these patients. The greatest divergences concern which exams should be performed and the time interval. Main Objective: To evaluate the impact of computed tomography of the thorax on the follow-up of patients operated by non-small cell lung cancer, in the detection of recurrence or second primary lung cancer. Materials and Methods: We studied patients from the AC Camargo Cancer Center with diagnosis of primary malignant cancer of the lung who underwent complete surgical resection in the period from 2007 to 2015. All follow-up consultations were evaluated, how many chest tomograms were performed and whether there were changes. Patients were classified into four groups: systemic and locoregional recurrence of pulmonary neoplasia; second primary lung cancer; second extrapulmonary primary neoplasia and absence of neoplasia. Results: The median age was 67 years and the majority were men (56.1%) and smokers (61.5%). The predominant histological type was adenocarcinoma (67.3%) and pulmonary lobectomy (67.6%). The majority of patients were in stage IA (53.4%) and some type of adjuvant treatment was performed in 41 patients (27.7%). The median follow-up time was 40.1 months. Sixty-five patients (43.9%) were identified with suspicious examination for relapse or second primary cancer, the majority of them being asymptomatic. Of these patients, 53 (81.5%) had the chest tomography as the suspicious examination. In 51 patients (78.4%) the suspicion was detected at the routine appointment. In the endpoint, we found 26 patients (40%) with recurrence of the disease; 17 patients (26%) with second primary lung cancer; 10 patients (15%) with second extrapulmonary primary cancer and 12 patients (18%) without cancer. Regarding the number of CT scans, 73.4% of the patients performed a number below that established by the institution's follow-up protocol, but this did not influence overall survival (p = 0.08). Conclusions: The present study shows that changes in chest CT were the first signs of relapse and mainly of second primary lung cancer. Most of these patients were asymptomatic, showing importance in the follow-up examination. There was a greater tendency for noncompliance with the institution's protocol regarding periodicity, but this did not show an impact on survival (AU)

Surgical excision of polymorphous adenocarcinoma in the left maxilla with mucocutaneous flap reconstruction / Exérese de adenocarcinoma polimorfo em maxila esquerda com reconstrução a base de retalho mucocutâneo

ABSTRACT Low-grade polymorphous adenocarcinoma is a malignant neoplasm of salivary glands with uncommon occurrence in the head and neck region, almost exclusively affecting minor salivary glands. While this condition has typical clinical pathological signs, it commonly presents low biological damage potential. The lesions occur more frequently among elderly females between the sixth and eighth decades of life, with a higher prevalence for the hard palate, soft palate and, most regularly, the upper lip and jugal mucosa. The clinical and histological differential diagnosis of this condition is between pleomorphic adenoma and adenoid cystic carcinoma. The most indicated surgical treatment is extensive surgical excision, eventually including resection of the underlying bone. Although infrequent, there may be metastasis for regional lymph nodes. Radical dissection of the neck is not indicated unless there is clinical evidence of cervical metastasis. The present study reports the case of surgical excision of polymorphous adenocarcinoma in the left maxillary tuberosity region. A 63-year-old white male patient sought the Maxillofacial Surgery and Traumatology Service at the Federal University of Pernambuco Clinics Hospital, complaining of a tumor-like lesion in his left maxilla, which gradually increased in volume. The patient further reported a history of surgery ten years before for removal of a tooth in the same region, upper left arch. Given the extent and complexity of the lesion, the surgical treatment in this case consisted of hemimaxillectomy.

RESUMO O adenocarcinoma polimorfo de baixo grau é uma neoplasia maligna das glândulas salivares incomum em região de cabeça e pescoço, ocorre quase exclusivamente em glândulas salivares menores. Entretanto essa patologia apresenta sinais clínico patológicos próprios e baixo potencial biológico. A lesão ocorre com maior frequência em indivíduos idosos do gênero feminino, entre a sexta e oitava década de vida, com maior prevalência para as regiões do palato duro, palato mole, sendo o lábio superior e a mucosa jugal as outras localizações mais comuns. O diagnóstico diferencial tanto clínico quanto histológico é feito com o adenoma pleomórfico e o carcinoma adenoide cístico. O tratamento cirúrgico mais indicado é a excisão cirúrgica ampla, incluindo algumas vezes a ressecção do osso subjacente. Podem ocorrer metástases para os linfonodos regionais, porém são incomuns. A dissecção radical do pescoço não está indicada a menos que haja uma evidência clínica de metástase cervical. O presente estudo objetiva relatar um caso clínico de exérese de adenocarcinoma polimorfo em região de tuberosidade maxilar esquerda. Paciente do gênero masculino, com 63 anos de idade, leucoderma, procurou o Serviço de Cirurgia e Traumatologia Buco Maxilo Facial do Hospital das Clínicas da Universidade Federal de Pernambuco, relatando que aproximadamente 10 anos, havia realizado uma exodontia na arcada superior esquerda e a partir desse procedimento cirúrgico, surgiu uma tumoração a nível de maxilar esquerdo, que foi aumentando de volume gradativamente. Diante da extensão e complexidade da lesão se fez necessário realizar a hemimaxilectomia.

Carcinoma de glândulas hepatoides em caninos / Hepatoid gland carcinoma in dogs

O carcinoma de glândulas hepatoides é uma neoplasia maligna, de origem epitelial, que acomete cães machos inteiros e com idade avançada. O presente trabalho relata o caso de dois caninos machos, o primeiro da raça Teckel e o segundo sem raça definida, 13 anos e 15 anos de idade respectivamente, o segundo apresentando sintomas de hematúria e piúria, com histórico de ectoparasitismo e que apresentavam nódulo em região de prepúcio. Foram realizados exames pré-operatórios e de pesquisa de metástase os quais não indicaram nada digno de nota. Houve o direcionamento para a realização de excisão cirúrgica dos nódulos os quais foram encaminhados para histopatologia e tiveram como diagnóstico morfológico o carcinoma de glândulas hepatoides.

Hepatoid gland carcinoma is a malignant neoplasm of epithelial origin that affects whole male dogs with advanced age. The present study reports the case of two male canines, the first of the Teckel breed and the second of no defined breed, 13 years and 15 years of age respectively, the second presenting symptoms of hematuria and pyuria, with a history of ectoparasitism and who presented with a nodule in foreskin region. Preoperative and metastatic research examinations were performed which indicated nothing of note. The patients were referred for surgical excision of the nodules, which were referred for histopathology and their morphological diagnosis was carcinoma of the hepatoid glands.

Tumor maligno da bainha perineural retrobulbar e intracraniano em cão: relato de caso / Malignant neoplasm of the perineural sheath retrobulbar and intracranial in dog: case report

Os tumores da bainha perineural são pouco frequentes em animais domésticos. Relata-se o caso de um cão, sem raça definida, de cinco anos, fêmea, com histórico de aumento de volume em região retrobulbar do globo ocular direito (GOD) havia três semanas. Ao exame clínico, constatou-se a presença de uma neoformação retrobulbar direita com deslocamento do globo ocular cranialmente. Aos exames realizados durante o internamento, não foi possível localizar a origem e a extensão da neoformação. O animal veio a óbito por parada cardiorrespiratória e foi encaminhado para a necropsia. À avaliação macroscópica, observou-se neoformação esbranquiçada fixada à base do crânio em região selar, com possível origem no terceiro (III) par de nervos cranianos, a qual se infiltrava no encéfalo na altura do hipotálamo, estendia-se caudalmente em direção ao tronco encefálico e cranialmente à órbita direita, comprimindo, assim, o GOD. Microscopicamente consistia de feixes curtos entrelaçados ou enovelados de células fusiformes com pleomorfismo discreto a moderado, alternando-se a áreas de necrose multifocalmente, compatível com tumor da bainha perineural. Ao exame imuno-histoquímico, apresentou marcação fraca para S100 e GFAP e marcação positiva para vimentina, o que indica caráter maligno.(AU)

Tumors of the perineural sheath are uncommon in domestic animals. We report the case of a 5-year-old female dog with a history of increased volume in the retrobulbar region of the right eye (RE) three weeks ago. The clinical examination revealed a presence of a right retrobulbar neoformation with cranial ocular globe displacement. In the examinations carried out during hospitalization, it was not possible to locate a source and an extension of the neoformation. The animal died of cardiorespiratory arrest and was referred to an autopsy. The macroscopic evaluation revealed a whitish neoformation fixated to the base of the skull in a seal region, with a possible non-III origin of cranial nerves, infiltrating non-encephalon at the height of the hypothalamus, extending caudally towards the brainstem and cranially to the orbit right, compressing RE. Microscopically it consisted of short bundles intertwined or enovelados of spindle cells with discrete to moderate pleomorphism, alternating to areas of multifocal necrosis, compatible with tumor of the perineural sheath. Immunohistochemical examination showed weak marking for S100 and GFAP and positive marking for vimentin, indicating malignancy.(AU)

Parotid gland adenocarcinoma in a cow: case report / Adenocarcinoma de glândula parótida em vaca: relato de caso

A 9-year-old Girolando dairy cow, weighing 400kg, with a history of increased volume in the right parotid region, which extended to the submandibular region, was assisted. Fine needle aspiration cytology was performed, and the cytological findings were consistent with malignant neoplasm of epithelial origin (carcinoma). Because of the unfavorable prognosis, the animal was euthanized and submitted to an anatomopathological examination. Samples of the increased parotid and affected lymph nodes were collected for histopathological evaluation. The microscopic changes were accentuated features of anaplasia, moderate cell proliferation, atypical mitotic figures, and necrosis. Stroma ranged from delicate to scirrhous, and the tumor boundaries were not distinct. These findings substantiated the preliminary histomorphological diagnosis of undifferentiated carcinoma with metastasis in lymph nodes. Immunohistochemical tests were performed with anti-CK Pan (clone AE1AE3), anti-CK HMW (clone 34ßE12), anti-CK19 (clone RCK108), anti-vimentin (clone V9), anti-S100 (polyclonal), and anti-androgen (polyclonal) antibodies. The immunophenotype favored the diagnosis of salivary gland adenocarcinoma. Despite the rareness in cattle, salivary gland adenocarcinoma should be considered in the differential diagnosis of diseases that occur with increased volume in the head, lymphadenopathy, drooling, dysphagia, and progressive weight loss.(AU)

Foi atendida uma vaca da raça Girolando, de nove anos de idade, de aptidão leiteira, pesando aproximadamente 400kg e com histórico de aumento de volume na região parotídea e submandibular direita. Diante do prognóstico desfavorável, o animal foi submetido à eutanásia e encaminhado para exame anatomopatológico. Fragmentos da glândula parótida e dos linfonodos alterados foram colhidos e encaminhados para exame histopatológico. À avaliação microscópica, observaram-se acentuada anaplasia, moderada proliferação celular, figuras de mitose atípicas e focos de necrose. O estroma variava de delicado a esquirroso e os limites do tumor eram imprecisos. Esses achados fundamentaram o diagnóstico de carcinoma indiferenciado com metástase em linfonodos. No exame imuno-histoquímico, foram utilizados anticorpos primários monoclonais anti-CK Pan (clone AE1AE3), anti-CK alto peso molecular (clone 34ßE12), anti-CK19 (clone RCK108), antivimentina (clone V9), anti-S100 (policlonal) e antirreceptor de andrógenos (policlonal). As células neoplásicas apresentaram imunomarcação para todos os anticorpos testados, resultado que favorece o diagnóstico de adenocarcinoma de glândula salivar. Embora raro em bovinos, o adenocarcinoma de glândula salivar deve ser considerado no diagnóstico diferencial de doenças que cursam com aumento de volume na cabeça, linfadenopatia salivação, disfagia e emagrecimento progressivo.(AU)

Parotid gland adenocarcinoma in a cow: case report / Adenocarcinoma de glândula parótida em vaca: relato de caso

A 9-year-old Girolando dairy cow, weighing 400kg, with a history of increased volume in the right parotid region, which extended to the submandibular region, was assisted. Fine needle aspiration cytology was performed, and the cytological findings were consistent with malignant neoplasm of epithelial origin (carcinoma). Because of the unfavorable prognosis, the animal was euthanized and submitted to an anatomopathological examination. Samples of the increased parotid and affected lymph nodes were collected for histopathological evaluation. The microscopic changes were accentuated features of anaplasia, moderate cell proliferation, atypical mitotic figures, and necrosis. Stroma ranged from delicate to scirrhous, and the tumor boundaries were not distinct. These findings substantiated the preliminary histomorphological diagnosis of undifferentiated carcinoma with metastasis in lymph nodes. Immunohistochemical tests were performed with anti-CK Pan (clone AE1AE3), anti-CK HMW (clone 34ßE12), anti-CK19 (clone RCK108), anti-vimentin (clone V9), anti-S100 (polyclonal), and anti-androgen (polyclonal) antibodies. The immunophenotype favored the diagnosis of salivary gland adenocarcinoma. Despite the rareness in cattle, salivary gland adenocarcinoma should be considered in the differential diagnosis of diseases that occur with increased volume in the head, lymphadenopathy, drooling, dysphagia, and progressive weight loss.(AU)

Foi atendida uma vaca da raça Girolando, de nove anos de idade, de aptidão leiteira, pesando aproximadamente 400kg e com histórico de aumento de volume na região parotídea e submandibular direita. Diante do prognóstico desfavorável, o animal foi submetido à eutanásia e encaminhado para exame anatomopatológico. Fragmentos da glândula parótida e dos linfonodos alterados foram colhidos e encaminhados para exame histopatológico. À avaliação microscópica, observaram-se acentuada anaplasia, moderada proliferação celular, figuras de mitose atípicas e focos de necrose. O estroma variava de delicado a esquirroso e os limites do tumor eram imprecisos. Esses achados fundamentaram o diagnóstico de carcinoma indiferenciado com metástase em linfonodos. No exame imuno-histoquímico, foram utilizados anticorpos primários monoclonais anti-CK Pan (clone AE1AE3), anti-CK alto peso molecular (clone 34ßE12), anti-CK19 (clone RCK108), antivimentina (clone V9), anti-S100 (policlonal) e antirreceptor de andrógenos (policlonal). As células neoplásicas apresentaram imunomarcação para todos os anticorpos testados, resultado que favorece o diagnóstico de adenocarcinoma de glândula salivar. Embora raro em bovinos, o adenocarcinoma de glândula salivar deve ser considerado no diagnóstico diferencial de doenças que cursam com aumento de volume na cabeça, linfadenopatia salivação, disfagia e emagrecimento progressivo.(AU)

Comparación de tres índices ecográficos para evaluación del riesgo de malignidad de los tumores anexiales / Comparison of three ultrasound index in evaluating the risk of malignancy of adnexal tumors

Resumen Objetivo: Determinar y comparar el rendimiento diagnóstico de las Reglas Ecográficas Simples (RES), Índice Morfológico Ecográfico (IME) e Índice de Riesgo de Malignidad de Jacobs (IRM) en el diagnóstico de benignidad o malignidad de un tumor anexial. Material y método: Estudio retrospectivo, transversal y analítico efectuado en el Hospital Militar de Especialidades de la Mujer y Neonatología de la Ciudad de México. Se incluyeron pacientes con diagnóstico ecográfico de tumor anexial intervenidas quirúrgicamente. Se estudió el rendimiento diagnóstico de los índices comparado con el diagnóstico histopatológico mediante tablas de contingencia. Resultados: Se analizaron 141 pacientes y 166 tumores; 22 casos fueron bilaterales. De la muestra analizada, 79 eran pacientes premenopáusicas y 62 posmenopáusicas. Los casos de neoplasia maligna fueron 43 (26%) y benigna 123 (74%). El Índice Morfológico Ecográfico tuvo sensibilidad de 98.8%, especificidad de 33.3%, valor predictivo positivo de 33.9% y valor predictivo negativo de 97.6%. Las Reglas Ecográficas Simples reportaron una sensibilidad de 97.2%, especificidad de 71.1%, valor predictivo positivo de 55.6% y valor predictivo positivo de 98.6%; y el Índice de Riesgo de Malignidad de Jacobs una sensibilidad de 72.7%, especificidad de 79.3%, valor predictivo positivo de 55.8% y valor predictivo positivo de 89.4%. Conclusiones: Las Reglas Ecográficas Simples son un modelo prequirúrgico que en 82% de los casos permitieron clasificar los tumores anexiales en benignos o malignos. Los casos indeterminados deben ser reevaluados por un ecografista experto. El método es reproducible por evaluadores de mediana experiencia y susceptible de aplicarse en instituciones hospitalarias de segundo y tercer nivel de atención.

Abstract Objective: To determine and compare the diagnostic performance of the Simple Ultrasound-Based Rules (SUR), Sonographic Morphology Index (SMI) and the Jacob´s Risk Malignancy Index (RMI) in the diagnosis of benignity or malignancy to an adnexal tumor. Materials and methods: Retrospective, cross-sectional and analytical study at the at the Hospital Militar de Especialidades de la Mujer y Neonatología of Mexico City. Patients with ultrasound diagnosis of adnexal tumor who underwent surgery were included. The diagnostic performance of the indices compared to histopathological diagnosis was studied using contingency tables. Results: 141 women and 166 tumors were included for analysis, 22 cases were bilateral. Of the sample analyzed, 79 were premenopausal and 62 postmenopausal. Cases of malignant neoplasm were 43 (25.9%) and benign 123 (74.1%). The SMI had a sensitivity of 98.8%, specificity of 33.3%, positive predictive value (PPV) of 33.9%, and negative predictive value (NPV) of 97.6%. SUR showed a sensitivity of 97.2%, specificity of 71.1%, PPV of 55.6% and NPV of 98.6%; And RMI had a sensitivity of 72.7%, specificity of 79.3%, PPV of 55.8% and NPV of 89.4%. Conclusions: The simple ultrasonographic rules are a presurgical model that in 82% of the cases allowed to classify the adnexal tumors in benign or malignant. Indeterminate cases should be reevaluated by an expert sonographer. The method is reproducible by evaluators of medium experience and susceptible of being applied in hospital institutions of the second and third level of care.

Tumor maligno da bainha perineural retrobulbar e intracraniano em cão: relato de caso / Malignant neoplasm of the perineural sheath retrobulbar and intracranial in dog: case report

Os tumores da bainha perineural são pouco frequentes em animais domésticos. Relata-se o caso de um cão, sem raça definida, de cinco anos, fêmea, com histórico de aumento de volume em região retrobulbar do globo ocular direito (GOD) havia três semanas. Ao exame clínico, constatou-se a presença de uma neoformação retrobulbar direita com deslocamento do globo ocular cranialmente. Aos exames realizados durante o internamento, não foi possível localizar a origem e a extensão da neoformação. O animal veio a óbito por parada cardiorrespiratória e foi encaminhado para a necropsia. À avaliação macroscópica, observou-se neoformação esbranquiçada fixada à base do crânio em região selar, com possível origem no terceiro (III) par de nervos cranianos, a qual se infiltrava no encéfalo na altura do hipotálamo, estendia-se caudalmente em direção ao tronco encefálico e cranialmente à órbita direita, comprimindo, assim, o GOD. Microscopicamente consistia de feixes curtos entrelaçados ou enovelados de células fusiformes com pleomorfismo discreto a moderado, alternando-se a áreas de necrose multifocalmente, compatível com tumor da bainha perineural. Ao exame imuno-histoquímico, apresentou marcação fraca para S100 e GFAP e marcação positiva para vimentina, o que indica caráter maligno.(AU)

Tumors of the perineural sheath are uncommon in domestic animals. We report the case of a 5-year-old female dog with a history of increased volume in the retrobulbar region of the right eye (RE) three weeks ago. The clinical examination revealed a presence of a right retrobulbar neoformation with cranial ocular globe displacement. In the examinations carried out during hospitalization, it was not possible to locate a source and an extension of the neoformation. The animal died of cardiorespiratory arrest and was referred to an autopsy. The macroscopic evaluation revealed a whitish neoformation fixated to the base of the skull in a seal region, with a possible non-III origin of cranial nerves, infiltrating non-encephalon at the height of the hypothalamus, extending caudally towards the brainstem and cranially to the orbit right, compressing RE. Microscopically it consisted of short bundles intertwined or enovelados of spindle cells with discrete to moderate pleomorphism, alternating to areas of multifocal necrosis, compatible with tumor of the perineural sheath. Immunohistochemical examination showed weak marking for S100 and GFAP and positive marking for vimentin, indicating malignancy.(AU)