RESUMO
A case of disseminated cysticercosis of brain, muscle subcutaneous tissue is reported and the use of musculoskeletal ultrasound in the diagnosis of the condition emphasized.
Assuntos
Cisticercose/diagnóstico , Cisticercose/tratamento farmacológico , Epilepsia/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Albendazol/uso terapêutico , Animais , Encéfalo/parasitologia , Cisticercose/complicações , Epilepsia/diagnóstico , Epilepsia/parasitologia , Feminino , Humanos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/parasitologia , Praziquantel/uso terapêutico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/parasitologia , Taenia solium/isolamento & purificação , Tomografia Computadorizada por Raios XRESUMO
In two earlier communications (Chatterjee et al 2012 Nanotechnology 23 085103, Chatterjee et al 2014 Nanotechnology 25 135101), we reported the development of a simple and unique method of synthesizing highly stable metallic copper nanoparticles (Cu NPs) with high antibacterial activity. Here we report on the cytotoxic potency of the NPs against cancer cells. The value of the IC50 dose of the Cu NPs against human skin cancer cell A-375 was found to be 1.71 µg ml-1 only, which was much less than values reported so far, and this concentration had no cytotoxic effect on normal white blood cells. The NPs caused (i) lowering of cell membrane rigidity, (ii) DNA degradation, (iii) chromosomal condensation, (iv) cell cycle arrest in the G2/M phase, (v) depolarization of the mitochondrial membrane and (vi) apoptosis of cells. Cellular apoptosis occurred in the caspase-9-mediated intrinsic pathway. This study revealed that our Cu NPs had high anticancer properties by killing tumor cells through the apoptotic pathway. Since this particle has high antibacterial activity, our Cu NPs might be developed in future as a dual action drug-anticancer as well as antibacterial.
Assuntos
Apoptose/efeitos dos fármacos , Cobre/farmacologia , Melanoma/patologia , Nanopartículas Metálicas/química , Neoplasias Cutâneas/patologia , Anisotropia , Caspase 3/metabolismo , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Membrana Celular/efeitos dos fármacos , Membrana Celular/metabolismo , Forma Celular/efeitos dos fármacos , Dano ao DNA , Humanos , Melanoma/ultraestrutura , Fluidez de Membrana/efeitos dos fármacos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Nanopartículas Metálicas/ultraestrutura , Espécies Reativas de Oxigênio/metabolismo , Neoplasias Cutâneas/parasitologia , Neoplasias Cutâneas/ultraestruturaAssuntos
Carcinoma Basocelular/parasitologia , DNA de Protozoário/genética , Infecções Oculares Parasitárias/parasitologia , Neoplasias Palpebrais/parasitologia , Ácaros/genética , Neoplasias Cutâneas/parasitologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Carcinoma Basocelular/patologia , Estudos de Casos e Controles , Infecções Oculares Parasitárias/patologia , Neoplasias Palpebrais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infestações por Ácaros , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Neoplasias Cutâneas/patologiaRESUMO
Objetivo. Estandarizar la cuantificación relativa por masa de tejido de la parasitación por Demodex folliculorum procedente de biopsias neoplásicas cutáneas de la zona periocular mediante técnicas de amplificación molecular con el objetivo de poder estudiar la posible relación de la aparición de carcinoma basocelular palpebral con la presencia y densidad del ácaro en trabajos posteriores. Material y métodos. Se desarrolló una PCR cuantitativa a tiempo real con sondas TaqMan. La PCR se probó en una serie piloto de 46 muestras reales de biopsias de carcinoma basocelular de tipo nodular. Resultados. La sensibilidad se situó con un límite de detección de entre 1 y 10 copias/μl. El 50% (23/46) de las biopsias fueron positivas a D. folliculorum. La especificidad fue del 100% confirmado mediante secuenciación. Conclusión. La técnica muestra buenos resultados de sensibilidad y especificidad que la pueden hacer útil como herramienta para estudios causa-efecto de D. folliculorum y basalioma (AU)
Objective. To standardize the relative quantification by mass of tissue parasitism by Demodex folliculorum infestation from neoplastic skin biopsies periocular using molecular amplification to study the possible relationship of the appearance of eyelid basal cell carcinoma with the presence and density of the mite in later works. Methods. A quantitative PCR was developed real-time probes TaqMan. PCR was tested in a pilot 46 actual biopsy samples nodular basal cell carcinoma series. Results. The sensitivity was placed with a detection limit of between 1 and 10 copies / μl. 50% (23/46) of the biopsies were positive for D. folliculorum. The specificity was 100% confirmed by sequencing. Conclusion. The technique shows good results for sensitivity and specificity that can make it useful as a tool for studies of cause and effect D. folliculorum and basal cell carcinoma (AU)
Assuntos
Humanos , Infestações por Ácaros/microbiologia , Ácaros/microbiologia , Neoplasias Cutâneas/parasitologia , Carcinoma Basocelular/complicações , Biópsia , Técnicas de Amplificação de Ácido Nucleico , Reação em Cadeia da PolimeraseRESUMO
OBJECTIVE: To standardize the relative quantification by mass of tissue parasitism by Demodex folliculorum infestation from neoplastic skin biopsies periocular using molecular amplification to study the possible relationship of the appearance of eyelid basal cell carcinoma with the presence and density of the mite in later works. METHODS: A quantitative PCR was developed real-time probes TaqMan. PCR was tested in a pilot 46 actual biopsy samples nodular basal cell carcinoma series. RESULTS: The sensitivity was placed with a detection limit of between 1 and 10 copies / µl. 50% (23/46) of the biopsies were positive for D. folliculorum. The specificity was 100% confirmed by sequencing. CONCLUSIONS: The technique shows good results for sensitivity and specificity that can make it useful as a tool for studies of cause and effect D. folliculorum and basal cell carcinoma.
Assuntos
Carcinoma Basocelular/parasitologia , Infestações por Ácaros/parasitologia , Ácaros/genética , Reação em Cadeia da Polimerase/métodos , Neoplasias Cutâneas/parasitologia , Animais , Biópsia/métodos , Carcinoma Basocelular/complicações , Humanos , Sensibilidade e Especificidade , Pele/parasitologia , Neoplasias Cutâneas/complicaçõesRESUMO
Advanced squamous cell carcinoma (SCC) is a challenge for treatment. It is also a risk factor for unintended infestation with diptera larvae (maggots) known as myiasis. We performed a retrospective investigation in our files from 2001 to 2014 and identified three patients with SCC-associated myiasis (three men). In all three cases, Lucilia spp. were found. A literature review using PUBMED revealed another 12 cases of SCC-associated myiasis due to different species. It is not only a disease of older age, as two of the patients were in their 20s. The male to female ratio was 2 to 1. Wound myiasis and cavity myiasis were seen in half of the cases each. Pain, bleeding, and infection were possible symptoms due to infestation but not all patients reported complaints. Treatment aims to completely remove all maggots and to prevent secondary tissue damage with blindness due to eye ball destruction as one of the worst.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Miíase/diagnóstico , Miíase/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Superinfecção/diagnóstico , Superinfecção/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/parasitologia , Carcinoma de Células Escamosas/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miíase/parasitologia , Miíase/terapia , Estudos Retrospectivos , Couro Cabeludo/parasitologia , Couro Cabeludo/patologia , Pele/parasitologia , Pele/patologia , Neoplasias Cutâneas/parasitologia , Neoplasias Cutâneas/terapia , Superinfecção/parasitologia , Superinfecção/terapiaAssuntos
Dípteros , Miíase/patologia , Infecção por Mosca da Bicheira/patologia , Neoplasias Cutâneas/patologia , Zoonoses/patologia , Adulto , Animais , Feminino , Humanos , Miíase/parasitologia , Couro Cabeludo/parasitologia , Couro Cabeludo/patologia , Infecção por Mosca da Bicheira/parasitologia , Neoplasias Cutâneas/parasitologia , Zoonoses/parasitologiaRESUMO
Myiasis is a disease caused by infestation of fly larvae in human and other vertebrate tissues. It is a skin condition common in tropical and subtropical countries and its predisposing factors are: chronic diseases, immunodeficiency, poor hygiene, senility, psychiatric disorders, skin cancers and ulcerated mucosae. We report the case of a healthy patient who after traumatic injury of a preexisting lesion showed a tumor on the dorsal region parasitized by fly larvae. The histopathological examination performed for the diagnosis of skin neoplasm surprisingly revealed the presence of a partially degenerated larva with characteristics of Dermatobia hominis, suggesting an association of primary and secondary myiasis on basal cell carcinoma.
Assuntos
Carcinoma Basocelular/patologia , Dípteros , Miíase/patologia , Neoplasias Cutâneas/patologia , Animais , Carcinoma Basocelular/parasitologia , Humanos , Masculino , Pessoa de Meia-Idade , Miíase/complicações , Neoplasias Cutâneas/parasitologiaRESUMO
Myiasis is a disease caused by infestation of fly larvae in human and other vertebrate tissues. It is a skin condition common in tropical and subtropical countries and its predisposing factors are: chronic diseases, immunodeficiency, poor hygiene, senility, psychiatric disorders, skin cancers and ulcerated mucosae. We report the case of a healthy patient who after traumatic injury of a preexisting lesion showed a tumor on the dorsal region parasitized by fly larvae. The histopathological examination performed for the diagnosis of skin neoplasm surprisingly revealed the presence of a partially degenerated larva with characteristics of Dermatobia hominis, suggesting an association of primary and secondary myiasis on basal cell carcinoma.
A miíase é uma doença causada por infestação de larvas de moscas nos tecidos humanos ou de outros animais vertebrados. É dermatose comum em países tropicais e subtropicais e tem como fatores predisponentes: doenças crônicas, imunodeficiência, má higiene, senilidade, doenças psiquiátricas, cânceres cutâneos e de mucosas ulcerados. Relata-se caso de paciente hígido que após trauma sobre lesão pré-existente, apresentou tumoração na região dorsal parasitada por larvas de moscas. O exame histopatológico realizado para o diagnóstico da neoplasia, de modo surpreendente, evidenciou a presença de uma larva parcialmente degenerada com características de Dermatobia hominis, sugerindo associação de miíase primária e secundária em carcinoma basocelular.
Assuntos
Animais , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Basocelular/patologia , Dípteros , Miíase/patologia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/parasitologia , Miíase/complicações , Neoplasias Cutâneas/parasitologiaRESUMO
Myiasis is a parasitic infestation of vital tissue of humans or other mammals by dipterous larvae. Human myiasis is a rare clinic condition but more frequently seen in tropical and subtropical areas, in patients who have poor hygiene, have bad housing conditions, are with mental retardation, or have advanced age. We report a case of myiasis in a malignant wound (squamous cell carcinoma) in the head and neck region because a few literature reports were seen in this localization. The patient's treatment was antisepsis, larval removal, and general care preventions, whereas standard treatment options or guidelines are not available.
Assuntos
Carcinoma de Células Escamosas/parasitologia , Neoplasias Faciais/parasitologia , Miíase/diagnóstico , Pescoço/parasitologia , Neoplasias Cutâneas/parasitologia , Idoso , Doença da Artéria Coronariana/complicações , Complicações do Diabetes , Seguimentos , Humanos , MasculinoRESUMO
Cutaneous angiosarcoma or lymphangiosarcoma represents an uncommon aggressive tumor known to arise on a background of chronic lymphedema secondary to various etiologies, principally following surgery or irradiation. There have been rarely reported cases of angiosarcoma following infective conditions that eventuate with lymphatic stasis. We report a case of angiosarcoma arising after 33 years within a background of filariasis. Awareness of this association can lead to early diagnosis and appropriate treatment of this potentially fatal malignant tumor.
Assuntos
Filariose/complicações , Filariose/patologia , Hemangiossarcoma/etiologia , Hemangiossarcoma/patologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologia , Idoso , Filariose/terapia , Hemangiossarcoma/parasitologia , Hemangiossarcoma/terapia , Humanos , Masculino , Neoplasias Cutâneas/parasitologia , Neoplasias Cutâneas/terapia , Fatores de TempoRESUMO
Amastigotes of the genus Leishmania have been observed in biopsies of apparently unrelated lesions in patients with AIDS and visceral leishmaniasis. We describe the case of a 40-year-old man with human immunodeficiency virus infection and severe immunodepression in whom the presence of the parasite was detected as an incidental finding on histological study of a perianal squamous cell carcinoma. This finding led to the diagnosis and subsequent treatment of previously unsuspected visceral leishmaniasis. In a review of the literature we have found no previous examples of this association.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/parasitologia , Leishmaniose Visceral/complicações , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/parasitologia , Adulto , Canal Anal , Humanos , MasculinoRESUMO
BACKGROUND: Cutaneous leishmaniasis displays considerable variation in its histopathological and clinical presentation. Clinically, it progresses from a papule into a painless ulcerated and crusted nodule/papule. Microscopically, it progresses from sheets of amastigote-filled histiocytes to granulomatous inflammation. METHODS: The study was conducted on 145 skin biopsies from untreated patients with histopathological and/or clinical suspicion of cutaneous leishmaniasis in Lebanon, Syria and Saudi Arabia (1992-2010). The pre-biopsy clinical diagnosis and demographic data were collected. Biopsies were evaluated for the major microscopic pattern, and the parasitic index (PI) was also determined. Diagnosis was confirmed by polymerase chain reaction (PCR) followed by molecular sub-speciation. RESULTS: Of the 145 patients, 125 were confirmed as cutaneous leishmaniasis by PCR. Eighteen cases presented with a pre-biopsy clinical diagnosis other than cutaneous leishmaniasis that ranged from dermatitis to neoplasm. Of the 125 cases, 57 showed a major histopathological pattern other than cutaneous leishmaniasis. Identification of amastigotes was equivocal (PI ≤1) in 38 of the 57 cases. Of interest, all the 18 cases with a pre-biopsy clinical diagnosis other than cutaneous leishmaniasis also showed atypical histopathology for cutaneous leishmaniasis. CONCLUSIONS: The manifestations of cutaneous leishmaniasis are broad and may mimic other inflammatory and neoplastic diseases. Pathologists and dermatologists should be aware of such pitfalls and can utilize PCR to confirm the diagnosis of leishmaniasis.
Assuntos
Leishmaniose Cutânea , Neoplasias Cutâneas , Adolescente , Adulto , Biópsia , Dermatite/genética , Dermatite/parasitologia , Dermatite/patologia , Diagnóstico Diferencial , Feminino , Humanos , Leishmaniose Cutânea/genética , Leishmaniose Cutânea/parasitologia , Leishmaniose Cutânea/patologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/parasitologia , Neoplasias Cutâneas/patologiaRESUMO
Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by a dramatic onset of high fever, neutrophilia and typical skin lesions. About 20 % of patients have an associated malignancy, most commonly hematologic diseases. Chronic and paucisymptomatic manifestations of Sweet syndrome may be misdiagnosed or misinterpreted as harmless, resulting in delayed diagnosis. "Atypical" manifestations are especially suspicious for associated malignancies. This is demonstrated by a 39-year old patient with chronic and afebrile disease who was referred to our clinic only after symptoms had persisted for several months. By that point, an underlying nodular lymphocyte predominant Hodgkin's lymphoma had already reached an advanced stage. Skin biopsies revealed dermal infiltrates of histiocytoid cells of myelogenous origin, supporting a diagnosis of histiocytoid Sweet syndrome. Specific cutaneous infiltrates associated with myelogenous leukemia were ruled out.
Assuntos
Histiócitos/patologia , Doença de Hodgkin/patologia , Síndromes Paraneoplásicas/patologia , Síndrome de Sweet/patologia , Adulto , Biomarcadores Tumorais , Biópsia , Diagnóstico Diferencial , Histiocitoma Fibroso Maligno/diagnóstico , Histiocitoma Fibroso Maligno/patologia , Doença de Hodgkin/diagnóstico , Humanos , Linfonodos/patologia , Linfócitos/patologia , Masculino , Neutrófilos/patologia , Síndromes Paraneoplásicas/diagnóstico , Pele/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/parasitologia , Síndrome de Sweet/diagnósticoRESUMO
BACKGROUND: Nonmelanoma skin cancers (NMSCs), the most common malignancy in kidney transplant recipients (KTRs), are more frequent and aggressive in KTR than in the general population. These phenomena could be caused by immunosuppressive treatments, both by decreasing immunosurveillance and by a direct oncogenic potential. METHODS: To assess the possible mechanisms involved in the clinical behavior of NMSC in KTR, we compared the tumoral expression of several molecule markers between 106 NMSC (basal cell carcinoma [BCC]; n=55, squamous cell carcinoma [SCC]; n=51) collected from 37 KTR and 51 control patients (CPs) from the general population. Immunohistochemical expression of transforming growth factor beta 1, epidermal growth factor receptor, protein 53 (p53), phospho-p70-S6-kinase, mammalian target of rapamycin (mTOR), and phospho-mTOR (Ser2448) were compared between KTR and CP and were also correlated with immunosuppressive therapy. RESULTS: p53 expression and transforming growth factor beta intensity were greater in SCC from KTR than from CP. In contrast, phospho-mTOR and phospho-p70S6K (Thr421Ser424) expressions were higher in SCC from CP. p53 and phospho-p70S6K (Thr389) expression were higher in BCC from KTR than from CP. Expression of the other biological markers showed no statistically significant differences between SCC and BCC from KTR treated with or without calcineurin inhibitors. CONCLUSIONS: Several prooncogenic markers showed distinct patterns of expression in NMSC from KTR. These differential characteristics could be responsible for the clinical behavior of posttransplantation NMSC. Furthermore, these markers may constitute possible targets for future therapeutic approaches to NMSC in KTR and could help to guide immunosuppressive therapy.
Assuntos
Transplante de Rim/efeitos adversos , Neoplasias Cutâneas/epidemiologia , Idoso , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/imunologia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/imunologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Quimioterapia Combinada , Feminino , Humanos , Imunocompetência , Hospedeiro Imunocomprometido , Imunossupressores/uso terapêutico , Transplante de Rim/imunologia , Masculino , Pessoa de Meia-Idade , Fenótipo , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/parasitologia , Neoplasias Cutâneas/cirurgiaRESUMO
Melanocytic skin tumors are caused by nevus cells, epidermal melanocytes and dermal melanocytes. The aim of the study was to detect the positivity of Demodex spp. in biopsy specimens of skin diagnosed as nevus. In this retrospective study, the specimens obtained from 110 patients diagnosed with nevus and stained by hematoxylin & eosin (H&E) method were assessed for Demodex. Statistical analysis was done using independent sample t test, Pearson Chi-square and Yates' adjusted Chi-square test. For statistics, p < 0.05 was considered significant. Consequently, 43 (39.1%) out of 110 specimens were detected to have Demodex spp. Demodex colonization augmented in nevi can be explained by the possible affinity of the parasite to the melanin pigment.
Assuntos
Ácaros e Carrapatos/fisiologia , Infestações por Ácaros/epidemiologia , Nevo/parasitologia , Neoplasias Cutâneas/parasitologia , Pele/parasitologia , Animais , Biópsia , Feminino , Humanos , Incidência , Masculino , Melanócitos/parasitologia , Melanócitos/patologia , Infestações por Ácaros/parasitologia , Nevo/patologia , Estudos Retrospectivos , Pele/patologia , Neoplasias Cutâneas/patologiaRESUMO
Roe deer papillomavirus (CcPV1) infection has been identified as an endemic disease in roe deer populations of the Carpathian basin in Central Europe (Hungary, Austria and Croatia). The disease is characterised by easily recognizable skin tumours similar to deer papillomavirus infection of North American deer species. In 2006, a questionnaire study was conducted among all Hungarian game management units (GMUs) in order to assess the distribution of the disease and its major epidemiological features. Categorical information was collected about disease occurrence, trend and frequency of detection, on primarily affected age classes in both sexes, and association of lesions with mortality. Replies were received from 539 GMUs representing 50.9% of total GMU territory and disease presence was reported by 295 (54.7%) GMUs. Older age classes of both sexes were found to be more affected. Association of various environmental factors with disease occurrence was evaluated and data were collected on the occurrence of similar skin lesions in other European countries. Pathological features of CcPV1 infection were described and the localisation of both CcPV1 antigen and DNA was characterised by immunohistochemistry and in situ DNA hybridisation in skin lesions. Virus presence was also demonstrated by PCR and PCR product sequencing.
Assuntos
Cervos/virologia , Infecções por Papillomavirus/veterinária , Animais , Antígenos Virais/análise , DNA Viral/genética , DNA Viral/isolamento & purificação , Europa (Continente)/epidemiologia , Cabeça/virologia , Membro Posterior/virologia , Humanos , Hungria/epidemiologia , Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/mortalidade , Infecções por Papillomavirus/patologia , Reação em Cadeia da Polimerase , Estações do Ano , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/parasitologia , Neoplasias Cutâneas/veterinária , Neoplasias Cutâneas/virologia , Inquéritos e QuestionáriosAssuntos
Doenças Nasais/diagnóstico , Rinosporidiose/diagnóstico , Dermatopatias Parasitárias/diagnóstico , Neoplasias Cutâneas/diagnóstico , Animais , Biópsia por Agulha Fina , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Nasais/parasitologia , Rinosporidiose/parasitologia , Rhinosporidium/isolamento & purificação , Dermatopatias Parasitárias/parasitologia , Neoplasias Cutâneas/parasitologia , Esporos de ProtozoáriosRESUMO
Human myiasis is a parasitosis found in tropical and underdeveloped countries. It usually affects the elderly, unhealthy and mentally disabled individuals. It is caused by dipterous that lay their eggs in necrotic or infected tissues, although areas of the body that are apparently healthy can also be affected. Frequently the fly deposits several eggs on the peripheral parts of scratches and wounds. The treatment of myiasis involves mechanical removal of the larvae with hemostatic pincers. Larvae rupture must be avoided. Application of topical ether or similar volatile substance is useful. Preventive approach measures, including basic health care, hygiene, access to primary health service, and safe water and drainage, are fundamental to prevent human myiasis. The authors present a case report of myiasis infestation over an extensive head and neck squamous cell carcinoma from a 72-year-old patient living in a rural area. Approximately 200 larvae were removed and the patient was taken to the hospital's head and neck surgery service.
Assuntos
Carcinoma de Células Escamosas/parasitologia , Neoplasias Faciais/parasitologia , Miíase/parasitologia , Neoplasias Cutâneas/parasitologia , Idoso , Carcinoma de Células Escamosas/patologia , Queixo/parasitologia , Neoplasias Faciais/patologia , Feminino , Humanos , Miíase/patologia , Neoplasias Cutâneas/patologiaRESUMO
OBJECTIVE: Primary human cerebral myiasis is an exceedingly rare condition and is almost never encountered by physicians in developed countries. The case report summarizes a case of extensive cerebral myiasis in a periurban community in the United States. CLINICAL PRESENTATION: After a minor motor vehicle accident, police brought a 75-year-old man to the emergency room because he was observed to have a large cranial lesion. Examination revealed a 15 x 17 cm frontal bone defect with eroded frontal dura, exposed cortex, and massive cortical maggot infestation. INTERVENTION: The patient was empirically treated with intravenous antibiotics for meningitis. Maggots (Phaenicia sericata, or the green bottle fly) were removed by suction, attrition, and gentle contact exposure to a mild bleach solution. Biopsy of the scalp and cranium revealed angiosarcoma, for which operative treatment was refused. The patient was transferred to a skilled nursing facility for palliative care where he died 3 months later. CONCLUSION: This is the first published case of cerebral myiasis in the United States. Although human cerebral myiasis is rare, conditions do exist in this country that permit myiasis.