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BACKGROUND: Sarcomas account for less than 1% of primary breast cancers, and breast angiosarcomas are responsible for only 0.05% of all breast malignancies. The male breast has the same potential for malignant transformation as the female breast. However, due to anatomical differences in the breast and the low incidence of angiosarcoma, it is difficult to determine how male breasts can be affected by this type of tumor. CASE PRESENTATION: A 36-year-old male patient was admitted to the hospital with a palpable lump in his right breast. Lymphadenopathy was negative. Ultrasonography showed a hypoechoic mass with partially defined contours, measuring 4.0 × 3.0 cm, with muscle infiltration. Histological examination revealed a malignant tumor. Radical mastectomy was then performed with clear surgical margins. The patient began chemotherapy with paclitaxel. Following the second cycle of chemotherapy, he presented with headache and seizures due to a frontal lobe metastasis. Twenty days after the onset of neurological symptoms, the patient died. CONCLUSIONS: Primary angiosarcomas of the male breast are extremely rare. This is the sixth case published in the literature. It is in agreement with other studies in the literature concerning clinical presentation and poor prognosis. Treatment consists in surgical removal of the tumor with clear margins and without axillary lymphadenectomy.

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ABSTRACT The making of three-dimensional virtual models is a promising technology in preoperative planning, but that is not used in the treatment of anorectal fistulas. The objective of this work is to describe the development and initial experience of the construction of a virtual three-dimensional model of the pelvic anatomy of a patient, allowing the exact identification of the relationships between the fistulous tracts of complex anorectal fistulas and the other pelvic structures. An MRI was performed on this patient, and the images were exported to the Vitrea fX Workstation® software. A radiologist did the analysis and segmentation of the images that were then sent to a three-dimensional image processor (Meshlab v. 1.3.3 - ISTI - CNR Research Center, Pisa University, Italy®). The final 3D color image was analyzed by the surgeon and used to guide the catheterization of the fistulous pathways, the internal orifice and to assist in the identification of adjacent structures. The final three-dimensional model presented a high correlation with the intraoperative findings and facilitated the surgical planning.

RESUMO A criação de modelos virtuais tridimensionais é uma tecnologia promissora no planejamento pré-operatorio, entretanto não é utilizada no tratamento de fistulas anais. O objetivo desse trabalho é descrever o desenvolvimento e a experiência inicial da construção de um modelo virtual tridimensional da anatomia pélvica de um paciente, que permite a identificação exata das relações entre os tratos fistulosos de fistulas anais complexas e as demais estruturas pélvicas. O paciente realizou uma ressonância magnética e as imagens foram exportadas para o programa Vitrea fX software Workstation®. Um radiologista realizou a analise e segmentação das imagens que, em seguida, foram enviadas para um processador de imagens tridimensionais (Meshlab v. 1.3.3 - ISTI - CNR research center, Pisa University, Italy®). A imagem 3D colorida final foi analisada pelo cirurgião e utilizada para guiar a cateterização dos trajetos fistulosos e orifício interno e para auxiliar na identificação das estruturas adjacentes. O modelo tridimensional final apresentou alta correlação com os achados intraoperatorios e facilitou o planejamento cirúrgico.

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BACKGROUND: The aim of this study was to evaluate Ki-67 and Bcl-2 antigen expression in colorectal polyps from women with breast cancer. METHODS: A randomized, controlled study was carried out in 35 women, either with or without breast cancer, who had adenomatous colorectal polyps. The patients were divided into two groups: group A (without breast cancer; control group; n = 17) and group B (with breast cancer; study group; n = 18). Immunohistochemistry was performed on the colorectal polyps to evaluate Ki-67 and Bcl-2 antigen expression. Student's t-test and the chi(2) test were used for the statistical analysis of Ki-67 and Bcl-2 expression, respectively. Statistical significance was established as P < 0.05. RESULTS: The mean percentage of Ki-67-stained nuclei in groups A and B was 36.25 +/- 2.31 and 59.44 +/- 3.34 (+/- SEM), respectively (P < 0.0001), while the percentage of cases with cells expressing Bcl-2 in groups A and B was 23.5 and 77.8%, respectively (P < 0.001). CONCLUSIONS: In the present study, there was greater proliferative activity and greater expression of the antiapoptotic protein Bcl-2 in the colorectal polyps of women with breast cancer.

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