RESUMO
Background: Male breast cancer is a rare entity, with an approximate rate of 1.1 / 100 000 in the US, with an average age of 67 years. In all cases a genetic study must be performed, in order to find mutations in known genes, and after the resolution of the disease, based on the results, a contralateral prophylactic mastectomy should be considered. Clinical case: 53 -year-old male diagnosed with right breast cancer, infiltrating ductal adenocarcinoma type, clinical stage IIB, breast cancer on 2 immediate family history, mutations of the BRCA1 gene and positive hormone receptors and Her2/Neu. He was treated with modified radical mastectomy in diseased side with subsequent neoadjuvant chemotherapy/radiotherapy. After a year of follow-up and a free behavior of disease, contralateral prophylactic mastectomy was performed. The patient progressed satisfactorily, following up to 18 months since the beginning, with no tumor activity data. Conclusions: Breast cancer in male patient has a worse prognosis than female patients, due to lower amount of tissue in breast exposed to an earlier chest spread and a different biological behavior, also a higher risk of prostate and pancreatic cancer is associated. Studies of adequate methodological quality are scarce, so that decisions are based on guidelines for breast cancer in women.
Introducción: el cáncer de mama en varones es una entidad poco frecuente, con una tasa aproximada de 1.1/100 000 habitantes en los Estados Unidos de América, con una edad media de presentación de 67 años. En todos los casos se aconseja realizar un estudio genético al paciente en búsqueda de mutaciones conocidas y después de la resolución de la enfermedad, con base en los resultados, considerar realizar una mastectomía profiláctica contralateral. Caso clínico: paciente masculino de 53 años de edad, con diagnóstico de cáncer de mama derecha, tipo adenocarcinoma canalicular infiltrante, estadio clínico IIB, con antecedentes de cáncer de mama en 2 familiares directos, mutaciones del gen BRCA1 y positivo tanto a receptores hormonales como para el gen Her2/Neu. Fue tratado con mastectomía radical modificada en lado enfermo con neoadyuvancia subsecuente a base de quimio/radioterapia, tras un año de seguimiento y con un comportamiento libre de enfermedad se realizó mastectomía profiláctica contralateral. El paciente evolucionó satisfactoriamente, en seguimiento a 18 meses sin datos de actividad tumoral. Conclusiones: el cáncer de mama en el paciente varón tiene un pronóstico peor respecto al paciente de sexo femenino, esto por la menor cantidad de tejido en mama que lo expone a una diseminación torácica más temprana y por su comportamiento más agresivo, además de asociarse a un mayor riesgo de desarrollar cáncer de próstata y páncreas, respecto a la población general. Los estudios de adecuada calidad metodológica son escasos, por lo que la toma decisiones se fundamenta en las directrices para el cáncer de mama en mujeres.
RESUMO
BACKGROUND: Mediastinal tumours in children are rare. Around 25% of them can be malignant. The thymoma is an uncommon neoplasm, and during adulthood it corresponds to 30% of anterior mediastinum tumours. The peak incidence is between 55-65 years. CLINICAL CASE: A case of lymphocytic thymoma case is reported in a 4 year old patient with no previous or associated symptomatology. There was only a volume increase on the anterior neck region. The neck radiography and neck and chest tomography confirmed an anterior mediastinal mass surrounding the aorta and vena cava, as well as multiple mediastinal lymph nodes CONCLUSIONS: Early diagnosis and complete resection are the basis for management and prognosis.
Assuntos
Timoma/cirurgia , Neoplasias do Timo/cirurgia , Idade de Início , Pré-Escolar , Feminino , Humanos , Incidência , Excisão de Linfonodo , Estadiamento de Neoplasias , Timoma/diagnóstico por imagem , Timoma/epidemiologia , Timoma/patologia , Neoplasias do Timo/diagnóstico por imagem , Neoplasias do Timo/epidemiologia , Neoplasias do Timo/patologia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Bronchogenic cyst is a malformation of the ventral portion of the intestine, which is limited by bronchial epithelium and produces alterations in the development of the tracheobronchial tree. They may be single or multiple, and are usually confined to one lung or to the mediastinum, rarely to the neck, which is a subcutaneous tissue. OBJECTIVE: The case of a 9 year old girl is reported, who presented with a clinical picture characterized by a slow-growing, asymptomatic tumour on the left side of the neck of 4 years onset. Chest X-ray, neck ultrasound and computed tomography of the neck and chest ruled out any other injury. A complete resection was performed, and the histopathological study confirmed the diagnosis of bronchogenic cyst. CONCLUSION: The symptomatology of a bronchogenic cyst is due to the compression of the vascular, digestive or air structures, as well as its size, infection and location. The treatment of choice is a surgical resection, even when asymptomatic.