RESUMO
Patients with systemic lupus erythematosus have a higher incidence of neoplasms associated with human papillomavirus infections, such as those that affect the vulva, the vagina, and the cervix; however, little is known about the frequency of anal cancer among these patients. Although there are recommendations for screening for this cancer in immunosuppressed individuals, it is possible that this procedure is not strictly followed. We describe the case of a 47-year-old woman with systemic lupus erythematosus who was treated with immunosuppressants and developed advanced anal squamous cell carcinoma after adequate treatment and healing of a high-grade cervical squamous intraepithelial lesion. Five years after the completion of the anal cancer treatment, the patient presented with cystic hepatic lesions that were histopathologically confirmed to be metastatic squamous cell carcinoma. This report aimed to highlight the need for anal cancer screening in patients with lupus, particularly if there was a history of cervical cytopathological alterations. (AU)
Resumo Pacientes com lúpus eritematoso sistêmico apresentam maior incidência de neoplasias associadas a infecções por HPV, como aquelas que acometem a vulva, a vagina e o colo do útero, mas pouco se sabe sobre a frequência de câncer anal entre essas pacientes. Embora existam recomendações para o rastreamento desse câncer em indivíduos imunossuprimidos, é possível que esse procedimento não esteja sendo rigorosamente seguido. Descrevemos uma mulher de 47 anos com lúpus eritematoso sistêmico, tratada com imunossupressores, que desenvolveu um carcinoma escamocelular anal avançado após tratamento adequado e cicatrização de lesão intraepitelial escamosa cervical de alto grau. Cinco anos após o término do tratamento do câncer anal, a paciente apresentou lesões císticas hepáticas cujo resultado citopatológico confirmou ser carcinoma escamocelular metastático. O presente relato teve como objetivo chamar atenção para a necessidade do rastreamento do câncer anal em pacientes com lúpus, principalmente se houver história prévia de alterações citopatológicas cervicais. (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias do Ânus/diagnóstico , Carcinoma Adenoescamoso , Lúpus Eritematoso Sistêmico , Infecções por Papillomavirus , Neoplasias Hepáticas/secundárioRESUMO
Adenosquamous carcinoma is characterized by the simultaneous presence of squamous and glandular components. This article reports a case of adenosquamous carcinoma in the oral mucosa in a dog. Microscopically, the tumour revealed an infiltrative epithelial proliferation with a tubular pattern and areas of squamous differentiation. In the lumina of the tubules, there were eosinophilic material (mucin). The alcian blue staining showed positive intraluminal material and the cytoplasm of neoplastic cells were immunoreactive for cytokeratin, supporting the diagnosis of adenosquamous carcinoma. The cells exhibited reduced or negative immunoreactivity for E-cadherin, which could be associated with more aggressive tumour behaviour and worse prognosis.(AU)
Assuntos
Animais , Neoplasias Bucais/diagnóstico , Carcinoma Adenoescamoso/diagnóstico , Cães , PalatoRESUMO
Mammary tumors are the most common in bitches, and bone and pulmonary metastases are not well described. Adenosquamous mammary carcinoma is a rare tumor that can be classified as a type of metaplastic tumor. This report describes the clinical and histopathological findings of this atypical presentation of mammary carcinoma in an 11-year-old, spayed, Poodle. Surgery was performed to remove malignant mammary nodules with a provisional diagnosis of carcinoma on cytologic examination. Thirteen months later, the dog returned showing left pelvic limb lameness that had persisted for 6 months prior to the consultation. The patient showed right pelvic limb lameness and a mass in the same limb. Radiographs of the affected limb revealed a pathological fracture in the femoral diaphysis and proliferation of the periosteum. After clinical staging, a left pelvic limb amputation was performed. A diagnosis of grade II adenosquamous mammary carcinoma was made through histopathology and immunohistochemistry. Although uncommon, bone and pulmonary metastases from mammary tumors, such as adenosquamous carcinoma, can be considered differential diagnoses for bony tumors. This report highlights the aggressive nature and significant metastatic potential of the adenosquamous carcinoma.
Os tumores mamários são os mais comuns em cadelas e as metástases ósseas e pulmonares não são bem descritas. O carcinoma mamário adenoescamoso é um tumor raro que pode ser classificado como um tipo de tumor metaplásico. Este relato descreve os achados clínicos e histopatológicos dessa apresentação atípica de carcinoma mamário em um Poodle de 11 anos de idade, castrado. A cirurgia foi realizada para remover nódulos mamários malignos com diagnóstico provisório de carcinoma no exame citológico. Treze meses depois, a cadela retornou apresentando claudicação do membro pélvico esquerdo que persistia por seis meses antes da consulta. O paciente apresentava claudicação do membro pélvico direito e uma massa no mesmo membro. A radiografia do membro afetado revelou fratura patológica na diáfise femoral, proliferação do periósteo e áreas de osteopenia. Após estadiamento clínico, foi realizada amputação do membro pélvico esquerdo. O diagnóstico de carcinoma adenoescamoso mamário grau II foi feito através da histopatologia e imunohistoquímica. Embora incomuns, as metástases ósseas e pulmonares de tumores mamários, como o carcinoma adenoescamoso, podem ser consideradas diagnósticos diferenciais para tumores ósseos. Este relatório destaca a natureza agressiva e significativo potencial metastático do carcinoma adenoescamoso.
Assuntos
Animais , Feminino , Cães , Neoplasias Mamárias Animais/cirurgia , Carcinoma Adenoescamoso/veterinária , Metaplasia/veterinária , Neoplasias Ósseas/veterinária , Imuno-Histoquímica/veterináriaRESUMO
BACKGROUND: Minimally invasive radical trachelectomy has emerged as an alternative to open radical hysterectomy for patients with early-stage cervical cancer desiring future fertility. Recent data suggest worse oncologic outcomes after minimally invasive radical hysterectomy than after open radical hysterectomy in stage I cervical cancer. OBJECTIVE: We aimed to compare 4.5-year disease-free survival after open vs minimally invasive radical trachelectomy. STUDY DESIGN: This was a collaborative, international retrospective study (International Radical Trachelectomy Assessment Study) of patients treated during 2005-2017 at 18 centers in 12 countries. Eligible patients had squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma; had a preoperative tumor size of ≤2 cm; and underwent open or minimally invasive (robotic or laparoscopic) radical trachelectomy with nodal assessment (pelvic lymphadenectomy and/or sentinel lymph node biopsy). The exclusion criteria included neoadjuvant chemotherapy or preoperative pelvic radiotherapy, previous lymphadenectomy or pelvic retroperitoneal surgery, pregnancy, stage IA1 disease with lymphovascular space invasion, aborted trachelectomy (conversion to radical hysterectomy), or vaginal approach. Surgical approach, indication, and adjuvant therapy regimen were at the discretion of the treating institution. A total of 715 patients were entered into the study database. However, 69 patients were excluded, leaving 646 in the analysis. Endpoints were the 4.5-year disease-free survival rate (primary), 4.5-year overall survival rate (secondary), and recurrence rate (secondary). Kaplan-Meier methods were used to estimate disease-free survival and overall survival. A post hoc weighted analysis was performed, comparing the recurrence rates between surgical approaches, with open surgery being considered as standard and minimally invasive surgery as experimental. RESULTS: Of 646 patients, 358 underwent open surgery, and 288 underwent minimally invasive surgery. The median (range) patient age was 32 (20-42) years for open surgery vs 31 (18-45) years for minimally invasive surgery (P=.11). Median (range) pathologic tumor size was 15 (0-31) mm for open surgery and 12 (0.8-40) mm for minimally invasive surgery (P=.33). The rates of pelvic nodal involvement were 5.3% (19 of 358 patients) for open surgery and 4.9% (14 of 288 patients) for minimally invasive surgery (P=.81). Median (range) follow-up time was 5.5 (0.20-16.70) years for open surgery and 3.1 years (0.02-11.10) years for minimally invasive surgery (P<.001). At 4.5 years, 17 of 358 patients (4.7%) with open surgery and 18 of 288 patients (6.2%) with minimally invasive surgery had recurrence (P=.40). The 4.5-year disease-free survival rates were 94.3% (95% confidence interval, 91.6-97.0) for open surgery and 91.5% (95% confidence interval, 87.6-95.6) for minimally invasive surgery (log-rank P=.37). Post hoc propensity score analysis of recurrence risk showed no difference between surgical approaches (P=.42). At 4.5 years, there were 6 disease-related deaths (open surgery, 3; minimally invasive surgery, 3) (log-rank P=.49). The 4.5-year overall survival rates were 99.2% (95% confidence interval, 97.6-99.7) for open surgery and 99.0% (95% confidence interval, 79.0-99.8) for minimally invasive surgery. CONCLUSION: The 4.5-year disease-free survival rates did not differ between open radical trachelectomy and minimally invasive radical trachelectomy. However, recurrence rates in each group were low. Ongoing prospective studies of conservative management of early-stage cervical cancer may help guide future management.
Assuntos
Neoplasias do Colo do Útero/cirurgia , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adolescente , Adulto , Brasil , Carcinoma Adenoescamoso/mortalidade , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Intervalo Livre de Doença , Feminino , Preservação da Fertilidade , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Traquelectomia , Neoplasias do Colo do Útero/mortalidade , Adulto JovemRESUMO
An 11-year-old pet goat presented a clinical history of acute respiratory distress with ultrasound diagnosis of wide lung injury. The animal was euthanized due to welfare reasons. At necropsy, it was found pleural effusion and adhesion on the right cranioventral thoracic region. The right cranial and middle lung lobes were firm and light gray with a neocavity containing purulent exudate. From the middle lobe, there was a nodular proliferation occupying alveolar spaces, densely cellular and composed by cuboid-columnar epithelial cells arranged in papillae and acini (60%), as well as polygonal cells arranged in nests with squamous differentiation (40%). Marked pleomorphism, anisocytosis and anisocariosis were also noted. A total of 39 mitosis figures for ten fields at 400x magnification were counted. Lung samples were negative for jaagsiekte retrovirus (JSRV) by PCR. Immunostaining for TTF1 and P53 occurred in zones of adenomatous and squamous differentiation, respectively. In MIB-1, 14% (82/594) of immunolabeled cells were observed in the squamous component. In conclusion, the histopathological and immunohistochemical characteristics confirmed the diagnosis of a pulmonary adenosquamous carcinoma, without JSRV involvement, in goat species.(AU)
Assuntos
Animais , Feminino , Cabras , Carcinoma Adenoescamoso/diagnóstico , Retrovirus Jaagsiekte de Ovinos/patogenicidade , Lesão Pulmonar/diagnóstico , Reação em Cadeia da Polimerase/métodosRESUMO
Colorectal cancer is the third most frequently diagnosed cancer in both men and women. Adenocarcinoma is the most common pathologic subtype of colon cancer and constitutes 86% of all colon cancers. Nontheless, there are other less frequent sybtyes of colorectal carcinomas, such as adenosquamous carcinoma, an extremely rare form of colon cancer, but with worse prognosis and greater potential of metástasis. We present the case of a 68-year-old female presented with a two-month history of anemia, hematochezia and abdominal pain. The colonoscopic study presented a tumor in the ascending colon, which after surgical resection and pathological studies, turned out to be a primary colonoc adenosquamous carcinoma.
Assuntos
Adenocarcinoma , Carcinoma Adenoescamoso , Neoplasias do Colo , Adenocarcinoma/diagnóstico , Idoso , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Feminino , Humanos , Masculino , PrognósticoRESUMO
Introdução: A prevalência do câncer de pulmão tem aumentado cerca de 2% ao ano e é considerado um problema de saúde pública mundial, sendo a principal causa de morte por câncer entre homens e mulheres. O Câncer de Pulmão de Células Não Pequenas (CPCNP) representa 85-90% dos cânceres de pulmão. A detecção do rearranjo do gene ROS1, considerada um importante fator preditivo para direcionamento terapêutico, constitui uma etapa crítica no tratamento de CPCNP. Objetivo: Avaliar a prevalência do rearranjo do gene ROS1 em pacientes portadores de CPCNP não escamoso, sem mutação de EGFR ou rearranjo de ALK, diagnosticados na Região da Foz do Rio Itajaí, Estado de Santa Catarina, Brasil, no período de 02/01/2019 a 27/07/2020. Materiais e Métodos: Estudo observacional, retrospectivo e prospectivo, descrito e analítico com 95 pacientes que possuíam material de biópsia suficiente para a realização de novas análises e que não apresentavam mutação de EGFR ou rearranjo de ALK. Os pacientes com imuno-histoquímica positiva para a proteína ROS1 foram testados pelo método de FISH, utilizando-se uma sonda de DNA do tipo break-apart para o gene ROS1. Foi realizada uma análise descritiva da amostra, e os resultados foram apresentados em números absolutos e porcentagens, representados por tabelas. O teste de qui-quadrado (χ2) foi empregado para comparação das frequências entre os grupos analisados. Resultados: 52,6% foram pacientes do sexo masculino; a idade mediana foi de 64 anos; 54,7% declararam-se tabagistas; 40,0% apresentavam doença estágio IV; 29,5% apresentaram tumores com alta expressão de PD-L1. Quanto a expressão de ROS1 por imuno-histoquímica: 89,5% foram identificados como ROS1+ em 0% das células tumorais, 4,2% como ROS1+ em <70% das células, e 6,3% como ROS1+ em ≥70% das células do tumor; portanto, 10,5% apresentaram resultados positivos para expressão de ROS1. Estes pacientes foram submetidos à análise de rearranjo de ROS1 pelo método de FISH e 7 (7,4%) apresentaram resultados positivos. Conclusão: Na população estudada, a análise pelo método de FISH mostrou uma prevalência de 7,4% para rearranjos do gene ROS1
Introduction: Lung cancer prevalence has been increasing at rate of 2% per year and is considered a major public health concern worldwide, being the main cause of cancer death among women and men. Non-small cell lung cancer (NSCLC) represents 85-90% of total lung cancer. Detecting the rearrangement of the ROS1 gene is critical to the treatment of NSCLC. Objective: To assess the prevalence of the ROS1 gene rearrangement in patients diagnosed with non-squamous NSCLC patients diagnosed between January 2019 to July 2020 at Foz do Rio Itajaí, in the state of Santa Catarina, Brazil. Materials and Methods: This is a retrospective and prospective observational study Ninety-five NSCLC whose tumors were negative for EGFR mutation and ALK rearrangement and who had enough tumor tissue to carry out additional molecular analysis. Patients whose tumors were positive for ROS1 by immune-histochemistry were tested using by FISH using a break-apart DNA probe (Abbot Molecular) for the ROS1 gene. A descriptive analysis was performed and results were presented as absolute frequencies and percentages and depicted in charts. Frequencies were compared with the chi-squared test (χ2). Results: 52,6% were male, mean and median age were 65,10 and 64 years, respectively. 54,7% self-declared as smokers; 40,0% had stage IV disease; 29,5% had tumours with high expression of PD-L1. Regarding the expression of ROS1 by immunohistochemistry: 89,5% were identified as ROS1+ in 0% of cells, 4,2% as ROS1+ in <70% of cells, and 6,3% as ROS1+ in ≥70% of the cells; therefore, 10,5% displayed positive results for the expression of ROS1+. These tumors were subjected to the analysis of ROS1 rearrangement by FISH and 7 (7,4%) were positive. Conclusion: We observed 7,4% prevalence for ROS1 gene rearrangements in this pre-selected population
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Imuno-Histoquímica , Rearranjo Gênico do Linfócito B , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Pulmonar de Células não Pequenas , Receptores ErbB , Quinase do Linfoma AnaplásicoRESUMO
A 9-year-old male Shih Tzu dog presented with a mass on the ventral region of the neck and developed ptyalism. Radiographs revealed a radiodense nodule located in the mid-third of the oesophagus compressing the trachea. Preoperative cytology showed large neoplastic cells with abundant vacuolated cytoplasm arranged in clusters. The nodule was removed by oesophagectomy and submitted for histopathology. Microscopically, the oesophageal mass was multilobulated and unencapsulated. It had a mixed cellular growth pattern with areas showing squamous and glandular differentiation. The squamous component of the tumor was formed by solid strands of neoplastic epithelial cells; many neoplastic cells had undergone central keratinization and sometimes formed keratin pearls. The deeper adenocarcinomatous portion of the tumor consisted of tubules filled with slightly basophilic mucinous material. Histological and immunohistochemical examination confirmed the diagnosis of primary adenosquamous carcinoma (ASC) of the esophagus. This is the first report of primary ASC of the cervical oesophagus in a dog.(AU)
Um cão Shih Tzu de nove anos de idade apresentou uma massa na região ventral do pescoço e desenvolveu ptialismo. As radiografias revelaram um nódulo radiodenso localizado no terço médio do esôfago que comprimia a traqueia. A citologia pré-operatória mostrou células neoplásicas grandes com citoplasma vacuolizado abundante, dispostas em aglomerados. O nódulo foi removido por esofagectomia e submetido à histopatologia. Microscopicamente, a massa esofágica era multilobulada e não encapsulada. Apresentava um padrão de crescimento celular misto, com áreas mostrando diferenciação escamosa e áreas de diferenciação glandular. O componente escamoso do tumor era formado por filamentos sólidos de células epiteliais neoplásicas; muitas células neoplásicas demonstravam queratinização central e, por vezes, formavam pérolas de queratina. A porção adenocarcinomatosa mais profunda do tumor consistia em túbulos preenchidos com material mucinoso levemente basofílico. O exame histológico e imunohistoquímico confirmaram o diagnóstico de carcinoma adenoescamoso primário do esôfago. No conhecimento dos autores, este é o primeiro relato de carcinoma adenoescamoso primário do esôfago cervical em um cão.(AU)
Assuntos
Animais , Cães , Doenças do Cão , Carcinoma Adenoescamoso/veterinária , Neoplasias Esofágicas/veterinária , Adenocarcinoma/veterináriaRESUMO
Background: The lung-digit syndrome is a rare syndrome characterized by the presence of a primary pulmonar neoplasiamanifesting metastasis to the digit, occurring exclusively in felines. The diagnosis is based on the clinical signs, associatedwith radiographic and histopathological exams. There are no therapeutic protocols well-established, and surgical excisionis considered controversial due to high recurrence and metastasis rates. The prognosis is considered poor, with low survivalrates. The aim of this paper is to report a case of lung-digit syndrome attended in Rio de Janeiro.Case: A 12-year-old female cat, no defined race, was attend with the complaint of weight loss and injury in the right thoraciclimb, already having histopathological diagnosis of squamous differentiation adenocarcinoma through biopsy. Physicalexamination showed no other clinical signs at first, including no signs of respiratory disease. Laboratory and imaging examswere performed, and the radiographic examination showed alterations in the pulmonary parenchyma showing a nodulararea of increased radiographic density. Followed up by the manifestation of breathing noise at rest, as the first respiratorysigns. The association of the clinical evaluation, medical history, and histopathological report from the limb lesion, leadto the suspicion diagnostic of lung-digit syndrome. The owners decide for the palliative treatment with chemotherapy, using carboplatin and prednisolone. Only the first session was performed, with the animal being euthanized due to clinicalworsening 48 days after the initial manifestation of clinical signs. The diagnosis was confirmed...(AU)
Assuntos
Animais , Feminino , Gatos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/veterinária , Metástase Neoplásica , Adenocarcinoma de Pulmão/veterinária , Carcinoma Adenoescamoso/veterináriaRESUMO
Background: The lung-digit syndrome is a rare syndrome characterized by the presence of a primary pulmonar neoplasiamanifesting metastasis to the digit, occurring exclusively in felines. The diagnosis is based on the clinical signs, associatedwith radiographic and histopathological exams. There are no therapeutic protocols well-established, and surgical excisionis considered controversial due to high recurrence and metastasis rates. The prognosis is considered poor, with low survivalrates. The aim of this paper is to report a case of lung-digit syndrome attended in Rio de Janeiro.Case: A 12-year-old female cat, no defined race, was attend with the complaint of weight loss and injury in the right thoraciclimb, already having histopathological diagnosis of squamous differentiation adenocarcinoma through biopsy. Physicalexamination showed no other clinical signs at first, including no signs of respiratory disease. Laboratory and imaging examswere performed, and the radiographic examination showed alterations in the pulmonary parenchyma showing a nodulararea of increased radiographic density. Followed up by the manifestation of breathing noise at rest, as the first respiratorysigns. The association of the clinical evaluation, medical history, and histopathological report from the limb lesion, leadto the suspicion diagnostic of lung-digit syndrome. The owners decide for the palliative treatment with chemotherapy, using carboplatin and prednisolone. Only the first session was performed, with the animal being euthanized due to clinicalworsening 48 days after the initial manifestation of clinical signs. The diagnosis was confirmed...
Assuntos
Feminino , Animais , Gatos , Adenocarcinoma de Pulmão/veterinária , Carcinoma Adenoescamoso/veterinária , Metástase Neoplásica , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/veterináriaRESUMO
INTRODUCTION: Median age at diagnosis of lung cancer is 70 years. Its presentation in patients 40 or younger is uncommon and it has been proposed that maybe it is a different disease due to its clinical characteristics and genetic makeup. There are a limited number of studies in this population and they report different clinic-pathological characteristics in comparison with older patients. METHODS: We described the incidence of lung cancer patients diagnosed at age 40 or younger at the Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima-Peru; from 2009 to 2017 and evaluated the characteristic of NSCLC. Epidemiologic and clinic-pathological data was collected from clinical files. Analysis was carried out using SPSSvs19 software. RESULTS: We identified 3823 patients with lung cancer seen at INEN during the study period. Among these, 166 (4.3%) patients were 40 years or younger, and 137/166 (82.5%) were NSCLC. Median age at diagnosis was 36 years (range 14-40 years) and 59.1% of patients were female. A smoking history was present in 14.4% of patients. Frequent symptoms at diagnosis were cough (62.0%), chest pain (51.8%) and dyspnea (40.9%). Adenocarcinoma was the most common histological type (63.3%). Most patients had advanced disease at diagnosis (84.7%). The median overall survival was 8.2 months. CONCLUSIONS: The proportion of young patients with lung cancer in our population is higher than that reported in the most recent literature. Lung cancer in the young is mostly sporadic, more frequent in women, usually adenocarcinoma type and it presents with advanced disease, resulting in a very poor survival.
Assuntos
Adenocarcinoma de Pulmão/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Pulmonares/epidemiologia , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/fisiopatologia , Adolescente , Adulto , Distribuição por Idade , Carcinoma/epidemiologia , Carcinoma/patologia , Carcinoma/fisiopatologia , Carcinoma Adenoescamoso/epidemiologia , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/fisiopatologia , Carcinoma de Células Grandes/epidemiologia , Carcinoma de Células Grandes/patologia , Carcinoma de Células Grandes/fisiopatologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/fisiopatologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/fisiopatologia , Dor no Peito/fisiopatologia , Tosse/fisiopatologia , Dispneia/fisiopatologia , Feminino , Humanos , Incidência , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/fisiopatologia , Masculino , Estadiamento de Neoplasias , Tumores Neuroendócrinos/epidemiologia , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/fisiopatologia , Peru/epidemiologia , Distribuição por Sexo , Fumar/epidemiologia , Taxa de Sobrevida , Adulto JovemRESUMO
OBJECTIVE: to analyze the expression of Vascular Endothelial Growth Factor (VEGF), its receptor (VEGFR-2), age and histological type of advanced cervical carcinomas with respect to the clinical response to neoadjuvant chemotherapy. METHODS: we studied 40 patients with cervical carcinoma (IB2 and IVA) diagnosed by biopsies prior to treatment. All patients underwent neoadjuvant chemotherapy and evaluation for clinical response and expression of VEGF. We considered a tumor regression greater than 50% as a good clinical response. RESULTS: eighteen patients (45%) had good response to chemotherapy, and 22 (55%), poor response. VEGF expression was positive in 16 patients and negative in 24. When analyzed separately for response to chemotherapy, only the positive expression of VEGF was associated with good clinical response (p=0.0157). CONCLUSION: VEGF expression alone was an important marker of good response to neoadjuvant chemotherapy in patients with advanced carcinoma of the cervix.
OBJETIVO: analisar a expressão do Fator de Crescimento do Endotélio Vascular (VEGF), seu receptor (VEGFR-2), idade e tipo histológico de carcinomas avançados de colo uterino com relação à resposta clínica à quimioterapia neoadjuvante. MÉTODOS: foram incluídas 40 pacientes com diagnóstico de carcinoma de colo uterino (IB2 e IVA), com biópsias prévias ao tratamento. Todas as pacientes foram submetidas à quimioterapia neoadjuvante e avaliadas quanto à resposta clínica e à expressão do VEGF. Considerou-se boa resposta clínica uma regressão tumoral total ou maior do que 50%. RESULTADOS: em relação à resposta à quimioterapia, 18 pacientes (45%) apresentaram boa resposta e 22 (55%), má resposta. Quanto à expressão do VEGF, em 16 pacientes foi considerada positiva e em 24, negativa. Quando os casos foram analisados separadamente em relação à resposta à quimioterapia, somente a expressão positiva de VEGF foi associada à boa resposta clínica (p=0,0157). CONCLUSÃO: a expressão de VEGF mostrou ser isoladamente, um importante marcador de boa resposta ao tratamento quimioterápico neoadjuvante das pacientes com carcinoma avançado de colo uterino.
Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Adenoescamoso/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias do Colo do Útero/tratamento farmacológico , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Adenocarcinoma/cirurgia , Adulto , Idoso , Biópsia , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Colo do Útero , Cisplatino , Feminino , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Prospectivos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgiaRESUMO
BACKGROUND: Although rare in the United States, gallbladder cancer (GBCA) is a common cause of cancer death in some parts of the world. To investigate regional differences in pathogenesis and outcomes for GBCA, tumor mutations were analyzed from a sampling of specimens. METHODS: Primary tumors from patients with GBCA who were treated in Chile, Japan, and the United States between 1999 and 2016 underwent targeted sequencing of known cancer-associated genes. Fisher exact and Kruskal-Wallis tests assessed differences in clinicopathologic and genetic factors. Kaplan-Meier methods evaluated differences in overall survival from the time of surgery between mutations. RESULTS: A total of 81 patients were included. Japanese patients (11 patients) were older (median age, 72 years [range, 54-81 years]) compared with patients from Chile (21 patients; median age, 59 years [range, 32-73 years]) and the United States (49 patients; median age, 66 years [range, 46-87 years]) (P = .002) and had more well-differentiated tumors (46% vs 0% for Chile/United States; P < .001) and fewer gallstone-associated cancers (36% vs 67% for Chile and 69% for the United States; P = .13). Japanese patients had a median mutation burden of 6 (range, 1-23) compared with Chile (median mutation burden, 7 [range, 3-20]) and the United States (median mutation burden, 4 [range, 0-27]) (P = .006). Tumors from Japanese patients lacked AT-rich interaction domain 1A (ARID1A) and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutations, whereas Chilean tumors lacked Erb-B2 receptor tyrosine kinase 3 (ERBB3) and AT-rich interaction domain 2 (ARID2) mutations. SMAD family member 4 (SMAD4) was found to be mutated similarly across centers (38% in Chile, 36% in Japan, and 27% in the United States; P = .68) and was univariately associated with worse overall survival (median, 10 months vs 25 months; P = .039). At least one potentially actionable gene was found to be altered in 80% of tumors. CONCLUSIONS: Differences in clinicopathologic variables suggest the possibility of distinct GBCA pathogenesis in Japanese patients, which may be supported by differences in mutation pattern. Among all centers, SMAD4 mutations were detected in approximately one-third of patients and may represent a converging factor associated with worse survival. The majority of patients carried mutations in actionable gene targets, which may inform the design of future trials.
Assuntos
Adenocarcinoma/patologia , Biomarcadores Tumorais/genética , Carcinoma Adenoescamoso/patologia , Neoplasias da Vesícula Biliar/patologia , Mutação , Adenocarcinoma/genética , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Adenoescamoso/genética , Carcinoma Adenoescamoso/cirurgia , Chile , Demografia , Feminino , Seguimentos , Neoplasias da Vesícula Biliar/genética , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Prognóstico , Taxa de Sobrevida , Estados UnidosRESUMO
RESUMO Objetivo: analisar a expressão do Fator de Crescimento do Endotélio Vascular (VEGF), seu receptor (VEGFR-2), idade e tipo histológico de carcinomas avançados de colo uterino com relação à resposta clínica à quimioterapia neoadjuvante. Métodos: foram incluídas 40 pacientes com diagnóstico de carcinoma de colo uterino (IB2 e IVA), com biópsias prévias ao tratamento. Todas as pacientes foram submetidas à quimioterapia neoadjuvante e avaliadas quanto à resposta clínica e à expressão do VEGF. Considerou-se boa resposta clínica uma regressão tumoral total ou maior do que 50%. Resultados: em relação à resposta à quimioterapia, 18 pacientes (45%) apresentaram boa resposta e 22 (55%), má resposta. Quanto à expressão do VEGF, em 16 pacientes foi considerada positiva e em 24, negativa. Quando os casos foram analisados separadamente em relação à resposta à quimioterapia, somente a expressão positiva de VEGF foi associada à boa resposta clínica (p=0,0157). Conclusão: a expressão de VEGF mostrou ser isoladamente, um importante marcador de boa resposta ao tratamento quimioterápico neoadjuvante das pacientes com carcinoma avançado de colo uterino.
ABSTRACT Objective: to analyze the expression of Vascular Endothelial Growth Factor (VEGF), its receptor (VEGFR-2), age and histological type of advanced cervical carcinomas with respect to the clinical response to neoadjuvant chemotherapy. Methods: we studied 40 patients with cervical carcinoma (IB2 and IVA) diagnosed by biopsies prior to treatment. All patients underwent neoadjuvant chemotherapy and evaluation for clinical response and expression of VEGF. We considered a tumor regression greater than 50% as a good clinical response. Results: eighteen patients (45%) had good response to chemotherapy, and 22 (55%), poor response. VEGF expression was positive in 16 patients and negative in 24. When analyzed separately for response to chemotherapy, only the positive expression of VEGF was associated with good clinical response (p=0.0157). Conclusion: VEGF expression alone was an important marker of good response to neoadjuvant chemotherapy in patients with advanced carcinoma of the cervix.
Assuntos
Humanos , Feminino , Adulto , Idoso , Carcinoma de Células Escamosas/tratamento farmacológico , Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Colo do Útero/tratamento farmacológico , Carcinoma Adenoescamoso/tratamento farmacológico , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Biópsia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Adenocarcinoma/cirurgia , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/patologia , Colo do Útero , Estudos Prospectivos , Cisplatino , Carcinoma Adenoescamoso/cirurgia , Carcinoma Adenoescamoso/patologia , Terapia Neoadjuvante , Pessoa de Meia-Idade , Estadiamento de NeoplasiasRESUMO
A 43-year-old man presented with two-month history of fatigue, weakness, paleness, rectal bleeding, sweating, and weight loss of 10 kg in the past one month. A complete blood count revealed anaemia. The patient underwent a right hemicolectomy. The microscopic examination revealed an adenosquamous carcinoma associated with a mucinous adenocarcinoma in a patient with microsatellite instability due to loss of MLH1 and PMS2 expression and retention of MSH2 and MSH6 expression in both the squamous and glandular components. We also observed an atypical immunohistochemical phenotype in the adenocarcinoma component showing CK7 expression and reduced CK20 and CDX2 expression.
Assuntos
Adenocarcinoma Mucinoso/patologia , Carcinoma Adenoescamoso/patologia , Neoplasias do Colo/patologia , Instabilidade de Microssatélites , Neoplasias Primárias Múltiplas/patologia , Adenocarcinoma Mucinoso/genética , Adulto , Carcinoma Adenoescamoso/genética , Neoplasias do Colo/genética , Humanos , Masculino , Endonuclease PMS2 de Reparo de Erro de Pareamento/genética , Proteína 1 Homóloga a MutL/genética , Neoplasias Primárias Múltiplas/genéticaAssuntos
Carcinoma Adenoescamoso/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Retroperitoneais/patologia , Idoso , Carcinoma Adenoescamoso/diagnóstico por imagem , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Humanos , Masculino , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Retroperitoneais/diagnóstico por imagemRESUMO
Pulmonary neoplasia is rare among wild New World primates. We report the gross, microscopical, and immunohistochemical features of a primary multicentric pulmonary adenosquamous carcinoma in a free-living black capuchin monkey (Sapajus nigritus). Herein, the spectrum of pulmonary neoplasms in non-human primates is widened and briefly reviewed.
Assuntos
Carcinoma Adenoescamoso/veterinária , Cebinae , Neoplasias Pulmonares/veterinária , Doenças dos Macacos/diagnóstico , Animais , Animais Selvagens , Brasil , Carcinoma Adenoescamoso/diagnóstico , Neoplasias Pulmonares/diagnóstico , MasculinoRESUMO
In this study, the epidemiological and pathological features of an outbreak of squamous cell carcinoma (SCC) in adult female sheep and a young ram, Friesian Milchschaf breed or crossbreed is described. Seven adult females belonging to an original flock nucleus of 20 animals were affected, as well as a young ram belonging to the same nucleus was affected in other establishment. Multiple verrucous neoplastic masses of several months of evolution were evident in the head region, with local invasion and regional lymph node metastases. Histological studies revealed a cancerous stage of invasion of the dermis and neoplastic proliferation characteristic of invasive SCC, and a pre-cancerous stage with solar elastosis and chronic solar keratosis lesions induced by sunlight. Decrease in latitude, increased level of solar radiation with long exposure to sunlight, and the phenotypic characteristics of the breed are the main factors responsible for the high prevalence of SCC, showing the susceptibility of the Friesian Milchschaf breed and crossbreed in temperate zones as Uruguay.(AU)
Neste estudo descrevem-se as características epidemiológicas e patológicas de um surto de carcinoma de células escamosas (SCC) em ovelhas adultas e ram jovem, raça Friesian Milchschaf ou cruza. Foram afetadas sete fêmeas adultas pertencentes a um núcleo de rebanho original de 20 animais, bem como um ram jovem pertencente ao mesmo núcleo em que foi afetado em outro estabelecimento. Múltiplas neoplásicas verrucosas de vários meses de evolução foram evidentes na região principal, com invasão local e metástases de linfonodos regionais. Estudos histológicos revelaram um estágio cancerígeno de invasão da derme e proliferação neoplásica característica do SCC invasivo e um estágio pré-cancerígeno com elastose solar e lesões de ceratose solar crônica induzidas pela luz solar. A diminuição da latitude, o aumento do nível de radiação solar com longa exposição à luz solar e as características fenotípicas da raça são os principais fatores responsáveis pela alta prevalência de SCC, mostrando a susceptibilidade da raça Friesian Milchschaf e cruzada em zonas temperadas como o Uruguai.(AU)
Assuntos
Animais , Ovinos , Carcinoma Adenoescamoso/veterinária , Carcinoma Verrucoso/veterinária , Neoplasias Primárias Múltiplas/veterinária , Metástase Linfática , Ceratose Actínica/veterinária , Imuno-Histoquímica/veterinária , UruguaiRESUMO
BACKGROUND: Cervical carcinoma (CC) is one of the most frequent neoplasms, especially in developing countries. The most common histopathological type is squamous cell carcinoma (SCC), followed by adenocarcinoma (AC) and adenosquamous carcinoma (ASC). Prognosis according to histological type is controversial. OBJECTIVE: The objective of this study is to describe and compare the prognoses of the most common histologies of CC in the early stages. MATERIALS AND METHODS: We reviewed records of patients attended at the Instituto Nacional de Cancerología of Mexico with CC surgically treated Stages IA2-IB1 and IIA1, including the histological types SCC, AC, and ASC. Patients who had another malignant neoplasm, cervical cancer in situ, locally advanced neoplasm, and metastatic neoplasm were excluded from the study. A descriptive and comparative analysis was conducted. Overall survival (OS) and disease-free period were calculated for each histological type with the Kaplan-Meier method and were compared with the log-rank test. RESULTS: A total of 202 records were obtained, of which 131 (64.9%) had SCC, 57 (28.2%) AC, and 14 (6.9%) ASC. The 5-year DFS was 94.4% for SCC, 98.1% for AC, and 92.3% for ASC, without a statistically significant difference (p = 0.55). The 5-year OS for SCC was 97.9%, for AC was 97.8%, and for ASC was 100%, without a statistically significant difference (p = 0.702). CONCLUSIONS: DFS and OS did not differ between the most common histological types of CC at the early stages.