RESUMO
Nevus lipomatosus cutaneous superficialis is a rare benign hamartomatous skin tumor characterized by dermal deposition of mature adipose tissue. Two clinical forms have been described (classical and solitary types). We describe a case of nevus lipomatosus cutaneous superficialis with a 13-year history of growth in a young woman who had a solitary skin-colored tumoral mass on the right buttock. Histopathological findings were typical and confirmed the diagnosis. In this case, the lesion was a skin-colored isolated mass, as described in the solitary type, but its localization and age of appearance were compatible with the classical type. The combination of simultaneous clinical findings of both types had not been published before.
Assuntos
Nádegas , Lipomatose/patologia , Nevo/patologia , Biópsia , Feminino , Humanos , Lipomatose/cirurgia , Nevo/cirurgia , Adulto JovemRESUMO
Abstract: Nevus lipomatosus cutaneous superficialis is a rare benign hamartomatous skin tumor characterized by dermal deposition of mature adipose tissue. Two clinical forms have been described (classical and solitary types). We describe a case of nevus lipomatosus cutaneous superficialis with a 13-year history of growth in a young woman who had a solitary skin-colored tumoral mass on the right buttock. Histopathological findings were typical and confirmed the diagnosis. In this case, the lesion was a skin-colored isolated mass, as described in the solitary type, but its localization and age of appearance were compatible with the classical type. The combination of simultaneous clinical findings of both types had not been published before.
Assuntos
Humanos , Feminino , Adulto Jovem , Nádegas , Lipomatose/patologia , Nevo/patologia , Biópsia , Lipomatose/cirurgia , Nevo/cirurgiaRESUMO
Fibroblastic connective tissue nevus (FCTN) is a rare, benign, dermal mesenchymal hamartoma that affects children. We report a 15-year-old boy with a congenital FCTN and describe the clinical, dermatoscopic, and histopathologic features.
Assuntos
Nevo/diagnóstico , Pele/patologia , Adolescente , Antígenos CD34/metabolismo , Dermoscopia , Diagnóstico Diferencial , Humanos , Masculino , Nevo/patologia , Nevo/cirurgiaAssuntos
Mama/anormalidades , Nevo/diagnóstico , Neoplasias Cutâneas/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Mamoplastia , Nevo/diagnóstico por imagem , Nevo/patologia , Nevo/cirurgia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
INTRODUÇÃO: O nevus congênito gigante (NCG) possui diversas modalidades de tratamento. A abordagem cirúrgica inclui a ressecção parcial seriada ou excisão total. Objetivo: Demonstrar as principais modalidades terapêuticas utilizadas para o tratamento do NCG e avaliar a incidência da localização, idade e tamanho destas lesões no Serviço de Cirurgia Plástica e Reparadora do Hospital de Clínicas da Universidade Federal do Paraná. MÉTODOS: Estudo retrospectivo dos pacientes submetidos a tratamento cirúrgico do NCG no período de janeiro de 2004 a janeiro de 2010. Foram coletados dados como: idade, gênero, tratamento realizado, número de cirurgias realizadas, evolução e complicações. RESULTADOS: Foram avaliados 11 pacientes, sendo 8 mulheres e 3 homens. A média de idade foi de 12,4 anos (3 a 25 anos). O subtipo mais encontrado foi o nevus melanocítico intradérmico correspondendo a 90,9% dos casos e 9,1% com nevus melanocítico composto. Não foram identificados casos de melanoma. A localização mais comum foi a região da cabeça e pescoço. O diâmetro médio das lesões foi de 9,1 cm.As técnicas utilizadas para reconstrução foram: sutura primária, retalhos locais, enxerto de pele e uso de expansores. No seguimento, 63,6% dos pacientes apresentavam ainda nevus residual, 27,3% apresentaram ressecção completa e 9,1% perderam seguimento. CONCLUSÃO: Foi observada maior incidência de NCG na faixa etária de 3 a 25 anos, sendo a localização mais comum na face e com tamanho médio de 9,1cm. O principal tratamento instituído para os pacientes com NCG foi a ressecção parcelada, com bons resultados.
INTRODUCTION: Several modalities are available for the treatment of giant congenital nevus (GCN). The surgical approach includes partial serial resection or total excision. Objective: To demonstrate the main therapeutic modalities in the treatment of GCN and to assess the incidence of location, age, and size of this lesion at the Plastic and Reconstructive Surgery Service of the Hospital de Clínicas, Federal University of Paraná. METHODS: This retrospective study included patients who had undergone surgical treatment for GCN between January 2004 and January 2010. We collected data such as age, sex, treatment performed, number of surgeries carried out, evolution, and complications. RESULTS: We evaluated 11 patients (8 female and 3 male). The average age was 12.4 years (range, 3-25 years). The GCN subtype most commonly found was intradermal melanocytic nevus, which accounted for 90.9% of cases, with melanocytic nevus accounting for the remaining 9.1%. No cases of melanoma were identified. The most common location was the head and neck. The average diameter of the lesions was 9.1 cm. The techniques used for the reconstruction included primary suture, local flaps, skin graft, and the use of expanders. In the follow-up period, 63.6% of the patients still presented a residual nevus, 27.3% underwent complete resection, and 9.1% were not monitored. CONCLUSION: A higher incidence of GCN was observed in patients aged 3-25 years. The most common location was the face, and the average size was 9.1 cm. The main treatment of patients with GCN was splitting resection, which resulted in satisfactory outcomes.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , História do Século XXI , Silicones , Ferimentos e Lesões , Dispositivos para Expansão de Tecidos , Prontuários Médicos , Estudos Transversais , Revisão , Procedimentos de Cirurgia Plástica , Estudo de Avaliação , Margens de Excisão , Neoplasias de Cabeça e Pescoço , Nevo , Silicones/uso terapêutico , Neoplasias Cutâneas , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/terapia , Dispositivos para Expansão de Tecidos/efeitos adversos , Dispositivos para Expansão de Tecidos/normas , Prontuários Médicos/normas , Estudos Transversais/normas , Procedimentos de Cirurgia Plástica/métodos , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/congênito , Neoplasias de Cabeça e Pescoço/patologia , Nevo/cirurgia , Nevo/congênito , Nevo/patologia , Nevo/terapiaRESUMO
Large congenital melanocytic nevus rarely presents itself without hairs, with hardened skin and progressive depigmentation. We report a girl who presented with a large congenital melanocytic nevus in the left cheek. Over the years, the nevus became pruriginous, light brown, bumpy, and hard. Histology revealed nevus cells interspersed with dense fibrosclerotic collagen bundles. There are few reported cases of large congenital melanocytic nevus with this evolution, so-called desmoplastic hypopigmented hairless nevus.
Assuntos
Hipopigmentação/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Biópsia , Pré-Escolar , Face/cirurgia , Feminino , Humanos , Hipopigmentação/congênito , Hipopigmentação/cirurgia , Lactente , Nevo/congênito , Nevo/cirurgia , Procedimentos de Cirurgia Plástica , Neoplasias Cutâneas/congênito , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoRESUMO
INTRODUÇÃO: Os nevos melanocíticos congênitos, apesar de apresentarem uma incidência relativamente rara, são lesões que necessitam acompanhamento por longo período, a fim de se evitar sequelas psicológicas e complicações inerentes a essa patologia, como estresse psicológico, melanose neurocutânea e degeneração maligna. MÉTODO: O presente estudo demonstra os dados epidemiológicos e terapêuticos em uma série de 45 casos atendidos na Divisão de Cirurgia Plástica e Queimaduras do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.
INTRODUCTION: Congenital melanocytic nevi despite presenting a relatively rare incidence are injuries that require monitoring for a long period. The purpose of this is to prevent psychological sequelae and complications inherent to this pathology, such as psychological stress, neurocutaneous melanosis and malignant degeneration. METHODS: The present study demonstrates the epidemiological data and treatment in a series of 45 cases treated in the Divisão de Cirurgia Plástica e Queimaduras do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Division of Plastic Surgery and Burns of School of Medicine, University of São Paulo).
Assuntos
Humanos , Masculino , Feminino , Melanoma , Melanose , Nevo Pigmentado/cirurgia , Nevo/cirurgia , Estresse Psicológico , Procedimentos Cirúrgicos Operatórios , Técnicas e Procedimentos Diagnósticos , Métodos , Síndromes Neurocutâneas , Patologia , Pacientes , Estudos Retrospectivos , Neoplasias CutâneasRESUMO
Melanocytoma is a rare intraocular tumor. There are some reports in the literature dealing with primary melanocytomas of the choroid and ciliary body. It is believed that most of these tumors are clinically diagnosed as nevi or melanoma, and are followed up or treated without surgical resection, respectively. Some clinical features can give a clue as to the correct diagnosis. We report on a 47-year-old white female with progressive visual loss of 2 months and right painful eye. Her visual acuity of finger counting was confined to 3.0m OD and 20/20 OS. Biomicroscopy OD showed a 360 degrees posterior synechia, and fundoscopy was not conclusive due to vitreous opacity. No alterations were seen on OS. Intraocular pressure was normal, and the pupillary reflex was present in both eyes. An ultrasound of the OD showed an elevated tumor on topography of the ciliary body and anterior choroid at the ora serrata level. Melanoma was the main diagnosis considered, and enucleation was indicated due to poor prognosis for visual acuity. Gross and histopathologic examinations of the OD showed a heavily pigmented tumor. The brownish pigment obscured the morphology of the tumor cells that could not be visualized by conventional H&E stain. Bleached slides showed that tumor was composed of melanocytoma cells type I.
Assuntos
Neoplasias da Coroide/patologia , Corpo Ciliar/patologia , Melanoma/patologia , Nevo/patologia , Neoplasias Uveais/patologia , Neoplasias da Coroide/cirurgia , Corpo Ciliar/cirurgia , Diagnóstico Diferencial , Enucleação Ocular , Feminino , Humanos , Pessoa de Meia-Idade , Nevo/cirurgia , Neoplasias Uveais/cirurgiaRESUMO
PURPOSE OF REVIEW: A variety of new indications for laser treatment have been raised in the dermatology field recently. They offer significant opportunities to manage a large spectrum of conditions in the pediatric population. Therefore, it is necessary to know the current trends and limitations of their use for the treatment of pigmented and vascular lesions. RECENT FINDINGS: The pulsed dye laser for port wine stain treatment remains the gold standard. However, pulsed dye laser-resistant port wine stain constitutes a difficult management problem. New therapeutic modalities such as photodynamic therapy and the application of different topical angiogenesis inhibitors promise better results in avoiding port wine stain redarkening. The potential systemic effects also require further study. Traditionally, the Q-switched pigmented laser has been used for pigmented lesions. However, the 1550 nm wavelength erbium-doped fiber laser could be a new modality of treatment for Becker's nevus. SUMMARY: Since the development of the first laser in 1960, dermatology and dermatologic surgery have rapidly evolved over the last two decades, thanks to the numerous technological and scientific acquisitions focused on improvement in the treatment of skin conditions. A large spectrum of vascular and pigmented lesions and other conditions such as chronic inflammatory skin diseases, such as psoriasis and eczema, keloids and hypertrichosis, are now managed safely with laser treatment.
Assuntos
Hemangioma/cirurgia , Terapia a Laser/métodos , Nevo/cirurgia , Mancha Vinho do Porto/cirurgia , Neoplasias Cutâneas/cirurgia , Criança , Pré-Escolar , Dermatologia/métodos , Humanos , Resultado do TratamentoRESUMO
PURPOSE: To report the impression cytology features of conjunctival nevi reported as more noticeable. METHODS: 35 patients who reported that a conjunctival lesion had become more noticeable after color or size change were enrolled. On slit-lamp examination, a clinical diagnosis of nevus was made and lesions underwent impression cytology using acetate cellulose strips and a combined staining with PAS, H&E and Papanicolaou. At patient's or parents' request, excision of the lesion was performed and the tissue was submitted to histopathological study. RESULTS: Impression cytology examination revealed nests or cluster of nevus cells within the epithelium layer containing or not mucous-secreting goblet cells in 32 cases (91.4%). Ten patients (28.5%) had the tumor removed and histopathological diagnosis was compound nevus in 8 eyes (1 from caruncle, 1 from plica semilunaris and 6 from bulbar conjunctiva) and subepithelial nevus from bulbar conjunctiva (2 eyes). CONCLUSION: Optical microscopy analysis of the impression cytology specimens confirmed the clinical diagnosis by demonstrating typical histopathological features of the superficial layers from conjunctival nevi in 91.4% of the cases. For amelanotic nevi IC can also allow a differential diagnosis from other nonpigmented lesions. The technique does not replace histopathological examination, but additionally, may assist in evaluating nevus cells in children and adults.
Assuntos
Neoplasias da Túnica Conjuntiva/patologia , Nevo/patologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Neoplasias da Túnica Conjuntiva/cirurgia , Estudos Transversais , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nevo/cirurgia , Adulto JovemRESUMO
Purpose: To report the impression cytology features of conjunctival nevireported as more noticeable. Methods: 35 patients who reported that a conjunctival lesion had become more noticeable after color or size changewere enrolled. On slit-lamp xamination, a clinical diagnosis of nevus was made and lesions underwent impression cytology using acetate cellulose strips and a combined staining with PAS, H&E and Papanicolaou. At patients or parents request, excision of the lesion was performed and the tissue was submitted to histopathological study. Results: Impression cytology examination revealed nests or cluster of nevus cells within the epithelium layer containing or not mucous-secreting goblet cells in 32 cases (91.4%). Ten patients (28.5%) had the tumor removed and histopathological diagnosis was compound nevus in 8 eyes (1 from caruncle, 1 from plica semilunaris and 6 from bulbar conjunctiva) and subepithelial nevus from bulbar conjunctiva (2 eyes). Conclusion: Optical microscopy analysis of the impression cytology specimens confirmed the clinical diagnosis by demonstrating typical histopathological features of the superficial layers from conjunctival nevi in 91.4% of the cases. For amelanotic nevi IC can also allow a differential diagnosis from othernonpigmented lesions. The technique does not replace histopathologicalexamination, but additionally, may assist in evaluating nevus cells in children and adults.
Objetivo: Relatar as características da citologia de impressão de nevos conjuntivais referidos como mais perceptíveis. Métodos: Trinta e cinco pacientes que notaram uma lesão conjuntival que se tornou mais perceptível, por mudança de cor ou de tamanho, foram avaliados. Ao exame biomicroscópico foi feito o diagnóstico clínico de nevo, sendo obtidas amostrasde citologia de impressão das lesões com auxílio do papel filtro de acetato de celulose, coradas com PAS, H&E e Papanicolaou. Para os indivíduos que optaram também pela remoção da lesão, o tecido foi enviado para análise histopatológica. Resultados: O exame de citologia de impressão revelou ninhos ou blocos de células névicas na camada epitelial, acompanhados ou não de células caliciformes em 32 casos (91,4%). Dez pacientes (28,5%) tiveram a lesão removida, sendo o diagnóstico histopatológico de nevo composto (um na carúncula, um na prega semilunar e seis na conjuntiva bulbar) e nevo subepitelial (dois na conjuntiva bulbar). Conclusão: Aanálise pela microscopia óptica das amostras de citologia de impressão confirmou o diagnóstico clínico ao demonstrar características típicas das camadas superficiais do nevo conjuntivalem 91,4% dos pacientes. Nos nevos amelanóticos a citologia pode auxiliar no diagnóstico diferencial de outras lesõesnão pigmentadas. A técnica não substitui o exame histopatológico, mas pode ser útil na avaliação de células névicas emcrianças e adultos.
Assuntos
Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias da Túnica Conjuntiva/patologia , Nevo/patologia , Estudos Transversais , Neoplasias da Túnica Conjuntiva/cirurgia , Técnicas de Diagnóstico Oftalmológico , Nevo/cirurgia , Adulto JovemRESUMO
PURPOSE/METHODS: To report a rare case of melanocytoma in a choroidal location. The clinical and echographic characteristics were similar to those of a melanoma. The treatment selected in our case was a choroidectomy. Tissue was stained with hematoxylin-eosin, periodic acid-Schiff, Masson's trichromic and immunohistochemistry was performed. RESULTS/CONCLUSIONS: The clinical and histopathologic features of choroidal melanocytoma are similar to the characteristics of a melanocytoma located in other parts of the eye. The differential diagnosis between choroidal melanoma and melanocytoma is very difficult without histopathologic correlation.
Assuntos
Neoplasias da Coroide/cirurgia , Nevo/cirurgia , Corioide/patologia , Neoplasias da Coroide/diagnóstico , Neoplasias da Coroide/patologia , Diagnóstico Diferencial , Feminino , Angiofluoresceinografia , Seguimentos , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Nevo/diagnóstico , Nevo/patologia , Fatores de Tempo , Resultado do TratamentoAssuntos
Humanos , Masculino , Feminino , Cirurgia Plástica , Nevo/cirurgia , Nevo/diagnóstico , Nevo/terapiaRESUMO
BACKGROUND: Tangential excision (shaving) is an effective surgical technique for the excision of nevocellular nevi on the trunk, limbs, and scalp. There are few studies on the application of this technique to lesions on the face. AIMS: To demonstrate the technique of tangential excision for the removal of nevocellular nevi on the face and to evaluate the cosmetic results, recurrence index, and possible complications. METHODS: Two hundred and fifteen patients with multiple nevocellular nevi on different aesthetic units of the face (total of 225 lesions) were selected. All the lesions were removed by tangential excision. The patients returned for postsurgical evaluation at 30, 60, and 90 days. RESULTS: The results were evaluated in relation to the skin type, sex, age, and histologic type of the lesions. An excellent result was achieved in 90.7%, good in 8.4% and poor in 0.9%, with a low index of complications. For comparison, the face was divided into seven aesthetic units. CONCLUSION: Tangential excision is an alternative surgical technique for the treatment of nevi. It is simple, fast, and efficient, has low risks and low cost for the patient, and yields excellent results when used for cosmetic purposes.
Assuntos
Nevo/cirurgia , Neoplasias Cutâneas/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Adolescente , Adulto , Criança , Face , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: Meningeal melanocytoma generally occurs in the posterior fossa. Orbital manifestation is rarely encountered. METHODS: A thirty-five year-old man presented with progressive proptosis of his right eye. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) of the brain showed an expansive intraconal mass lesion occupying the superior orbital compartment, the entire orbital apex, and the optic foramen. Histological analysis and Immunohistochemical staining for S-100 and HMB-45 monoclonal antibodies confirmed melanocytoma. FINDINGS: Microsurgical removal was accomplished through a fronto-orbital craniotomy. Chemotherapy and irradiation followed the initial intervention. The patient returned for follow up two years after surgery, complaining of headache and right visual loss. A subfrontal tumor with massive edema was found on follow up CT scan. INTERPRETATION: Meningeal melanocytomas are rare benign pigmented tumors of the central nervous system. They are predominant in the posterior fossa and spinal cord and frequently mistaken for melanomas, especially on frozen sections. Orbital presentation is rare. The natural history is poorly defined.
Assuntos
Neoplasias Meníngeas/cirurgia , Nevo/cirurgia , Neoplasias Orbitárias/cirurgia , Adulto , Antígenos de Neoplasias , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/análise , Quimioterapia Adjuvante , Terapia Combinada , Craniotomia , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Antígenos Específicos de Melanoma , Neoplasias Meníngeas/tratamento farmacológico , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/radioterapia , Microcirurgia , Proteínas de Neoplasias/análise , Recidiva Local de Neoplasia/diagnóstico , Nevo/tratamento farmacológico , Nevo/patologia , Nevo/radioterapia , Órbita/patologia , Órbita/cirurgia , Neoplasias Orbitárias/tratamento farmacológico , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/radioterapia , Complicações Pós-Operatórias/diagnóstico , Radioterapia Adjuvante , Proteínas S100/análise , Tomografia Computadorizada por Raios XRESUMO
El nevo blanco esponja (NBE) es una rara afección benigna, de naturaleza hereditaria autosómica dominante, que involucra la mucosa bucal y menos frecuentemente la nasal, esofágica, genital y rectal. Es un defecto de la queratina ocasionado por una mutación del gen codificante, que afecta el epitelio pavimentoso estratificado no queratinizado que reviste la mucosa bucal. Si bien su fisiopatología no está totalmente aclarada, la distribución y naturaleza de las lesiones en las mucosas sugieren que la mutación de la queratina 4 (K4) y/o queratina 13 (K13) serían las responsables de esta entidad. Se presentan tres nuevos casos, describiendo las alteraciones clínicas observadas en la mucosa bucal, sus aspectos histopatológicos y diferentes terapéuticas (AU)
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Nevo/classificação , Nevo/diagnóstico , Nevo/ultraestrutura , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/classificação , Neoplasias Bucais/ultraestrutura , Mucosa Bucal/patologia , Diagnóstico Diferencial , Nevo/genética , Nevo/fisiopatologia , Nevo/cirurgia , Terapia a Laser/métodos , Crioterapia/métodos , Antibacterianos/uso terapêuticoRESUMO
El tratamiento del los nevus de gran tamaño es un desafío para el cirujano plástico.El objetivo de este trabajo es mostrar nuestra experiencia en cuatro pacientes pediátrico con nevus de gran tamaño en cara,cuero cabelludo y tronco.El tratamiento implica resecciones completas o seriadas utilizando expansores o injerto de piel
Assuntos
Criança , Nevo/cirurgia , Dispositivos para Expansão de Tecidos/estatística & dados numéricos , Transplante de Pele , Pediatria , Cirurgia GeralRESUMO
El tratamiento del los nevus de gran tamaño es un desafío para el cirujano plástico.El objetivo de este trabajo es mostrar nuestra experiencia en cuatro pacientes pediátrico con nevus de gran tamaño en cara,cuero cabelludo y tronco.El tratamiento implica resecciones completas o seriadas utilizando expansores o injerto de piel