Frequência de ocorrência de carcinoma basocelular palpebral na região Centro-Oeste paulista e características dos portadores

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Surgical treatment of renal cell carcinoma recurrence at the renal fossa following radical nephrectomy

CONTEXTO: A recorrência local única do carcinoma renal de células claras em seu leito renal após nefrectomia radical é um evento raro. Estima-se que essa situação ocorra em 0,8% a 3,6% do total de procedimentos. Comumente, seu diagnóstico é realizado através de tomografia computadorizada de abdômen ou ultra-som renal usados no acompanhamento desses pacientes. É polêmico qual o melhor tratamento dessa rara condição entre urologistas e oncologistas devido aos poucos relatos em literatura. RELATO DE CASO: Relatamos um caso de recidiva neoplásica única no leito renal após quatro anos e meio da nefrectomia radical por adenocarcinoma de células claras, sem evidência de metástases a distância em outros órgãos. O diagnóstico foi realizado por meio de tomografia abdominal em acompanhamento ambulatorial, observando-se massa retroperitoneal em topografia renal. A massa foi retirada por meio de uma incisão subcostal ampliada, em cirurgia sem intercorrências. O paciente evoluiu bem no pós-operatório. Após um ano e meio do procedimento, foi evidenciada uma metástase no pulmão esquerdo, e seis meses após, outra recorrência metastática na nona costela anterior à direita, mesmo com paciente totalmente assintomático. O tratamento cirúrgico agressivo em recorrência local única é um bom método para controlar essa rara doença. Tomografia computadorizada de abdômen deve ser feita em acompanhamento de carcinoma renal por longos períodos após a nefrectomia radical para o diagnóstico de recorrências tardias e o tratamento deve ser feito como o de uma metástase recorrente única.

Tratamento cirúrgico na recidiva retroperitoneal tardia por carcinoma renal de células claras após nefrectomia radical

Late renal cell carcinoma recurrence in the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomies. We reported a late recurrence at the renal fossa about four and half years after radical nephrectomy due to a renal cell carcinoma (RCC) without metastasis elsewhere. Diagnosis in an outpatient follow-up was made during an abdominal computed tomography and we observed a retroperitoneal mass in the renal fossa. The excision at the recurrence area was made through a subcostal transversal incision without any difficulty. After 6 months from this second procedure, there was no evidence of recurrence. The surgical aggressive treatment for late retroperitoneal RCC recurrence is a good method in this rare situation. Abdominal computed tomography must be done during long periods of follow-up for patients with radical nephrectomy for RCC to search for late retroperitoneal recurrences.

Papilomatose oral em cães: revisão da literatura e estudo de doze casos

Canine papillomatosis is an infectious viral disease characterized by oral, cutaneous or ocular papillomas, usually benign. The treatment is indicated in animals, with multiple tumors that produce pharyngeal obstruction, and problems, of eating or for aesthetic reasons. Different treatment protocols have been proposed, including surgical excision, cryosurgery, electro surgery, autogenous or recombinant vaccines, imunomodulators drugs, systemic and intralesional chemotherapy. In this study were reviewed the more important aspects of canine oral papillomatosis. In the 12 studied animals, the papillomas were observed predominantly in mouth, gum and palate regions, in puppies until 12 months, presenting combined infection with ehrlichiosis. The treatment using Propionibacterium acnes and/or autogenous vaccine showed efficacy in eight dogs (66.7%).

Orbital solitary fibrous tumor: Report of two cases and literature review

Background: Solitary fibrous tumor (SFT) is a rare, benign, and very uncommon lesion in the orbit. Because of its complex and variable clinical and histological appearance the SIFT is often misdiagnosed.Cases: Two new cases of orbital SIFT are reported, one in a man and the other in a woman, both unilateral and in the superomedial orbit.Observations: Clinical and tomographical evaluations were conducted and the lesions were excised. The histological evaluation showed the tumors were composed of spindle-shaped cells within colla.-en bundles and vascular channels. Immunohistochemical staining was positive for CD 34 and negative for S-100 protein.Conclusion: Immunohistochemical study is an important adjuvant in determining the SIFT diagnosis. Long-term follow-up is necessary because of the possibility of SFT recurrence after excision. (C) 2003 Japanese Ophthalmological Society.

Flabby Ridge Correction Using an Auxiliary Technique With Connective Tissue Graft

A common finding in patients with edentulous maxilla and partially dentate mandible is mainly the presence of flabbiness in the anterior edentulous alveolar ridge that can compromise the retention and stability of a denture. Thus, this case report presents the correction of a flabby ridge, using an auxiliary technique combining surgical excision and autogenous connective tissue grafting. The technique improved the quality of the osteomucosal support of the alveolar ridge and increased the vestibule deepness, whose result increased the success rate of the new conventional total prosthesis.

Conservative Treatment of Odontogenic Myxoma

Odontogenic myxomas (OMs) are nonencapsulated rare benign tumors that can occur in gnathic bones. They are locally invasive and have a high recurrence rate. Radiologically, OMs show a multilocular (in the majority of cases) or unilocular radiolucency, with either distinct or poorly defined margins. Histopathologically, OMs are characterized by spindle-, wedge-, or stellate-shaped cells loosely arranged in an abundant mucoid background. Myxomas are mainly asymptomatic. Radical surgery, excision, and enucleation followed by curettage of the surrounding bony tissue have all been advocated as treatment options. This study presents a successful case of conservative treatment of OMs with a 5-year follow-up.

Large Unicystic Ameloblastoma of the Mandible: Management Guided by Biological Behavior

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is a slow-growing benign tumor of the jaw, and patients usually present late after the tumor achieves considerable size to cause facial disfigurement. Diagnosis mainly from tissue biopsy and radiograph findings does assist in differentiating between types of ameloblastoma. Unicystic ameloblastoma is a tumor with a strong propensity for recurrence. There is a difference in biological behavior between mural unicystic ameloblastoma and those which are simply cystic or show intraluminal proliferation. The challenges in the management of this tumor are to provide complete excision in addition to reconstructing the bony defect, to provide the patient with reasonable cosmetic and functional outcome. The authors report a case of a mural unicystic ameloblastoma in a 23-year-old man who was treated by partial resection of the mandible. Biomedical prototypes were used because they provide acceptable precision and are useful for treatment planning.

Palatal lymphangioma: A case report

Lymphangioma is a rare, congenital benign tumor involving vascular malformation, with a great potential for recurrence. It appears during the early years of life and therefore is highly common among children. We report here a five-year-old patient with a simple lymphangioma. The mother of the child reported she had noted the lesion in the palate after an injury in the area with a pen. The recommended treatment was surgical excision since this was a small and well-delimited lesion. Periodic clinical controls for 18 months showed that the mucosa presented normal characteristics, with no signs of recurrence.

Structural basis of nuclear import of flap endonuclease 1 (FEN1)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ameloblastic fibro-odontoma: A case report

Ameloblastic fibro-odontoma (AFO) is a rare, benign, slow-growing odontogenic tumor, generally asymptomatic and more prevalent in children and adolescents. We report a case of AFO in the mandible of an eight-year-old Caucasian male patient, and review the literature. Intraoral examination revealed a swelling extending from the deciduous second molar to the retromolar triangle, covered with normal mucosa. A panoramic radiograph showed a large, well-demarcated radiolucency with radiopaque areas. The provisional diagnosis was of AFO, and so an incisional biopsy was performed. Histologically, the lesion was composed of connective tissue resembling the dental papilla, with epithelial strands or islands, as well as denticles and amorphous masses of enamel and dentin consistent with a diagnosis of AFO. Surgical excision and curettage of the lesion were performed. The patient has been monitored for eight years and the lesion has not recurred.

Pseudotumor inflamatório do pulmão

We report a case of a ten year old boy with an inflammatory pseudotumor in the right upper lobe. Surgical excision was undertaken. Inflammatory pseudotumors of the lung often occur in children. We recommend complete resection for diagnosis and cure. This tumor can mimic malignant neoplastic lesions and can recur after surgical treatment.

Uso de dilatador temporário em papilas mamárias de vacas, submetidas a lesões experimentais

Trinta e duas papilas mamárias de vacas da raça Holandesa, em período seco, foram submetidas a telotomia lateral que produziu defeito linear na mucosa da parte papilar do seio lactífero (PPSL). Houve excisão de um retângulo de mucosa de tamanho padronizado que provocou um defeito retangular na mucosa do PPSL, oposto à telotomia. Todas as telotomias foram suturadas e, aleatoriamente, em 16 delas foram introduzidas sondas de Foley de 2,7mm de diâmetro, formando o grupo de papilas com dilatador. A distensão dos balonetes das sondas de Foley provocou a dilatação da PPSL o que forçou a manutenção das sondas, por sete dias, na papila mamária. As 16 papilas restantes formaram o grupo de papilas sem dilatador. Foram realizadas videoteloscopias antes (dia 0) e após as telotomias (dia 8, após a retirada das sondas de Foley e dia 15). As avaliações morfológica e histológica do processo de cicatrização dos defeitos lineares e retangulares evidenciaram que o uso de dilatador na PPSL auxiliou na orientação cicatricial, mantendo a patência do seio lactífero em um maior número de papilas, quando os dois grupos foram comparados. A dilatação da PPSL interferiu na cicatrização das telotomias, e provocou maior número de alterações no epitélio de revestimento do seio lactífero.

Superficial acral fibromyxoma of the thumb: a case report

The authors report a case of superficial acral fibromyxioma (SAF) in a 74-year-old male who presented with a painless mass in a periungual dorsoradial region of the right thumb. It is a rare benign neoplasm, which was recently described, that arouse on the skin and subcutaneous tissue of the hands and feet, especially in the proximity to the ungual region of male adults. Surgical treatment was performed with the excision in blocks of the margins of the lesion and fragmentation of the nail and nail matrix, according to the literature recommendation. Although there may be local recurrence in 22% of the cases, the patient presents no symptoms, deformities or functional limitations. In addition, there was no sign of tumor recurrence 18 months after the surgery. We are not aware of a similar case report in the Brazilian literature

Nasolabial cyst: case report

O cisto nasolabial é classificado como um cisto fissural, localizado externamente ao tecido ósseo, na região correspondente ao sulco nasolabial e asa do nariz. Estes cistos são freqüentemente assintomáticos e geralmente promovem a elevação da asa do nariz. Apesar da sua difícil ocorrência, é importante reconhecermos as características desta lesão. O objetivo deste artigo é o de revisar a literatura e de discutir aspectos histológicos e etiológicos desta condição, bem como o tratamento por meio da excisão cirúrgica.