Summary. Vulvar carcinoma corresponds to the fourth gynecological malignancy in incidence, with more than forty thousand new cases being estimated worldwide in 2020. It is a disease characterized by locoregional spread presenting high recurrence rates although distant metastases are an uncommon event. The purpose of this work is to describe the diagnosis, treatment, and clinical course of vulvar carcinoma in a patient who presented regional recurrences and late metastasis to the mammary gland. Vulvar cancer is a disease with a well-defined natural history; but with the advancement of therapeutic possibilities in recent years, it has been possible to improve the prognosis, reducing the chance of locoregional recurrence. Thus, the possibility of distance recurrence must be remembered in inpatient follow-up with locally advanced vulvar carcinoma, even if atypically, as in the case reported.
No abstract
Introdução: Sarcomas cutâneos são neoplasias malignas incomuns, e compõem um grupo heterogêneo de doenças. Apesar de serem pouco frequentes, devem ser incluídos como diagnósticos diferenciais em lesões cutâneas que possuem apresentação clínica não habitual e/ou histopatologia inconclusiva. Relato do caso: Foram descritos dados clínicos, histológicos, e imuno-histoquímicos, forma de tratamento e de seguimento oncológico de três pacientes com diagnóstico de sarcoma cutâneo de linhagem celular muscular. Os pacientes tinham idade entre 63 e 74 anos; sendo que dois deles possuíam queixa de recidiva local da neoplasia após tratamento cirúrgico prévio. Foram submetidos à avaliação clínica, e, na sequência, à ressecção alargada com margens de 2cm. Nenhum deles apresentou recidiva regional, ou à distância, durante o seguimento oncológico. Conclusão: Tanto o leiomiossarcoma como o rabdomiossarcoma cutâneos, possuem melhor prognóstico quando comparados às neoplasias mesenquimais malignas de linhagem muscular que surgem em outros sítios anatômicos. No entanto, a definição do diagnóstico e, consequentemente, o tratamento cirúrgico de forma precoce são fundamentais para o controle locorregional da doença.
Introduction: Primary squamous cell carcinoma (SCC) of the breast is a rare neoplasm, which represents less than 0.1% of invasive breast cancers. Therefore, it is essential to discriminate between a primary SCC and a metastatic SCC. In order to be considered a primary carcinoma of the breast, a histological examination of the lesion must show more than 90% of squamous neoplastic cells, in addition to the absence of cutaneous SCC or other anatomical sites. Extra-mammary neoplasm metastases are uncommon, representing 0.5% to 2% of breast malignancies. Metastatic SCC in the mammary gland is an uncommon event. To date, only three cases were reported in the literature of secondary involvement of vulvar SCC in the mammary gland. The objective of this work is to report the case of a patient with secondary mammary metastasis to a vulva SCC. Case report: A 74-year-old female patient who underwent radical modified vulvectomy 10 years before. Her pathological stage was characterized as IIIB. For this reason, she was also submitted to adjuvant treatment with chemotherapy associated with radiotherapy to the vulvar region, inguinal lymph node chains and pelvic arteries. On the ninth year of cancer follow-up, she presented recurrence in the vaginal wall. In the complementary image exams, an extentension of neoplasia to pelvic organs was identified, but no distant metastatic lesions were found. She underwent monobloc resection of pelvic organs, with reconstruction of the urinary and intestinal transits. The patient showed a good clinical evolution, with no pelvic complaints. After one year, the patient returned complaining of a nodule in the right breast. On physical examination, a lesion was observed at the junction of the lateral quadrants of the breast, measuring +/- 3.5 cm, with associated inflammatory signs and imprecise limits, with a central region showing a fistulous orifice through which the necrotic material passed. On the mammography, a dense, rounded and partially delimited lesion was identified. She underwent a core biopsy that described a SCC. According to her clinical history, it was considered a remote relapse of the vulvar SCC. The patient was submitted to a quadrantectomy with an ipsilateral axillary lymphadenectomy and reconstruction with a lateral thoracic flap. On an anatomopathological examination there was a description that the neoplasm would invade the underlying muscle tissue; and the resection margins were free. Four out of the fourteen isolated axillary lymph nodes had metastases, without perinodal soft tissue invasion. Six months after breast surgery, the patient evolved metastases to both lungs and soon after she died without response to the systemic treatment employed. This report was approved by the Research Ethics – UFFS (Universidade Federal da Fronteira Sul) (number 4.034.565).
Atualmente, a Atenção Básica é porta principal das Redes de Atenção à Saúde (RAS) do SUS, sendo responsável pela ordenação dos serviços e atendimento integral aos indivíduos e coletividades, abrangendo questões subjetivas pertencentes ao campo da saúde mental, como o sofrimento. O sofrimento mental pode ser caracterizado como tristeza, desânimo, irritabilidade, podendo ou não ser acompanhado por uma patologia como depressão e ansiedade, sendo todo e qualquer sentimento ou situação que interfira nas ações cotidianas do indivíduo. Objetiva-se relatar a experiência de ações extensionistas, na modalidade eventos,realizados a partir das necessidades encontradas por um projeto de pesquisa cujo tema foi aabordagem do sofrimento mental por profissionais da Atenção Básica de Saúde. Foram realizadas ações, durante o período de outubro de 2017 a outubro de 2018,nosCentros de Saúde da Família, na Secretaria Municipal de Saúde e na Universidade, os seguintes eventos:Devolutivas da Pesquisa e Seminários de Integração e Socialização de Estudos na área de Sofrimento Mental e Saúde Coletiva.O público alvo incluiu: profissionais, gestores, acadêmicos edocentes. Por meio da experiência realizada foi possível promover a socialização dos achados de um projeto de pesquisa, e, além disso, promoveu um espaço para reflexão e fomento de propostas para os problemas relacionados ao sofrimento mental na Atenção Básica, de acordo com a realidade local.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.