Papilloma associated with recurrent respiratory papillomatosis (RRP), caused by human papilloma virus (HPV) infection types 6 and 11, is the most common benign neoplasm of the larynx. The clinical features of RRP vary widely from mild to aggressive forms. RRP in children is known as juvenile-onset recurrent respiratory papillomatosis (JORRP). Its outcome may be poor or even fatal due to the high rate of recurrence and eventual spread to the entire respiratory tract. Pulmonary invasion is reported to occur in 3.3% of patients with RRP, and malignant transformation in 0.5% of patients. We report the case of a 39-year-old female patient with a diagnosis of JORRP from the age of 3 years, with extensive bilateral pulmonary involvement and malignant transformation. Analysis of the papilloma and carcinomatous tissues revealed the presence of HPV type 11, which is associated with rapid and aggressive progression. We discussed the case on the basis of a literature review on pulmonary invasion, malignant transformation, and HPV 11 aggressiveness.

Oral squamous papilloma is a benign tumor whose pathogenesis has been associated with human papillomavirus infection. Thus, it is noteworthy that human papillomavirus infection is one of the risk factors associated with the development of cervical, anogenital, pharynx, larynx and oral cavity carcinomas. Oral squamous papilloma can affect any region of the oral cavity, and transmission of human papillomavirus can occur by direct contact, sexual intercourse or from mother to child during delivery. The diagnosis is clinical and histopathological, with surgical removal representing the treatment of choice. Recently, widefield optical fluorescence has been used as a complementary examination to the conventional clinical examination in the screening of oral pathological lesions and for the delimitation of surgical margins. We report a case of oral squamous papilloma with its clinical, histopathological features and, in addition, from the perspective of wide field optical fluorescence.

Study objectives  To perform anal lesion and anal cancer screening in men living with HIV/AIDS. Methods  This is a descriptive, observational, cross-sectional study. Data were obtained from the Specialized Assistance Service (SAE) in Divinópolis, Minas Gerais. A sociodemographic, epidemiological, and sexual behavior questionnaire was applied; material was collected for cytology, high-resolution anoscopy (AAR) was performed, and an acceptability questionnaire applied. Main results  Of the 50 men living with HIV/AIDS invited to participate in this study, 6% were excluded because they were illiterate, 40% refused to participate, and 54% participated in the survey. Among these, all answered the self-administered questionnaire. However, ten (37.0%) underwent proctological examination and anal cytology. Of these, two did not respond to the acceptability questionnaire. No anal lesions were identified during AAR and no biopsy was required. A 10% change in anal cytology was found. Conclusions  Through the study it was possible to construct a flow of referrals from the SAE to the UFSJ Coloproctology outpatient clinic. Moreover, the existence of internal stigmas on the part of the participants regarding the proctological examination and the lack of information about anal cancer screening are challenges to be overcome.

slowly progressing anterior mediastinal teratoma. This is an extremely rare case, not only in terms of the presence of this type of tumor in an elderly patient but also in terms of its evolution to malignancy. This, together with the fact that, in the literature, we have found only three studies of carcinoid tumors arising within mediastinal teratomas, has motivated us to write this article. Case reportA 66-year-old male patient, born in the city of São Luiz (in the state of Maranhão) and a resident of the city of São Paulo (in the state of São Paulo), was admitted to IntroductionTeratomas are germ cell tumors originating from the three embryonic germ layers. These tumors can be found at multiple sites, and most are benign. They are the second most common tumors of the anterior mediastinum, after thymomas, and are most often seen in young adults.(1) They account for 8 to 13% of all tumors occurring in this region. If they are treated surgically, the prognosis is quite favorable. Although there is little data in the literature regarding the evolution of a teratoma to malignancy, it is known to be an extremely rare occurrence. (2,3) We report the case of a 66-year-old patient submitted to resection of a carcinoid tumor (revealed by anatomopathological examination) that had arisen within a AbstractHere, we report the case of a patient with a slowly-progressing anterior mediastinal teratoma submitted to surgical resection. The anatomopathological examination of the sample revealed malignant degeneration to carcinoid tumor. Such evolution is very rare, and we have found only three related studies in the literature. We describe the clinicopathological features of the tumor and discuss the treatment administered. The evolution was satisfactory, and the patient was submitted to oncological treatment.Keywords: Mediastinal neoplasms; Teratoma; Carcinoid tumor; Mediastinum/surgery. ResumoNo presente artigo, relatamos o caso de um paciente portador de teratoma de mediastino anterior, de evolução lenta, o qual foi submetido à ressecção cirúrgica. O exame anatomopatológico da peça revelou degeneração maligna para tumor carcinóide. Tal evolução é extremamente rara, sendo encontrados na literatura apenas três artigos correlatos. Apresentamos uma descrição clínico-patológica do tumor e, por fim, discutimos a conduta terapêutica. Houve evolução satisfatória, e o paciente foi submetido a tratamento oncológico.Descritores: Neoplasias do mediastino; Teratoma; Tumor carcinóide; Mediastino/cirurgia.

A 38-year-old woman underwent mammography and ultrasonography (US) for a 1.5 cm palpable mass that had been noticed after last breast feeding, 8 years ago, in the upper outer quadrant of the right breast, 11-o'clock position. She had mild discomfort at the site in recent months but without enlargement. The patient did not have nipple discharge.Initial mammography of the right breast had demonstrated a circumscribed oval area of radiolucency that was mostly obscured at mediolateral mammography, but its borders appeared predominantly circumscribed in the craniocaudal projection (Fig. 1). There were no associated calcifications. US demonstrated a well-circumscribed, echogenic solid mass, an anechoic halo (Fig. 2). Due to pain, patient requested the investigation and her physician asked for fine needle aspiration which was performed.The cytology smears were studied with Papanicolaou staining. The smears showed numerous, compact and semitransparent pink/purple crystals with defined borders and variable shapes and sizes ("crystalline structures"). The background showed granular, amorphous and proteinaceous material with scattered foamy macrophages and rare epithelial cells with no atypia (Fig. 3).In view of the cytology, clinical and radiological findings, a diagnosis of a chronic galactocele was made.Galactocele arises generally after pregnancy, during and after lactation, and the diagnosis is confirmed by the aspiration of milk. They are the most common benign breast lesions in lactating women, and frequently occur after cessation of breast-feeding, when (a) (b) Figure 2. (a, b) US. (a) Ultrasound of the right breast shows an echogenic mass with anechoic halo (b) no flow was detected.