Background Different names for stroke might mislead physicians and emergency medical service workers. This study aimed to assess the different words for stroke in Brazil and both intended response and related symptoms associated with those names. Methods Cross-sectional study enrolling healthy individuals from urban areas in Northeast of Brazil for an open-ended survey. We presented a typical clinical case of a stroke (an elderly who had sudden onset of hemiparalysis and slurred speech) and asked “what is happening?”, “what would you do?” and “which other symptoms could happen in this condition?”. Resuts From 1,475 interviewed individuals, 1,220 (82,7%) recognized the scenario as a stroke. There were 3 words to correctly identify (based on correct intended response and spontaneously evoked associated symptoms) the stroke, which were “AVC” (acronym for cerebrovascular accident, in Portuguese), “derrame” (spillage) and “trombose” (thrombosis). There were significant differences among them concerning demographic, economic, educational and geographical aspects, but there was no difference according to the intended reaction among them. The most cited associated symptoms (excluding those present in the case) were impaired consciousness (10.6%), headache (8.9%) and dysesthesia (7.7%). “Aneurisma” (aneurism) was also cited, by 3 individuals. Conclusion There are at least three words for stroke in Portuguese (“AVC”, “derrame” and “trombose”); they were similar in terms of correct intended responses and spontaneously cited accompanying symptoms. Stroke campaigns should apply different names to reach a broader audience and to improve stroke recognition.

Introduction: Encapsulated papillary carcinoma corresponds to approximately 1% of breast tumors. Although rare, it has a good prognosis, slow growth, and a 10-year survival close to 100%. Axillary metastases of non-breast neoplasms are also uncommon, and the coexistence of metastatic non-breast neoplasm in the axilla and another histological type of breast neoplasm is exceedingly rare. Objective: To describe a case of breast neoplasm with axillary metastasis of non-breast disease. Method/Case report: F.R., 95 years old, had a nodule in the left breast (LB) for 1 year, with progressive growth. Examination revealed an irregular nodule in the entire LB with retraction of the papilla, measuring 11x12 cm, and hardened lymphadenopathy of 2 cm in the right axilla. Ultrasound showed a mixed tumor with a multinodular central mass of 18.3x19.7 cm and two enlarged, heterogeneous lymph nodes in the right axilla. Core breast biopsy indicated carcinoma with a papillary growth pattern. She underwent left mastectomy and lymph node excision in the right axilla. Anatomopathological results revealed a 14 cm encapsulated papillary carcinoma with free margins and right axillary lymph node as a high-grade metastatic neuroendocrine carcinoma. She is on exclusive hormone therapy with tamoxifen. When investigating the primary axillary site, abdominal computed tomography (CT) showed an expansive, predominantly cystic, retroperitoneal formation on the left side, in close contact with the tail of the pancreas, adrenal gland, and left renal vein, pending clarification, probably related to the right axillary lesion. Due to clinical conditions, she continues without a diagnosis for the primary site of axillary metastasis. Results/Discussion: Encapsulated papillary carcinoma is characterized by being solitary, unilateral, of slow growth, with papillary proliferation, central malignancy, surrounded by cystic ductal dilatation. It has a good prognosis and is rarely metastatic. Usually, it presents low or intermediate nuclear grade and strong positivity for estrogen receptor. Neuroendocrine tumors are a relatively rare group of neoplasms in any part of the body, occurring in the digestive tract in 62%–82% of cases. They can be asymptomatic or have symptoms associated with the primary tumor or metastasis. They are a heterogeneous group, often found in the retroperitoneum, abdominal lymph nodes, and mediastinum, usually have multiple metastases, and their primary site is hard to identify. Axillary metastases are uncommon, mainly coexisting with breast neoplasm of good prognosis. Conclusion: The rarity of axillary metastasis of neuroendocrine carcinoma associated with the good prognosis of encapsulated papillary carcinomas gives scientific importance to the current case since its axillary approach allowed reaching an unlikely diagnosis of neoplasm with uncommon metastatic site.

Introduction: Schwannoma is a benign tumor originating from Schwann cells present in the myelin sheath of peripheral nerves. Breast presentation is rare, and its clinical manifestation can mimic that of breast carcinoma. Objectives: To report the case of a patient with breast Schwannoma. Method/Case report: T.S.L., 14 years old, presented a nodule in the left breast (LB) with local growth for 2 months. Ultrasound (US) revealed a cystic formation in the lower outer quadrant of 1.8x1.3 cm, BI-RADS 2. Physical examination indicated a nodular skin lesion next to the LB fold, with 2 cm at 5 h, 7 cm from the nipple. After the surgical excision of the nodule, anatomopathological examination showed a spindle cell neoplasm without nodular-pattern atypia or malignancy characteristics. Immunohistochemistry (IHC) confirmed the Schwannoma diagnosis. Considering this scenario, annual control was started, and the patient has no evidence of the disease after 5 years of diagnosis. Results/Discussion: Schwannoma is a typically benign tumor originating from Schwann cells in the myelin sheath of the nerves. It may result from the parasympathetic or sympathetic division of the autonomic nervous system of the organ. It is one of the few truly encapsulated tumors of the human body and almost always solitary. It is usually located in the trunk, flexor surfaces, retroperitoneum, and rarely in the breast, representing approximately 2.6% of Schwannoma cases. It affects individuals aged 30 to 50 years, with equal incidence in both men and women. The skin lesion presents as a sessile, asymptomatic nodule of 1–3 cm and slow growth. Pain and sensitivity may be present when tumor growth causes nerve compression. Mammography (MMG) shows well-circumscribed opacity, with a density similar to that of soft tissue. US usually reveals well-defined, hypoechoic, solid lesions and can include the target sign, posterior acoustic enhancement, and continuity with peripheral nerves. The definitive diagnosis is made histologically, and the differential diagnosis involves other spindle cell neoplasms, such as fibroadenoma, phyllodes tumor, leiomyoma, fibromatosis, and, rarely, metaplastic carcinoma. Fine-needle aspiration biopsy (FNAB) showed palisading fibrillar cells with non-atypical spindle-shaped nuclei forming Verocay bodies. IHC indicates intense and uniform expression of S-100 protein. Malignant transformation occurs in 3–10% of cases, with high cellular proliferation, atypical mitotic activity, cellular and nuclear pleomorphism, and foci of necrosis. The treatment of choice is surgical excision of the lesion. Tumor recurrence is low and associated with the mitotic index. Conclusion: The case reported and publications found bring to light the discussion on diagnosis and treatment of breast Schwannoma, a rare and benign neoplasm in this location.