Objectives. Assess the prevalence of thyroid nodules and predictors of malignant origin in patients with autoimmune thyroid diseases. Patients and Methods. Retrospective study including 275 patients, 198 with Graves' disease and 77 with Hashimoto's thyroiditis. Clinical and demographical data, ultrasonographical nodule characteristics, total thyroid volume and histological characteristics were recorded. Results. Graves' disease: the prevalence of thyroid nodules and thyroid carcinoma were 27.78% and 5.05%, respectively. Older age (OR = 1.054; 95% CI = 1.029–1.080) and larger thyroid volumes (OR = 1.013; 95% CI = 1.003–1.022) increased the chance of nodules. Younger age (OR = 1.073; 95% CI = 1.020–1.128) and larger thyroid volume (OR = 1.018; 95% CI = 1.005–1.030) predicted thyroid carcinoma. Hashimoto's thyroiditis: the prevalence of thyroid nodules and carcinomas were 50.7% and 7.8%, respectively. Nodules were predicted by thyroid volume (OR = 1.030; 95% CI = 1.001–1.062). We found higher number of nodules in patients with thyroid carcinoma than in those with benign nodules (3 versus 2; P = 0.03). Patients with Hashimoto's thyroiditis presented nodules more frequently than patients with Graves' disease (50.65% versus 27.28%; P < 0.001), while the prevalence of carcinoma was similar (P = 0.751). Conclusions. Larger goiter was associated with carcinoma in Graves' disease and Hashimoto's thyroiditis. Younger patients presented higher risk of papillary thyroid carcinoma in Graves' disease. The prevalence of carcinoma was similar in both conditions.

Gastric-type adenocarcinoma of the cervix (GAS) is an uncommon and aggressive tumour unrelated to human papillomavirus (HPV) infection with distinctive histological and immunohistochemical characteristics. GAS may be associated with lobular endocervical glandular hyperplasia (LEGH), another unusual lesion. We report a case of a 59-year-old woman with screening cytology 'AGC-Neo' and cervical conisation exhibiting cervical intraepithelial neoplasia grade 1, extensive LEGH and canal sampling with abundant mucinous cells. Based on the possible association between LEGH and GAS, a total hysterectomy was performed. The histological diagnosis revealed a morphological gradient of lesions: LEGH, minimal deviation adenocarcinoma and GAS with lymphatic invasion. Immunohistochemistry revealed strong MUC6 expression and no p16 staining. After pelvic radiotherapy, the patient continues follow-up evaluation. The diagnostic difficulties of GAS and its relationship with LEGH are discussed. This rare tumour is important because it is poorly symptomatic and potentially aggressive. In addition, the methods for cancer control related to HPV do not affect this tumour.

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IntroductionIt is estimated that 1.8 million pregnant women worldwide are infected with syphilis and less than 10% are diagnosed and treated. In Brazil, about 30 thousand cases/year with progressive growth are related to social inequalities and lost opportunities of diagnosis and prevention. Considering the importance of a faster detection of this disease, an analysis is necessary because such data could contribute to the development of new syphilis control strategies in this population.MethodsThis retrospective case-control study included 170 women (34 cases and 136 controls), where the presence of VDRL and TPHA have defined as a case. The study was based on analyses of medical records of women admitted to the Women’s Hospital Prof.Dr.José Aristodemo Pinotti/Unicamp-São Paulo-Brazil, matched by age over a period of 24 months. Statistical analysis was performed using chi-square and Fisher’s exact tests. For the quantitative variables, descriptive measures were obtained and to verify a significant difference between the mean values, a Mann-Whitney test was used.ResultsThe prevalence was 1.04% and the mean age was 27.5a. 58.8% of women cases were white, 52.9% with a fundamental education and were in the 3.24 gestation (or 6.77). 70.6% of the controls were white with 45.6% average education and were at 2.27 gestation. In women with syphilis, the average number of sexual partners was 7, the beginning of the sexual activity was 15.3a, 29.5% were drug users (or 0.0001), and 35.3% had a history of STDs. Controls had an average of 2.6 sexual partners, sex at 17.1a, 11.1% used drugs and 7.4% had a history of STDs. The cases had 6.2 consultations (p=0.0664). Half of the partners were not treated. There was 1 neonatal death. Of the 34 women diagnosed with syphilis, only 5 achieved follow-up and cure.ConclusionA high prevalence of syphilis was identified, which was associated with white, young and multiparous women. Socio-demographic vulnerability and difficulty in diagnosis seem to influence the disease, it is noteworthy that only 1 in 7 women obtained a cure.

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