São Paulo medical journal = Revista paulista de medicina
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Hemangiopericytoma is a relatively rare tumor, first described in 1942, with approximately 300 cases described in the literature to date. In most cases, it affects the trunk and lower extremities. The head and neck incidence is less than 20%, mostly in adults. We describe a case of malignant head and neck hemangiopericytoma in a child. ⋯ A twelve-year-old male patient noted the presence of a firm painless right-side retroauricular lymph node of 1 cm in diameter, which at first remained unchanged for six months, but subsequently enlarged progressively. He denied having had previous trauma at that site. In November 2000, he presented nasal obstruction and voluminous epistaxis that required hospitalization and blood transfusion. During dental treatment one month later, a cranial x-ray revealed bone alterations. A subsequent computed tomography scan showed an extensive lesion of soft tissue density that had invaded the maxillary fossa, eroding the skull base and middle and nasal fossa. The child was then referred to our service, where biopsy was performed, giving a diagnosis of hemangiopericytoma. Shortly afterwards, magnetic resonance imaging revealed that this lesion had undergone significant growth, while maintaining the same invasion pattern. The patient was submitted to conservative surgery in April 2001, with only partial resection of the tumor because of its extent. Histopathological examination of the specimen confirmed the presence of malignant hemangiopericytoma. Following the surgery, the patient presented fast regrowth of the lesion, with partial response to chemotherapy and radiotherapy.
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Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients, although few studies have been done in our environment to analyze the results obtained from the implantation and utilization of such catheters. ⋯ The low rate of complications obtained in this study confirms the safety and convenience of the use of totally implantable accesses in patients undergoing prolonged chemotherapy regimes.
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Despite the advances in the cure rate for acute lymphoblastic leukemia, approximately 25% of affected children suffer relapses. Expression of genes for the multiple drug resistance protein (MDR-1), multidrug resistance-related protein (MRP), and lung resistance protein (LRP) may confer the phenotype of resistance to the treatment of neoplasias. ⋯ Evaluation of the expression of genes for resistance to antineoplastic drugs in childhood acute lymphoblastic leukemia upon diagnosis, and particularly the expression of the LRP gene, may be of clinical relevance, and should be the object of prospective studies.
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Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. ⋯ A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates.