Letteratura scientifica selezionata sul tema "Skin calcifications"
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Articoli di riviste sul tema "Skin calcifications":
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Devriese, Magali, Anne Legrand, Marie-Cécile Courtois, Xavier Jeunemaitre e Juliette Albuisson. "Pseudoxanthoma elasticum with prominent arterial calcifications evoking CD73 deficiency". Vascular Medicine 24, n. 5 (4 giugno 2019): 461–64. http://dx.doi.org/10.1177/1358863x19853360.
Abstract (sommario):
Pseudoxanthoma elasticum (PXE) is a rare disorder characterized by skin, eye, and cardiovascular lesions due to ectopic mineralization and fragmentation of elastic fibers of connective tissues. We present an atypical case of PXE with diffuse vascular calcification and negligible skin and eye lesions. The patient was a 37-year-old man suffering from severe bilateral arterial calcifications in superficial femoral and posterior tibial arteries. Eye fundoscopy and skin examination were first considered normal. This phenotype suggested first the diagnosis of Arterial Calcification due to Deficiency of CD73 (ACDC) characterized by mutations in NT5E gene. However, we found two variants in ABCC6 gene, and no variant in NT5E. Skin reexamination revealed few lateral skin papules confined to the scalp. Phenotypic overlap was described in vascular calcification disorders, between GACI and PXE phenotypes, and we discuss here expansion of this overlap, including ACDC phenotype. Identification of these expanding and overlapping phenotypes was enabled by genetic screening of the corresponding genes, in a systematic approach. We propose to create a calcification next generation sequencing (NGS) panel with NT5E, GGCX, ENPP1, and ABCC6 genes to improve the molecular diagnosis of vascular calcification.
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Letavernier, Emmanuel, Elise Bouderlique, Jeremy Zaworski, Ludovic Martin e Michel Daudon. "Pseudoxanthoma Elasticum, Kidney Stones and Pyrophosphate: From a Rare Disease to Urolithiasis and Vascular Calcifications". International Journal of Molecular Sciences 20, n. 24 (17 dicembre 2019): 6353. http://dx.doi.org/10.3390/ijms20246353.
Abstract (sommario):
Pseudoxanthoma elasticum is a rare disease mainly due to ABCC6 gene mutations and characterized by ectopic biomineralization and fragmentation of elastic fibers resulting in skin, cardiovascular and retinal calcifications. It has been recently described that pyrophosphate (a calcification inhibitor) deficiency could be the main cause of ectopic calcifications in this disease and in other genetic disorders associated to mutations of ENPP1 or CD73. Patients affected by Pseudoxanthoma Elasticum seem also prone to develop kidney stones originating from papillary calcifications named Randall’s plaque, and to a lesser extent may be affected by nephrocalcinosis. In this narrative review, we summarize some recent discoveries relative to the pathophysiology of this mendelian disease responsible for both cardiovascular and renal papillary calcifications, and we discuss the potential implications of pyrophosphate deficiency as a promoter of vascular calcifications in kidney stone formers and in patients affected by chronic kidney disease.
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Frenna, T. H., e J. E. Meyer. "Identification of atypical skin calcifications." Radiology 187, n. 2 (maggio 1993): 584. http://dx.doi.org/10.1148/radiology.187.2.8475315.
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Poesen, N., M. Heidbüchel, J. J. Van den Oord e M. Morren. "Chronic Renal Failure and Skin Calcifications". Dermatology 190, n. 4 (1995): 321–23. http://dx.doi.org/10.1159/000246730.
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Lukac, Sonja, Maja Stankov, Dijana Niciforovic, Jelena Pilipovic-Grubor, Daniela Donat e Tijana Mrdjanin. "Unusual presentation of dermal microcalcifications on mammography images: A case report". Medical review 75, n. 9-10 (2022): 305–7. http://dx.doi.org/10.2298/mpns2210305l.
Abstract (sommario):
Introduction. Calcifications and microcalcifications are mineral deposits in the breast tissue. Breast calcifications are a common mammographic finding, present on over 80% of images, and they are usually benign. Characteristics such as size, shape, number, distribution pattern, location, density, and other findings help determine the pathology. Dermal calcifications of the breast are superficial and benign calcifications that are usually found on the sebaceous glands of the skin. In some cases, calcifications can be the first marker of underlying cancer development. They may be associated with the presence of ductal carcinoma in situ or even invasive ductal carcinoma that has spread to the surrounding breast tissue. By correct identification of benign calcifications as such, unnecessary interventions and use of limited resources can be avoided. Case Report. A 66-year-old female patient presented for a regular mammography check-up. On the previous mammographic examination, she was categorized as bilateral breast imaging reporting and data system 1. The new mammography images showed numerous newly formed grouped microcalcifications at the junction of the lower quadrants of the right breast, and a stereotactic vacuum-assisted biopsy was indicated. During the biopsy attempt, the image guided biopsy program did not detect any calcifications in the parenchyma or in any projection and therefore it did not allow the biopsy procedure to continue after several attempts. Examination of the right breast skin revealed lesions treated by the patient for a few weeks; a repeat mammogram was performed and it was observed that the calcifications were of dermal origin. Conclusion. Dermal calcifications are mostly tiny, about the size of skin pores, single or clustered, and often have a calcified rim surrounding a lucent center. However, dermal calcifications deserve a special attention, because they sometimes lack a lucent center and simulate grouped intraparenchymal calcifications that require careful monitoring or biopsy.
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Žatecký, Jan, Oldřich Coufal, Dobroslav Sekret e Matúš Peteja. "Symptomatic Calcifications after Mastectomy: A Rare Case Report with a Review of the Literature". Medicina 60, n. 3 (26 febbraio 2024): 399. http://dx.doi.org/10.3390/medicina60030399.
Abstract (sommario):
Introduction: Symptomatic calcifications of the breast or skin after breast cancer surgery and adjuvant radiotherapy are a rare entity, with only a few case reports published worldwide, reducing the patient’s quality of life, whilst asymptomatic calcifications are a common finding on imaging methods. Case presentation: Herein, we present a rare case report of calcifications after mastectomy and post-mastectomy radiation therapy causing chronic inflammation with ulceration and fistula formation, with a two-step surgical approach consisting of excision with linear suture and excision with the reconstruction using a thoraco-epigastric flap. Conclusions: To our knowledge, this is the first publication proving the feasibility of this therapy in patients with symptomatic dystrophic calcifications of the skin or the breast. Moreover, the article provides an up-to-date review of published studies about symptomatic calcifications after breast cancer surgery and radiotherapy with a focus on the time of the clinical manifestation from the radiotherapy and the used radiotherapy scheme.
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Diekmann, Felix, Susanne Diekmann, Ulrich Bick e Bernd Hamm. "Reduced-Dose Digital Mammography of Skin Calcifications". American Journal of Roentgenology 178, n. 2 (febbraio 2002): 473–74. http://dx.doi.org/10.2214/ajr.178.2.1780473.
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Sinitsyna, Anastasiya Vyacheslavovna, Yelena Vladimirovna Sinelnikova, Valentin Nikolayevich Krivokhizh, Olga Leonidovna Krasnogorskaya, Ruslan Abdullayevich Nasyrov, Pavel Vladimirovich Gavrilov e Yevgeniy Viktorovich Zharov. "Particular Features of the Sonograms of the Ligamentum Arteriosum and Para-Aortic Arterial Calcifications in Children Suffering From Tuberculosis of Intrathoracic Lymph Nodes". Pediatrician (St. Petersburg) 5, n. 1 (15 marzo 2014): 70–75. http://dx.doi.org/10.17816/ped5170-75.
Abstract (sommario):
The paper presents the results of a study aimed to check the assumption that there is disparity in interpretation of X-ray and ultrasound images of Ductus arteriosus in children supposed to have tuberculosis. In total the images of 230 children with ambiguous Mantoux tuberculin skin test and with calcification adjusted to aortic window described in terms of regular X-ray were investigated. It is stated that multispiral computer tomograms are usually falsely interpreted as presenting calcifications in cases when ultrasound scans reveal only tissue heterogeneity near former Ductus arteriousus.
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Rael, Jesse, e Gunnar Cederbom. "CARCINOMA-LIKE CALCIFICATIONS CAUSED BY UNUSUAL SKIN CONDITION". Southern Medical Journal 83, Supplement (settembre 1990): 2S—103. http://dx.doi.org/10.1097/00007611-199009001-00417.
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Linden, S. S., e D. C. Sullivan. "Breast skin calcifications: localization with a stereotactic device." Radiology 171, n. 2 (maggio 1989): 570–71. http://dx.doi.org/10.1148/radiology.171.2.2649928.
Libri sul tema "Skin calcifications":
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Freer, Phoebe E. Skin Calcifications. A cura di Christoph I. Lee, Constance D. Lehman e Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0049.
Abstract (sommario):
Dermal and epidermal calcifications in the breast are extremely common and are typically benign, of no clinical significance, and are unrelated to breast cancer. If the radiologist attempts to do a mammographically guided needle localization for surgical excisional biopsy of calcifications that are not recognized to be in the dermis, it is possible that the patient may proceed to surgical biopsy with no calcifications seen in the excised specimen. Therefore, it is important to recognize dermal calcifications as such at the time of screening or diagnostic imaging. This chapter reviews the key imaging and clinical features of skin calcifications that may be encountered either incidentally on breast imaging or on diagnostic imaging when a patient has been recalled from screening for grouped calcifications. Topics discussed include obtaining tangent views to accurately diagnose skin calcifications, as well as how to recognize calcifications on tomosynthesis.
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Holbrook, Anna I. Dystrophic Calcifications. A cura di Christoph I. Lee, Constance D. Lehman e Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0033.
Abstract (sommario):
Dystrophic calcifications are typically large (usually >1 mm), coarse, irregular or plaque-like and associated with lucent centers. They also may be thin, smooth, and round or oval, with lucent centers, called “rim” (previously also known as “eggshell”) calcifications. They form in response to trauma, including surgery or irradiation. They can be seen in association with other findings of breast trauma, including surgical clips, architectural distortion, skin retraction, skin thickening, oil cysts, or trabecular thickening. This chapter, appearing in the section on calcifications, reviews the key imaging and clinical features, imaging protocols, differential diagnoses, and management recommendations for dystrophic calcifications. Topics discussed include findings after breast trauma or surgery/radiation treatment and the evolution of fat necrosis.
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Horvath, Laura J. Reduction Mammoplasty. A cura di Christoph I. Lee, Constance D. Lehman e Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0061.
Abstract (sommario):
Reduction mammoplasty is a surgical procedure performed to decrease breast size. Breast parenchyma and skin are resected, and the nipple is repositioned to a more superior location on the smaller breast mound. The goals of the procedure are to alleviate a variety of physical and psychological complaints. Because women with a history of reduction surgery are commonly seen for screening mammography and other breast imaging studies, it is important to be aware of the normal post-operative appearance. This chapter, appearing in the section on intervention and surgical change, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for reduction mammoplasty. Topics discussed include clinical indications, surgical technique, and benign post-operative changes, including scars, oil cysts, fat necrosis, and calcifications.
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Galperin, Timur A., Kieron S. Leslie e Antonia J. Cronin. Cutaneous manifestations of end-stage renal disease. A cura di David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0131.
Abstract (sommario):
A broad range of skin diseases occur in patients with end-stage renal disease. Some of these conditions are benign, and make little impact on patients’ lives. Others, however, have a greater impact on quality of life, may be physically disabling, and even life-threatening. Mostly, they result from a combination of factors, such as electrolyte imbalance and co-morbid disease. Uraemic pruritus is the most commonly troublesome and an approach to it is presented. Other non-specific skin manifestations of CKD include skin-colour changes, xerosis, half-and-half nails Specific manifestations include acquired perforating dermatosis, bullous dermatoses, metastatic calcification, and nephrogenic systemic fibrosis. Pathophysiology, clinical presentation, diagnosis, and treatment options are discussed.
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Winearls, Christopher G. Kidney disease-focused features on examination. A cura di Christopher G. Winearls. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0005.
Abstract (sommario):
Examination depends on the context and clinical presentation and the emphasis will be different too. Tell-tale signs are often unnoticed in the general examination of the eyes (lecithin cholesterol acyltransferase deficiency, Fabry disease, corneal calcification), the skin (vasculitis, Anderson–Fabry disease), the optic fundus (haemorrhages and exudates, papilloedema), and the hands (nail patella syndrome, splinter haemorrhages of systemic lupus erythematosus, and subacute bacterial endocarditis). Many of these are illustrated. The regular review of patients on dialysis or with a kidney transplant is also considered.
Capitoli di libri sul tema "Skin calcifications":
1
Baselga, Eulalia T. "Calcification and Ossification in the Skin". In Harper's Textbook of Pediatric Dermatology, 95.1–95.13. Oxford, UK: Wiley-Blackwell, 2011. http://dx.doi.org/10.1002/9781444345384.ch95.
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Battistella, Maxime, e Bernard Cribier. "Calcification and Ossification". In Clinical and Pathological Aspects of Skin Diseases in Endocrine, Metabolic, Nutritional and Deposition Disease, 161–69. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-1-60761-181-3_21.
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Casey, Jillian P., Ellen Crushell, Kyle Thompson, Eilish Twomey, Langping He, Sean Ennis, Roy K. Philip, Robert W. Taylor, Mary D. King e Sally Ann Lynch. "Periventricular Calcification, Abnormal Pterins and Dry Thickened Skin: Expanding the Clinical Spectrum of RMND1?" In JIMD Reports, 13–19. Berlin, Heidelberg: Springer Berlin Heidelberg, 2015. http://dx.doi.org/10.1007/8904_2015_479.
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Vossen, Josephina A. "Scleroderma". In Musculoskeletal Imaging Volume 1, a cura di Kevin B. Hoover, 185–86. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190938161.003.0041.
Abstract (sommario):
Chapter 41 discusses scleroderma, which is a rare autoimmune condition that can affect any organ system. The pathogenesis of scleroderma is complex and remains incompletely understood. Scleroderma affects women more than men and frequently becomes apparent in the fourth to sixth decades of life. Skin involvement is the most common manifestation and often associated with musculoskeletal involvement, especially in the hands. Imaging findings overlap with other connective tissue diseases and erosive arthritides. Radiographs of symptomatic body parts, most commonly the hands, are the standard initial imaging assessment of the musculoskeletal system. Soft tissue calcifications and sclerodactyly are characteristic with less common articular changes resembling the erosive arthritides.
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Rosenow, Edward C. "Ochronosis". In Mayo Clinic Challenging Images for Pulmonary Board Review, 635–38. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199756926.003.0084.
Abstract (sommario):
• Metabolic disorder of deforming arthropathy • Homogentisic acid in urine, which becomes dark on standing and is characteristic • May be first diagnosed on lateral CXR • Eventually pigmentation of skin, sclerae, and ear and nose cartilage • Earliest change is laminated calcification of intervertebral disk, followed by collapse of disk spaces and osteoporosis. Osteophytes are a later occurrence, as is involvement of weight-bearing joints...
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Jong, E. W. De Vrind-De, P. R. Van Emburg e P. M. De Vrind. "Mechanisms of calcification: Emilianiahuxleyi as a model system". In The Haptophyte Algae, 149–66. Oxford University PressOxford, 1994. http://dx.doi.org/10.1093/oso/9780198577720.003.0008.
Abstract (sommario):
Abstract Coccolithophorids are haptophytes which form calcified scales called coccoliths. Heterococcoliths consist of unit elements of an often complex shape and are formed intracellularly. Holococcoliths contain rhombohedral calcite crystals and are apparently formed extracellularly. We assume that similar mechanisms play a role in the nucleation and growth control of both heterococcoliths and holococcoliths. The formation of heterococcoliths in the species Emilianiahuxleyi is described as a model system. Coccoliths were observed with transmission electron microscopy. They were subjected to morphometric and crystallographic analysis and a model approach for the morphogenesis of coccoliths is briefly described. It is concluded that the majority of faces of the unit elements of coccoliths represent biologically inhibited faces instead of crystal faces of calcite. An acidic polysaccharide isolated from coccoliths is thought to play a role in crystal growth control. A similar function is attributed to the organic skins associated with the mineral elements of coccoliths of other coccolithophorid species.
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Marinho, Sandra Aparecida, e Heglayne Pereira Vital da Silva. "Basal cell nevoid carcinoma syndrome: A review". In A LOOK AT DEVELOPMENT. Seven Editora, 2023. http://dx.doi.org/10.56238/alookdevelopv1-086.
Abstract (sommario):
Basal cell nevoid carcinoma syndrome (BCNCS) is a rare autosomal dominant genetic syndrome that is predisposed to cancer. It is characterized by the presence of multiple basal cell carcinomas (BCCs) on the skin, as well as numerous maxillary odontogenic keratocyst (QTOs), palmoplantar punctate depressions (pits), skeletal abnormalities, and other developmental defects. The genetic basis of this syndrome lies in causal mutations in the PTCH1 gene, a tumor suppressor gene located on chromosome 9. The present study aimed to review recent literature concerning SCNBC, addressing aspects such as clinical manifestations, diagnostic criteria, genetic etiology, and molecular tests used. A total of 88 articles were included, most of which were clinical cases. Among the clinical manifestations, QTOs were the most frequently mentioned major diagnostic criteria, followed by calcification of the cerebral sickle. Ocular anomalies, on the other hand, were the alterations belonging to the most prevalent minor criteria. A total of 18 clinical cases underwent molecular testing for mutations in the PTCH1 gene. The most used methods were genetic sequencing and the mutations frequently found were frameshift and nonsense mutation, which occurred in exons 2, 3, 6, 8, 11, 12, 18, and 21. Despite the existence of several mutations in the PTCH1 gene that are attributable to the etiology of SCNBC, the performance of diagnostic molecular tests were not performed in many of the studies analyzed, and even those that did not identify a correlation with the patient's phenotype or prognosis, and these are indicated only in some particular cases.
Atti di convegni sul tema "Skin calcifications":
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Gonçalves, Bruno Garcia, Helena Barbosa de Cerqueira Zarur, Rafael Alves Tumeh e Eduardo Montag. "One-STEP TechniqueTM for harvesting fat graft: A new technology to improve the outcome in breast reconstruction". In Brazilian Breast Cancer Symposium 2023. Mastology, 2023. http://dx.doi.org/10.29289/259453942023v33s1076.
Abstract (sommario):
Objective: The authors present a new technique that provides the harvest of the fat graft and conduct its immediate grafting in the breast reconstructed, after the treatment of breast cancer. Methodology: A total of 42 cases were performed by the senior author from April 2019 to December 2022, in patients submitted to breast reconstruction procedures in private hospitals in Goiânia, Goiás, Brazil. All patients have been submitted to surgical treatment of breast cancer in the past, whether by conservative treatment with partial resection and radiotherapy or any kind of mastectomy and implantbased breast reconstruction. Some patients had adjuvant radiotherapy. The Selective Tissue Engineering Photostimulation Technique (One-STEP TechniqueTM) involves using a diode laser with a wavelength of 1,210 nm applied to the subcutaneous tissue from the abdomen, hips, medial thighs, or axillary extension, before harvesting the fat grafts. The fat graft obtained by the One-STEP technique has innovative characteristics; as the laser is specific for the subcutaneous tissue, it reaches its maximum energy at the adipocytes causing them to vibrate, denaturing the connective tissue and releasing the adipocytes and stromal vascular fraction. The fat grafting was carried out immediately after the fat extraction, as an adjunct to improve the quality of the usual results, and no additional processing steps are required. The evaluation of results was performed at 40 and 90 days postoperatively. Results: The technique features make it easier to aspirate the graft and preserve the viability of cells. The authors observed an excellent take of the grafted fat showing great improvement in the skin quality and reduced formation of oil cysts and calcifications. Some patients showed great improvement even in radiated skin. Conclusion: The One-STEP TechniqueTM is an excellent alternative to improve the quality of the fat graft in order to achieve a more aesthetic breast reconstruction.
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Sousa, Andrea Alves da Silva de, Rocio Fernandez Santos Viniegra, Francisco Gabriel da Silva Frederico e Peterson Tiago Galvão. "SYNCHRONOUS BILATERAL CARCINOMA IN SITU: A CASE REPORT". In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1009.
Abstract (sommario):
Synchronous bilateral breast carcinoma (SBBC) is defined as the simultaneous presence of two primary tumors at diagnosis, one in each breast. It is also considered synchronous when the ipsilateral cancer is diagnosed within 12 months of the first diagnosis. No consensus has been reached on the origin of SBBC, as it can be interpreted as either a metastasis or a new primary tumor, and its prognosis is controversial. As this tumor is rare and requires further investigation, this study aims to report the case of a patient with SBBC with different biological characteristics. A woman, 63 years old, white, was referred to a private clinic in Rio de Janeiro, in June 2021 because her mammography was classified as BI-RADS IV. Menarche at 13 years, gravida 1 para 1. Menopause: 48 years, oral hormone therapy for 5 years. She has two maternal cousins with breast cancer who were diagnosed after the age of 50 years. She receives treatment for depression and denies other diseases. Physical examination: small breasts, no swelling or retraction. Palpation: left breast (LB) was more diffusely dense in the junction of outer quadrants. Negative papillary expression was found on both sides and axillae without suspicious lymph nodes. Mammography — June 2021: LB with amorphous calcifications with a 20 mm length in the 1/3 depth of the left lower quadrant (category IV). Right breast (RB): benign calcifications (category II). Breast ultrasound (June 2021): Category I. LB mammotomy: ductal carcinoma in situ (DCIS). Immunohistochemistry: estrogen receptor positive, progesterone receptor negative, and positive CREB-B2. She underwent stereotactic excision of the LB lesion and sentinel lymph node biopsy. Result: Negative sentinel lymph node, ductal carcinoma “in situ” with comedo, cribriform, micropapillary, and solid patterns; nuclear grade 3; presence of necrosis; and lobular cancerization. Positive superior, inferior, and anterior surgical margins were observed. Extent of margin involvement: moderate. Pathological staging: pT1mi pN0. Given the positive margins in the small volume breast and the extensive intraductal component, the treatment given to the patient was bilateral skin and nipple-sparing mastectomy with prosthesis implantation. Histopathological results of the skin and nipple-sparing mastectomy were as follows: LB: (micro)invasive breast carcinoma of no special type, with four foci of microinvasion. Presence of ductal carcinoma in situ with comedocarcinoma, cribriform, micropapillary, and solid architectural patterns; nuclear grade 3. Surgical margins were free of neoplasia. Nipple-areola complex with a focus on ductal carcinoma in situ, solid pattern, and intermediate-grade lobular cancerization were observed. The surgical margin was free of neoplasia. Pathological classification (AJCC/8aed): pT1mi (m) pN0. RB: ductal carcinoma in situ, cribriform architectural pattern, and nuclear grade 1; absence of necrosis and microcalcifications; and good cosmetic surgical result. Although SBBC is rare (ranges from 0.3% to 12% of breast cancer cases), it must always be remembered and investigated in screening tests and physical examinations, especially in patients at high risk of developing breast cancer, in order to contribute to timely diagnosis and treatment and to improve the woman’s prognosis. In this case, the findings of carcinoma in situ of the LB associated with comedonecrosis, high nuclear grade, HER2 positive, and microinvasions justify the warning for investigating lesions in the contralateral breast. The surgical choice may vary according to the optimal referral for the treatment of each lesion — mastectomy is not mandatory — providing similar survival.
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Belluco, Rosana Zabulon Feijó, Carolina Gaze Gonçalves Fontenele Gomes, Camila Pires Marinho, Renata Betelli Cardoso Alves, Geovanna Sabóia Veras, Júllia Eduarda Feijó Belluco, Flávio Lúcio Vasconcelos e Carmelia Matos Santiago Reis. "Breast neoplasm with distinct histological subtypes: A case report". In Brazilian Breast Cancer Symposium 2023. Mastology, 2023. http://dx.doi.org/10.29289/259453942023v33s1048.
Abstract (sommario):
Introduction: Breast cancer is a heterogeneous disease, divided into many subtypes, the most common being invasive ductal. Breast tumors can be derived from epithelial tissue or mesenchymal cells. Most malignant breast tumors are made up of a single type of tumor. Cases where there are two or more types of malignant tumors occurring at the same time are rare. We report a case with different types of malignancies, i.e., non-special invasive ductal carcinoma, metaplastic carcinoma, and squamous cell carcinoma occurred together. Case report: A woman, 56 years old, with no family history of gynecological neoplasia, sought care referring to a painful and erythematous nodule in her left breast for about 25 days. On physical examination, a 15×11 cm, slightly mobile nodule with irregular borders was noticed in the left breast and palpable axillary lymph nodes. The mammogram showed an isodense nodule with internal calcifications, measuring 10.2×9.4×7.2 cm, in the superolateral quadrant (QSL) of the left breast (ME) — BI-RADS V. The central biopsy showed nonspecial invasive breast carcinoma (NOS), triple-negative, and KI67 30%. She underwent neoadjuvant chemotherapy, and 5 months after the start, she showed evidence of tumor progression. The tumor was ulcerated and occupying the entire QSL of ME and on palpation of the armpit, multiple hardened lymph nodes on the left. Left radical mastectomy with axillary lymphadenectomy was performed. The anatomopathological examination of the specific specimen revealed different tumor types: ulcerated and moderately differentiated squamous cell carcinoma, invasive metaplastic breast carcinoma, with a negative immunohistochemical profile for RP, ER, and HER2, positive cytokeratin 7, and 70% Ki67. Two months after the mastectomy, she had tumor recurrence and underwent a new surgical approach. Plastron histopathology showed squamous cell carcinoma infiltrating skin, negative estrogen and progesterone receptors, and positive p63. She underwent radiotherapy and is currently being followed up, with no signs of recurrence.
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Boff, Germano Ramos, Elan Jedson Lemos, Bruna Walter Pasetti, Leonardo Henrique Bertolucci e Ricardo Antonio Boff. "A CASE REPORT: BREAST MYIASIS — AN UNCOMMON DISEASE". In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1015.
Abstract (sommario):
Myiasis is a dermatosis resulting from flies’ larvae infestation in animal and human tissues. More prevalent in subtropical and tropical countries, it is related to lower social and economic levels. The fly species that can cause this pathology are Cordylobia anthropophaga, Cochliomyia hominivorax, and Dermatobia hominis. The infestation happens after eggs are deposited in a disrupted tissue or by an orifice caused by a fly sting and attacks cutaneous and mucous membranes in many body regions, including the breast. There is no person-to-person transmission. The larvae feed on the injured tissue, leading to pain and tissue destruction. The abscesses, tuberculosis, and inflammatory sebaceous cysts are clinical conditions to be ruled out in differential diagnosis. An abscess is the most common inflammatory breast condition, presenting with pain, erythema, and local heating. A cold abscess may lead to the suspicion of mycobacteria infection, mostly in lactating women. Otherwise, sebaceous cysts when inflamed may look like an abscess, but will not have fluctuation signs, and an ultrasound (US) image will help the diagnosis. The diagnosis is clinical and done by observing moving larvae or by US showing a well-defined lesion, with high echogenicity, and the presence of larvae. The best treatment option is manual larvae extraction, associated or not with paste vaseline or mineral oil covering the affected area, which causes larvae immobilization and asphyxia. The ideal treatment is to remove the larvae intact, because maceration leads to the release of irritating substances into the surrounding tissue. Surgery is not a good option. It is useful to prescribe an antibiotic regimen to treat or prevent infections. This case report allows the conclusion that myiasis is an uncommon breast pathology and sometimes may be ignored in the clinical setting. For this reason, its presence must always be taken into consideration in the differential diagnosis of breast diseases in certain groups of patients coming from at-risk areas. A 56-yearold white female, obese, with low social and economic conditions, came to a public health outpatient clinic complaining of increasing volume, hardening, and skin alterations in the right breast (hyperemia and skin thickening) in the past 10 years. No investigation was done during this long period, but the symptoms worsened in the past 6 months and severe pain was reported by the patient. She was referred to a specialized center and a bilateral mammogram revealed an extensive asymmetry in the upper outer quadrant of the right breast with architectural distortion associated with uncountable atypical calcifications and diffuse dermal thickening, classified as BIRADS 5. Physical examination revealed the presence of bilateral, enlarged, suspected axillary lymph nodes. The patient underwent breast core biopsy that resulted in invasive breast cancer of nonspecial histologic type, Nottingham grade 3, molecular type luminal B (RE 20%, RP 30%, negative HER-2, and KI-67 60%/cells). After being staged with radiologic examinations, she was found with multiple bone metastases in the thoracic and lumbar bodies, as well as a lytic lesion in the left iliac wing. She started treatment with the oncology team using hormone therapy plus Zoledronic Acid plus chemotherapy. One month after beginning therapy, she went to an emergency unit presenting cavitations and dimpling in the right breast, associated with bullous lesions, necrosis, and bad smell. Physical examination demonstrated live moving larvae over the necrotic tissue, confirming the diagnosis of breast myiasis associated with a stage IV breast carcinoma.
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Belluco, Rosana Zabulon Feijó, Flávio Lúcio Vasconcelos, Paulo Eduardo Silva Belluco, Júllia Eduarda Feijó Belluco e Carmelia Matos Santiago Reis. "NIPPLE MINIMUM PAGET DISEASE: A CASE REPORT". In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1059.
Abstract (sommario):
Paget’s disease (PD) of the nipple is a rare cancer that affects the nipple and areola and accounts for between 0.4% and 5% of breast cancers. It was first described in 1877 by the English physician Sir James Paget. It affects women between 60 and 70 years of age and very rarely affects men. In PD, the skin on the nipple and areola becomes thicker. Clinical presentations are usually erythema, desquamation, or eczematous changes in the nipple, features that can progressively progress to erosion, overt destruction, and ulceration of the papilla. Bloody papillary discharge, itching, nipple retraction, and/or a palpable mass may be associated. Cancer cells, called Paget cells, are malignant, large, with clear, abundant cytoplasm and nuclei with prominent nucleoli. Like glandular cells, they appear either as isolated cell in the epidermal tissue or as groups of cells. Most women diagnosed with PD also have ductal adenocarcinoma, either in situ or invasive. The prevalence is 67–100% of cases, which gives a worse prognosis to the patient. Patients with Paget-associated invasive breast disease have lower hormone receptor expression, greater lymph node involvement, and higher human epidermal growth factor receptor type 2 (HER2) expression. An 82-year-old woman sought the mastology outpatient clinic for a follow-up of carcinoma in situ in the right breast 2 years ago, having been submitted to quadrantectomy and hormone therapy with tamoxifen, with no signs of recurrence. She complained of an exudative pruritic lesion on the left nipple that had started 6 months ago. She reported that the lesion started with itching and burning, associated with a spontaneous discharge of serous secretion from the itchy surface of the breast, which improved with the use of “talcum powder.” On physical examination, the presence of a discrete reddened area with a diameter of 3 mm, eczematous, with bloody areas interspersed with serous secretion was observed on the left nipple. Areola lesions and palpable nodules in the left breast were absent. She underwent mammography, which showed symmetrical breasts with fat-replaced parenchyma, absence of nodules, presence of isolated calcifications, and grouping in the superior lateral region of the left breast, categorized as BIRADS II. On ultrasound, a nodule with angled edges, measuring 5×4 mm in the superomedial quadrant of the left breast, which showed nodular enhancement and persistent kinetic curve on magnetic resonance imaging of the breasts. The histopathological study diagnosed moderately differentiated left breast ductal carcinoma, associated with a high-grade solid intraductal carcinoma and PD of the nipple, without the involvement of the areola. Immunohistochemistry revealed the absence of estrogen and progesterone hormone receptors and HER-2 overexpression in both histological types. She underwent mastectomy with sentinel lymph node biopsy that was free of neoplasia. Oncological follow-up with no signs of recurrence. PD, if left untreated, extends to the areola and other regions of the breast. Therefore, clinical suspicion from the first physical examination allows an early diagnosis of extreme importance, which improves the prognosis and allows less aggressive treatments.
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Vlaisavljevich, Eli, Logan P. Janka, Keat G. Ong e Rupak M. Rajachar. "Magnetoelastic Materials as Novel Bioactive Coatings for Bone Anchored Prostheses". In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206406.
Abstract (sommario):
Enhanced fibroblast activity at the implant-soft tissue interface is a key concern to the long-term success of many implanted biomaterials. Uncontrolled fibrosis has been shown to dramatically decrease the stability, function, and lifespan of biomedical implants. Fibrosis, defined as the overgrowth of various tissues about the implant, is caused by the excess synthesis of extracellular matrix components, primarily collagen, and often leads to walling off and hardening (calcification) of tissues at the biomaterial interface (1). Fibrosis is currently a major deterrent to stable bone anchored prostheses. These bone anchored mounting systems are designed to surgically attach a prosthesis mounting post directly into a patient’s bone. The attached post protrudes from the bone through the overlying soft tissue of the amputated limb providing an external connection point for the prosthetic. Although the bone anchoring system dramatically improves prosthetic limb mechanical stability, uncontrolled fibrosis at the soft tissue-mounting post interface is a significant problem (2). The fibrosis caused from aberrant cellular growth leads to the formation of irregular skin folds that prevent proper sealing to the bone anchoring post and also serves as a site for opportunistic infection and failure of the prosthetic system.
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Freitas, Laura Rabelo de, Lilian Cristina Silva da Costa, Maria Gabriela Ferreira da Silva, Luiza Rodrigues Batista e Daniele Pitanga Torres. "GIANT PHYLLODES BREAST TUMOR AFTER INDUSTRIAL SILICONE INJECTIONS: A CASE REPORT". In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1038.
Abstract (sommario):
A phyllodes tumor is an uncommon lesion in the breast. There are three forms of presentation: benign, borderline, and malignant. The major incidence of phyllodes tumor is seen in women between 40 and 50 years old, and the benign presentation is the most frequent, being more current in those women, the reason why it is so relevant to have a complete exeresis of the lesion with free surgical margins. We present a case of a female patient with a giant phyllodes tumor on the right breast after an industrial silicone injection. In March 2021, a 60-year-old patient suffering from high blood pressure and anxiety was assisted at the Mastology Clinic at Hospital Federal da Lagoa (HFL). Before 28 years, she had submitted to an industrial silicone injection in the breast, with no medical evaluation before or after the procedure. In 2016, she found a tumor in her right breast, a lesion with a progressive growth. In October 2020, she noticed an ulcer near the tumor, which is why she sought medical help. After two biopsies with no malignant evidence, she was forwarded to our service, presenting an extensive injury at the right breast: an ulcerated lesion filling (>12 cm), filling the lateral aspect of the breast, with bleeding areas and necrosis. The papillary areolar complex was completely deviated to the medial side. Another biopsy was made, but the results were again inconclusive of malignant cancer, despite the clinical features. The axillary area was affected by lymphadenopathy. The left breast had uncountable tumors, because of the industrial silicone injection. The patient chose the mastectomy of both breasts, afraid of a possible malignant disease. The surgery was performed in June 2021, with a lymph node biopsy on the right side. The histopathology reported a giant and benign phyllodes tumor (15×13 cm) with an extensive inflammatory process, necrosis, calcification, edema, vascular congestion, fibrosis, and foreign body giant cells reaction. The skin and papilla were attacked by the inflammatory process in all the depths of the dermis. The lymph nodes just presented an inflammatory process and surgical margins were free. The left breast presented the same lesions of the inflammatory process visible in the right breast. The patient remains in followup, considering the possibility of recurrence of the phyllodes tumor, and awaiting the appropriate time for breast reconstruction. Although there is no evidence about the risk factors for developing a phyllodes tumor, there is no doubt about the mutagenic potential of the silicone liquid in the body. The relevance of this study is based on the rare clinical disease and on the problem associated with illegal practice of aesthetic medicine, still frequent in our Society.