You searched for:"Daniel Guimarães Tiezzi"
We found (16) results for your search.Summary
Rev Bras Ginecol Obstet. 2007;29(4):200-204
DOI 10.1590/S0100-72032007000400006
PURPOSE: the aim of this clinical study of the histological findings in nonpalpable breast lesions managed by surgical excision after wire localization. METHODS: a total of 48 women subjected to 51 preoperative localizations of nonpalpable, mammographically detected breast lesions during August 2001 to April 2005. Indications for biopsy were clustered microcalcifications, solid mass, radiologic parenchymal distortion and focal asymmetries. The lesions were localized preoperatively using hook wire methods, and all biopsies were performed under local anesthesia and venous sedation. RESULTS: histopathology revealed carcinoma in 16 biopsies (31.4%). Noninvasive carcinoma was found in 50% of malignant lesions. Successful lesion sampling was achieved at the first attempt in 100% of cases. Among all malignant lesions, positive-surgical margins were observed in 18.7%. Postoperative complications were a rare event in our series. Suture dehiscence was found in four patients (7.8%). Two of these (3.9%) had local infection. CONCLUSIONS: the hook-wire localization for nonpalpable breast lesions is a simple, accurate and safe method for detection of early breast cancers. The appropriate surgical approach in a single procedure is an excellent method for diagnosis and treatment for early stage, nonpalpable breast carcinoma.
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Rev Bras Ginecol Obstet. 2013;35(5):221-225
DOI 10.1590/S0100-72032013000500006
PURPOSE: We aimed to determine whether clinical examination could adequately ascertain the volume of tissue to be resected during breast-conserving surgery after neoadjuvant therapy. METHODS: We reviewed the clinical reports of 279 patients with histologically diagnosed invasive breast carcinomas treated with neoadjuvant therapy followed by surgery or with primary surgery alone. We estimated volumes of excised tissues, the volume of the tumor mass and the optimal volume required for excision based on 1 cm of clear margins. The actual excess of resected volume was estimated by calculating the resection ratio measured as the volume of the resected specimen divided by the optimal specimen volume. The study endpoints were to analyze the extent of tissue resection and to ascertain the effect of excess resected tissue on surgical margins in both groups of patients. RESULTS: The median tumor diameter was 2.0 and 1.5 cm in the surgery and neoadjuvant therapy groups, respectively. The median volume of resected mammary tissue was 64.3 cm³ in the primary surgery group and 90.7 cm³ in the neoadjuvant therapy group. The median resection ratios in the primary surgery and neoadjuvant therapy groups were 2.0 and 3.3, respectively (p<0.0001). Surgical margin data were similar in both groups. Comparison of the volume of resected mammary tissues with the tumor diameters showed a positive correlation in the primary surgery group and no correlation in the neoadjuvant therapy group. CONCLUSION: Surgeons tend to excise large volumes of tissue during breast-conserving surgery after neoadjuvant therapy, thereby resulting in a loss of the correlation between tumor diameter and volume of the excised specimen.
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Rev Bras Ginecol Obstet. 2014;36(6):235-236
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Rev Bras Ginecol Obstet. 2010;32(6):257-259
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Rev Bras Ginecol Obstet. 2005;27(6):331-339
DOI 10.1590/S0100-72032005000600007
PURPOSE: to evaluate the epidemiologic data and signs of trophoblastic hyperplasia in patients with complete hydatidiform mole (CHM) and to estimate the risk associated with the persistence of the disease. METHODS:: we evaluated 214 patients with CHM submitted to uterine evacuation between 1980 and 2001. The patients were included prospectively. All patients were followed until negative bHCG with weekly clinical evaluation and bHCG quantification. We considered persistence when the patient needed another treatment after uterine evacuation. The risk factors for persistence were evaluated through univariate and multivariate analysis, and the odds ratio (OR) was calculated for each one. RESULTS: among the epidemiologic factors, only negative Rh was significant (OR=2.28). All signs of trophoblastic hyperplasia, represented by uterine size larger than expected, sonographic uterine volume, tecaluteinic cysts, and betaHCG higher than 10(5) were associated with risk for the presistence of the disease. The presence of at least one sign of trophoblastic hyperplasia showed sensitivity of 82% and predictive positive value of 35.1% (OR=4.8). The logistic regression identified larger uterine size than expected and bHCG higher than 10(5) as risk factors for persistence of the gestational trophoblastic disease (OR=4.1 and 5.5, respectively). CONCLUSIONS: the signs of trophoblastic hyperplasia showed good sensitivity to predict persistence of the disease; however, the low predictive positive value does not allow using these criteria to change treatment. It is very important to reinforce the importance of serial betaHCG quantification in these high-risk patients.
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Rev Bras Ginecol Obstet. 2009;31(1):35-40
DOI 10.1590/S0100-72032009000100007
Desmoid tumor is a noncapsulated neoplasia, locally aggressive, originated from the fibroblasts of the musculo-aponeurotic tissues. Even though with no malignant behavior, such as the ability of generating metastasis or of invasion, the desmoid tumor has a high tendency for local growth, causing deformities in the adjacent organs, pain and sometimes organ dysfunction, depending on the area involved. We report the case of a large intra-abdominal desmoid tumor, invading pelvic organs in a 53 year-old patient. The neoplasia has been totally extirpated and, at the moment, five years after the surgery, the patient presents no clinical or radiologic sign of lesion relapse.
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Rev Bras Ginecol Obstet. 2013;35(9):385-387