Você pesquisou por y - Revista Brasileira de Ginecologia e Obstetrícia
You searched for:"Sérgio Ferreira Juaçaba"
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Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(3):211-214
DOI 10.1590/S0100-72032003000300011
The authors present a case of lymphangiosarcoma in the upper left limb of a 52-year-old patient previously submitted to a left-sided modified radical mastectomy followed by radiotherapy due to breast cancer six years earlier. This rare syndrome is associated with chronic lymphedema as a consequence of radical mastectomy followed by radiotherapy. Approximately 400 cases have been reported in the literature. The infrequent occurrence of this disease and the rather innocuous appearance of the tumor often lead to late diagnosis and treatment. In the present case, the diagnosis was based on an incision biopsy of the lesion and confirmed immunohistochemically using endothelial markers, antibodies (anti-CD31), vimentin and muscle actin. The patient's limb was amputated and no local or distant recurrence has so far been observed during 18 months of follow-up.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(3):211-214
DOI 10.1590/S0100-72032003000300011
The authors present a case of lymphangiosarcoma in the upper left limb of a 52-year-old patient previously submitted to a left-sided modified radical mastectomy followed by radiotherapy due to breast cancer six years earlier. This rare syndrome is associated with chronic lymphedema as a consequence of radical mastectomy followed by radiotherapy. Approximately 400 cases have been reported in the literature. The infrequent occurrence of this disease and the rather innocuous appearance of the tumor often lead to late diagnosis and treatment. In the present case, the diagnosis was based on an incision biopsy of the lesion and confirmed immunohistochemically using endothelial markers, antibodies (anti-CD31), vimentin and muscle actin. The patient's limb was amputated and no local or distant recurrence has so far been observed during 18 months of follow-up.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(4):233-239
DOI 10.1590/S0100-72032002000400004
Purpose: to analyze sensitivity, specificity, positive and negative predictive values and the likelihood ratio of transvaginal ultrasound and hysteroscopy when compared with the histopathologic examination of the endometrium in women with breast cancer who have been treated with tamoxifen. Methods: transversal study with 30 women in whom transvaginal ultrasound evaluated the echogenic pattern of endometrial echo and its thickness. Hyteroscopy was performed and described as normal (normal or atrophic endometrium) or abnormal (thickening, polyps, leiomyoma, synechia). Material for histopathology was obtained from endometrial biopsy and the findings were considered normal (irregular endometrial maturation and/or atrophy) or abnormal (polyps, simple or complex hyperplasia, leiomyoma or endometrial carcinoma). Results: the general diagnosis of endometrial modifications was present in 36.6% of patients. The most frequent results were cystic atrophy (46.6%) and endometrial polyps (26.6%). Through the ROC curve the best cutoff of 8 mm of endometrial thickness measure was determined. This measure showed sensitivity of 72.7%, specificity of 72.9%, positive predictive value of 66.6%, negative predictive value of 83.3% and likelihood ratio of 3.4. Hysteroscopy showed sensitivity of 90.9%, specificity of 68.4%, positive predictive value of 62.5%, negative prediction value of 92.8% and likelihood ratio of 2.8. Conclusions: the most frequent endometrial modifications were cystic atrophy followed by polyps. Transvaginal ultrasound showed a higher rate of false-positive (42.1%), when the cutoff for the thickness of the endometrium was 5 mm; however acuracy improved when the measure of 8 mm was used. The cutoff of 8 mm was determined through the ROC curve.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(4):233-239
DOI 10.1590/S0100-72032002000400004
Purpose: to analyze sensitivity, specificity, positive and negative predictive values and the likelihood ratio of transvaginal ultrasound and hysteroscopy when compared with the histopathologic examination of the endometrium in women with breast cancer who have been treated with tamoxifen. Methods: transversal study with 30 women in whom transvaginal ultrasound evaluated the echogenic pattern of endometrial echo and its thickness. Hyteroscopy was performed and described as normal (normal or atrophic endometrium) or abnormal (thickening, polyps, leiomyoma, synechia). Material for histopathology was obtained from endometrial biopsy and the findings were considered normal (irregular endometrial maturation and/or atrophy) or abnormal (polyps, simple or complex hyperplasia, leiomyoma or endometrial carcinoma). Results: the general diagnosis of endometrial modifications was present in 36.6% of patients. The most frequent results were cystic atrophy (46.6%) and endometrial polyps (26.6%). Through the ROC curve the best cutoff of 8 mm of endometrial thickness measure was determined. This measure showed sensitivity of 72.7%, specificity of 72.9%, positive predictive value of 66.6%, negative predictive value of 83.3% and likelihood ratio of 3.4. Hysteroscopy showed sensitivity of 90.9%, specificity of 68.4%, positive predictive value of 62.5%, negative prediction value of 92.8% and likelihood ratio of 2.8. Conclusions: the most frequent endometrial modifications were cystic atrophy followed by polyps. Transvaginal ultrasound showed a higher rate of false-positive (42.1%), when the cutoff for the thickness of the endometrium was 5 mm; however acuracy improved when the measure of 8 mm was used. The cutoff of 8 mm was determined through the ROC curve.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(4):241-246
DOI 10.1590/S0100-72032002000400005
Purpose: to make a differential diagnosis in regard to breast carcinoma and to evaluate diagnostic and clinical methods in the treatment of breast tuberculosis and the follow-up after adequate treatment. Patients and Methods: three patients with breast tuberculosis were observed from March 2001 to March 2002; the first two were hospitalized at our Mastology Department and the third patient was treated at a private clinic. The clinical signs and symptoms, laboratory findings, response to therapy and follow-up were evaluated. Results: the average age of the patients was 40.6 years. The most frequent signs and symptoms were pain and breast tumor. In two patients the presumptive diagnosis was based on the clinical findings, on the histological findings (granulomatous inflammatory process), and on the therapeutic response to tuberculostatic drugs. Only one patient had a microbiological diagnosis, as Koch's bacillus was identified in a sample of her breast tissue. Treatment with a triple tuberculostatic regimen, including rifampin, isoniazid and pyrazinamide, led to the regression of the lesions. Conclusion: primary breast tuberculosis, a rare occurrence which may present clinically as a breast nodule and radiologically as carcinoma, should be taken into account when making the differential diagnosis of patients presenting with mammary mass.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(4):241-246
DOI 10.1590/S0100-72032002000400005
Purpose: to make a differential diagnosis in regard to breast carcinoma and to evaluate diagnostic and clinical methods in the treatment of breast tuberculosis and the follow-up after adequate treatment. Patients and Methods: three patients with breast tuberculosis were observed from March 2001 to March 2002; the first two were hospitalized at our Mastology Department and the third patient was treated at a private clinic. The clinical signs and symptoms, laboratory findings, response to therapy and follow-up were evaluated. Results: the average age of the patients was 40.6 years. The most frequent signs and symptoms were pain and breast tumor. In two patients the presumptive diagnosis was based on the clinical findings, on the histological findings (granulomatous inflammatory process), and on the therapeutic response to tuberculostatic drugs. Only one patient had a microbiological diagnosis, as Koch's bacillus was identified in a sample of her breast tissue. Treatment with a triple tuberculostatic regimen, including rifampin, isoniazid and pyrazinamide, led to the regression of the lesions. Conclusion: primary breast tuberculosis, a rare occurrence which may present clinically as a breast nodule and radiologically as carcinoma, should be taken into account when making the differential diagnosis of patients presenting with mammary mass.
