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Fernandes L, Machado B, José Cruz A, Sarmento G, Quelhas Costa R, Pereira T, Scigliano H, Cerqueira R. Collagenous sprue: a rare cause of watery diarrhea and villous atrophy - case report. Gastroenterol Hepatol Bed Bench 2023; 16:532-538. [PMID: 37070112 PMCID: PMC10105505 DOI: 10.22037/ghfbb.v16i1.2671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/21/2022] [Indexed: 04/19/2023]
Abstract
Collagenous sprue is a rare and unrecognized cause of diarrhea and weight loss, mainly affecting the duodenum and small bowel. The clinical picture often resembles that of coeliac sprue, the main differential diagnosis, albeit, being refractory to a gluten-free diet. The histological features are fundamentally characterized by the deposition of collagen beneath the basement membrane of gut mucosa. Treatment should be initiated as soon as the diagnosis is established, so as to prevent the progression of fibrosis. We will describe the case of a 76-year-old woman with collagenous sprue, her diagnostic workup, histopathological examination, and response to treatment.
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Affiliation(s)
- Luís Fernandes
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Bárbara Machado
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - António José Cruz
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Gonçalo Sarmento
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Rita Quelhas Costa
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Teresa Pereira
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Horácio Scigliano
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Rute Cerqueira
- Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
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Marques-Antunes J, Cardoso F, Santos T, Nora M, Scigliano H. Invasive Lobular Carcinoma Arising in Ectopic Breast Tissue: A Case Report. Cureus 2022; 14:e24055. [PMID: 35573574 PMCID: PMC9097936 DOI: 10.7759/cureus.24055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
Incomplete regression of the embryonic mammary line occurs in 0.3-6% of the population. Ectopic breast tissue is mostly asymptomatic and can undergo malignant transformation. Ectopic breast cancer accounts for 0.2-0.6% of all breast cancers. Screening breast examinations can miss these lesions due to their location making the diagnosis more challenging. We describe a case of a primary invasive lobular carcinoma in an ectopic breast on the left axilla detected in a 49-year-old woman. Firstly diagnosed as a sebaceous cyst, the lesion was excised under local anesthesia. Histopathology showed breast tissue widely infiltrated by an invasive carcinoma. Excision of the remnant tissue with axillary lymph node dissection was performed. Ectopic breast carcinoma is a rare diagnosis and there is a general lack of awareness. The presence of an abnormal mass along the mammary ridge should raise clinicians’ attention. Management of primary ectopic breast carcinoma should be based on a multidisciplinary approach under the same principles as breast cancer. Furthermore, it does not appear to bring a worse prognosis when diagnosed at similar disease stages.
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Rodrigues E, Cardoso F, Scigliano H, Nora M. An Atypical Pleomorphic Lipomatous Tumor Presenting As Groin Mass. Cureus 2021; 13:e19410. [PMID: 34926009 PMCID: PMC8654064 DOI: 10.7759/cureus.19410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/26/2022] Open
Abstract
Cutaneous tumors with adipocyte differentiation are frequently excised by surgeons in their daily clinical practice and sometimes less common histological diagnoses arise. Knowledge of different pathological entities and their natural history is essential for better patient management. Atypical spindle cell/Pleomorphic lipomatous tumor (ASPLT) is a recent group included in the WHO classification. We report a case of a middle-aged man with an atypical pleomorphic lipomatous tumor in an unusual location.
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Marques-Antunes J, Braga J, Santos T, Nora M, Scigliano H. Basal cell carcinoma after radiation therapy in breast cancer. Breast J 2021; 27:678-680. [PMID: 34176183 DOI: 10.1111/tbj.14266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Joana Marques-Antunes
- Department of General Surgery, Centro Hospitalar entre Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
| | - José Braga
- Department of General Surgery, Centro Hospitalar entre Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
| | - Teresa Santos
- Department of General Surgery, Centro Hospitalar entre Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
| | - Mário Nora
- Department of General Surgery, Centro Hospitalar entre Douro e Vouga (CHEDV), Santa Maria da Feira, Portugal
| | - Horácio Scigliano
- Anatomical Pathology Laboratory Dr. Albino Oliveira (Unilabs), Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused a major global healthcare crisis, and the fields of science and medicine have been engaged in a massive effort to control and prevent the resultant deaths and morbidity. Researchers and pharmaceutical companies have developed in record time vaccines against COVID-19 that are intended to be safe and effective; however, the short validation time has been a challenge for doctors and epidemiologists, especially in light of the increase in reports emerging from various parts of the world about the adverse effects of the new vaccines. Portugal's national regulatory authority, the National Authority of Medicines and Health Products (INFARMED), has recently granted approval for Pfizer-BioNTech (Pfizer Inc., New York, NY; BioNTech SE, Mainz, Germany) and Moderna (Moderna, Inc, Cambridge, MA) COVID-19 vaccines, and they are being rolled out to be administered among the general population. In light of this, it is important for breast surgeons, family doctors, hematologists, and radiologists to consider the effects of recent COVID-19 vaccination history as a possible cause in the differential diagnosis for patients with unilateral cervical adenopathy. The objective of this report is to present a case that involves an adverse reaction involving acute-onset cervical lymphadenopathy in a female patient that coincided with her vaccination against COVID-19, even though cervical lymphadenopathy had not been previously reported as a potential side effect of the COVID-19 vaccination. We discuss the case of a Portuguese physician with a family history of breast cancer, who developed right cervical lymphadenopathy after receiving the first dose of the COVID-19 vaccine. Lymph node growth and ultrasound changes observed in the patient over the weeks, and a lack of information on the COVID-19 vaccine's adverse effects, prompted an in-depth study to understand its etiology.
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Affiliation(s)
- Florinda Cardoso
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Alcinda Reis
- Radiology, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Catarina Osório
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Horácio Scigliano
- Pathology, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Mário Nora
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
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Correia P, Correia JF, Scigliano H, Nora M. Unusual Cutaneous Metastases From Colon Adenocarcinoma. Cureus 2021; 13:e14065. [PMID: 33898148 PMCID: PMC8062121 DOI: 10.7759/cureus.14065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Skin metastases from internal malignancies are rare, even more from colorectal tumours, and are usually a sign of disseminated disease with a poor prognosis. However, with increased numbers of cancer survivors, a high index of suspicion should exist during the evaluation of cutaneous lesions since it can be the initial sign of disease progression or even the first sign that triggers a malignancy diagnosis, potentially improving the patient's odds. Herein, we report a case of synchronous cutaneous metastases from colon adenocarcinoma with unusual localization on the back and forearm of a 65-year-old man.
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Affiliation(s)
- Penélope Correia
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Joana F Correia
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Horácio Scigliano
- Pathology, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Mário Nora
- General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
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Rodrigues R, Branco M, Silva R, Ruano L, Fontão L, Lopes M, Scigliano H, Taipa R, Pires MM, Santos C. Peripheral neuropathy in systemic vasculitis and other autoimmune diseases - a report of five cases emphasizing the importance of etiologic characterization. eNeurologicalSci 2020; 21:100272. [PMID: 32995578 PMCID: PMC7502409 DOI: 10.1016/j.ensci.2020.100272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/24/2020] [Accepted: 09/09/2020] [Indexed: 10/24/2022] Open
Abstract
Introduction Peripheral neuropathies may present in the context of systemic vasculitis and other autoimmune diseases. The etiologic characterization is crucial to define the treatment and prognosis in secondary vasculitis. The purpose of this study is to describe the pathway of etiologic investigation including the role of nerve biopsy. Methods Retrospective analysis of patients seen in the neuromuscular outpatient clinic during the last four years with peripheral neuropathy in the context of systemic vasculitis or other autoimmune diseases. Results We present five patients with stepwise progressive sensorimotor deficits of upper and lower limbs. All patients presented with systemic features and one of them had an established diagnosis of systemic vasculitis. They underwent an extended blood panel, including autoimmune and serologic tests. Electromyography and nerve conduction studies revealed asymmetric axonal sensorimotor polyneuropathies in four patients, and an axonal sensorimotor multiple mononeuropathy in one. Four patients underwent nerve biopsy and the other performed a skin biopsy, with findings suggestive of possible vasculitic processes. The etiologies identified included microscopic polyangiitis, HBV-related polyarteritis nodosa and two eosinophilic granulomatosis with polyangiitis. In the last patient a specific etiology could not be established. Conclusion This series reveals the etiologic and phenotypic diversity of peripheral neuropathies related with systemic vasculitis. The therapeutic approach and prognosis were distinct in each patient, emphasizing the importance of a prompt diagnosis and appropriate treatment.
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Affiliation(s)
- Rita Rodrigues
- Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Mariana Branco
- Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Renata Silva
- Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Luís Ruano
- Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.,Public Health and Forensic Sciences and Medical Education Department, Faculty of Medicine of Porto University, Porto, Portugal
| | - Luís Fontão
- Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Marta Lopes
- Neurology Department, Hospital Privado de Braga Sul, Trofa Saúde Hospitais, Braga, Portugal
| | | | - Ricardo Taipa
- Neuropathology Unit, Department of Neurosciences, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Manuel Melo Pires
- Neuropathology Unit, Department of Neurosciences, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Catarina Santos
- Neurology Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
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Carvalho L, Ferreira T, Frutuoso L, Matos L, Castro T, Rodrigues D, Oliveira V, Gonçalves G, Nora M, Scigliano H. Large mucinous cystic neoplasm of the pancreas during pregnancy: a case report. J Surg Case Rep 2020; 2020:rjaa085. [PMID: 32665837 PMCID: PMC7342093 DOI: 10.1093/jscr/rjaa085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 12/13/2019] [Accepted: 03/19/2020] [Indexed: 12/18/2022] Open
Abstract
Mucinous cystic neoplasms (MCNs) of the pancreas occurring during pregnancy constitute a rare condition requiring special management due to its large size, malignant potential and the risk of fetal growth restriction. The key points to manage MCNs are to perform a correct diagnosis, accurately evaluate the grade of malignant potential in order to establish the right time for pancreatic surgery and to choose the most appropriate fetal mode of delivery. We describe a case of an incidental abdominal mass detected in a third-trimester pregnant woman. At surgery, a huge pancreatic cystic tumour was found and a distal pancreatectomy with splenic preservation was performed. The histopathological analysis revealed an MCN of the pancreas with low-grade dysplasia. To our knowledge, this is the largest pancreatic MCN detected in a pregnant woman reported in the literature and one of the few successfully resected after vaginal delivery.
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Affiliation(s)
- Lúcia Carvalho
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Tiago Ferreira
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Luísa Frutuoso
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Leonor Matos
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Tiago Castro
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Domingos Rodrigues
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Vera Oliveira
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Gil Gonçalves
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Mário Nora
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Horácio Scigliano
- Anatomical Pathology Laboratory Dr. Albino Oliveira (Unilabs), Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
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Ribeiro H, Scigliano H, Gonçalves E. Síndrome de Sweet - a propósito da localização incomum da forma clássica. Gal Clin 2017. [DOI: 10.22546/45/1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Lopes M, Santos C, Scigliano H, Campelos S. Atypical neuropathy in MPO-ANCA small vessel vasculitis. Rev Neurol 2016; 63:380-382. [PMID: 27699755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- M Lopes
- Entre Douro e Vouga Hospital Centre, Santa Maria da Feira, Portugal
| | - C Santos
- Entre Douro e Vouga Hospital Centre, Santa Maria da Feira, Portugal
| | - H Scigliano
- Entre Douro e Vouga Hospital Centre, Santa Maria da Feira, Portugal
| | - S Campelos
- Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
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Abstract
Most cases of pancreatoblastoma, a rare malignant epithelial tumor of the pancreas, are seen in the pediatric population. The rarity of pancreatoblastoma, the similar radiologic findings to those seen in other pancreatic lesions, and its histopathologic heterogeneity, make its preoperative diagnosis in adults a real challenge. We report ultrasound, computed tomography and magnetic resonance imaging correlative findings of a histologically proven pancreatoblastoma in a 37-year-old woman. Pancreatoblastoma should be considered in the differential diagnosis of a pancreatic mass presenting uncommon imaging features.
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Affiliation(s)
- Filipa Vilaverde
- Department of Radiology, Centro Hospitalar de Entre o Douro e Vouga, Feira, Portugal
| | - Alcinda Reis
- Department of Radiology, Centro Hospitalar de Entre o Douro e Vouga, Feira, Portugal
| | - Pedro Rodrigues
- Department of Surgery, Centro Hospitalar de Entre o Douro e Vouga, Feira, Portugal
| | - Ana Carvalho
- Department of Pathologic Anatomy, Centro Hospitalar de Lisboa Central - Hospital Curry Cabral, Lisboa, Portugal
| | - Horácio Scigliano
- Laboratório de Anatomia Patológica Dr. Albino Oliveira Lda, Centro Hospitalar de Entre o Douro e Vouga, Feira, Portugal
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Abstract
Solid Pseudopapillary Tumor of the pancreas is a rare nonfunctioning tumor. It is considered a low-grade malignancy that is apparently curable with surgical complete excision in most instances. We present a case of solid pseudopapillary pancreatic tumor that represented a challenge to the radiologists. This case highlights its possible various appearances and the need to the radiologist to be familiar with them.
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Affiliation(s)
- Ana Frias Vilaça
- Department of Imagiology, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal.
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