Data documento
06/05/2024

Título
Management of Early-Stage Vulvar Cancer

Autor(es)
Pedrão P.G. - Guimarães Y.M. - Godoy L.R. - Possati-Resende J.C. - Bovo A.C. - Andrade C.E.M.C. - Longatto-Filho A. - Dos Reis R.

Palavras chave
vulvar cancer - vulvar neoplasms - diagnosis and staging - sentinel lymph node

Resumo
Vulvar cancer is a rare gynecological malignancy since it represents 4% of all cancers of the female genital tract. The most common histological type is squamous cell carcinoma (90%). This type can be classified into two clinicopathological subtypes according to the etiology. The first subtype is associated with persistent human papillomavirus infection and is usually diagnosed in younger women. The second subtype is associated with lichen sclerosus condition, and in most cases is diagnosed in postmenopausal women. Currently, an increase in first subtype cases has been observed, which raised the concern about associated mortality and treatment morbidity among young women. Vulvar cancer treatment depends on histopathology grade and staging, but surgery with or without radiotherapy as adjuvant treatment is considered the gold standard. In recent decades, sentinel lymph node biopsy has been incorporated as part of the treatment. Therefore, we sought to review and discuss the advances documented in the literature about vulvar cancer focusing on the treatment of early-stage disease. Relevant articles, such as the GROINS-V studies and the GOG protocols, are presented in this review. Additionally, we discuss key points such as the evolution of treatment from invasive surgery with high morbidity, to more conservative approaches without compromising oncologic safety; the role of sentinel lymph node mapping in the initial staging, since it reduces the complications caused by inguinofemoral lymphadenectomy; the recurrences rates, since local recurrence is common and curable, however, groin-associated, or distant recurrences have a poor prognosis; and, finally, the long-term follow-up that is essential for all patients.

Citação
Pedrão PG, Guimarães YM, Godoy LR, Possati-Resende JC, Bovo AC, Andrade CEMC, Longatto-Filho A, Dos Reis R. Management of Early-Stage Vulvar Cancer. Cancers (Basel). 2022 Aug 29;14(17):4184. doi: 10.3390/cancers14174184. PMID: 36077719; PMCID: PMC9454625.

Data documento
06/05/2024

Título
Paracoccidioidomycosis with sarcoid-like cutaneous lesion: A clinicopathological challenge

Autor(es)
Cárcano C.B.M. - Tanaka V.D. - Alessi C. - Reis M.T. - Ferreira M.S.

Palavras chave
Paracoccidioidomycosis - Mycoses - Histology - Dermatology - Diagnosis - Sarcoidosis

Resumo
We describe a case of sarcoid-like cutaneous paracoccidioidomycosis in a 26-year-old male, with a 10-year evolution, wrongly diagnosed as granulomatous rosacea. The correct diagnosis was only possible after the appearance of a new skin lesion with a more typical characteristic of the dermatosis, correlated with anatomopathological, laboratory and imaging exams. The clinical presentation of paracoccidioidomycosis is diverse, and the sarcoid-like form can mimic several chronic granulomatous diseases, such as sarcoidosis, tuberculoid leprosy, leishmaniasis, or tuberculosis. This presentation of cutaneous paracoccidioidomycosis is rare, and its diagnosis depends on the clinicopathological correlation, which can be a challenge for the dermatologist.

Citação
Cárcano CBM, Tanaka VD, Alessi C, Reis MT, Ferreira MS. Paracoccidioidomycosis with sarcoid-like cutaneous lesion: A clinicopathological challenge. IDCases. 2022 Jul 18;29:e01574. doi: 10.1016/j.idcr.2022.e01574. PMID: 35923859; PMCID: PMC9340507.