METAPLASTIC BREAST CARCINOMA IN A YOUNG PATIENT: A CASE REPORT

RESUMO CONTEXTUALIZAÇÃO: O câncer de mama é a 2ª neoplasia mais comum entre as mulheres no Brasil e no mundo. Essa doença, relativamente rara antes dos 35 anos possui características altamente heterogêneas, patologia específica e comportamento biológico distinto. Dentre os Subtipos, o Carcinoma Mamário Metaplásico possui uma incidência de apenas 0,2-5% nos casos de câncer de mama. O objetivo desse estudo é relatar, a partir de uma comparação e revisão de literatura, o caso de uma paciente portadora do carcinoma mamário metaplásico, abaixo de 40 anos, pela raridade do tipo histológico e de seu comportamento agressivo. DESCRIÇÃO DA EXPERIÊNCIA: A paciente inicialmente aos 28 anos apresentou o Papiloma Atípico e 2 anos depois desenvolveu o Carcinoma Mamário Metaplásioco, além de múltiplos nódulos metastáticos pulmonares, comum desse subtipo, e hepáticos. CONSIDERAÇÕES FINAIS: Deve-se destacar que é difícil extrair conclusões definitivas quanto ao prognóstico e tratamento destas lesões, uma vez que elas são muito infrequentes na maior parte de série de casos publicados.   Palavras-chave: Carcinoma Mamário Metaplásico, Carcinoma Mamário, Neoplasia Mamária Malígna, Câncer de Mama. ABSTRACT CONTEXT: The breast cancer is the 2nd most common neoplasia among women in Brasil and around the world. This disease, relatively rare before the age of 35 years, has highly heterogeneous characteristics, especific pathology and distinct biological behavior. Among the subtypes, the Metaplastic Breast Carcinoma has an incidence of only 0,2-5% between the breast cancer cases. The purpose of this study is to report, from a comparison and literature review, the case of a patient with Metaplastic Breast Carcinoma, below 40 yers old, due to the rarity of the histological type and its aggressive behavior. EXPERIENCE DESCRIPTION: The patient, inicially 28 years old presented the Atipic Papilloma and 2 years later developed the Metaplastic Breast Carcinoma, in adittion to multiple metastatic pulmonary nodes, common of the type, and hepatic. FINAL CONSIDERATIONS: It should be noted that it is difficult to draw definitive conclusions about the prognosis and treatment of these lesions, since they are very infrequent in most of the series of published cases. Keywords: Metaplastic Breast Carcinoma, Breast Carcinoma, Malign Breast Neoplasia, Breast Cancer

Splenectomy in non-traumatic diseases

Splenectomy represents the first choice for treatment of spontaneous splenic rupture, abscesses, cysts, tumours, and an alternative for control of hereditary, autoimmune, and myeloproliferative disorders. However, its relative indications have been reviewed for better understanding of both the primary affections and of splenectomy per se, particularly with regard to the immune system. The emergence of minimally invasive surgery, the possibility of splenic preservation, and availability of biological therapy has shown that the procedure has often been referred to as salvage therapy upon failure of other therapeutic propositions. On the other hand, patients have their general health status compromised by the underlying disease, by the use corticosteroids or biologic therapy, immunosuppressed, coagulation disorders, which contribute to the incidence of postoperative complications, such as infections, bleeding and venous thrombosis. Therefore, this scenario favours higher morbidity and mortality rates than those of other intra-abdominal surgical procedures. Thus, this review has the primary and comprehensive objective of purpose the best moment for splenectomy, when surgeons can interfere in the natural course of the disease increasing patients’ quality of life and survival. In short, it is desired that the surgeon has complete knowledge of the profound physiological changes imposed on the host. In addition, to distinguish when it is curative and mandatory from when it must be put on hold due to other non-operative treatments with similar outcomes and, lastly, when it is not recommended for not aggregating survival