Surgical and histological evidence of case reports showing Schwannomas in the nasal area

Introduction and importance: Schwannomas are benign neurogenic neoplasms with an uncommon involvement of the nasal cavity and paranasal sinus, which usually appear as a painless formation. We report two cases of nasal schwannoma that was successfully treated by surgical excision with satisfactory functional outcomes. The aim of this study is to discuss the clinical assessment and imaging, (CT, MRI) differential diagnosis, histological examination, surgical approaches of this rarely encountered neoplasm in the sinus-nasal area. Case presentation: Case 1: a 53 years-old Caucasian male, hospitalized in the ENT Department with a 5-month progressive history of right nasal obstruction without epistaxis was diagnosed as a Schwannoma following clinical, histology and ENT endoscopy examination. Case 2: a 45 years-old Caucasian male with asymptomatic swelling arising 4 months before in the nasal tip area with progressive nasal deformity, diagnosed as a schwannoma and analyzed with MRI. Clinical discussion: Case 1: The patient had an uneventful post-operative course and a follow-up examination at 36 months showed no recurrence of the neoplasm with satisfactory functional result. Case 2: The patient had an uneventful post-operative course and a follow-up examination at 5 years showed no recurrence of the neoplasm and satisfactory aesthetic result. Conclusions: Schwannomas arising from sinonasal area are extremely rare, painless and with slow-growing evolution. The surgical option and histologic analysis are mandatory for a correct diagnosis

Solitary biceps muscle metastasis from neuroendocrine breast tumor.

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Potencial Larvicida de Melia Azedarach l. E ilex Paraguariensis st. Hil. No Controle de Aedes Aegypti (linnaeus, 1762) (diptera: Culicidae)

http://dx.doi.org/10.5902/2179460X15922The mosquito Aedes aegypti is the main vector of dengue. The conventional synthetic products used in the population control of this vector have presented resistance of the populations, in addition to risks to the health of the population and of the applicators themselves. This study was aimed at assessing the larvicidal potential of ethanolic extracts of Ilex paraguariensis and Melia azedarach in the control of A. aegypti in laboratory conditions. The assays were performed in plastic containers with a capacity of 150 ml, where were put 60 ml of the solutions containing different concentrations of the extracts. To this solution, 10 active larvae of the instars L2 and L3 were added. The experiment was accomplished in triplicate by using a control containing only water and food. The susceptibility assessments were accomplished at 24h and 48h after application. The treatments were compared with basis on the amount of live larvae. The efficiency of the tested treatments was recorded by means of the percentage of mortality calculated by the Abbott’s formula (1925). The larvicidal potential of the treatments was 100% for the concentration of 500 µg/mL for the extract of the fruits of M. azedarach (48 h) and 2000 µg/mL for the extracts of the leaves of I. paraguariensis (24 h) and M. azedarach (48 h). The efficiency of the extracts of I. paraguariensis and M. azedarach are promising results. The possibility of use of the extracts of these plants as larvicidal agents for A. aegypti is an accessible alternative before the synthetic product recommended by the Ministry of Health to control dengue.O mosquito Aedes aegypti é o principal vetor da dengue. Os produtos sintéticos convencionais utilizados no controle populacional deste vetor têm apresentado resistência das populações, além de riscos à saúde da população e dos próprios aplicadores. Esse estudo se propôs a avaliar o potencial larvicida de extratos etanólicos de Ilex paraguariensis e Melia azedarach no controle de A. aegypti em condições de laboratório. Os ensaios foram conduzidos em recipientes plásticos com capacidade de 150 ml, onde foram colocados 60 ml das soluções contendo concentrações diferentes dos extratos. A esta solução foram adicionadas 10 larvas ativas dos instares L2 e L3. O experimento foi realizado em triplicata, utilizado um controle contendo apenas água e alimento. As avaliações de susceptibilidade foram realizadas com 24h e 48h após a aplicação. Os tratamentos foram comparados entre si com base no número de larvas vivas. A eficiência dos tratamentos testados foi registrada por meio do percentual de mortalidade calculado pela equação de Abbott (1925). O potencial larvicida dos tratamentos foi de 100% para a concentração de 500 µg/mL para o extrato dos frutos de M. azedarach (48 h) e 2000 µg/mL para os extratos das folhas de I. paraguariensis (24 h) e M. azedarach (48 h). A eficiência dos extratos de I. paraguariensis e M. azedarach são resultados promissores. A possibilidade do uso dos extratos destas plantas como larvicida para A. aegypti representa uma alternativa frente ao produto sintético recomendado pelo Ministério da Saúde para o controle da dengue

Microsatellite and RAS/RAF Mutational Status as Prognostic Factors in Colorectal Peritoneal Metastases Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Background Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) leads to prolonged survival for selected patients with colorectal (CRC) peritoneal metastases (PM). This study aimed to analyze the prognostic role of micro-satellite (MS) status and RAS/RAF mutations for patients treated with CRS. Methods Data were collected from 13 Italian centers with PM expertise within a collaborative group of the Italian Society of Surgical Oncology. Clinical and pathologic variables and KRAS/NRAS/BRAF mutational and MS status were correlated with overall survival (OS) and disease-free survival (DFS). Results The study enrolled 437 patients treated with CRS-HIPEC. The median OS was 42.3 months [95% confidence interval (CI), 33.4-51.2 months], and the median DFS was 13.6 months (95% CI, 12.3-14.9 months). The local (peritoneal) DFS was 20.5 months (95% CI, 16.4-24.6 months). In addition to the known clinical factors, KRAS mutations (p = 0.005), BRAF mutations (p = 0.01), and MS status (p = 0.04) were related to survival. The KRAS- and BRAF-mutated patients had a shorter survival than the wild-type (WT) patients (5-year OS, 29.4% and 26.8% vs 51.5%, respectively). The patients with micro-satellite instability (MSI) had a longer survival than the patients with micro-satellite stability (MSS) (5-year OS, 58.3% vs 36.7%). The MSI/WT patients had the best prognosis. The MSS/WT and MSI/mutated patients had similar survivals, whereas the MSS/mutated patients showed the worst prognosis (5-year OS, 70.6%, 48.1%, 23.4%; p = 0.0001). In the multivariable analysis, OS was related to the Peritoneal Cancer Index [hazard ratio (HR), 1.05 per point], completeness of cytoreduction (CC) score (HR, 2.8), N status (HR, 1.6), signet-ring (HR, 2.4), MSI/WT (HR, 0.5), and MSS/WT-MSI/mutation (HR, 0.4). Similar results were obtained for DFS. Conclusion For patients affected by CRC-PM who are eligible for CRS, clinical and pathologic criteria need to be integrated with molecular features (KRAS/BRAF mutation). Micro-satellite status should be strongly considered because MSI confers a survival advantage over MSS, even for mutated patients