Oral squamous cell carcinoma in young people with human papilomavirus / Carcinoma de Células Escamosas oral em pessoas jovens com papilomavírus humano

Introduction: The growth of oral squamous cell carcinoma (SCC) in positive human papillomavirus (HPV) patients is observed. The epidemiological profile is: young men, non-smokers and non-alcoholics. This is attributed to changes in promiscuous sexual practice. Objective: To understand HPV carcinogenesis, epidemiological and preventive implications. Methods: An integrative review of the literature was carried out in March 2018 in the PubMed and Science Direct databases. The descriptors used were: SCC, Young, HPV and Staging, combined by the AND modulator. Inclusion criteria were articles published in the last 10 years, related to the thematic and in the English, Portuguese and Spanish languages. In the PubMed were found 75 articles, after the application of the inclusion criteria were selected 64 articles for study. In the Science Direct were found 8 articles, after applying the selection criteria was selected 1 article for analysis. Results: HPV subtypes 16 and 18 are the most virulent. HPV is carcinogenic through the E6 and E7 genes. E6 inactivates the tumor suppressor gene p53. E7 inactivates the tumor suppressor gene pRb, resulting in overexpression of the p16 tumor suppressor protein that is associated with a better prognosis. The impact of TNM staging changed over time, the effect of N staging on mortality reduced, while the impact of T staging increased. Conclusion: Protected sexual practice and vaccination are efficient measures for the control of SCC, HPV positive. Therefore, the campaigns should be extended to the male audience. In addition, the staging of the disease should be updated for a better prognosis

Lipoma de traqueia simulando doença pulmonar obstrutiva Tracheal lipoma mimicking obstructive lung disease

Os tumores de traqueia são raros e podem ser de difícil diagnóstico, por mimetizarem outras afecções pulmonares de caráter obstrutivo, como asma e DPOC. Relatamos um caso de lipoma de traqueia em uma paciente que fora tratada para asma e DPOC, sem resposta adequada, até apresentar complicações infecciosas. A presença do tumor foi sugerida por TC de tórax e confirmada por fibrobroncoscopia. A paciente foi submetida à ressecção endoscópica do tumor; porém, evoluiu para o óbito por pneumonia e choque séptico.<br>Tracheal tumors are rare and can be difficult to diagnose due to their capacity to mimic other obstructive lung diseases, such as asthma and COPD. We report the case of a female patient with a tracheal tumor. She had previously been treated for asthma and COPD, with little response to the treatment. The onset of infectious complications prompted further investigation. Chest CT images suggested the presence of a tumor, which was confirmed by fiberoptic bronchoscopy. The tumor was endoscopically resected. However, the patient evolved to death due to pneumonia and septic shock