Adenocarcinoma primário multicêntrico com 12 focos: relato de caso e revisão da literatura Multicenter primary adenocarcinoma with 12 foci: case report and literature review

Relata-se caso raro de adenocarcinoma primário multicêntrico sincrônico em intestino delgado, apêndice cecal e intestino grosso, em homem de 82 anos, com quadro de abdome agudo inflamatório. Foi submetido à laparotomia exploradora, observando-se lesão intestinal estenosante e infiltrativa no ângulo hepático e múltiplas aderências entre as alças do intestino delgado. Foi realizada hemicolectomia direita. O estudo anatomopatológico mostrou 12 focos de adenocarcinomas primários comprometendo intestino delgado (oito focos), válvula ileocecal, apêndice cecal e intestino grosso (cólon ascendente e transverso).<br>A rare case of synchronous multicenter primary adenocarcinoma in the small intestine, cecal appendix and large intestine, in an 82-year-old man with a condition of acute abdominal inflammation, is reported. He underwent exploratory laparotomy, and a stenosing and infiltrative intestinal lesion was seen in the hepatic angle, along with multiple adherences between the loops of the small intestine. Right hemicolectomy was performed. The anatomopathological evaluation showed 12 foci of primary adenocarcinomas affecting the small intestine (eight foci), ileocecal valve, cecal appendix and large intestine (ascending and transverse colon)

Frontal cortex neuron types categorically encode single decision variables

Individual neurons in many cortical regions have been found to encode specific, identifiable features of the environment or body that pertain to the function of the region(1-3). However, in frontal cortex, which is involved in cognition, neural responses display baffling complexity, carrying seemingly disordered mixtures of sensory, motor and other task-related variables(4-13). This complexity has led to the suggestion that representations in individual frontal neurons are randomly mixed and can only be understood at the neural population level(14,15). Here we show that neural activity in rat orbitofrontal cortex (OFC) is instead highly structured: single neuron activity co-varies with individual variables in computational models that explain choice behaviour. To characterize neural responses across a large behavioural space, we trained rats on a behavioural task that combines perceptual and value-guided decisions. An unbiased, model-free clustering analysis identified distinct groups of OFC neurons, each with a particular response profile in task-variable space. Applying a simple model of choice behaviour to these categorical response profiles revealed that each profile quantitatively corresponds to a specific decision variable, such as decision confidence. Additionally, we demonstrate that a connectivity-defined cell type, orbitofrontal neurons projecting to the striatum, carries a selective and temporally sustained representation of a single decision variable: integrated value. We propose that neurons in frontal cortex, as in other cortical regions, form a sparse and overcomplete representation of features relevant to the region's function, and that they distribute this information selectively to downstream regions to support behaviour