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Introduction: The Merkel cell carcinoma is a rare cutaneous neuroendocrine tumor that originates from cells responsible for tactile sensitivity, it has an aggressive character, fast evolution and difficult treatment. Case report: 49 years Caucasian male patient, with a painless nodule, infiltrating deep tissue, not ulcerated and located in left arm identified during the dermatological consultation. The result of the incisional biopsy was positive for Merkel cell carcinoma. After resection of the lesion, complementary exams revealed metastatic disease in the axilla and chest wall. The chemotherapy treatment brought an initial improvement with tumor reduction, however, it was not durable, because new areas with tumor metastases in upper regions of the body were revealed, the patient was submitted to an another surgical procedure, after which a new chemotherapy regimen failed. Conclusion: At the time of the treatment of this patient, monoclonal antibodies, such as avelumab, were not available. Early diagnosis with immediate lesion excision surgery, before the involvement of other regions, remains the best option for a better prognosis. However, regardless of this, because of the limitations at the time of the treatment, the patient died. Introducción: El carcinoma de células de Merkel es un tumor neuroendocrino cutáneo raro, que se origina en células responsables de la sensibilidad táctil, tiene un carácter agresivo, una evolución rápida y un tratamiento difícil. Relato del caso: Paciente masculino, de 49 años, caucásico, que en atención dermatológica encontró nódulo indoloro, infiltrando tejidos profundos, no ulcerados y ubicados en la región del brazo izquierdo. El resultado de la biopsia incisional fue positivo para el carcinoma de células de Merkel. Después de la resección de la lesión, los exámenes complementarios mostraron enfermedad metastásica en la axila y la pared torácica. Con el tratamiento de quimioterapia, hubo un beneficio inicial con la reducción del tumor, sin embargo, no es duradero, ya que se revelaron nuevas áreas con metástasis tumorales en las regiones superiores del cuerpo, que se sometieron a un nuevo procedimiento quirúrgico, que después de un nuevo régimen de quimioterapia no tuvo éxito. Conclusión: En el momento del tratamiento de este paciente, los anticuerpos monoclonales, como avelumab, no estaban disponibles. El diagnóstico temprano con cirugía para la escisión de la lesión inmediata, antes de la participación de otras regiones, sigue siendo la mejor opción para un pronóstico favorable para el paciente. Sin embargo, a pesar de esto, con las limitaciones al momento del tratamiento, el paciente falleció. Introdução: O carcinoma de células de Merkel é um raro tumor neuroendócrino cutâneo, que se origina das células responsáveis pela sensibilidade tátil, possui caráter agressivo, evolução rápida e difícil tratamento. Relato do caso: Paciente do sexo masculino, 49 anos, caucasiano, que, ao atendimento dermatológico, apresentou nódulo indolor, infiltrando tecidos profundos, não ulcerado e localizado na região do braço esquerdo. O resultado da biópsia incisional foi positivo para carcinoma de células de Merkel. Após ressecção da lesão, os exames complementares evidenciaram doença metastática na axila e parede torácica. Com o tratamento quimioterápico, houve um benefício inicial com redução tumoral, porém, não durável, uma vez que foram reveladas novas áreas com metástases tumorais em regiões superiores do corpo, sendo submetido a novo procedimento cirúrgico, o qual, após novo regime quimioterápico, não obteve sucesso. Conclusão: Na ocasião do tratamento desse paciente, os anticorpos monoclonais, como o avelumab, não estavam disponíveis. O diagnóstico precoce com cirurgia de exérese da lesão imediata, antes do acometimento de outras regiões, permanece sendo a melhor opção para um prognóstico favorável ao paciente. Contudo, a despeito disso, com as limitações à época do tratamento, o paciente evoluiu a óbito.

Submitted by Almir Squinsani (almir.squinsani@unioeste.br) on 2019-04-25T13:35:05Z No. of bitstreams: 2 Thalita_Basso_2019.pdf: 2021893 bytes, checksum: 041871280dbeff2856c6a3f3cf66974b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Made available in DSpace on 2019-04-25T13:35:06Z (GMT). No. of bitstreams: 2 Thalita_Basso_2019.pdf: 2021893 bytes, checksum: 041871280dbeff2856c6a3f3cf66974b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2019-02-25 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES Introduction: Anti-neutrophil cytoplasmic antibodies (ANCA) are able to activate neutrophils through binding to their antigens, such as myeloperoxidase (p-ANCA), inducing neutrophil degranulation and respiratory burst even in sterile situations. This corroborates for cellular and tissue damage, and may be involved in the development and progression of breast cancer. Objective: This study measured pANCA levels in serum and breast tissue of women (n= 150) diagnosed with benign breast lesions (n= 58) and mammary carcinoma (n= 92), correlating these levels with clinicopathological aspects. Methods: Peripheral blood and breast tissue samples were collected from women attended at Francisco Beltrão Cancer Hospital - CEONC, Paraná, Brazil, from May 2015 to December 2017. Blood samples were centrifuged to obtain serum, and the tissue fragments were homogenized and centrifuged for further analysis of the supernatants. The analyses were conducted in pools, grouped according to different clinicopathological characteristics. The pANCA dosage was performed by enzyme immunoassay (IBL International Myeloperoxidase-Ab ELISA Kit, RE75601). The results were evaluated by the statistical program GraphPad Prism 6.0, considering p≤0,05 as significant. Results: p-ANCA levels were found to be elevated in pools related to worse prognostic aspects such as high histological grade (serum p=0.0465, tissue p