The epithelioid sarcoma (ES) is an unusual variant of the sarcoma, not reaching 1% of all soft tissue sarcomas. Initially reported in 1970, it has a more aggressive variant, which was classified as the “proximal-type” in 1997. These are aggressive tumors with high rates of distant metastasis and local relapses. Isolated radio and chemotherapy responses are poor and free-margin surgical resection is the treatment of choice.This is the case report of a 25-year-old male patient diagnosed with “proximal-type” ES in the perineal region. He underwent surgical resection in another institution and was later admitted to our institution with local recurrence with rectal and left thigh muscle invasion. Neoadjuvant radio-chemotherapy was performed, followed by laparoscopic abdominoperineal rectal resection and partial left hemipelvectomy associated with left lower-limb amputation. The patient had no postoperative complications and is currently undergoing outpatient follow-up. The anatomopathological analysis showed tumor-free margins.The “proximal-type” ES is a rare soft-tissue sarcoma subtype. High local recurrence, as well as the metastasis rates, makes its treatment a challenging task.
Solid pseudopapillary tumors (SPTs) of the pancreas are rare tumors with low potential for malignancy, uncertain lineage, and favorable prognosis in most cases. The SPT has an excellent prognosis, and the standard treatment is surgical resection. The agenesis of the dorsal pancreas (ADP) is an extremely rare type of congenital pancreatic malformation and is characterized by partial or total loss of the body and tail of the gland. Its association with SPT has been reported only in two studies. We report a case of SPT associated with total ADP. A 36-year-old woman was diagnosed with a complex mass on pancreatic head topography, measuring 7.8×5.5cm, associated with complete agenesis of the body and tail of the pancreas. She underwent gastropancreatoduodenectomy with a successful postoperative outcome. The anatomopathological examination suggested an SPT and it was confirmed by immunohistochemistry.
Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine neoplasm with a poor prognosis. It usually affects white-skinned old individuals in areas chronically exposed to solar radiation. MCC's spontaneous regression is a mechanism not yet clearly understood. It is a known fact and a rare occurrence in MCC, after biopsy or incomplete resection has been performed. Considering the rarity of this type of occurrence, we will describe a clinical case treated at Hospital da Baleia, Belo Horizonte, State of Minas Gerais, Brazil. The report will address a male patient, 72 years old, leukodermic, with systemic arterial hypertension, type 2 diabetes mellitus and vitiligo. He was referred to the surgery department with a lesion in the right hypothenar region with an onset 4 months before admission, and presented with tumor regression after biopsy. Data was assembled through the analysis of the patient's medical record, after declared authorization, open interview with the patient at the time of follow-up appointments to the hospital's outpatient clinic, and analysis of photographic records of the injury before and after the instituted therapy.
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