The diagnosis of cervical mass is a challenge due to the wide variety of benign and malignant etiologies. Extrapulmonary small cell carcinomas (EPSCC) are rare entities, and those tumours arising as a primary cervical, especially in the thyroid gland, are exceedingly rare. As others small cell neuroendocrine carcinomas, the disease has an aggressive behavior. This case report is about a 40-years-old female patient admitted to the Hospital Felício Rocho, with airway compression caused by a cervical mass originated in the thyroid gland. The data were extracted from the medical records and information provided by the attendants. We describe here the multidisciplinary approach used to treat the patient as well as her outcome. We also review the clinical and molecular aspects of this rare entity.

The diagnosis of cervical mass is a challenge due to the wide variety of benign and malignant etiologies. Extrapulmonary small cell carcinomas (EPSCC) are rare entities, and those tumours arising as a primary cervical, especially in the thyroid gland, are exceedingly rare. As others small cell neuroendocrine carcinomas, the disease has an aggressive behavior. This case report is about a 40-years-old female patient admitted to the Hospital Felício Rocho, with airway compression caused by a cervical mass originated in the thyroid gland. The data were extracted from the medical records and information provided by the attendants. We describe here the multidisciplinary approach used to treat the patient as well as her outcome. We also review the clinical and molecular aspects of this rare entity.

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After the introduction of total mesorectal excision (TME) and radiochemotherapy, excellent results have been achieved in the treatment of patients with rectal cancer. With better oncologic control of the disease, the functional results of this type of therapeutic approach and their impact on the quality of life (QOL) of patients started to be increasingly valued. The aims of this study were to evaluate the QOL of patients with rectal cancer submitted to TME in the late postoperative period and the possible factors that directly influence their quality of life. A total of 72 patients submitted to TME due to extraperitoneal rectal tumor were assessed, after at least one postoperative year, by applying QOL questionnaires (EORTC QLQ-C30 and EORTC QLQ-CR38), in addition to a specific clinical questionnaire and rectal examination. Patients were evaluated regarding gender, age, indication of radiotherapy and chemotherapy preoperatively, length of postoperative period, distance from the anastomosis to the anal verge and general health status. The mean overall health status of patients was satisfactory (82.06). There was no difference in overall health status between patients with respect to gender, but the male patients had less insomnia (p = 0.002), better future prospects (p = 0.011), fewer effects of chemotherapy (p = 0.020) and better sexual function (p < 0.0001). Patients younger than 50 years had fewer urinary problems (p = 0.035), whereas those older than 65 years reported poorer sexual function (p = 0.012). Patients who underwent neoadjuvant therapy had more diarrhea (p = 0.012). Quality of life did not change significantly with time after surgery and the distance from the anastomosis to the anal verge. We conclude that patients undergoing TME have a good quality of life one year after the surgery and that the factors capable of affecting QOL should be identified and improved.

10597 Background: Identification of a germline mutation in a breast cancer predisposition gene has implications for the patients and their families. The National Comprehensive Cancer Network (NCCN) has published guidelines for genetic testing. In Brazil, this assessment is covered by health insurance in accordance with criteria defined by the National Supplementary Health Agency (ANS). For the majority of the population, served by the public health system (SUS), the assessment is not routinely available. Methods: In order to determine the prevalence rates of NCCN and ANS criteria for germline testing in breast cancer (primary outcome) we retrospectively analyzed data from patients treated at two SUS oncology centers in Belo Horizonte, Minas Gerais, Brazil, between 01/01/18 and 12/31/19. The secondary outcomes were comparisons between the groups with and without germline testing criteria (NCCN and ANS) regarding overall survival, clinical and epidemiological characteristics. The association between qualitative variables was calculated using the Chi-square and Fisher tests. The Kaplan-Meier method was used to analyse the survival data and the differences between the groups were tested using the log-rank test. The level of significance was 5%. Results: A total of 357 patients were included in the final analysis. The presence of germline testing criteria were found in 126 patients (35%) according to NCCN guidelines and in 82 patients (23%) according to ANS guidelines. None of them were tested for germline mutations. The most common criteria were women up to 60 years old with triple negative tumors (n = 43, 12% of all patients) and diagnosis of cancer up to 45 years old (n = 75, 21% of all patients) according to ANS and NCCN criteria, respectively. When the group of patients who met at least one criterion for germline testing were compared with the group who did not met any criteria, we found in the first group: more ductal carcinomas and less lobular tumors (p = 0.009), more grade 3 tumors (p = 0.002), more triple negative tumors (p < 0.001), more neoadjuvant treatments (p = 0.008) and less hormonal therapies (p = 0.011). After a median follow up of 13.5 months there were 22 deaths in the cohort, 7 in the group with testing criteria (5.7%) and 15 in the group without testing criteria (6.4%). There was no statistical significant difference between the groups in terms of overall survival (p = 0.77). Conclusions: To our knowledge this is the first study to evaluate the prevalence of NCCN and ANS criteria for germline testing in patients with breast cancer treated in the Brazilian public health system. Our results show that more than a third of those patients are candidates for germline testing. Moreover, the data highlight a serious shortcoming in the management of breast cancer and must be considered in the development of public health policies for routine germline testing in that population.