The aim of our study was to investigate whether there has been a reduction in patient admission to a high-complexity cancer care center in Brasil during the COVID-19 pandemic, similar to what was reported in Europe. METHODS: We reviewed the cancer tracking database of the largest cancer center in southern Brasil and performed statistical tests to compare first-time appointments from the onset of the outbreak until the end of June to those of the equivalent period in 2019. RESULTS: We observed a dramatic reduction (-42%) in first-time appointments during the pandemic compared to the same period in the previous year (P <0.001). This reduction was observed among all medical specialties (P <0.001). CONCLUSION: The onset of COVID-19 was correlated with a reduction in admission to a high-complexity cancer care center in Brasil. Since a delay in diagnosis and treatment may influence prognosis, it is important that cancer centers and public health strategies reinforce care for non-COVID-19 patients to prevent potentially unnecessary deaths.

Lynch syndrome (LS) is the most common cause of hereditary colorectal cancer (CRC); however, it is still underrecognized and underdiagnosed. While international guidelines gravitate towards universal screening, the underuse of screening methods has been reported in real-world scenarios. This study aims to evaluate screening for LS among patients diagnosed with CRC in a public cancer center in Brazil and evaluate access to genetic counseling and testing for abnormal screens. For that purpose, all patients with CRC registered in our institution from July 2012 to December 2018 had their charts reviewed. Demographic and clinical characteristics were noted, as well as immunohistochemistry and microsatellite instability analysis results, when available. After applying exclusion criteria, a total of 1234 charts were reviewed. Among these, 257 patients were screened for LS, making up a 20.8% screening rate; when considering Jerusalem criteria, screening rate was 24.5%; for Bethesda criteria, it was 35.1%. Almost 80% of patients fulfilling Amsterdam criteria I/II were screened. There were 64 abnormal screens, from which 40 (62.5%) underwent genetic counseling and 12 (18.7%) underwent genetic testing. We concluded that overall screening rates for LS among CRC patients in a public cancer center in Brazil are low, and still very guided by stringent clinical criteria. Referral to genetic counseling and access to testing is limited, calling the whole process into question. Public policies aiming to raise awareness on hereditary cancer and include genetic testing in the public health system could help improve this scenario.

Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare. Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV- on the left upper limb, and grade IV+ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 × 1.8 Gy in the skull and neuroaxis and 5 × 1.8 Gy in tumor boost), the patient progressed without recurrence. Conclusion Since the characteristics of the tumor are similar to those of medulloblastoma, it is necessary to expand the studies on these lesions, to better understand their pathophysiology and list better diagnostic and therapeutic methods, in addition to those already available.

Introdução: O tumor de células gigantes (TCG) é raro, geralmente benigno, e pode ser localmente agressivo, com incidência quase desconhecida no crânio. Relato do caso: Paciente pediátrico com diagnóstico de sarcoma de Ewing (SE) e posteriormente de TCG, quando procurou atendimento médico por conta do aumento de volume em arco zigomático e região pré-auricular à direita. Os exames de imagem evidenciaram lesão expansiva em porção zigomática e escamosa do osso temporal à direita, com componente intracraniano extradural em fossa média, sem evidências de infiltração. Do ponto de vista anatomopatológico, observou-se neoplasia fusocelular. O marcador CD68 foi positivo e o marcador S100, negativo. Realizou-se microcirurgia para ressecção do tumor. O paciente permanece em acompanhamento com exames de imagem nos serviços de neurocirurgia e ortopedia, com as últimas ressonâncias magnéticas de crânio mostrando redução no tamanho da lesão. Além disso, não realiza terapia adjuvante e atualmente não apresenta queixas. Conclusão: Este é um caso importante em razão da sua raridade e dos dados clínicos que agregam informações sobre as patologias apresentadas, permitindo que, no futuro, novas pesquisas possam otimizar o tratamento da referida neoplasia e o prognóstico desses pacientes.