SUZANA MATAYOSHI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Relationship between actinic keratosis and malignant skin lesions on the eyelid(2023) ROSSATO, Luiz Angelo; CARNEIRO, Rachel Camargo; MACEDO, Erick Marcet Santiago de; LIMA, Patricia Picciarelli de; URBANO, Mariana Ragassi; MATAYOSHI, SuzanaPurpose: To evaluate the variables possibly related to actinic keratosis and malignant skin lesions on the eyelid. Methods: A prospective study of patients with suspected eyelid malignancy was conducted. The participants underwent a 2-mm punch biopsy at two opposite sites of the lesion for diagnosis, and the results were compared with those of the histopathological study of the surgical excised specimen. The patients with an actinic keratosis component were divided into two groups (actinic keratosis-associated malignancy and actinic keratosis alone), which were compared for the following variables: age, disease duration, largest diameter, tumor area, Fitzpatrick classification, sex, tumor site and margin involvement. A cluster analysis was also performed. Results: We analyzed 174 lesions, of which 50 had an actinic keratosis component. Actinic keratosis was associated with squamous cell carcinoma in 22% of the cases and to basal cell carcinoma in 38%, which shows that both neoplasms may have contiguous actinic keratosis. Statistical analysis revealed no significant difference among the variables. In a cluster analysis, four groups were identified with malignant lesions in the medial canthus with the largest mean diameter and area. All margin involvements on the lower eyelid were related to malignancy, which means that all cases with margin involvement had an almost 100% risk of malignancy. Conclusions: Larger actinic keratosis lesions in the medial canthus and lesions with margin involvement on the lower eyelid have a greater probability of malignant association.
- Invasive squamous cell carcinomas and precursor lesions on UV-exposed epithelia demonstrate concordant genomic complexity in driver genes(2020) VEGA, Lorena Lazo de la; BICK, Nolan; HU, Kevin; RAHRIG, Samantha E.; SILVA, Camilla Duarte; MATAYOSHI, Suzana; PICCIARELLI, Patricia; WANG, Xiaoming; SUGAR, Alan; SOONG, Hunson Kaz; MIAN, Shahzad I.; ROBINSON, Dan R.; CHINNAIYAN, Arul M.; DEMIRCI, Hakan; DANIELS, Anthony B.; WORDEN, Francis; EBERHART, Charles G.; TOMLINS, Scott A.; RAO, Rajesh C.; HARMS, Paul W.Although squamous cell carcinomas (SCC) are the most frequent human solid tumor at many anatomic sites, the driving molecular alterations underlying their progression from precursor lesions are poorly understood, especially in the context of photodamage. Therefore, we used high-depth, targeted next-generation sequencing (NGS) of RNA and DNA from routine tissue samples to characterize the progression of both well- (cutaneous) and poorly (ocular) studied SCCs. We assessed 56 formalin-fixed paraffin-embedded (FFPE) cutaneous lesions (n = 8 actinic keratosis,n = 30 carcinoma in situ [CIS],n = 18 invasive) and 43 FFPE ocular surface lesions (n = 2 conjunctival/corneal intraepithelial neoplasia,n = 20 CIS,n = 21 invasive), from institutions in the US and Brazil. An additional seven cases of advanced cutaneous SCC were profiled by hybrid capture-based NGS of >1500 genes. The cutaneous and ocular squamous neoplasms displayed a predominance of UV-signature mutations. Precursor lesions had highly similar somatic genomic landscapes to SCCs, including chromosomal gains of 3q involvingSOX2, and highly recurrent mutations and/or loss of heterozygosity events affecting tumor suppressorsTP53andCDKN2A. Additionally, we identify a novel molecular subclass of CIS withRB1mutations. AmongTP53wild-type tumors, human papillomavirus transcript was detected in one matched pair of cutaneous CIS and SCC. Amplicon-based whole-transcriptome sequencing of select 20 cutaneous lesions demonstrated significant upregulation of pro-invasion genes in cutaneous SCCs relative to precursors, includingMMP1,MMP3,MMP9,LAMC2,LGALS1, andTNFRSF12A. Together, ocular and cutaneous squamous neoplasms demonstrate similar alterations, supporting a common model for neoplasia in UV-exposed epithelia. Treatment modalities useful for cutaneous SCC may also be effective in ocular SCC given the genetic similarity between these tumor types. Importantly, in both systems, precursor lesions possess the full complement of major genetic changes seen in SCC, supporting non-genetic drivers of invasiveness.
- Terapia fotodinâmica em carcinoma basocelular periocular: Relato de caso(2012) CARNEIRO, Rachel Camargo; MACEDO, Erick Marcet Santiago de; LIMA, Patricia Picciarelli de; MATAYOSHI, SuzanaThe authors report the use of photodynamic therapy with methyl aminolevulinate (Metvix (R)) in a patient with nodular and infiltrative basal cell carcinoma in the right lower eyelid. Side effects on the eye were evaluated weekly. After 12 weeks of treatment, to confirm cure the patient was submitted to a 2-mm punch biopsy, the anatomopathological findings of which were negative for neoplasia. Photodynamic therapy with methyl aminolevulinate was shown to be an attractive alternative to surgical excision(-)the current gold standard treatment worldwide.
- Imiquimod cream efficacy in the treatment of periocular nodular basal cell carcinoma: a non-randomized trial(2015) MACEDO, Erick Marcet Santiago de; CARNEIRO, Rachel Camargo; LIMA, Patricia Picciarelli de; SILVA, Breno Goncalves; MATAYOSHI, SuzanaBackground: The recurrence rate of periocular nodular basal cell carcinoma (PNBCC) following treatment with imiquimod (IMQ) has not yet been established. Previous studies did not include histological follow-up. The aim of this analysis was to evaluate the efficacy of topical immunotherapy with 5% IMQ cream for the treatment of PNBCC. Methods: Study design: A prospective, non-randomized, and uncontrolled longitudinal case series study. No participants were blinded. Punch biopsy confirmed PNBCC patients were included at the Ophthalmology Clinic of Sao Paulo University Medicine School Hospital (from 2008 to 2012). Patients were treated with 5% IMQ cream once a day, 5 days per week, for 8-16 weeks. Standard lesion photographic documentation was done during the study. Three months after treatment ended, an image-guided biopsy was performed. Patients were followed at 6-month intervals and annually for control biopsies. Main outcome measures were clinical and histological clearance rates. Data were analysed by frequency distribution for qualitative group characteristics and central tendency measures for quantitative data. Results: Twenty-four patients met the inclusion criteria, 19 of whom remained until the end of treatment. The histological clearance rate was 89.5% and 84.2%, respectively, at 3 and 39.5 months. The 3-year histological clearance rate was 81.8% (9/11) for lesions >10 mm, and 100% (8/8) for lesions <10 mm. Three patients did not tolerate the side effects of the medication and left the study. Two patients were excluded for treatment interruption related to comorbidities. Conclusions: Our results indicated that 5% IMQ cream was a useful alternative treatment for NBBCC, especially for lesions <10 mm. IMQ also showed a significant neoadjuvant effect on lesions >10 mm.
- Unilateral Eyelid Mass as an Unusual Presentation of Ocular Adnexal IgG4-Related Inflammation(2013) FONSECA, Fabricio L. da; RAMOS, Renata de Iracema Pulcheri; LIMA, Patricia P. de; NOGUEIRA, Ariel B.; MATAYOSHI, SuzanaPurpose: IgG4-related sclerosing disease is a new clinicopathologic systemic entity, which can involve ocular adnexal structures, such as lacrimal glands and orbital tissues. However, this entity seems to display a more diffuse, frequently bilateral, pattern in such cases. Conjunctival involvement has not been reported in this disease. Methods: We report the case of a 67-year-old woman with left upper palpebral mass for 5 months. A biopsy was performed, and the patient underwent systemic evaluation for IgG4-related disease. Results: The clinicopathologic study revealed intense lymphoplasmacytic and sclerosing inflammation, with IgG4-positive plasma cells and an IgG4: IgG ratio >40%. The conjunctiva was also involved, which was different from previous studies. The only abnormality was hyperglycemia at 180 mg/dL (reference range, 70-99 mg/dL) and a raised glycosylated hemoglobin at 7.8%. Serum IgG and IgG4 levels were normal. Conclusions: Our case presented an unusual framework of ocular adnexal IgG4-related inflammation, with a more benign and restricted palpebral manifestation involving the conjunctiva.
- Diagnóstico dos subtipos agressivos de carcinoma basocelular palpebral pela biópsia por trépano de 2mm: estudo prospectivo e comparativo(2016) ROSSATO, LUIZ ANGELO; CARNEIRO, Rachel Camargo; MACEDO, Erick Marcet Santiago de; LIMA, Patrícia Picciarelli de; MIYAZAKI, Ahlys Ayumi; MATAYOSHI, SuzanaABSTRACT Objective : to compare the accuracy of preoperative 2-mm punch biopsy at one site and at two sites in the diagnosis of aggressive subtypes of eyelid basal cell carcinoma (BCC). Methods : we randomly assigned patients to Group 1 (biopsy at one site) and Group 2 (biopsy at two sites). We compared the biopsy results to the gold standard (pathology of the surgical specimen). We calculated the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Kappa coefficient to determine the level of agreement in both groups. Results : we analyzed 105 lesions (Group 1: n = 44; Group 2: n = 61). The agreement was 54.5% in Group 1 and 73.8% in Group 2 (p = 0.041). There was no significant difference between the groups regarding the distribution of quantitative and qualitative variables (gender, age, disease duration, tumor larger diameter, area and commitment of margins). Biopsy at two sites was two times more likely to agree with the gold standard than the biopsy of a single site. Conclusions : the accuracy and the performance indicators were better for 2-mm punch biopsy in two sites than in one site for the diagnosis of aggressive subtypes of eyelid BCC.
- Lesão palpebral como manifestação primária do lúpus eritematoso discóide(2013) TELES, Juliana Grilo; MATAYOSHI, Suzana; ARAF, Davi; KATO, Juliana Mika; LIMA, Patricia Picciarelli deThe discoid lupus erythematosus is an autoimmune disorder which generally affects the sun-exposed skin. Presentation of lesions on the eyelids in the absence of any other cutaneous abnormality is uncommon and the lower-eyelid involvement is seen in 6% of patients with cronic cutaneous lupus erythematosus. We have reported the case of a 40 year-old, woman who presented hyperemia, madarosis and ulceration on the lower eyelid of the left eye. She was treated for blepharitis without resolution. Before that, another similar lesion had been described on the upper eyelid of the right eye. Nevertheless, the incisional biopsies of that eyelid were inconclusive. Faced with a migratory lesion similar to the first one, the clinical hypothesis of discoid lupus erythematosus was suggested and diagnosis was confirmed by histopathological review. A high index of suspicion and early recognition may prevent misdiagnosis, clinical complications and inappropriate treatment, as described in the case of eyelid lesion as a primary manifestation of discoid lupus erythematosus.
- Is 2-mm Punch Biopsy Useful in the Diagnosis of Malignant Eyelid Tumors?(2012) CARNEIRO, Rachel Camargo; MACEDO, Erick Marcet Santiago de; LIMA, Patricia Picciarelli de; BONATTI, Rodolfo; MATAYOSHI, SuzanaPurpose: Two-millimeter punch biopsy is a swift and practical diagnostic tool in the outpatient setting. However, few studies have evaluated the efficacy of the method for diagnosis of malignant eyelid tumors. Methods: This was an observational study of patients with suspicion of malignant eyelid tumor attending the Ocular Plastic Surgery Center at Hospital das Clinicas, University of Sao Paulo School of Medicine. Following standard procedures, preoperative biopsies were taken with a 2-mm trephine and surgical excision was performed with safety margins, followed by reconstruction. Anatomopathologic analysis of the surgical specimen was used as gold standard to evaluate the accuracy of diagnosis by punch biopsy. Results: The study included 50 periocular tumors with suspicion of malignancy. The indicators of efficacy in the identification of malignancy by 2-mm punch biopsy were: sensitivity 88%, specificity 100%, positive predictive value 100%, and negative predictive value 64%. Accuracy was 90% for malignancy and 80% for histologic type. The. index of agreement between the diagnostic methods was 0.722 (p < 0.001). Conclusion: A positive result with 2-mm punch biopsy is a safe indication for surgical excision of the tumor, whereas a negative result does not necessarily imply benignity. In cases of high clinical suspicion, a second biopsy should be taken from a different part of the tumor to rule out malignancy. (Ophthal Plast Reconstr Surg 2012;28:282-285)