FERNANDO PEREIRA FRASSETTO
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conferenceObject ATYPICAL TERATOID RHABDOID TUMORS (ATRT): RESULTS FROM A SINGLE INSTITUTION IN BRAZIL - SAO PAULO UNIVERSITY(2022) BARRETO, Juliana Silveira; GOMEZ, Karen Nirit Melo; DUTRA, Alvaro Pimenta; AZAMBUJA, Alessandra Milani Prandini De; CRISTOFANI, Lilian Maria; SANDERS, Felipe Hada; PETITO, Carlo; BARALDI, Helena Espindola; WELTMAN, Eduardo; FERRACIOLLI, Suely Fazio; FRASSETTO, Fernando Pereira; LUCATO, Leandro Tavares; ROSEMBERG, Sergio; ODONE FILHO, Vicente- Systemic dengue infection associated with a new dengue virus type 2 introduction in Brazil - a case report(2021) CUNHA, Marielton dos Passos; DUARTE-NETO, Amaro Nunes; POUR, Shahab Zaki; HAJJAR, Ludhmila Abrahao; FRASSETTO, Fernando Pereira; DOLHNIKOFF, Marisa; SALDIVA, Paulo Hilario do Nascimento; ZANOTTO, Paolo Marinho de AndradeBackgroundDengue infection is caused by an arbovirus with a wide range of presentations, varying from asymptomatic disease to unspecific febrile illness and haemorrhagic syndrome with shock, which can evolve to death. In Brazil, the virus circulates since the 1980s with many introductions of new serotypes, genotypes, and lineages since then. Here we report a fatal case of dengue associated with a Dengue virus (DENV) lineage not detected in the country until now.Case presentationThe patient, a 58-year-old man arrived at the hospital complaining of fever and severe abdominal pain due to intense gallbladder edema, mimicking acute abdomen. After 48h of hospital admission, he evolved to refractory shock and death. DENV RNA was detected in all tissues collected (heart, lung, brain, kidney, spleen, pancreas, liver, and testis). Viral sequencing has shown that the virus belongs to serotype 2, American/Asian genotype, in a new clade, which has never been identified in Brazil before. The virus was phylogenetically related to isolates from central America [Puerto Rico (2005-2007), Martinique (2005), and Guadeloupe (2006)], most likely arriving in Brazil from Puerto Rico.ConclusionIn summary, this was the first fatal documented case with systemic dengue infection associated with the new introduction of Dengue type 2 virus in Brazil during the 2019 outbreak.
- Oncocytic Meningioma: Case Report of a Rare Meningioma Variant(2023) CASAL, Yuri Reis; TEIXEIRA, Livia Porto; BANDEIRA, Gabriela Alencar; PORCEBAN, Matheus Moreli; PAIVA, Wellingson Silva; GODOY, Luis Filipe de Souza; YAMAKI, Vitor Nagai; LUCATO, Leandro Tavares; ALVES, Venancio Avancini Ferreira; FRASSETTO, Fernando PereiraOncocytic meningioma has been first identified in 1997 as a rare meningioma variant, composed predominantly of large meningothelial cells with abundant intracytoplasmic mitochondria. Here, we describe a 34-year-old male patient presenting with 2 weeks of progressive holocranial headache. Brain magnetic resonance imaging (MRI) revealed an extra axial solid-cystic expansive lesion in the left parieto-occipital parasagittal region, with intense vascularization. Histological and immunohistochemical analysis established the diagnosis. We also review briefly the pathological and radiological findings of this rare variant of meningioma as described in the literature.
- Hydrocephalus: a rare initial manifestation of sporadic intramedullary hemangioblastoma(2017) MORAIS, Barbara Albuquerque; CARDEAL, Daniel Dante; RIBEIRO, Renan Ribeiro e; FRASSETTO, Fernando Pereira; ANDRADE, Fernanda Goncalves; MATUSHITA, Hamilton; TEIXEIRA, Manoel JacobsenBackground Intramedullary hemangioblastomas are rare benign vascular tumors, infrequent in pediatric patients. Clinical symptoms vary according to the age of presentation, tumor size, location, and concomitant syringomyelia. This is the second reported case of hemangioblastoma presenting with acute hydrocephalus. Case presentation A 3-month-old infant with acute hydrocephalus was asymptomatic after a ventriculoperitoneal shunt was placed. She returned 3 months later with irritability, acute paraplegia, and respiratory distress. Magnetic resonance imaging (MRI) showed an intramedullary T8-T9 tumor with syringomyelia. She underwent surgical resection with good results during the 6-month follow-up. Conclusion Intramedullary tumors may present as hydrocephalus and other nonspecific symptoms, with invariably delayed diagnosis in children, but must be considered in suspicious cases.
- Myasthenia Gravis Related to Thymic Carcinoma: A Case Study(2020) LOPES, Daniel Thomas Pereira; GOMES, Samila Marissa Pinheiro; SIQUEIRA, Sheila Aparecida Coelho; FRASSETTO, Fernando Pereira; SAMPAIO, Pedro Henrique Martins Arruda; MORENO, Cristiane Araujo Martins; ROCHA, Maria Sheila Guimaraes; ESTEPHAN, Eduardo PaulaMyasthenia gravis and thymoma are often presented in association with similar to 10% of myasthenic cases having concomitant thymoma. Thymic carcinoma is one of the rarest/aggressive human epithelial tumors and has no correlation with myasthenia gravis hitherto. Here is provided a clinical case and review of literature on a very rare association of thymic carcinoma (with no sign of thymoma) and myasthenia gravis (antiacetylcholine receptor antibody positive). Two years after thymectomy, clinical evolution was satisfactory. This clinical case elicits hypothesis that thymic carcinoma may be related with myasthenia gravis, what may have good prognostic from oncologic and neurologic perspectives.
- Loss of an eye to mucormycosis following corticosteroid therapy for COVID-19(2022) RODRIGUES, M. G.; SEKIGUCHI, W. K.; GONçALVES, S.; CASAL, Y. R.; FRASSETTO, F. P.; SILVA, V. T. G. da; SANTO, M. P. D. E.; MAGRI, M. M. C.Mucormycosis is a rare, sometimes severe fungal infection that has emerged as a possible complication of COVID-19. We report a case of a non-diabetic, apparently immunocompetent patient diagnosed with rhino-orbital-cerebral mucormycosis shortly after COVID-19 treatment with dexamethasone. The patient received optimized systemic antifungal therapy and extensive surgical treatment. So far, four months after the last hospital discharge, the patient has been in good general condition. This case is a dramatic reminder that beneficial corticosteroid therapy in general inevitably carries a risk of opportunistic infection, and corticosteroid therapy for COVID-19 risks orbital-rhinocerebral mucormycosis that clinicians should watch for with vigilance. © 2021 The Author(s).
conferenceObject Neuropathological Alterations in Cases of Yellow Fever Submitted to Autopsy(2019) FRASSETTO, Fernando; ROSEMBERG, Sergio- Teaching NeuroImages: Bilateral intracerebral hemorrhage in expanded dengue syndrome(2017) CAVALCANTE, Wagner Cid Palmeira; SOARES NETO, Herval Ribeiro; GRATIVVOL, Ronnyson Susano; SPERA, Raphael Ribeiro; FRASSETTO, Fernando Pereira; LUCATO, Leandro Tavares; NITRINI, Ricardo
- Survivin: A Potential Marker of Resistance to Somatostatin Receptor Ligands(2023) HERKENHOFF, Clarissa G. Borba; TRARBACH, Ericka B.; BATISTA, Rafael Loch; SOARES, Ibere Cauduro; FRASSETTO, Fernando Pereira; NASCIMENTO, Felipe Barjud Pereira do; GRANDE, Isabella Pacetti Pajaro; SILVA, Paula P. B.; DUARTE, Felipe H. G.; BRONSTEIN, Marcello D.; JALLAD, Raquel S.Context Invasive and somatostatin receptor ligand (SRL)-resistant pituitary tumors represent a challenge in the clinical practice of endocrinologists. Efforts have been made to elucidate reliable makers for both. Survivin and eukaryotic translation initiation factor-binding protein 1 (4EBP1) are upregulated in several cancers and involved in apoptosis and cell proliferation. Objective We explored the role of these markers in somatotropinomas. Methods Immunostains for survivin and 4EBP1, and also for somatostatin receptor type 2 (SSTR2), Ki-67, and cytokeratin 18, were analyzed in tissue microarrays containing 52 somatotropinoma samples. Tumor invasiveness was evaluated in all samples while drug resistance was evaluated in 34 patients who received SRL treatment. All these parameters were correlated with first-generation SRL (fg-SRL) responsiveness and tumor invasiveness. Results Low survivin expression (P = 0.04), hyperintense signal on T2 weighted image (T2WI) (P = 0.01), younger age (P = 0.01), sparsely granular adenomas (SGA) (P = 0.04), high postoperative growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels (P = 0.049 and P < 0.001, respectively), and large postoperative tumor size (P = 0.02) were associated with resistance to fg-SRL. Low survivin and SSTR2 expression and high 4EBP1 expression were associated with SGA (P = 0.04, P = 0.01, and P = 0.001, respectively). Younger age (P = 0.03), large tumor pre- and postoperative (P = 0.04 and P = 0.006, respectively), low SSTR2 expression (P = 0.03), and high baseline GH and IGF-1 (P = 0.01 and P = 0.02, respectively) were associated with tumor invasiveness. However, survivin, 4EBP1, Ki-67, and granulation patterns were not associated with tumor invasion. Conclusion This study suggests that low survivin expression is predictive of resistance to fg-SRL in somatotropinomas, but not of tumor invasiveness.
- Glioneuronal and Neuronal Tumors: Who? When? Where? An Update Based on the 2021 World Health Organization Classification(2023) AYRES, A. S.; BANDEIRA, G. A.; FERRACIOLLI, S. F.; TAKAHASHI, J. T.; MORENO, R. A.; GODOY, L. F. de Souza; CASAL, Y. R.; LIMA, L. G. C. A. de; FRASSETO, F. P.; LUCATO, L. T.Neuronal and glioneuronal tumors usually have a benign course and may have typical imaging characteristics, allowing their diagnosis based on MR imaging findings. The most common lesions are dysembryoplastic neuroepithelial tumors and gangliogliomas, which have typical imaging characteristics. The fifth edition of the World Health Organization Classification of Tumors of the Central Nervous System, recently published in 2021, places greater emphasis on molecular markers to classify tumors of the CNS, leading to extensive changes in the classification of tumors, including neuronal and glioneuronal tumors. The 2021 revision included 3 new tumors types: multinodular and vacuolating neuronal tumor, diffuse glioneuronal tumor with oligodendroglioma-like features and nuclear clusters (a provisional type), and myxoid glioneuronal tumor. Following these recent changes in the World Health Organization classification, we aimed to review the main imaging features of these lesions in relation to their histopathologic and molecular features. Learning Objectives: To list the neuronal and glioneuronal tumors; recognize the main imaging findings and histologic characteristics of neuronal and glioneuronal tumors; know the typical location of each neuronal and glioneuronal tumor; and become familiar with the main molecular alterations of neuronal and glioneuronal tumors to better understand their behavior