ABRAO RAPOPORT
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- Extracranial neurogenic tumors of the head and neck(2015) CURIONI, Otavio Alberto; SOUZA, Ricardo Pires de; MERCANTE, Ana Maria da Cunha; JESUS, Ana Carolina de; PAVELEGENI, Alysson; DEDIVITIS, Rogerio Aparecido; RAPOPORT, AbraoIntroduction: Peripheric nerve tumors typically derive from Schwann cells of the peripheral nerve sheet. Since these tumors are uncommon, they should be considered in preoperative differential diagnosis. Objective: To report the experience of a tertiary care department. Methods: Forty-two patients with head and neck peripheral neurogenic tumors were retrospectively analyzed and evaluated from 1977 to 2013. The preoperative diagnosis was confirmed by biopsy or imaging study. Results: The mean age was 41.7 and 15 patients (36%) were male. The mean size was 5.5 cm and 26 (61%) were located laterally in the neck. Most tumors (39.9%) presented as an asymptomatic neck mass. Most (39.9%) were resected through a neck approach. Cranial nerves were the commonest site of origin. Conclusions: Extracranial neurogenic tumors presented with a mean size of 5.5 cm, were located laterally in the neck, normally had their origin from cranial nerves, and their resection approach is cervical.
- Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth(2013) AMAR, Ali; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors. Objective: To evaluate the causes of treatment failure in carcinomas of the tongue and floor of the mouth due to staging. Method: This study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+. Results: Among the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients. Conclusion: Salvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease.
- Esvaziamento cervical no carcinoma epidermoide de laringe: indicação de esvaziamento eletivo contralateral(2012) AMAR, Ali; CHEDID, Helma Maria; FRANZI, Sergio Altino; RAPOPORT, AbrãoUnilateral or bilateral neck dissection must be considered in the treatment of laryngeal cancer AIM: To evaluate the prevalence of contralateral metastases in larynx cancer and distribution of these metastases according to lymph node levels in the neck. METHOD: Retrospective longitudinal study of 272 charts from patients with squamous cell cancer of the larynx treated between 1996 and 2004; and we selected 104 surgical cases submitted to neck dissection. We evaluated the incidence of bilateral or contralateral metastases, according to the location and extension of the primary tumor, considering the anatomical sub-sites and the midline. RESULTS: Contralateral metastases in lateral tumors were observed in 3.5% of glottic lesions and in 26% of supraglottic lesions. Contralateral metastases were uncommon in N0 patients. Lymph nodes levels IIa and III were the most commonly involved in the neck. CONCLUSION: In lateral glottic tumors there is no need for elective contralateral neck dissection. In supraglottic lesions without ipsilateral metastases, the incidence of hidden metastasis does not justify elective contralateral dissection. The midline is not a reliable indicator of the risk of contralateral laryngeal tumors.
- Epidemiological assessment and therapeutic response in hypopharyngeal cancer(2013) AMAR, Ali; CURIONI, Otavio Alberto; PAIVA, Diogenes Lopes de; RAPOPORT, Abrao; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaDespite the low incidence, diagnostic and therapeutic advances, hypopharyngeal cancer still has high mortality. Objective: To evaluate retrospectively the epidemiological profile and response to surgery and radiation/chemotherapy of patients with hypopharyngeal cancer. Method: We reviewed the medical records of 114 patients treated between 2002 and 2009 in a tertiary hospital with histopathological diagnosis of squamous cell carcinoma. Results: The mean age of the patients was 57 years, 94.7% were males and 5.3% females, 98.2% were smokers and 92% consumed alcohol; 72% are illiterate or did not complete first grade schooling. The main complaints were: neck node (28%), pain and dysphagia (22%), odynophagia (12.2%), dysphonia (7.8%). The clinical staging was: I (1.7%), II (3.5%), III (18.4%), IV (76.3%). The treatment was carried out with radiotherapy and chemotherapy alone in 35%, with mean 2-year survival of 20% and 5-year survival of 18%; surgery followed by radiotherapy and chemotherapy in 22.8% with 2-year survival of 60.0% and 5 years of 55.0%; chemotherapy alone in 2.6%, and 39.4% without treatment. Conclusion: Most patients already had advanced clinical stages and independent of the treatment option, had a low survival rate, confirming the poor prognosis of this neoplasm.
- Value of immunohistochemistry in the diagnosis of malignant cervical lymph nodes(2013) CALY, Decio de Natale; RAPOPORT, Abrao; CURIONI, Otavio Alberto; DEDIVITIS, Rogerio Aparecido; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaThe cervical lymph nodes are relevant due to the diversity of clinical entities. The use of immunohistochemistry is a real method to elucidate the diagnosis of adenopathy, both primary and metastatic neoplasms. Objective: To assess the value of immunohistochemistry in the diagnosis of cervical lymph nodes malignancies. Method: Retrospective study of the database histopathological specimens from 2009 to 2011. Results: Out of 32 biopsies of cervical lymph nodes, in 16 (50%) the immunohistochemistry was employed, being 68.75% (11) in hematological neoplasms and 31.25% (5) in carcinomas. It was used in all cases of lymphoma. Conclusion: The immunohistochemistry was used in 50% of the biopsies of lymph nodes under suspicion of malignancy, being 31.25% in epithelial lesions and 68.75% in lymphoproliferative lesions.
- Review of survival rates 20-years after conservative surgery for papillary thyroid carcinoma(2015) RAPOPORT, Abrao; CURIONI, Otavio Alberto; AMAR, Ali; DEDIVITIS, Rogerio AparecidoIntroduction: A less extensive thyroidectomy could be used for patients in the low risk group. Objective: To perform a critical follow-up after lobectomy with isthmusectomy for the treatment of papillary thyroid carcinoma in patients with a single nodule limited to the periphery of the lobe. Methods: Thirty-one patients with thyroid papillary carcinoma operated on till 1993 were selected. They had undergone lobectomy with isthmusectomy. This is a retrospective cohort study in which the oncological outcome (contralateral and regional recurrence) and the reoperation complications (recurrent nerve paralysis/paresis and hypoparathyroidism) were evaluated. Descriptive analysis was employed. Results: In the last decade (2003-2013), 6 (20%) contralateral recurrences were observed in the remaining lobe and in 1 of these cases (3%), contralateral lymph node metastases were noted. A completion thyroidectomy plus lymphadenectomy was performed, without modification of global survival. Conclusion: Because of the rate of 20% of contralateral recurrence after a 20-year follow-up, we suggest modification of the surgical paradigm for total thyroidectomy as an initial therapy. (C) 2015 Published by Elsevier Editora Ltda. on behalf of Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Ameloblastoma demographic, clinical and treatment study - analysis of 40 cases(2012) FRANCA, Luciano Jose de Lemos; CURIONI, Otavio Alberto; PAIVA, Diogenes Lopes; VIANNA, Debora Modelli; DEDIVITIS, Rogerio Aparecido; RAPOPORT, AbraoDental lesions represent about 1% of oral cavity tumors being ameloblastoma the most common one. It is a tumor of epithelial origin that mainly affects the jaw, and less commonly the maxilla. Its clinical presentation is that of an asymptomatic slow-growing tumor. Despite being a benign tumor, it has an invasive behavior with a high rate of recurrence if not treated properly. Objective: To describe the cases of ameloblastoma in a reference department. Methods: Retrospective analysis of 40 cases. The variables analyzed were: age, gender, ethnicity, tumor location, type of treatment, complications and recurrence. Results: The most affected gender was male - 21 cases (52.5%); with a predominance of Caucasians - 24 cases (60%). The mean age was 35.45 years; the most common location was in.the jaw - 37 cases (92.5%). Facial asymmetry was the most frequent complaint. Of the 40 cases, 33 were submitted to surgery. Of those submitted to surgery, 24 (72.72%) underwent segmental resection, with recurrence in 4 (12.12%) cases. Conclusion: Ameloblastoma may relapse when treatment is not performed with broad surgical resection of the lesion with wide safety margins.
- Indications and pitfalls of immunohistochemistry in head and neck cancer(2013) CALY, Decio de Natale; VIANA, Acklei; RAPOPORT, Abrao; DEDIVITIS, Rogerio Aparecido; CURIONI, Otavio Alberto; CERNEA, Claudio Roberto; BRANDAO, Lenine GarciaImmunohistochemistry (IHC) has been employed in the differential diagnosis of tumors. Objective: To assess the use of IHC in cases of head and neck tumor. Method: This is a retrospective study of the cases included in the Cancer Registry of the institution. Results: IHC was used in 76 (11%) of 704 pathology tests. Most cases were carcinomas (85.80%), and 83.66% of them were squamous cell carcinomas. All tests were done with diagnostic purposes. The most frequently used antibodies were 34BE12 (37.18%), AE1/AE3 (35.9%), 35BH11 (28.21%), CD45 (25.64%), CD20 (24.36V, CD30 (24.36%), CK7 (23.08%) and CD3 (23.08%). Conclusions: IHC was used in 10.67% of the head and neck tumor cases submitted to pathology testing, mostly for carcinoma (5.26%). In the determination of squamous cell carcinoma, IHC accounted for 18.42% of all tumors.
- Valor da PET/CT na abordagem do câncer de cabeça e pescoço(2012) CURIONI, Otávio Alberto; SOUZA, Ricardo Pires de; AMAR, Ali; VIANA, Débora; RAPOPORT, Abrão; DEDIVITIS, Rogério Aparecido; CERNEA, Claudio Roberto; BRANDÃO, Lenine GarciaOBJECTIVE: To evaluate the role of PET/CT in the approach to patients with head and neck cancer. MATERIALS AND METHODS: Retrospective study of medical records and PET/CT images of 63 patients with head and neck cancer. RESULTS: Alterations were observed in 76% of the cases. Out of these cases, 7 (11%) were considered as false-positive, with SUV < 5.0. PET/CT demonstrated negative results in 15 cases (24%). Among the 14 cases where the method was utilized for staging, 3 (22%) had their stages changed. CONCLUSION: PET/CT has shown to be of potential value in the routine evaluation of patients with head and neck cancer, but further studies of a higher number of cases are required to define a protocol for utilization of the method.
- The histological rarity of thyroid cancer(2012) VIANNA, Debora Modelli; CURIONI, Otavio Alberto; FRANCA, Luciano Jose de Lemos; PAIVA, Diogenes Lopes de; POMPEU, Bernardo Fontel; DEDIVITIS, Rogerio Aparecido; RAPOPORT, AbraoThyroid cancer is the most common endocrine cancer, accounting for about 1% of all cancers. Sarcomas, lymphomas and metastases to the thyroid gland are rare and only with a handful of descriptions in the literature. Objective: To describe rare histological types of thyroid cancer found in a reference center. Methods: Medical chart review from admitted patients diagnosed with thyroid cancer in the period from 1977 to 2010. Demographic, diagnostic, therapeutic and histopathological information were collected. Results: 3,018 records of patients admitted with thyroid disease were reviewed. Among the cases diagnosed with rare tumors there was a predominance of: anaplastic carcinoma: 22 cases (0.7%), followed by 11 cases of medullary carcinoma (0.36%); 2 cases of sarcoma (0.07%), 2 cases of lymphoma (0.07%) and one case of metastatic carcinoid tumor (0.03%). There were more females diagnosed (57%) as well as Caucasians (84%). The most frequent clinical presentation was a palpable thyroid nodule. All patients with lymphoma, sarcoma and anaplastic carcinoma died. Conclusion: Sarcomas, lymphomas and thyroid metastases are uncommon and tend to worse outcomes.