Papers by Dr Sabas Vieira
Revista Brasileira em Promoção da Saúde
Este artigo está publicado em acesso aberto (Open Access) sob a licença Creative Commons, que per... more Este artigo está publicado em acesso aberto (Open Access) sob a licença Creative Commons, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho seja corretamente citado. Opinião de médicos brasileiros sobre o tratamento da COVID-19 Opinion of Brazilian physicians on the treatment of COVID-19 Opinión de médicos brasileños sobre el tratamiento de la COVID-19
Einstein (São Paulo)
Angiosarcoma of the breast accounts for less than 1% of breast tumors. This tumor may be primary ... more Angiosarcoma of the breast accounts for less than 1% of breast tumors. This tumor may be primary or secondary to previous radiation therapy and it is also named "radiogenic angiosarcoma of the breast", which is still a rare entity with a poor prognosis. So far, there are only 307 cases reported about these tumors in the literature. We present a case of a 73-year-old woman with a prior history of breast-conserving treatment of right breast cancer, exhibiting mild pinkish skin changes in the ipsilateral breast. Her mammography was consistent with benign alterations (BI-RADS 2). On incisional biopsy specimens, hematoxylin-eosin showed atypical vascular lesion and suggested immunohistochemisty for diagnostic elucidation. Resection of the lesions was performed and histology showed radiogenic angiosarcoma. The patient underwent simple mastectomy. Immunohistochemistry was positive for antigens related to CD31 and CD34, and C-MYC oncogene amplification, confirming the diagnosis of angiosarcoma induced by breast irradiation. A delayed diagnosis is an important concern. Initial skin changes in radiogenic angiosarcoma are subtle, therefore, these alterations may be confused with other benign skin conditions such as telangiectasia. We highlight this case clinical aspects with the intention of alerting to the possibility of angiosarcoma of the breast in patients with a previous history of adjuvant radiation therapy for breast cancer treatment. Sixteen months after the surgery the patient remains asymptomatic.
Mastology, 2021
Introduction: Male breast cancer (MBC) is a very rare disease, which accounts for approximately 1... more Introduction: Male breast cancer (MBC) is a very rare disease, which accounts for approximately 1.0% of all breast cancers and around 0.17%–1.0% of all male malignancies, more common in the age group of 60 years, and 93.7% of cases of MBC are histologically classified as the invasive carcinoma of no special type (ICNS). Treatment (i.e., surgery, radiotherapy, chemotherapy, and hormone therapy) and prognosis are similar to breast cancer in women. The aim of this study was to describe five MBC cases and to analyze the occurrence of relapse in a follow-up of 88 months (36–180 months). Case series: The mean age of five patients of the case series was 69 years (57–88 years). All cases were histologically classified as ICNS. The mean tumor size of the series was 2.6 cm (1.0–5.2 cm). One patient of the case series presented with perineural invasion, and another case had axillary node involvement (+5/15). None of the patients had metastasis at the time of diagnosis. All patients underwent s...
Research, Society and Development, 2022
Introdução: O câncer do colo do útero diagnosticado durante a gravidez é incomum, e existem fator... more Introdução: O câncer do colo do útero diagnosticado durante a gravidez é incomum, e existem fatores de risco para essa condição, como a falta de acesso aos serviços de saúde e a não realização do rastreamento preconizado para o diagnóstico precoce das lesões precursoras do câncer do colo do útero. Em pacientes jovens com maturação fetal, o tratamento é a histerectomia radical com linfnodenectomia pélvica bilateral, precedida de cesariana. Relatamos uma paciente de 33 anos que foi diagnosticada com um carcinoma epidermoide invasivo em seu estágio inicial no curso de uma gravidez de 26 semanas. Após discussão com o casal, optou-se por aguardar a maturação fetal e a gravidez seria interrompida na 36ª semana por cesárea, seguida de histerectomia radical e linfonodectomia pélvica bilateral. Metodologia: Trata-se de um estudo observacional retrospectivo, transversal, qualitativo e descritivo. Este trabalho foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual do Piauí, co...
Mastology, 2021
Introduction: Metaplastic breast carcinoma (MBC) is understood as a heterogeneous group of malign... more Introduction: Metaplastic breast carcinoma (MBC) is understood as a heterogeneous group of malignant tumors, which exhibits the transformation of part or its entire glandular carcinomatous component into a nonglandular component by means of epithelial and mixed mesenchymal differentiation. The MBC is a rare and aggressive breast cancer, accounting for approximately 1% of all breast tumors that have a worse prognosis. The aim of this study was to describe four cases of MBC, analyzing the progression of patients in a mean follow-up of 25 months (11–43 months). Case series: All patients were female. The mean age of the four cases of the series was 50 years (40–61 years). All patients had tumors that were histologically classified as metaplastic carcinoma. The mean tumor size of the series was 8.3 cm (2.2–15.5 cm). Two patients had the angiolymphatic invasion, and none had the perineural invasion. In three cases, there was an axillary node involvement. None of the cases had metastasis a...
1 Graduate medical student, Universidade Federal do Piauí, Brazil. 2 Graduate medical student, Un... more 1 Graduate medical student, Universidade Federal do Piauí, Brazil. 2 Graduate medical student, Universidade de Ribeirão Preto (Unaerp), São Paulo, Brazil. 3 MD, PhD, professor of Universidade Federal do Piauí, Brazil. 4 MD, PhD, professor of Universidade Estadual do Piauí, Brazil. Correspondence: Dr. Sabas Carlos Vieira. Rua Félix Pacheco, n.o 2159, sala 305, Centro/Sul, Teresina-PI, Zip 64001-160. Internet: sabas. [email protected] Received on November 23, 2011. Accepted on December 10, 2011. RESUMO
Mastology, 2020
Introduction: Women who inherit a deleterious mutation in BRCA face substantially increased risks... more Introduction: Women who inherit a deleterious mutation in BRCA face substantially increased risks of developing breast cancer, estimated in 70%. Even though the annual screening with magnetic resonance and mammography promotes the early detection of the disease, the gold standard for the primary prevention of breast cancer is still bilateral mastectomy. Objectives: To characterize breast cancer with mutation in the BRCA gene. Method: This is a retrospective study, case series. We included all patients who had tested positive for BRCA mutation and who had a previous or current diagnosis of breast cancer from 1999 to 2019. The study was approved by the Research Ethics Committee of Universidade Federal do Piauí, report n. 2.817.502. Results: We found 10 patients with previous breast cancer, or at the time when they had a mutation in the BRCA gene. They were all female, with mean age of 39.4 years at diagnosis, average of 3.6 cases of cancer in the family. Five (50.0%) were triple negat...
Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery, 2019
This case report describes the application of the thoracoabdominal flap technique after locally a... more This case report describes the application of the thoracoabdominal flap technique after locally advanced tumor mastectomy in a patient with breast cancer 1 (BRCA1) mutation. The mastectomy included resection of nearly the entire left pectoralis major muscle, with homolateral axillary lymphadenectomy and reconstruction of the large chest wall defect with a fasciocutaneous thoracoabdominal flap based on the posterior intercostal arteries.
Mastology, 2018
Objective: To evaluate the benefit of radiotherapy planning, involving the use of surgical clips ... more Objective: To evaluate the benefit of radiotherapy planning, involving the use of surgical clips in conservative treatment of earlystage breast cancer. Methods: Retrospective cohort. Twelve (12) breast cancer female patients were retrospectively evaluated. These women had undergone breast-conserving treatment in which the tumor bed had been demarcated with titanium 200 surgical clips to guide breast boost radiotherapy. Volumes were calculated. Radiotherapy planning in the same patient with boost dose guided by metal clips was compared to planning guided by surgical scar or by imaging tests prior to surgical treatment. Results: A reduction of 36.7% in total volume of the irradiated breast (p=0.022), a reduction of 55.7% in boost volume (p=0.001), a reduction of 35.9% (p=0.001) in the breast volume receiving the prescribed boost dose and a reduction of 4.5% (p=0.014) in the maximum dose applied to the lung were shown. Conclusions: Clip placement in surgical bed following conservative treatment for breast cancer determined a reduction of 36.7% in irradiated breast volume and use of a lower dose of irradiation.
Revista Brasileira de Mastologia, 2017
Relato de caso de um osteossarcoma metaplásico da mama em um hospital de Teresina, com resumo e d... more Relato de caso de um osteossarcoma metaplásico da mama em um hospital de Teresina, com resumo e discussão de literatura. O carcinoma metaplásico da mama é mais comum em mulheres entre 55 e 60 anos. Apresenta-se em forma de uma massa palpável sem preferência por quadrante, com rápido crescimento e geralmente é mais largo do que outros tipos de tumores mamários. Os carcinomas têm poucos receptores para hormônios sexuais. No caso de carcinoma metaplásico com diferenciação osteossarcomatosa, sua apresentação é bem agressiva. A decisão sobre o tratamento apresenta dificuldades em função do baixo número de casos relatados na literatura. Neste relato, apresenta-se uma paciente com carcinoma metaplásico e diferenciação osteossarcomatosa no quadrante superior da mama direita. Foi realizada uma mastectomia com ressecção da pele do quadrante e do segmento do músculo peitoral infiltrado pelo tumor, com preservação do restante da pele e do complexo papiloareolar. Serão discutidas as descobertas patológicas. Devido às diversas opções de tratamento disponíveis para a paciente, conclui-se que mais estudos devem ser realizados sobre qual terapêutica possui maior impacto no prognóstico do paciente, bem como o papel da radioterapia/quimioterapia no paciente.
Revista Brasileira de Mastologia, 2017
Relatamos o caso de uma paciente do sexo feminino, 43 anos, que se submeteu a uma mastectomia rad... more Relatamos o caso de uma paciente do sexo feminino, 43 anos, que se submeteu a uma mastectomia radical modificada seguida por reconstrução imediata com retalho de músculo grande dorsal e prótese. Recebeu quimioterapia adjuvante com doxorrubicina, ciclofosfamida e docetaxel, seguida de radioterapia. Paciente desenvolveu um seroma na área doadora do retalho 14 meses após a cirurgia. A formação de seroma no sítio doador durante o pós-operatório imediato é uma complicação comum após rotação de músculo grande dorsal, contudo, não é usual que a secreção de fluidos se acumule tanto tempo depois da cirurgia.
Revista Brasileira de Mastologia, 2016
The authors report a case of neutropenic enterocolitis (typhlitis) secondary to the use of adjuva... more The authors report a case of neutropenic enterocolitis (typhlitis) secondary to the use of adjuvant chemotherapy for breast cancer treatment. A 46-year-old woman received the diagnosis of typhlitis and underwent a right hemicolectomy. RESUMO Os autores relatam um caso raro de enterocolite neutropênica (tiflite) secundária ao uso de quimioterapia adjuvante para tratamento de câncer de mama. Uma mulher de 46 anos de idade foi diagnosticada com tiflite, sendo realizada hemicolectomia direita.
Femina, Aug 1, 2011
Resumo Objetivo: Avaliar a viabilidade da biópsia do linfonodo sentinela (LS) em pacientes com ca... more Resumo Objetivo: Avaliar a viabilidade da biópsia do linfonodo sentinela (LS) em pacientes com carcinoma invasor de células escamosas da vulva. Metodologia: Realizou-se uma busca de estudos publicados na língua inglesa, na base de dados PubMed, utilizando-se as palavras sentinel vulvar cancer. Dos artigos encontrados, foram lidos todos os resumos e selecionados os que tinham pelo menos 20 pacientes incluídas, e que abordavam a utilização do conceito de LS no carcinoma da vulva. Resultados: Foram encontrados 212 artigos e selecionados 24 que avaliaram a segurança e utilidade clínica da detecção do LS no carcinoma de vulva. Nenhum estudo randomizado foi encontrado, todos eram séries de casos prospectivas ou retrospectivas. Um total de 1.203 pacientes foi avaliado. Tecnécio e/ou corante azul vital foram utilizados para identificação do LS, sendo que a associação das duas técnicas aumentou as taxas de detecção. A imunoistoquímica aumentou a sensibilidade na detecção de metástases quando comparada com à hematoxilina-eosina. Especificidade e valor preditivo positivo foram 100%. Observou-se sensibilidade acima de 80% em 22 estudos. Taxas de falso negativo variaram de 0 a 11,1%, com 18 estudos não alcançando 5%. O tempo médio de seguimento variou de 6,9 a 55,2 meses. Conclusão: A técnica do linfonodo sentinela pode ser oferecida a pacientes com câncer de vulva invasor sem metástase inguinal evidente.
Anais Brasileiros de Dermatologia, 2013
Nonmelanoma skin cancer is the most frequent cancer in the world. Squamous cell cancer often occu... more Nonmelanoma skin cancer is the most frequent cancer in the world. Squamous cell cancer often occurs in sun-exposed areas, such as the head and neck. When it involves the breast and ulce-rates, invading the glandular parenchyma, it may mimic breast cancer. Confirmation by means of histopathological examination, combined with clinical examination, is a critical instrument for the accuracy of the diagnosis. We report a case of an epidermoid carcinoma located on the breast skin, initially diagnosed as breast cancer.
The New Zealand medical journal, Jan 11, 2012
Mondor's disease is a thrombophlebitis that affects mainly the superficial veins of the breas... more Mondor's disease is a thrombophlebitis that affects mainly the superficial veins of the breast. The aetiology of Mondor's disease is multifaceted and there are reports in the literature of an association between Mondor's disease and breast cancer. This disease occurs more commonly in women than men, mainly in the third and fourth decades of life, leading to a spontaneous remission in most cases. We report a case of a 45-year-old female patient that had been treated for breast carcinoma in situ.
Revista da Associação Médica Brasileira, 2003
Sao Paulo Medical Journal, 2014
CONTEXT AND OBJECTIVE: Use of mammography for breast cancer screening has resulted in a significa... more CONTEXT AND OBJECTIVE: Use of mammography for breast cancer screening has resulted in a significantly increased number of patients with nonpalpable radiological findings that need histopathological study for better management. The present study evaluated an alternative to excision of nonpalpable breast lesions, using injection of patent blue (CAS 3536-49-0) dye and air. DESIGN AND SETTING: Cohort study of 64 consecutive patients at a private clinic in the city of Teresina (Piauí), between January 2009 and December 2010. METHODS : The patients had received mammographic diagnoses of nonpalpable breast lesions classified as BI-RADS 3, 4 and 5, with indication of histopathological study. They underwent stereotaxy and/or ultrasound-guided injection of patent blue, for marking and subsequent excision of the lesion. RESULTS : The patients' mean age was 47.7 years. Nodes accounted for 53.1% of the breast abnormalities; microcalcifications, 37.5%; and complex cysts, 9.4%. In 89.1% of cas...
BJOG: An International Journal of Obstetrics and Gynaecology, 2005
Annals of Surgical Oncology, 2008
Background: To evaluate changes in pulse oximetry readings in patients with cervical carcinoma af... more Background: To evaluate changes in pulse oximetry readings in patients with cervical carcinoma after the injection of patent blue dye into the uterine cervix for sentinel lymph node detection. Methods: Fifty-six patients underwent radical hysterectomy and bilateral pelvic lymphadenectomy for the treatment of International Federation of Gynecology and Obstetrics stage I or II cervical cancer. Four milliliters of patent blue dye were injected into the cervix. On the eve of surgery, all patients also received an injection of Dextran 500 labeled with technetium 99 m (Tc-99 m Dextran, 600 to 800 lCi) into the cervix and subsequently underwent pelvic lymphoscintigraphy. Results: Of the 56 patients, 1 (1.79%) had an anaphylactic reaction, and in 13 (23.22%), pulse oximetry readings were <96%. The lowest median pulse oximetry reading in these patients was 87%. Pulse oximetry readings began to decrease between 2 and 10 minutes after patent blue dye injection into the cervix and lasted for approximately 5 minutes. No changes in blood pressure, heart rate, or electrocardiogram were found during the period in which this alteration was recorded by the pulse oximeter. Conclusion: The decrease in pulse oximetry readings after patent blue dye injection into the cervix was associated with larger tumors and tumors that surrounded the external cervical os.
American Journal of Roentgenology, 1996
S clerosing peritonitis, a seldomrecognized entity that causes ascites, peritoneal thickening, an... more S clerosing peritonitis, a seldomrecognized entity that causes ascites, peritoneal thickening, and bowel wall thickening, has been described in association with certain drugs and as a complication of chronic ambulatory peritoneal dialysis. The condition may also occur as a result of luteinized thecomas. We report this particularly interesting variant, which to our knowledge has not been previously reported in the radiologic literature, B, Marked circumferential thickening of the colon wall involves both intra-and extraperitoneal surfaces (arrows). C, Bilateral complex adnexal masses mimic ovarian carcinoma (arrows).
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Papers by Dr Sabas Vieira