Introduction: Non-melanoma skin cancer (NMSC) comprises a group of neoplasms with a high incidence in the world population. It is divided into basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). As it is highly prevalent, understanding the process of oncogenesis and the relationship with ions, proteins and cellular receptors in CPMN can contribute to the evaluation of new therapies. Objective: To understand the oncogenesis process of non-melanoma skin tumors and its relationship with the immunolocalization of IP3R. Method: Integrative literature review with evidence synthesis. The database was PUBMED; the search strategy: “squamous cell carcinoma, AND/OR basal cell carcinoma, AND/OR IP3R, AND/OR immunohistochemistry”. Works published between 2018 and 2023 were considered for review; 40 works were included, fully read and summarized. Results: NMSC is the most common malignant tumor worldwide, with 75-80% being BCC, and up to 25% being SCC. Molecular interactions in general involve a large participation of tumor suppressor molecules, as well as procto-oncogenes. Furthermore, voltage-dependent ion channels control the cytosolic flow of ions, including calcium. The IP3R (phosphatidyl inositol-3 receptor) allows the exit of calcium from the endoplasmic reticulum so that it can be used by the cell for physiological activities such as proliferation, angiogenesis, motility and invasion capacity. Conclusion: The IP3R, due to its immunohistochemical expression characteristics, appears may also be related to the pathophysiology of NMSC.

Introdução: O câncer de pele não melanoma (CPNM) compeende grupo de neoplasias com alta incidência na população mundial. É dividido em carcinoma basocelular (CBC) e de células escamosas (CEC). Por ser de grande prevalência, entender o processo de oncogênese e a relação com íons, proteínas e receptores celulares no CPMN pode contribuir para que novas terapêuticas sejam avaliadas. Objetivo: Entender o processo da oncogênese dos tumores de pele não melanomas e sua relação com a imunolocalização do IP3R. Método: Revisão integrativa da literatura com síntese de evidências. A base de dados foi o PUBMED; a  estratégia de busca: “carcinoma espinocelular, AND/OR carcinoma basocelular, AND/OR IP3R, AND/OR imunoistoquímica”. Foram considerados para revisão os trabalhos publicados entre 2018 e 2023. Foram incluídos 40 trabalhos, integralmente lidos e resumidos. Resultados: CPNMs são os tumores malignos mais comuns em todo o mundo, sendo 75-80% o CBC, e até 25% o CEC. As interações moleculares de forma geral, envolvem grande participação de moléculas supressoras tumorais, assim como de procto-oncogenes. Além disso, canais iônicos voltagem dependente controlam o fluxo citosólico de íons, dentre eles o cálcio. O IP3R (receptor do fosfatidil inositol-3) permite a saída de cálcio do retículo endoplasmático para que seja utilizado pela célula para atividades fisiológias como proliferação, angiogênese, motilidade e capacidade de invasão. Conclusão: O IP3R, pelas características de expressão imunoistoquímica, parece estar relacionado também, à fisiopatologia do CPNM.

RESUMO Objetivo: Traçar um perfil epidemiológico dos pacientes acometidos por tumores palpebrais, além de comparar o índice de acerto do diagnóstico clínico de tumores palpebrais ao exame histopatológico padrão-ouro. Métodos: Estudo retrospectivo com análise de prontuários de pacientes, no período entre 2015 e 2019, submetidos à biópsia excisional das lesões como forma de tratamento definitivo, com consequente classificação histopatológica da peça cirúrgica. Foram analisados idade e sexo dos pacientes, além de localização, diagnóstico clínico e classificação histopatológica dos tumores. Resultados: Foram verificados 273 prontuários, totalizando 331 tumores palpebrais. O índice de acerto do diagnóstico clínico, comparado ao laudo anatomopatológico, foi de 88,2%. Dos tumores encontrados, 284 (85,8%) eram benignos; dentre os malignos, o mais prevalente foi o carcinoma basocelular (80,6%), seguido pelo espinocelular (8,5%) e o sebáceo (6,4%); dentre os benignos, o mais prevalente foi o papiloma (19,7%), seguido pelo nevus (13,7%) e pelo hidrocistoma (13,4%). A idade média dos pacientes foi de 49,5±20,1 anos, com prevalência feminina de 56,4% (n=155). Dos pacientes, 42 (15,3%) apresentaram tumores com malignidade, sendo 23 (54,8%) mulheres. Os tumores acometeram 178 pálpebras inferiores e 125 superiores, 22 cantos mediais e seis laterais. O lado mais acometido foi o direito, com 169 tumores; 162 foram no lado esquerdo, e 19 pacientes tiveram acometimento bilateral. Conclusão: O exame histopatológico é uma ferramenta essencial no diagnóstico definitivo e no acompanhamento do paciente com tumor palpebral, o qual, em geral, mostra predomínio benigno, assim como preferência por idade próxima e/ou superior a 50 anos, sexo feminino, lado direito e pálpebra inferior. Esses fatos devem ser levados em consideração durante a consulta oftalmológica, devido à probabilidade de malignidade de tumores palpebrais. O melhor tratamento continua sendo a excisão cirúrgica total com margens livres da lesão.

ABSTRACT Objective: Delineate an epidemiological profile of patients affected by eyelid tumors, while comparing the rate of correct clinical diagnosis to the gold standard histopathological analysis, verifying the data with the literature. Methods: Retrospective analysis of medical records, from 2015 to 2019, of patients submitted to excisional biopsy of the lesions with consequent histopathological classification of the anatomical specimen. Patients’ age and sex and tumors location, clinical diagnosis and histopathological classification were considered. Results: In total, 331 eyelid tumors from 273 medical records were inspected. The rate of correct clinical diagnosis, compared to the anatomopathological report, was 88.2%. Of all tumors, 284 (85.8%) were benign. Among malignant tumors, the most prevalent was Basal Cell Carcinoma (80.6%), followed by Squamous Cell Carcinoma (8.5%) and Sebaceous Carcinoma (6.4%); Among benign tumors, it was Papilloma (19.7%), followed by Nevus (13.7%) and Hydrocystoma (13.4%). The mean age was 49.5±20.1 years, with female prevalence (155, 56.4%). Forty-two patients (15.3%) had malignant tumors, 23 (54.8%) were women. The tumors affected 178 lower and 125 upper eyelids, 22 medial canthus and 6 lateral canthus; 169 tumors affected the right side and 162 the left; 19 of the patients had bilateral involvement. Conclusion: Histopathological analysis is an essential tool in the diagnosis of eyelid tumors, which, predominantly, are benign affecting more often women with ages close to or over 50 years, on the right side and lower eyelid. These facts must be considered during the ophthalmological consultation due to the probability of malignancy. The best treatment remains surgical excision of the lesion with free margins.

RESUMO O oncocitoma é um tipo de neoplasia rara na prática clínica e descrito na literatura, principalmente quando localizado no olho. Quando localizado nos anexos oculares, é mais frequentemente na carúncula. Analisou-se o caso de uma paciente de 74 anos, caucasiana, que relatou desconforto visual no olho esquerdo, e cujo exame físico mostrou lesão tumoral na carúncula esquerda, com volume moderado, presença de neovascularização e secreção excessiva. A excisão cirúrgica da lesão foi realizada sob sedação, e a peça foi enviada para avaliação anatomopatológica. A lesão foi diagnosticada histologicamente como oncocitoma, sem malignidade, e a paciente não apresentou recidiva após o procedimento. Embora raro, esse tumor deve ser reconhecido pelos oftalmologistas, devido ao risco já relatado de desenvolvimento de adenocarcinoma.

ABSTRACT Oncocytoma is a neoplasm rarely observed in clinical practice and reported in the literature, especially when located in the eye. When described in the ocular adnexa, it is most often located in the caruncle. The case of a 74-year-old Caucasian female patient is reported. She complained of visual discomfort in the left eye, and physical examination showed a tumoral lesion in the left caruncle, of moderate volume, presence of neovascularization, and excessive secretion. Surgical excision of the lesion was performed under sedation, and the specimen was sent for pathological examination. The lesion was histologically diagnosed as oncocytoma with no malignancy, and the patient presented no recurrence after the procedure. Although rare, this tumor must be recognized by ophthalmologists due to the risk of developing adenocarcinoma, as already reported.

RESUMO A amiloidose é caracterizada pela deposição extracelular de fibrilas amiloides proteicas nos tecidos, incluindo conjuntiva, motivada por sua insolubilidade em proteínas proteolíticas. A amiloidose conjuntival, afetando especificamente a conjuntiva palpebral, é um achado raro na prática clínica. Os autores descrevem um caso de um paciente do sexo masculino, caucasiano, de 71 anos, apresentando lesões bilaterais localizadas na conjuntiva da pálpebra inferior, elevadas, bem delimitadas, amareladas, aliadas a pálpebras desestabilizadas. Foi realizada excisão cirúrgica das lesões, e o exame histológico confirmou se tratar de amiloidose conjuntival. Não houve recorrência após o procedimento. A amiloidose conjuntival afetando ambas as pálpebras inferiores é um achado raro na literatura. O manejo da amiloidose conjuntival depende da extensão do envolvimento local e do status sistêmico do paciente, variando de sintomático, com o uso de lubrificantes, até cirúrgico, com a remoção das lesões.

ABSTRACT Amyloidosis is characterized by extracellular deposition of protein amyloid fibrils in tissues, including conjunctiva, which are insoluble in proteolytic proteins. Conjunctival amyloidosis specifically in the palpebral conjunctiva is a rare finding in clinical practice. The authors described the case of a 71-year-old caucasian male patient, with bilateral lesions located in the lower eyelid conjunctiva, elevated, well-defined, yellowish, combined with destabilized eyelids. Surgical excision of the lesions was performed, and the histological examination confirmed conjunctival amyloidosis. There was no recurrence after the procedure. Conjunctival amyloidosis in both lower eyelids is a rare finding in the literature. The management of conjunctival amyloidosis depends on the extent of local involvement and patient’s general health status, varying from symptomatic, with use of ocular lubricants, to surgical, by removing the lesions.

Abstract Scleromyxedema or lichen myxedematosus is a rare papular mucinosis of chronic and progressive course and unknown etiology. It is commonly associated with monoclonal gammopathy and may show extracutaneous manifestations, affecting the heart, lung, kidney, and nerves. The diagnosis is based on four criteria: generalized papular and sclerodermoid lesions; mucin deposition, fibroblast proliferation, and fibrosis in the histopathology; monoclonal gammopathy; and no thyroid disorders. This article reports the case of a scleromyxedema patient with a recent history of acute myocardial infarction and monoclonal gammopathy.

Abstract: BACKGROUND: Permanent alopecia after bone marrow transplantation is rare, but more and more cases have been described, typically involving high doses of chemotherapeutic agents used in the conditioning regimen for the transplant. Busulfan, classically described in cases of irreversible alopecia, remains associated in recent cases. The pathogenesis involved in hair loss is not clear and there are few studies available. In addition to chemotherapeutic agents, another factor that has been implicated as a cause is chronic graft-versus-host disease. However, there are no histopathological criteria for defining this diagnosis yet. OBJECTIVE: the study aims to evaluate clinical and histological aspects in cases of permanent alopecia after bone marrow transplantation, identifying features of permanent alopecia induced by myeloablative chemotherapy and alopecia as a manifestation of chronic graft-versus-host disease. METHODS: data were collected from medical records of 7 patients, with description of the clinical features and review of slides and paraffin blocks of biopsies. RESULTS: Two distinct histological patterns were found: one similar to androgenetic alopecia, non-scarring pattern, and other similar to lichen planopilaris, scarring alopecia. CONCLUSION: The first pattern corroborates the literature cases of permanent alopecia induced by chemotherapeutic agents, and the second is compatible with manifestation of chronic graft-versus-host disease on scalp, that has never been described yet. The results contribute to the elucidation of the factors involved in these cases, including the development of therapeutic methods