ABSTRACT Mantle cell lymphoma of the ocular and periorbital regions is extremely rare but should be considered in the differential diagnosis of lesions affecting the periorbital tissues. In this study, we present a rare case of mantle cell lymphoma of the lacrimal sac in a 65-year-old male presenting with a mass in the lacrimal sac region and epiphora. After clinical examinations and imaging studies, the mucocele was misdiagnosed. Considering the unexpected findings during external dacryocystorhinostomy, a frozen biopsy was performed, which confirmed the diagnosis of lymphoma. tissues study 65yearold yearold 65 year old epiphora studies misdiagnosed dacryocystorhinostomy performed 6

ABSTRACT A patient presented with corneoscleral thinning five months after the treatment of suspected ocular squamous surface neoplasia with mitomycin-C and interferon. For tectonic and aesthetic purposes, we decided to perform lamellar corneoscleral transplantation. The approach used established new tectonic support and corneal homeostasis. This technique might be an option in similar cases. mitomycinC mitomycin C interferon purposes transplantation homeostasis cases

RESUMO: Dentre as neoplasias hematopoiéticas, as leucemias são originadas pelas células mieloides ou linfoides na medula óssea, podendo ser de forma aguda, com um pior prognóstico, principalmente, acometendo gatos com leucemia felina (FeLV positivos) ou, de forma crônica, que apresentam um prognostico reservado, especialmente em gatos idosos. As leucemias possuem várias classificações, cujas diferenciações irão depender de exames complementares como hemograma, mielograma, citologia e citometria de fluxo, importantes para a caracterização e para o melhor tratamento do animal. RESUMO hematopoiéticas óssea aguda prognóstico principalmente FeLV positivos crônica reservado idosos classificações hemograma mielograma fluxo animal

ABSTRACT: Among the hematopoietic neoplasms, leukemias are caused by myeloid or lymphoid cells in the bone marrow, which can either be acute with an unfavorable prognosis and mostly affect cats that tested positive for feline viral leukemia (FeLV) or chronic in older cats that have a poor prognosis. Leukemias have several classifications in which the differentiation depends on complementary tests, such as blood profile, myelogram, cytology. and flow cytometry, which help determine the best treatment for the animal. ABSTRACT neoplasms marrow FeLV (FeLV tests profile myelogram cytology cytometry animal

ABSTRACT Purpose: Although Brazil has a high prevalence of retinoblastoma, there is a lack of epidemiological data on the disease. Thus, in this study, we aimed to evaluate the epidemiological profile of patients diagnosed with retinoblastoma in the ophthalmology department of a pediatric tertiary referral hospital in Ceara, Brazil. Methods: A descriptive and cross-sectional study was conducted by retrospectively analyzing the clinical and socioeconomic data from the medical records of pediatric patients followed-up at the hospital between 2007 and 2021. Retinoblastoma was diagnosed on the basis of a fundoscopic or histopathologic examination. Results: The data of 105 patients were included in the study, and the mean patient age at the time of diagnosis was 1.7 years. Most of the patients were women (50.5%) and hailed from rural areas (57.4%), which was associated with a higher tumor stage. Of the 150 patients, 57.1% initially presented with leukocoria. Ocular hyperemia was associated with more advanced stages of retinoblastoma (p=0.004). Bilateral involvement was observed in 25.7% of the patients and at a significantly younger age (p=0.009). The presence of retinal detachment, vascularized lesions, and vitreous seeds significantly increased the likelihood of requiring enucleation. Discussion: This study presents an epidemiological description of retinoblastoma in Brazil, which highlights the significance of early detection. Delayed diagnosis is associated with a poorer visual prognosis and higher mortality rate, particularly in patients with unilateral disease. Risk factors for a more severe disease were retinal detachment, vascularized lesions, and vitreous seeds. The correlation between histopathological features and clinical outcomes was limited. Conclusion: Further studies are required to assess the influence of ocular hyperemia, fundoscopic assessment, and histopathologic findings on the prognosis of retinoblastoma. Moreover, it is critical to devise interventions to reduce the time-to-diagnosis in rural areas. Purpose Thus Ceara Methods crosssectional cross sectional followedup followed up 200 2021 examination Results 10 17 1 7 1. years 50.5% 505 50 5 (50.5% 57.4%, 574 57.4% , 57 4 (57.4%) stage 15 571 57.1 leukocoria p=0.004. p0004 p p=0.004 . 0 004 (p=0.004) 257 25 25.7 p=0.009. p0009 p=0.009 009 (p=0.009) detachment lesions enucleation Discussion detection rate limited Conclusion assessment Moreover timetodiagnosis 20 202 50.5 (50.5 57.4 (57.4% 57. p000 p=0.00 00 (p=0.004 2 25. (p=0.009 50. (50. (57.4 p00 p=0.0 (p=0.00 (50 (57. p0 p=0. (p=0.0 (5 (57 p=0 (p=0. ( p= (p=0 (p= (p

Abstract Background Merkel cell polyomavirus (MCPyV), a human polyomavirus that is unequivocally linked to merkel cell carcinoma (MCC), has been found in association with keratinocytes carcinomas (KC), especially basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). Nevertheless, there is scarce information about the possible involvement of MCPyV in the development of KC. Objectives To assess the presence of MCPyV DNA and Large-T Antigen (LT-Ag) via Polymerase Chain Reaction (PCR) and Immunohistochemistry (IHC) in cases of KC, and to correlate its presence with immunohistochemical markers p16, p53, and ki67, tumor type and subtype, sun-exposed location, and epidemiological data. Methods The prevalence of MCPyV DNA, LT-Ag, and immunohistochemical markers p16, p53, and ki67 was assessed by PCR and Immunohistochemistry (IHC) in 127 cases of KC, these results were correlated with tumor type and subtype, sun-exposed location, and epidemiological data. Results The MCPyV DNA was detected in 42.57% (43 of 101) cases by PCR, the LT-Ag was detected in 16.4% (20 of 122) of cases, p16 in 81.5% (97 of 119), p53 in 66.4% (83 of 125), ki67 in 89% (73 of 82). No correlation between MCPyV LT-Ag and DNA confronted with tumor type, subtype, location site, and immunohistochemical markers was found. A single correlation between the MCPyV LT-Ag and cSCC tumors and peri-tumoral lymphocyte cells was noted. Study limitations Further steps need to be taken to better evaluate the MCPyV influence and its possible role in KC carcinogenesis, as the evaluation of the virus genome state, the gene sequence that encodes LT-Ag in the KC tumor cells, and in situ hybridization for viral DNA or RNA in these cells. Conclusions Despite the frequent detection of MCPyV in KC, the data available so far does not support the hypothesis of a causal relationship between them. MCPyV, , (MCPyV) MCC, MCC (MCC) (KC) BCC (BCC cSCC. . (cSCC) Nevertheless LargeT Large T LTAg LT Ag (LT-Ag (PCR IHC (IHC p ki subtype sunexposed sun exposed LTAg, Ag, ki6 12 4257 42 57 42.57 43 (4 101 164 16 4 16.4 20 (2 122 p1 815 81 5 81.5 97 (9 119, 119 119) p5 664 66 66.4 83 (8 125, 125 125) 89 73 (7 82. 82 82) site peritumoral peri tumoral noted carcinogenesis state them (MCPyV (MCC (KC (cSCC 1 425 42.5 ( 10 16. 2 8 81. 9 11 6 66. 7 42.

Abstract Introduction Juvenile nasopharyngeal angiofibroma (JNA) is a benign vascularized tumor that affects almost exclusively male adolescents. Surgery is the treatment of choice for JNA. Objectives The present study is a 42-year retrospective review of a series of JNA cases treated surgically without previous embolization. Methods The present is a retrospective, descriptive study based on medical records of 96 patients with JNA who underwent microscopic or endoscopic excision without previous embolization from 1978 to 2020 in a single institution. The patients were categorized according to the Andrews et al. stage, and data were collected on age, gender, tumor staging, surgical approach, affected side, and outcome. Results All patients were male, with an average age of 17 years. The predominant tumor stage consisted of type II, with 52.1%. A total of 33.3% of the patients were submitted to the microscopic technique and 66.7%, to the endonasal technique. The rate of intraoperative blood transfusion was of 17.7%. Conclusion The present study reinforces that resection of JNA in various stages is viable without previous artery embolization. (JNA adolescents 42year year 42 9 197 202 institution al gender staging approach side outcome 1 years II 521 52 52.1% 333 33 3 33.3 667 66 7 66.7% 177 17.7% 4 19 20 5 52.1 33. 6 66.7 17.7 2 52. 66. 17.

Abstract Vulvar leiomyosarcoma is a malignant tumor with a very rare presentation; there are about 50 cases published in the literature. Its prognosis is poor due to its local recurrence and hematogenous dissemination, with mainly lung and liver involvement. We present the case of a 30-year-old patient with a rapidly growing palpable tumor on the right labia majora, which, due to its size and vascular component, was embolized by interventional radiology before surgical removal, with good clinical evolution.

Resumen El leiomiosarcoma vulvar es un tumor maligno de presentación muy rara, existen publicados cerca 50 casos en la literatura. Su pronóstico es malo, por su recidiva local y diseminación por vía hematógena con principal afección pulmonar y hepática. Se presenta el caso de una paciente de 30 años con tumoración palpable de rápido crecimiento en labio mayor derecho, el cual debido a su tamaño y componente vascular fue embolizado por radiología intervencionista previo a extirpación quirúrgica, con buena evolución clínica.

Abstract The objective of this study was to identify indicators of social inequalities associated with mortality from neoplasms in the Brazilian adult population. A scoping review method was used, establishing the guiding question: What is the effect of social inequalities on mortality from neoplasms in the Brazilian adult population? A total of 567 papers were identified, 22 of which were considered eligible. A variety of indicators were identified, such as the Human Development Index and the Gini Index, which primarily assessed differences in income, schooling, human development and vulnerability. A single pattern of association between the indicators and the different neoplasms was not established, nor was a single indicator capable of explaining the effect of social inequality at all levels of territorial area and by deaths from all types of neoplasms identified. It is known that mortality is influenced by social inequalities and that the study of indicators provides an opportunity to define which best explains deaths. This review highlights important gaps regarding the use of non-modifiable social indicators, analysis of small geographical areas, and limited use of multidimensional indicators. population used question 56 identified 2 eligible income schooling vulnerability established nonmodifiable non modifiable areas 5

Resumo O objetivo deste estudo foi identificar indicadores de desigualdades sociais associados à mortalidade por neoplasias na população adulta brasileira. Utilizou-se como método a revisão de escopo, estabelecendo-se a pergunta norteadora: qual o efeito das desigualdades sociais na mortalidade por neoplasias na população adulta brasileira? Foram identificados 567 trabalhos, sendo 22 considerados elegíveis. Identificou-se uma diversidade de indicadores, como o Índice de Desenvolvimento Humano e o Índice de Gini, entre outros, que avaliaram primordialmente diferenças de renda, escolarização, desenvolvimento humano e vulnerabilidade. Não foi estabelecido um único padrão de associação entre os indicadores e as diferentes neoplasias, assim como não se identificou um indicador único capaz de explicar o efeito da desigualdade social em todos os níveis de área e por óbitos por todos os tipos de neoplasias, mas identificou-se que a mortalidade é influenciada pelas desigualdades sociais e que o estudo dos indicadores proporciona definir qual melhor explica os óbitos. Essa revisão destaca importantes lacunas referentes ao uso de indicadores sociais não modificáveis, à análise de pequenas áreas e ao uso limitado de indicadores multidimensionais. brasileira Utilizouse Utilizou escopo estabelecendose estabelecendo norteadora 56 trabalhos 2 elegíveis Identificouse Identificou Gini outros renda escolarização vulnerabilidade identificouse modificáveis multidimensionais 5

ABSTRACT Background Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is associated with significant morbidity and mortality. We present an alternative technique that preserves the complete mesenteric vascularization during the isolation of the intestinal segment used in ICUD, including distal vessels. This approach aims to minimize the risk of ischemia in both the ileal anastomosis and the isolated loop at the diversion site. Methods This cohort study included 31 patients, both male and female, who underwent RARC with ICUD from February 2018 to November 2023, performed by a single surgeon. Intraoperative and postoperative complications data were retrieved for analysis, employing our proposed mesentery-sparing technique in all cases. The primary endpoint was the incidence of intraoperative and postoperative complications directly attributable to the mesentery-sparing approach in ICUD. Secondary endpoints included other postoperative variables not directly related to mesentery preservation, such as the incidence of postoperative ileus requiring parenteral nutrition and the duration of hospitalization. Results None of the patients experienced intraoperative or postoperative complications directly related to mesentery-sparing, such as intestinal fistulae or internal hernias. The median duration of hospitalization was 6 days, and postoperative ileus necessitating total parenteral nutrition occurred in 19% of the patients. Minor complications (Clavien–Dindo grades I-II) accounted for 27.6% of the cases and major complications (grades III-V) accounted for 20.6%. Conclusion The mesentery-sparing technique outlined herein offers an alternative method for preserving the vascularization of intestinal segments and reducing the risk of intestinal complications in ICUD during RARC. Roboticassisted Robotic assisted (RARC (ICUD mortality vessels site 3 female 201 2023 surgeon analysis mesenterysparing sparing preservation mesenterysparing, sparing, hernias days 19 Clavien–Dindo ClavienDindo Clavien Dindo III I II I-II 276 27 27.6 IIIV V III-V 206 20 20.6% 202 1 2 27. 20.6 20.

ABSTRACT Introduction Chemotherapy and radiation therapy are considered standard treatments for stage II seminoma patients; however, these therapies are associated with long-term toxicities. Recently, retroperitoneal lymph node dissection has emerged as an alternative strategy, and the first three phase II trials were published in 2023 with promising results. The present study conducted a systematic review and meta-analysis to evaluate this surgery as an alternative treatment for stage IIA/B seminoma patients. Purpose Seminomas are the most common testicular tumors, often affecting young adult males. Standard treatments for stage II seminomas include chemotherapy and radiation therapy, but these therapies are associated with long-term toxicities. Thus, identifying alternative strategies is paramount. Herein, we conducted a systematic review and meta-analysis to appraise the efficacy and safety of retroperitoneal lymph node dissection (RPLND) for treating this condition. Methods We systematically searched the PubMed, Embase, and Cochrane databases for studies evaluating RPLND as a primary treatment for stage II A/B seminomas. Using a random-effects model, single proportion and means and pooled 2-year recurrence-free survival rates with hazard rates and 95% CI were calculated. Results Seven studies were included, comprising 331 males with stage II seminomas. In the pooled analysis, the recurrence rate was 17.69% (95% CI 12.31–24.75), and the 2-year RFS rate was 81% (95% CI 0.77–0.86). The complication rate was 9.16% (95% CI 6.16–13.42), the Clavien–Dindo > 2 complication rate was 8.83% (95% CI 5.76–13.31), and the retrograde ejaculation rate was 7.01% (95% CI 3.54–13.40). The median operative time was 174.68 min (95% CI 122.17–249.76 min), median blood loss was 105.91 mL (95% CI 46.89–239.22 mL), and patients with no evidence of lymph node involvement ranged from 0–16%. Conclusions Primary RPLNDs for treating stage IIA/B seminomas have favorable RFS rates, with low complication and recurrence rates. These findings provide evidence that this surgery is a viable alternative therapy for these patients. however longterm long term toxicities Recently strategy 202 results metaanalysis meta analysis IIAB IIA B tumors Thus paramount Herein (RPLND condition PubMed Embase AB A randomeffects random effects model 2year year recurrencefree free 95 calculated included 33 1769 17 69 17.69 (95 12.31–24.75, 12312475 12.31–24.75 , 12 31 24 75 12.31–24.75) 81 0.77–0.86. 077086 0.77–0.86 . 0 77 86 0.77–0.86) 916 9 16 9.16 6.16–13.42, 6161342 6.16–13.42 6 13 42 6.16–13.42) ClavienDindo Clavien Dindo 883 8 83 8.83 5.76–13.31, 5761331 5.76–13.31 5 76 5.76–13.31) 701 7 01 7.01 3.54–13.40. 3541340 3.54–13.40 3 54 40 3.54–13.40) 17468 174 68 174.6 1221724976 122 249 122.17–249.7 min, min) 10591 105 91 105.9 468923922 46 89 239 22 46.89–239.2 mL, mL) 016 0–16% 20 176 1 17.6 (9 1231247 12.31–24.7 07708 0.77–0.8 9.1 616134 6.16–13.4 4 88 8.8 576133 5.76–13.3 70 7.0 354134 3.54–13.4 1746 174. 122172497 122.17–249. 1059 10 105. 46892392 23 46.89–239. 0–16 17. ( 123124 12.31–24. 0770 0.77–0. 9. 61613 6.16–13. 8. 57613 5.76–13. 7. 35413 3.54–13. 12217249 122.17–249 4689239 46.89–239 0–1 12312 12.31–24 077 0.77–0 6161 6.16–13 5761 5.76–13 3541 3.54–13 1221724 122.17–24 468923 46.89–23 0– 1231 12.31–2 07 0.77– 616 6.16–1 576 5.76–1 354 3.54–1 122172 122.17–2 46892 46.89–2 123 12.31– 0.77 61 6.16– 57 5.76– 35 3.54– 12217 122.17– 4689 46.89– 12.31 0.7 6.16 5.76 3.54 1221 122.17 468 46.89 12.3 0. 6.1 5.7 3.5 122.1 46.8 12. 6. 5. 3. 122. 46.

ABSTRACT Purpose We assessed the prognostic impact of the 2012 Briganti nomogram on prostate cancer (PCa) progression in intermediate-risk (IR) patients presenting with PSA <10ng/mL, ISUP grade group 3, and clinical stage up to cT2b treated with robot assisted radical prostatectomy eventually associated with extended pelvic lymph node dissection. Materials and Methods From January 2013 to December 2021, data of surgically treated IR PCa patients were retrospectively evaluated. Only patients presenting with the above-mentioned features were considered. The 2012 Briganti nomogram was assessed either as a continuous and a categorical variable (up to the median, which was detected as 6%, vs. above the median). The association with PCa progression, defined as biochemical recurrence, and/or metastatic progression, was evaluated by Cox proportional hazard regression models. Results Overall, 147 patients were included. Compared to subjects with a nomogram score up to 6%, those presenting with a score above 6% were more likely to be younger, had larger/palpable tumors, presented with higher PSA, underwent tumor upgrading, harbored non-organ confined disease, and had positive surgical margins at final pathology. PCa progression, which occurred in 32 (21.7%) cases, was independently predicted by the 2012 Briganti nomogram both considered as a continuous (Hazard Ratio [HR]:1.04, 95% Confidence Interval [CI]:1.01-1.08;p=0.021), and a categorical variable (HR:2.32; 95%CI:1.11-4.87;p=0.026), even after adjustment for tumor upgrading. Conclusions In IR PCa patients with PSA <10ng/mL, ISUP grade group 3, and clinical stage up to cT2b, the 2012 Briganti nomogram independently predicts PCa progression. In this challenging subset of patients, this tool can identify prognostic subgroups, independently by upgrading issues. 201 (PCa intermediaterisk intermediate risk (IR 10ngmL ngmL 10ng mL ng <10ng/mL 3 cTb cT b dissection 2021 abovementioned mentioned median 6 vs median. . median) recurrence andor or models Overall 14 included younger largerpalpable larger palpable tumors nonorgan non organ disease pathology 21.7% 217 21 7 (21.7% cases Hazard HR1.04, HR104 HR 1.04, 1 04 [HR]:1.04 95 CI1.011.08p=0.021, CI101108p0021 CIp CI 1.01 1.08 p=0.021 , 01 08 p 0 021 [CI]:1.01-1.08;p=0.021) HR2.32 HR232 2.32 2 (HR:2.32 95%CI1.114.87p=0.026, 95CI111487p0026 95%CI 1.11 4.87 p=0.026 11 4 87 026 95%CI:1.11-4.87;p=0.026) subgroups issues 20 202 21.7 (21.7 HR1 HR1.04 HR10 104 1.04 [HR]:1.0 9 CI1 011 08p CI1.011.08p=0.021 CI101108p002 101 1.0 108 p0021 p=0.02 02 [CI]:1.01-1.08;p=0.021 HR2 HR2.3 HR23 232 2.3 (HR:2.3 114 87p 95%CI1.114.87p=0.026 95CI111487p002 95CI 111 1.1 487 4.8 p0026 8 95%CI:1.11-4.87;p=0.026 21. (21. HR1.0 10 [HR]:1. CI1.011.08p=0.02 CI101108p00 1. p002 p=0.0 [CI]:1.01-1.08;p=0.02 HR2. 23 2. (HR:2. 95%CI1.114.87p=0.02 95CI111487p00 48 4. 95%CI:1.11-4.87;p=0.02 (21 HR1. [HR]:1 CI1.011.08p=0.0 CI101108p0 p00 p=0. [CI]:1.01-1.08;p=0.0 (HR:2 95%CI1.114.87p=0.0 95CI111487p0 95%CI:1.11-4.87;p=0.0 (2 [HR]: CI1.011.08p=0. CI101108p p0 p=0 [CI]:1.01-1.08;p=0. (HR: 95%CI1.114.87p=0. 95CI111487p 95%CI:1.11-4.87;p=0. ( [HR] CI1.011.08p=0 p= [CI]:1.01-1.08;p=0 (HR 95%CI1.114.87p=0 95%CI:1.11-4.87;p=0 [HR CI1.011.08p= [CI]:1.01-1.08;p= 95%CI1.114.87p= 95%CI:1.11-4.87;p= CI1.011.08p [CI]:1.01-1.08;p 95%CI1.114.87p 95%CI:1.11-4.87;p

ABSTRACT Background and Objective Salvage robot assisted radical prostatectomy (sRARP) is performed for patients with biochemical or biopsy proven, localized prostate cancer recurrences after radiation or ablative therapies. Traditionally, sRARP has been avoided by lower volume surgeons due to technical demand and high complication rates. Post-radiation sRARP outcomes studies exist but remain few in number. With increasing use of whole gland and focal ablative therapies, updates on sRARP in this setting are needed. The aim of this narrative review is to provide an overview of recently reviewed studies on the oncologic outcomes, functional outcomes, and complications after post-radiation and post-ablative sRARP. Tips and tricks are provided to guide surgeons who may perform sRARP. Materials and Methods We performed a non-systematic literature search of PubMed and MEDLINE for the most relevant articles pertaining to the outlined topics from 2010-2022 without limitation on study design. Only case reports, editorial comments, letters, and manuscripts in non-English languages were excluded. Key Content and Findings Salvage robotic radical prostatectomy is performed in cases of biochemical recurrence after radiation or ablative therapies. Oncologic outcomes after sRARP are worse compared to primary surgery (pRARP) though improvements have been made with the robotic approach when compared to open salvage prostatectomy. Higher pre-sRARP PSA levels and more advanced pathologic stage portend worse oncologic outcomes. Patients meeting low-risk, EAU-biochemical recurrence criteria have improved oncologic outcomes compared to those with high-risk BCR. While complication rates in sRARP are higher compared to pRARP, Retzius sparing approaches may reduce complication rates, particularly rectal injuries. In comparison to the traditional open approach, sRARP is associated with a lower rate of bladder neck contracture. In terms of functional outcomes, potency rates after sRARP are poor and continence rates are low, though Retzius sparing approaches demonstrate acceptable recovery of urinary continence by 1 year, post-operatively. Conclusions Advances in the robotic platform and improvement in robotic experience have resulted in acceptable complication rates after sRARP. However, oncologic and functional outcomes after sRARP in both the post-radiation and post-ablation settings are worse compared to pRARP. Thus, when engaging in shared decision making with patients regarding the initial management of localized prostate cancer, patients should be educated regarding oncologic and functional outcomes and complications in the case of biochemically recurrent prostate cancer that may require sRARP. (sRARP proven therapies Traditionally Postradiation Post number needed postradiation post postablative nonsystematic non systematic 20102022 2010 2022 2010-202 design reports comments letters nonEnglish English excluded pRARP (pRARP presRARP pre lowrisk, lowrisk low risk, risk low-risk EAUbiochemical EAU highrisk BCR injuries contracture year postoperatively. postoperatively operatively. operatively post-operatively However postablation ablation Thus 2010202 201 202 2010-20 201020 20 2010-2 20102 2 2010-

Abstract Background 5-Fluorouracil (5-FU) is a first-line drug to treat cutaneous field cancerization (CFC). There are few clinical trials with topical colchicine (COL). Objective To evaluate the effectiveness of 0.5% COL cream versus 5% 5-FU cream in the treatment of CFC. Method This was a randomized, open, self-controlled clinical trial. Forty-five patients (90 forearms), with three to ten actinic keratoses (AK) on each forearm, used 0.5% COL cream 2×/day for seven days on one forearm, and 5% 5-FU cream 2× /day, for 21 days, on the other forearm. The dosages were defined based on previous clinical trials for each drug. Adverse effects were evaluated after 14 days and outcomes after 90 days of inclusion. The primary outcome was complete AK clearance and the secondary outcomes were: partial clearance (≥50%), reduction in AK count, assessment of the Forearm Photoaging Scale (FPS), AK Severity Score (AKSS), and adverse effects. Results After 90 days, there was complete clearance of AK in 37% (95% CI 24%-49%) and partial clearance in 85% (95% CI 76%-93%) of the forearms treated with 5-FU,versus 17% (95% CI 7%-27%) and 78% (95% CI 66%-88%) for COL (p > 0.07). There was a percentage reduction of 75% in the AK count of the forearms treated with 5-FU (95% CI 66%-83%) and 64% in those treated with COL (95% CI 55%-72%). Regarding FPS and AKSS, there was improvement in both groups, with no difference regarding FPS (p = 0.654), and 5-FU superiority for AKSS (p = 0.012). Study limitations Single-center study. Conclusions 5-FU and COL are effective for treating CFC, with neither showing superiority regarding the reduction in AK counts. 5Fluorouracil Fluorouracil 5 5FU FU (5-FU firstline first line CFC . (CFC) COL. (COL) 05 0 0.5 randomized open selfcontrolled self controlled trial Fortyfive Forty five (9 forearms, , forearms) (AK forearm 2day day 2 /day 1 9 inclusion ≥50%, 50 ≥50% (≥50%) FPS, (FPS) (AKSS) 37 95% 95 (95 24%49% 2449 24% 49% 24 49 24%-49% 85 76%93% 7693 76% 93% 76 93 76%-93% 5FU,versus 5FUversus FUversus FU,versus 17 7%27% 727 7% 27% 7 27 7%-27% 78 66%88% 6688 66% 88% 66 88 66%-88% p 0.07. 007 0.07 07 0.07) 75 66%83% 6683 83% 83 66%-83% 64 55%72%. 5572 55% 72% 55 72 55%-72%) groups 0.654, 0654 0.654 654 0.654) 0.012. 0012 0.012 012 0.012) Singlecenter Single center study counts (CFC (COL 0. ( ≥50 (≥50% (FPS (AKSS 3 24%49 244 4 24%-49 8 76%93 769 76%-93 7%27 7%-27 66%88 668 6 66%-88 00 0.0 66%83 66%-83 55%72% 557 55%-72% 065 0.65 65 001 0.01 01 ≥5 (≥50 24%4 24%-4 76%9 76%-9 7%2 7%-2 66%8 66%-8 55%72 55%-72 06 0.6 ≥ (≥5 24%- 76%- 7%- 66%- 55%7 55%-7 (≥ 55%-

Abstract Background Skin modification through tattoos is as old as humanity itself. However, this trend is on the rise, and with the use of different types of pigments and application practices, both cutaneous and systemic complications can arise. Adverse reactions can be grouped into five classes: inflammatory, infectious, neoplastic, aesthetic, and miscellaneous. On histopathology, inflammatory reactions can exhibit a lichenoid pattern or present as spongiotic dermatitis, granulomatous reactions, pseudolymphoma, pseudoepitheliomatous hyperplasia, or scleroderma/morphea-like changes. This article reviews tattoo complications, including their clinical and histopathological characteristics. Methods An open search was conducted on PubMed using the terms “tattoo”, “complications”, and “skin”. No limits were set for period, language, or publication type of the articles. Results Reactions to tattoos are reported in up to 67% of people who get tattooed, with papulonodular and granulomatous reactions being the most common. Some neoplastic complications have been described, but their causality is still debated. Any pigment can cause adverse reactions, although red ink is more frequently associated with them. Patients with pre-existing dermatoses may experience exacerbation or complications of their diseases when getting tattoos; therefore, this procedure is not recommended for this patient group. Conclusions Dermatological consultation is recommended before getting a tattoo, as well as a histopathological examination in case of complications. In patients who develop cutaneous inflammatory reactions following tattooing, additional studies are recommended to investigate systemic diseases such as sarcoidosis, pyoderma gangrenosum, atopic dermatitis, and neoplasms. It is important for physicians to be trained in providing appropriate care in case of complications. itself However rise practices arise classes infectious aesthetic miscellaneous histopathology dermatitis pseudolymphoma hyperplasia scleroderma/morphealike sclerodermamorphealike scleroderma/morphea like scleroderma morphea changes characteristics , “tattoo” “complications” skin. skin . “skin” period language articles 67 tattooed common described debated them preexisting pre existing therefore group tattooing sarcoidosis gangrenosum neoplasms morphealike sclerodermamorphea “tattoo “complications “skin 6

ABSCTRACT Introduction: Prostate neoplasia is the second most diagnosed cancer in men, having well established risk factors such as advanced age, familial and ethnic susceptibility. Recently, the association with environmental or lifestyle factors has been investigated, opening the possibility of certain occupational risk factors being associated with a higher incidence of this disease. Although controversial, as it does not necessarily imply a malignant etiology, prostate-specific antigen remains the mainstay in screening for this disease. Case report: This is the case of a 60-year-old surgeon with 36 years of professional history, including shift and night-work. As part of the health surveillance carried out by Occupational Medicine, he underwent complementary diagnostic tests and an increase in prostate-specific antigen was detected, culminating in a biopsy which ultimately confirmed the diagnosis of prostate adenocarcinoma. Discussion/Conclusion: Shift work, and particularly night work, has been investigated as a possible carcinogen and is currently classified by the International Agency for Research on Cancer as "probably carcinogenic to humans". Given the growing evidence linking certain occupational factors with this and other neoplasms, it may be sensible to include cancer screening in workers' health surveillance protocols, in some sectors. In the case presented, the inclusion of prostate-specific antigen measurement in the complementary tests requested by Occupational Medicine allowed for a timely diagnosis, with detection and treatment of the disease at an early stage.

RESUMO Introdução: A neoplasia da próstata é a segunda mais comummente diagnosticada no sexo masculino, destacando-se como fatores de risco bem estabelecidos a idade avançada, a suscetibilidade familiar e étnica. Recentemente, a associação a fatores ambientais ou de estilo de vida tem vindo a ser investigada, abrindo a possibilidade à associação de fatores de risco ocupacionais com uma maior incidência desta patologia. Apesar de controverso por não significar necessariamente a existência de patologia maligna, o antigénio específico da próstata mantém-se como o pilar no rastreio desta doença. Descrição do caso: Trata-se do caso de um cirurgião de 60 anos, com 36 anos desta atividade profissional, realizando trabalho por turnos e trabalho noturno. No âmbito da vigilância da saúde realizada pela Saúde Ocupacional, é submetido a exames complementares de diagnóstico, detetando-se um aumento do antigénio específico da próstata, que culmina na realização de biópsia, confirmando o diagnóstico de adenocarcinoma da próstata. Discussão/Conclusão: O trabalho por turnos e, particularmente, o trabalho noturno, tem vindo a ser investigado como possivelmente carcinogénico, estando, atualmente, classificado pela Agência Internacional para a Investigação em Cancro como “provavelmente carcinogénico para humanos”. Tendo em conta a crescente evidência relacionando fatores ocupacionais com esta e outras neoplasias, poderá fazer sentido incluir rastreios oncológicos nos protocolos de vigilância da saúde dos trabalhadores, em alguns setores. No caso apresentado, a inclusão da medição de antigénio específico da próstata nos exames complementares pedidos pela Saúde Ocupacional permitiu um diagnóstico atempado, com deteção e tratamento da doença numa fase precoce.