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  • ISSN: 2373-9819
    Volume 6, Issue 5
    Case Report
    Martins P. Vieira* and Iriart JA. Bernstein
    Leprosy is a disease caused by Mycobacterium leprae and etiologic agent is transmitted from person to person through prolonged contact, and through patients in the form of multibacillary (lepromatous or borderline) without treatment. It remains a serious public health problem in Brazil, and in the northeast it is especially common. This study aims to understand how patients diagnosed with leprosy feel during the treatment in the city of Salvador, Bahia. From an anthropological perspective the objective of this study is to understand how patients felt during the diagnosis, changes in the body and the social impact of the disease in their lives. Eighteen narrative interviews were conducted with patients receiving treatment for leprosy in Salvador. The results highlight the social impact of the disease on people’s lives causing unemployment, family conflicts and exclusion. In some cases, changes in the body have implied identity transformations caused by the fact that the person is no longer able to recognize themselves. We also noted that the individuals themselves often feel a sense of guilt or the need to find out who is responsible sought for their contamination. Therefore, infected individuals clearly demonstrated a lack of support for social and 33 professional integration, which still exists today.
    Arguelles-Ambriz JA*, Murillo-Barrios IE, Carbajal-Contreras G, Lara-Perez MA, Cabrera-Mendoza F, and Ruiz-Mercado H
    Introduction: The reappearance after the removal of a carotid paraganglioma is very uncommon. It represents a surgical challenge due to difficulties caused by its high vascularity, proximity and possible infiltration of the carotid division.
    Objective: Case report and a review of this pathology, discarding cancer and the complexity of surgical management.
    Case description: 70-year-old male with previous resection of right carotid paraganglioma also common carotid artery ligation at the same intervention. After 15 years, he started to present progressive dysphagia, non pulsatile mass in neck, Kocher sign, non-palpable carotid pulse, for over one year. Imaging studies were performed, demonstrating adequate cerebral vascular compensation.
    An incision was made to the neck, the fore border of the sternocleidomastoid muscle. The tumor was removed by blocks and the internal and external carotid artery was ligated without evidence of cerebral ischemia. It was wrapping nerves and arteries. He presented coughs after surgery due to swallowing and infiltration of the superior laryngeal nerve.
    Postsurgical findings: Histopathological report: the paraganglioma is confirmed and negative to cancer. With satisfactory evolution after resection.
    Conclusion: We recommend the paraganglioma removal, when tumor reappearance, due to risk of potential cancer.
    Agathe Nallatamby, Julie Tronche, Ali Abdeh, and Nicolas Pichon*
    76 years-old woman, with a medical history of thyroidectomy and no significant medical history of thromboembolic disease, presented to emergency department with severe dyspnea and chest pain.
    Iraj Z. Afzal*, Dominik Dabrowski, David Haddock, Andrea Batshon, and Mohamad Aziz
    Microcystic adnexal carcinomas (MAC) are a very rare form of locally invading neoplasms. This paper reports a case of a 74-year-old female diagnosed with a MAC neoplasm localized to the left upper cheek; she was treated with both surgery and radiotherapy. The patient had two recurrences after surgical excisions with the second excision being coupled with radiotherapy. This report asses the rarity of this disease, which may lead to misdiagnosis, and the optimal treatment to minimize the possibility of known high recurrence rates. MAC is not considered a highly metastatic neoplasm; however, potential for metastasis exists, as discussed in this case.
    Mackenzie L. Shindorf* and Prabir K. Chaudhuri
    Context: The standard of care for benign pheochromocytomas and paragangliomas is surgical resection however there is no definitive curative or standard therapy for the treatment of malignant pheochromocytomas or paragangliomas. Current therapeutic options include surgical resection, chemotherapy (CVD therapy), MIBG-radiotherapy, somatostatin analogues, and combination targeted therapies such as temozolomide and thalidomide although they offer no survival benefit. Case description: 38 year old man found to have an unrespectable metastatic paraganglioma located in the Organ of Zuckerkandl has been treated with single agent thalidomide for over 15 years with minimal growth and stabilization of metastatic lesions. Conclusion: Despite multiple treatment options, the 5-year mortality rate for malignant pheochromotoma and paraganglioma remains exceedingly high. Although some patients demonstrate short-lived responses, there has been no statistically significant survival benefit with current therapies and therefore the aim is palliation and symptom control. Our patient has been managed for greater than 15 years with a single agent therapy of thalidomide which challenges the efficacy and role of chemotherapy and other accepted therapies for malignant pheochromocytoma and paraganglioma.
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