ABSTRACT The modern era has brought an appreciation that renal cell carcinoma (RCC) includes diverse subtypes derived from the various parts of the nephron, each with its distinctive genetic basis and tumor biology. Carcinoma of the collecting ducts of Bellini (CDC) is a rare subtype of RCC, with a predictably poor prognosis. This rare subtype represents less than 1% of all kidney carcinomas. It derives from presumably numerous chromosomal losses. It is of chief importance to differentiate CDC from other types of renal cell cancer. Typically, it is characterized by a firm, centrally located tumor with infiltrative borders. Regarding the histopathologic characteristics, we can find complex, highly infiltrative cords with inflamed (desmoplastic) stroma, with high-grade nuclei and mitoses. Most reported cases of CDC had been high grade, advanced stage, and unresponsive to conventional therapies. This rare form of disease highlights the importance of multidisciplinary teams in the management of cancer patients.

O Carcinoma fibrolamelar é uma variante rara de hepatocarcinoma, não associado a cirrose ou hepatites virais. Os níveis séricos de alfafetoproteína são geralmente normais; A histologia é de um tumor bem diferenciado e o estadiamento é o mesmo do hepatocarcinoma. Descrevese o caso clínico de um doente do sexo feminino, na sua 4a década de vida com diagnóstico de Hepatocarcinoma fibrolamelar com abordagem multimodal. A rara incidência desta neoplasia e a sua apresentação clínica incomum justificam a notificação deste caso e destacam a importância de equipas multidisciplinares no tratamento dos doentes oncológicos.

Fibrolamellar carcinoma is a rare variant of hepatocellular carcinoma not associated with cirrhosis or viral hepatitis. Serum alpha-fetoprotein levels are usually normal; the histology is of a well-differentiated tumor, and the staging is the same as for hepatocellular carcinoma. We describe the case of a female patient in her 4th decade of life with a diagnosis of fibrolamellar hepatocellular carcinoma with a multimodal approach. The rare incidence of this cancer and its unusual clinical presentation justifies reporting this case and highlights the importance of multidisciplinary teams in the treatment of cancer patients.

Resumo O nódulo mamário pode ser benigno ou maligno, sendo que este último pode ser primário da mama ou metastático. Quando a neoplasia primária é desconhecida, o diagnóstico e orientação terapêutica podem ser bastante difíceis. Apresentamos o caso de uma doente com cancro gástrico, estadio IV, em que a primeira apresentação foi um nódulo da mama. A incidência rara de tal apresentação clínica justifica o relato deste caso e destaca a importância de existência de equipas multidisciplinares na abordagem do doente oncológico.

Abstract A breast lump can be benign or malignant, the late one can be primary or metastatic. When the primary neoplasm is unknown the diagnosis, management and treatment maybe quite difficult. We present a case of stage IV gastric cancer, where the first complaint was a breast lump. The rare incidence of such clinical presentation justifies reporting this case and highlights the importance of multidisciplinary teams in the management of cancer patients.

ABSTRACT Coronavirus disease 2019 (COVID-19), first recognized in Wuhan, China, was recently declared a global pandemic by the World Health Organization (WHO). Advanced age and comorbid disease, well-known characteristics in the solid tumor population, have been reported as risk factors for severe disease and death. Cancer-related immunosuppression and its treatments also seem to play an active role in the prognosis, response, and clinical outcomes of these patients. The most effective combination therapy for COVID-19 is still under investigation, and the use of corticosteroids is controversial. Although, as a group, metastatic cancer patients are often considered not to be good candidates for ICU treatment, the individual prognosis should always come into consideration, even in a context of high pressure on medical facilities. We report the case of a stage IV prostate cancer patient infected with SARS-CoV-2 who required ICU admission and recovered from COVID-19 infection. Further studies are needed in order to identify accurate clinical prognostic criteria and provide the best treatment for these challenging patients.