title: Association between paracoccidioidomycosis and cancer.
abstract: OBJECTIVE
  To analyze the association between paracoccidioidomycosis (Pcm) and cancer in a series of 25 cases and to review the literature on this topic.
  
  
  METHODS
  A retrospective review of 25 cases diagnosed with Pcm and cancer, retrieved from a series of 808 consecutive adult patients diagnosed with Pcm based on tests conducted in the Mycology Laboratory of the Santa Casa Complexo Hospitalar, in the city of Porto Alegre, Brazil, between 1972 and 2007. The diagnosis of Pcm was confirmed by means of direct microscopic examination, histopathological examination or immunodiffusion test. All cancer cases were confirmed by histopathological or cytopathological examination.
  
  
  RESULTS
  Respiratory symptoms were the principal complaints of the patients evaluated. Pulmonary involvement predominated, followed by skin and lymph node involvement. The most prevalent tumor was bronchial carcinoma, in 15 patients, followed by other types of carcinoma, and 1 patient had Hodgkin's lymphoma. In 16 patients (64%), the site of the Pcm was the same as that of the tumor. In most cases, Pcm treatment consisted of the isolated administration of sulfanilamide, sulfamethoxazole-trimethoprim, ketoconazole, itraconazole or amphotericin B. The most common treatment for cancer was surgery, followed by radiotherapy and chemotherapy. Of the 25 patients, 12 were cured of Pcm, and 4 died. In 9 patients, the final outcome was unknown. In the general population of the area under study, the prevalence of lung cancer was significantly higher in smokers with Pcm than in smokers without Pcm (p < 0.001).
  
  
  CONCLUSIONS
  A diagnosis of Pcm appears to increase the risk of lung cancer.
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: Gustavo da Silva
authors.initials: Gda S
authors.lastname: Rodrigues
authors.forename: Cecília Bittencourt
authors.initials: CB
authors.lastname: Severo
authors.forename: Flávio de Mattos
authors.initials: Fde M
authors.lastname: Oliveira
authors.forename: José da Silva
authors.initials: Jda S
authors.lastname: Moreira
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Prolla
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Severo
mesh_terms: D000328:Adult; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors