1/6. Perianal extramammary Paget's disease.Perianal extramammary Paget's disease is a rare disorder of unknown aetiology and is frequently associated with malignancy. Since Sir James Paget's original description, extramammary Paget's disease has been surrounded by controversy, speculation and much interest on the part of surgeons, pathologists and dermatologists. This case report draws attention to this rare condition, which should be considered in the differential diagnosis of perianal disorders. The physician must maintain a high index of suspicion, especially in cases with characteristic lesions unresponsive to conventional dermatological therapy. The importance of awareness of the condition is stressed and the diagnosis and treatment are commented upon. Treatment and prognosis depend on the presence of an underlying invasive carcinoma. An adequate initial evaluation and long-term follow up are necessary to identify recurrence and development of other malignancies.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. Anal melanoma: an aggressive malignancy masquerading as hemorrhoids.Anal melanoma is a devastating malignancy easily confused with benign hemorrhoids. Physician unfamiliarity with this bleeding rectal lesion can lead to delays in diagnosis and therapy. Four cases of anal melanoma, all initially mistaken for hemorrhoids, have been documented in the past 4 years at our institution. Despite surgical intervention and chemoimmunotherapy, each patient succumbed to widely metastatic disease. Average survival was 15.2 months. The clinical, pathologic, surgical, and oncologic features of anal melanoma are reviewed to enhance physician recognition of this unusual anorectal disorder.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/6. Children with condylomata acuminata.BACKGROUND. The modes of transmission of genital human papillomavirus (HPV) infection in children are controversial. Studies have varied in reporting suspicion of sexual abuse in children with condylomata acuminata from zero to 90.9%. Possible modes of transmission include sexual, from mother to infant in utero, passage through an infected birth canal, infection of a nongenital type virus to the genital area, and nonsexual acquisition from a fomite. methods. Seven children, ranging in age from 2 to 12 years, who had genital HPV infections were assessed for sexual abuse. An interview with each child was conducted and an examination with a colposcope of the external genitalia was performed. A shave biopsy of a representative genital lesion was obtained. The tissue was sent for HPV typing. RESULTS. Six of the children had perianal warts; the seventh had a labial lesion. Five of the children (71%) had been sexually abused as determined by the history, physical examination, or an investigation by child Protective Services. Five had HPV type 6 or 11, one had HPV type 16 or 18, and one had a novel HPV type. CONCLUSIONS. Genital types of HPV (6 or 11, 16 or 18, and others) should alert the family physician to proceed with a careful assessment for sexual abuse. This study supports the findings of other reports that genital HPV infection can be the result of sexual abuse and points out the usefulness of HPV typing.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/6. Perianal melanoma disguised as hemorrhoids: case report and discussion.Perianal melanoma is a very rare disease that carries a grave prognosis. The difficulty in making the diagnosis and the rarity of the disease results in failure of recognition until the disease is widespread. Ultimately, the burden is on the physician to uncover this ominous cancer. Not doing so is one of the most significant correlates to poor outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/6. Home study course: summer 2005.OBJECTIVE: The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his or her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management, or that demonstrate new and important knowledge in the area of colposcopy or pathology. Participants may benefit from reading and studying the material or from testing their knowledge by answering the questions. ACCME accreditation: The American Society for colposcopy and Cervical pathology (ASCCP) is accredited by the accreditation Council for Continuing Medical education (ACCME) to provide continuing medical education for physicians. The ASCCP designates this continuing medical education activity for 1-hour Category I credit of the Physician's Recognition Award of the american medical association and 1-hour Category I credit of the ASCCP's Program for Continuing Professional Development. Credit is available for those who choose to apply. The Home Study Course is planned and produced in accordance with the ACCME's Essential Areas and elements.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/6. Hartmann's pouch carcinoma.Since 1921, when Henry Hartmann first described his procedure for rectal carcinoma, multiple modifications of the original technique have been proposed. However, the basic principle of a rectal pouch has always been retained. Two cases of carcinoma developing in such a pouch are described; both occurred years after creation of the pouch. One was managed by local resection through a transsacral approach; the other required an abdominoperineal resection. Consideration must be given to careful examination and sigmoidoscopy of these pouches as they tend to be forgotten by the physicians due to their hidden location.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |