1/3860. Verruciform xanthoma associated with squamous cell carcinoma.Verruciform xanthoma (VX) is a rare lesion of unknown etiology that is typically solitary and predominantly located within the oral cavity. Less commonly, they arise on the skin, with the majority of cases occurring in anogenital sites. They can be confused clinically with verruca vulgaris, condyloma, leukoplakia, verrucous carcinoma, and squamous cell carcinoma. Histologic features include acanthosis with uniform elongation of the rete ridges and xanthomatous cells that lie in and are typically confined to the papillary dermis. Although epidermal atypia is not a characteristic finding, we describe an unusual case of VX that has features of both VX and squamous cell carcinoma. In addition, there was a VX with typical histologic characteristics located at a separate site in the same patient. This case is also the first to our knowledge to be reported on the neck and axilla and is the third case associated with cutaneous graft versus host disease secondary to bone marrow transplant for acute lymphoblastic leukemia.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
2/3860. p53 gene mutation in 150 dissected lymph nodes in a patient with esophageal cancer.For thoracic esophageal cancer, we perform extended three field lymph node dissection, and have achieved nearly 50% of overall 5-year survival. However, patients sometimes develop lymph node recurrences in spite of having no lymph node metastases found by conventional histopathologic examination. In a patient with esophageal squamous cell carcinoma, we sequenced all the p53 cDNA translated regions (exon 2-10) of primary carcinoma, and confirmed one p53 nonsense mutation in exon 10. Then we extracted genomic dna from 150 surgically dissected lymph nodes from that patient, and performed polymerase chain reaction analysis (PCR-RFLP) to detect the same p53 mutation in the lymph nodes. PCR-RFLP analysis showed the same p53 mutation in six lymph nodes. One node was located along the right recurrent laryngeal nerve, where no positive nodes was identified by conventional histopathologic examination. The p53 mutational diagnosis of metastatic cancer may be useful in detecting minimal residual disease.- - - - - - - - - - ranking = 0.14285714285714keywords = cell (Clic here for more details about this article) |
3/3860. Free fibula osteoseptocutaneous-pedicled pectoralis major myocutaneous flap combination in reconstruction of extensive composite mandibular defects.Lateral composite mandibular defects resulting from excision of advanced oral carcinoma often require mandible, intra-oral lining, external face, and soft-tissue bulk reconstruction. Ignorance of importance soft-tissue deficit in those patients may cause significant morbidity and functional loss. Such defects, therefore, can be reconstructed best with a double free flap technique. However, this procedure may not be feasible for every patient or surgeon. An alternative procedure is a free fibula osteoseptocutaneous flap combined with a pedicled pectoralis major myocutaneous flap. This combination was used in reconstruction of extensive composite mandibular defects in 14 patients with T3/T4 oral squamous cell carcinoma. All patients were men, and the average age was 54.3 years. The septocutaneous paddle of the fibula flap was used for the mucosal lining of the defects while the bony part established the rigid mandibular continuity. The pectoralis major flap then covered the external skin defect in the face and cheek, and the dead spaces left by the extirpated masticator muscles, buccal fat, and parotid gland. One free fibula flap failed totally, and one pectoralis major flap developed marginal necrosis. At the time of final evaluation, nine patients (64.3 percent) were alive, surviving an average of 25.7 months. All patients eventually regained their oral continence and an acceptable cosmetic appearance. In conclusion, the fibula osteoseptocutaneous flap plus regional myocutaneous flap choice is a successful and technically less demanding alternative to the double free flap procedures in reconstruction of extensive lateral mandibular defects.- - - - - - - - - - ranking = 0.14285714285714keywords = cell (Clic here for more details about this article) |
4/3860. Microvascular reconstruction of the skull base: indications and procedures.PURPOSE: The aim of the current study was to review the use of free tissue transfer for reconstruction of the skull base and for coverage of intracranial contents. patients AND methods: From 1990 until 1996, revascularized flaps were transferred to the skull and the skull base in 11 patients in whom intracranial/extracranial resection of tumors of the skull base was performed in cooperation with the Department of neurosurgery. The defects resulted from removal of squamous cell carcinomas (n = 4), basal cell carcinomas (n = 4), malignant melanoma, malignant schwannoma, and malignant meningioma. Defect repair was accomplished by revascularized transfer of latissimus dorsi muscle flaps in seven cases and rectus abdominis flaps and forearm flaps in two cases each. In five patients with extensive intracranial tumor spread, reconstruction was performed for palliative reasons. RESULTS: A safe soft tissue closure of the intracranial and intradural space was achieved in all patients, whereas the contour of the facial skull and the neurocranium was satisfactorily restored at the same time. By using the entire length of the grafted muscle, the vascular pedicle could be positioned next to the external carotid artery and conveniently connected to the cervical vessels. The mean survival time of the patients with palliative treatment was 8.4 months, with an average duration of hospital stay of 24.5 days. CONCLUSIONS: Despite the increased surgical effort of revascularized tissue transfer, microvascular reconstruction of large skull base defects appears to be justified, even as a palliative measure.- - - - - - - - - - ranking = 0.28571428571429keywords = cell (Clic here for more details about this article) |
5/3860. Bilateral middle ear squamous cell carcinoma and clinical review of an additional 5 cases of middle ear carcinomas.We reported a retrospective review of the clinical records for a 64 year old male patient with bilateral middle ear squamous cell carcinoma (MESCC), and for the five other patients with MESCC treated at our institution during the last 20 years. The patient with bilateral MESCC has survived and remained tumor free for more than 1.5 years after extended radical resection of the secondary tumor combined with intra-arterial and systemic chemotherapy, radiotherapy and immunotherapy. Four patients with unilateral MESCC were treated with multidisciplinary treatment (induction chemotherapy, surgery and radiotherapy), and the remaining patient was treated with radiotherapy and mastoidectomy. Five of the six patients are alive with no evidence of disease. The patient treated with radiotherapy and radical mastoidectomy died of local recurrence 3 years after diagnosis. We suggest that MESCC should be considered when refractory granulation, long-standing otorrhea, otalgia and facial paralysis are observed. Multidisciplinary treatment, including intra-arterial chemotherapy and en bloc resection of the temporal tumor is useful for the treatment of MESCC and will improve the prognosis of patients with this disease.- - - - - - - - - - ranking = 0.71428571428571keywords = cell (Clic here for more details about this article) |
6/3860. A pathologic and clinical study of adenosquamous carcinoma of the larynx. Report of four cases and review of the literature.Four cases of adenosquamous carcinoma are described. Emphasis is put on the rarity of this histological type of tumour which was first described in the larynx by Gerughty et al. (1968) who reported three cases. An exhaustive histological documentation of the neoplasm accompanies the discussion of its pathomorphological characteristics, histogenesis, differential diagnosis, prognosis and treatment. Stress is laid on the extreme aggressiveness of the neoplasm and on its high biologic malignancy. Elective treatment is radical surgery. The tumour in question is a distinct anatomo-clinical entity with its own connotations and therefore must be distinguished from the most common squamous cell carcinoma of the larynx.- - - - - - - - - - ranking = 0.14285714285714keywords = cell (Clic here for more details about this article) |
7/3860. Mohs' surgery as an approach to treatment of multiple skin cancer in rhinophyma.BACKGROUND: skin cancer arising within a rhinophyma is rare, less than would be expected from the coexisting chronic active inflammatory process. In rhinophyma, multiple coexisting tumours of different histologic types present an unusual challenge and have never been described in the literature. OBJECTIVE: The treatment approach to multiple tumours occurring in rhinophyma, utilizing Mohs' surgery, is reported and discussed. PATIENT: The case of a 64-year-old farmer with basal cell carcinoma, squamous cell carcinoma, and basosquamous carcinoma occurring in the setting of longstanding rhinophyma is described. CONCLUSION: skin cancer, especially basal and squamous cell carcinoma, diagnosed simultaneously in a rhinophyma creates a challenge; the enlarged, inflamed, and hypertrophied tissue masks their margins. In our opinion, Mohs' micrographic surgery is the treatment of choice and should be primarily considered in view of the malignant potential of these tumours, as is shown by the substantial tumour extension in the case described.- - - - - - - - - - ranking = 0.42857142857143keywords = cell (Clic here for more details about this article) |
8/3860. leg ulcers: a common problem with sometimes uncommon etiologies.In the U.S., leg ulcers present a significant clinical problem, occurring at a rate of approximately 600,000 new cases per year. In most cases, the cause of ulceration is venous or arterial in nature. One uncommon but significant cause of leg ulcers is sqaumous cell carcinoma (SCC). Although the incidence of SCC is higher in white than black populations, blacks with SCC typically exhibit involvement of areas of the skin that are not chronically sun-exposed, especially the lower extremeties. Predisposing factors include burn scars, chronic infection or ulceration, and chronic discoid lupus erythematosus. leg ulcers of atypical presentation or those that fail to heal should alert the clinician to consider uncommon etiologies.- - - - - - - - - - ranking = 0.14285714285714keywords = cell (Clic here for more details about this article) |
9/3860. Fine-needle aspiration cytology of cystic hypersecretory ductal carcinoma in situ of the breast: a case report.Cystic hypersecretory intraductal carcinoma is an unusual, cystic form of intraductal breast carcinoma affecting middle-aged women. Cytopathologists have rarely encountered this lesion, with only 2 other cases having been previously reported (Colandrea et al., Arch Pathol Lab Med 1988:112:560-563; Kim et al., Acta Cytol 1997;41:892-896). In our cases, the cytologic findings of both air-dried, Diff-Quick-stained and ethanol-fixed, Papanicolaou-stained smears are presented. The cytologic hallmarks of this entity include the presence of a few scattered epithelial cells with bland nuclear morphology in a background of extensive, amorphous, pink-staining material. Cytomorphologically, the differential diagnosis includes other entities containing pink-staining material such as colloid carcinoma, mucocele-like lesion of the breast, and benign fibrocystic change.- - - - - - - - - - ranking = 0.14285714285714keywords = cell (Clic here for more details about this article) |
10/3860. Squamous cell carcinoma of the breast following silicone injection of the breasts.During the 1960s, injecting liquid silicone into the breasts for augmentation purposes was a common practice. Many women suffered complications, usually developing silicone mastopathy, but there have been reports of carcinoma as well. A case of squamous cell carcinoma of the breast is reported in a patient who had previously undergone injection of silicone into the breasts. Upon review of the literature, this is only the second reported case of squamous cell carcinoma of the breast following silicone injection. Squamous cell carcinoma of the breast is a very rare tumor comprising 0.04 to 0.075 percent of all breast malignancies. The tumor appears to develop from metaplasia of benign epithelial cells within the breast. Many theories are presented for the development of this metaplastic process. The clinical presentation, evaluation, and treatment of squamous cell carcinoma of the breast is quite similar to that of infiltrating ductal carcinoma of the breast of comparable stage and size.- - - - - - - - - - ranking = 1.2857142857143keywords = cell (Clic here for more details about this article) |
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