1/15. endometriosis on laparotomy scar. A three-case report.endometriosis of surgical scar is a rare late complication of cesarean section. 3 cases of endometriosis after Pfannenstiel-type laparotomy are reported. The typical surgical presentation, present in all 3 cases, is a nodule on laparotomy scar after cesaren section, spontanously painful during the menstrual period. Ultrasound, performed in two cases, and cytological examination, performed in one, proved to be ineffective in establishing the diagnosis. The histopathological analysis of surgical specimens revealed in all cases multiple foci of well developed endometrial tissue scattered in a sclerotic stroma. Both stromal and glandular components of the endometrial mucosa were present showing the typical changes of the various phases of the menstrual cycle. In our opinion, an accurate clinical history should directly lead the surgeon to the excision with inclusion of the needle tract, whenever biopsy is performed. Surgical excision is at present the most appropriate diagnostic and therapeutic procedure.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/15. cytodiagnosis and comparison of nondecidualized and decidualized endometriosis of the abdominal wall. A report of two cases.We describe two cases of endometriosis of the abdominal wall occurring in young, multiparous women in which the diagnosis was made by fine needle aspiration biopsy. One case illustrates the cytologic features of non-decidualized endometriosis: a biphasic population of stromal and glandular cells. In contrast, the other case showed large, plump stromal cells in a distinctive myxoid background, creating a picture of decidualized endometriosis. The differential diagnoses of palpable masses in the abdominal wall and the importance of clinicopathologic correlation are discussed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/15. Pleural mesothelioma with cutaneous extension to chest wall scars.BACKGROUND: Cutaneous mesothelioma is rare but may occur following local surgical procedures for visceral mesothelioma or as a metastasis. methods: A patient with pleural mesothelioma, who developed papules within chest wall scars, 14 and 15 months after pleural biopsy and thoracentesis, respectively, is reported. RESULTS: Histopathology showed an epithelioid tumor forming tubulopapillary and glandular structures. The diagnosis of mesothelioma was confirmed with immunohistochemistry. Tumor cells stained characteristically for low-molecular-weight cytokeratins 5/6, calretinin, and vimentin and were negative for mucicarmine, carcinoembryonic antigen, thyroid transcription factor 1, prostate-specific antigen, gross cystic disease fluid protein, S-100, factor viii, and CD31. CONCLUSIONS: Histologically, mesothelioma may resemble a primary adnexal neoplasm, metastatic adenocarcinoma, or angiosarcoma. immunohistochemistry can clarify the diagnosis. Clinicians should be aware of the varied presentations of mesothelioma, as cutaneous presentations are becoming increasingly common.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/15. Basal cell carcinoma occurring in scar tissue following excision of a parotid gland pleomorphic adenoma.BACKGROUND: A 49-year-old patient presented with a basal cell carcinoma growing on scar tissue left following excision of a parotid gland pleomorphic adenoma. OBJECTIVE: The objective was to determine whether the basal cell carcinoma had resulted from tumor spillage at the time of the pleomorphic adenoma excision. methods: Substantial evidence is presented linking the two tumors. RESULTS: The basal cell carcinoma most likely occurred as the result of tumor spillage at the time of the parotid gland pleomorphic adenoma excision. CONCLUSIONS: Cutaneous connective tissue stroma plays a significant role in determining the differentiation of basal cell carcinomas.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
5/15. Correlation of corneal complications with eyelid cicatricial pathologies in patients with stevens-johnson syndrome and toxic epidermal necrolysis syndrome.PURPOSE: To look at the correlation between many factors (time of hospitalization, floppy eyelid syndrome, trichiasis, open lacrimal puncta, symblepharon, and aqueous tear deficiency) and corneal complications in stevens-johnson syndrome (SJS). DESIGN: Observational cases series. patients: Clinical data were retrospectively reviewed from 38 patients (32.7 /-20.1 years old) with SJS (n = 11) and with toxic epidermal necrolysis (TENS) (n = 27) from January 2002 to August 2004. One case report with SJS was included to verify the presence of tarsal/lid margin ulceration at the acute stage. methods: The medical history was retrieved regarding presumed causative medications used within 15 days and the duration of hospitalization. Data of the latest photographic documentation and eye examination were compared and correlated in a masked fashion. MAIN OUTCOME MEASURES: Floppy eyelid, trichiasis, lid margin keratinization, meibomian gland orifice metaplasia, symblepharon, tarsal scar, and corneal complications. RESULTS: Acute SJS/TENS was characterized by tarsal conjunctival ulceration. Keratinization of the eyelid margin with variable degrees of meibomian gland dysfunction was observed in all cases. Floppy eyelid, trichiasis, partially or totally opened lacrimal punctum, symblepharon, and aqueous tear deficiency were not significantly correlated with corneal complications. In contrast, there was a strong correlation between the severity of eyelid margin and tarsal pathology and the extent of corneal complications (Spearman r, 0.54; P = 0.0005). A multivariable regression analysis also showed that the extent of eyelid and tarsal pathology had a significant effect on corneal complications (coefficient, 0.84; P = 0.006). CONCLUSIONS: patients with acute SJS/TENS are characterized by severe inflammation and ulceration of the tarsal conjunctiva and lid margins. If left unattended, lid margin keratinization and tarsal scar, together with lipid tear deficiency, contribute to corneal complications because of blink-related microtrauma. Attempts to suppress inflammation and scarring by amniotic membrane transplantation at the acute stage and to prevent microtrauma at the chronic stage are vital to avoid sight-threatening complications.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
6/15. collagen-rich crystalloids in a scarred vascularized cornea.collagen-rich crystalloids, also referred to as collagenous crystalloids, are uncommon findings in benign salivary gland tumors with myoepithelial differentiation and in cutaneous neoplasms. Herein, we report the presence of collagen-rich crystalloids in the scarred, vascularized cornea of a 56-year-old woman. The patient underwent penetrating keratoplasty, and microscopic examination of hematoxylin-eosin-stained sections disclosed large aggregates of refractile material within the corneal stroma. The deposits were partially birefringent when viewed with polarized light and composed of radially arranged columns (long rectangles) with rounded to pointed tips. The deposits had tinctorial properties of collagen using Masson trichrome and the van Gieson method for collagen, and they stained with alcian blue, pH 2.5, and Verhoeff elastic stain. They did not stain with Gomori methenamine silver, Snook reticulin stain, or tyrosine using the Baker modification of the Millon reaction. This is the first report, to our knowledge, of collagen-rich crystalloids in the cornea. Their presence in the cornea indicates that these structures may occur in the absence of neoplasia.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/15. Corrosive injury of oral cavity--a rare presentation.Corrosive injury of the upper gastrointestinal tract has been frequently reported in medical literature. The ingestion of acid or alkali may be accidental or intentional. The spectrum of injury varies from involving the oesophagus, stomach, and duodenum either individually or together. The oral cavity is rarely involved. The sequelae of oral cavity caustic injury that have been reported include microstomia, shallow vestibule, ankyloglossia, speech impairment, loss of teeth and impairment of facial expression. We report a case of corrosive injury of the oral cavity following accidental ingestion of caustic alkali, who presented to us with bilateral submandibular gland enlargement following the development of corrosive stricture of the submandibular ducts. The scar tissue in the anterior floor mouth was excised with the submandibular salivary glands. Concomitant release of the contracture in the gingivo-buccal sulcus was also done and the defect was covered with a radial forearm free flap. The presentation of corrosive oral injury as salivary duct obstruction and enlarged salivary glands has not been reported. Free tissue transfer for corrosive scarring in the oral cavity helps to restore pliable tissue.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
8/15. Squamous cell carcinoma with hypercalcemia and leukocytosis.Squamous cell carcinoma with hypercalcemia and leukocytosis arising from burn scars in a 45-year-old man is reported. hypercalcemia and leukocytosis improved with pepleomycin treatment and worsened with recurrence of the tumor. serum levels of parathyroid hormone, prostaglandin E and 25-OH-vitamin d were within normal limits. autopsy did not disclose any bone metastases or abnormalities of the parathyroid glands. It is suggested that hypercalcemia and leukocytosis were due to factors produced by the squamous cell carcinoma. This is the fifth reported case of cutaneous squamous cell carcinoma associated with hypercalcemia in the absence of bone metastasis or parathyroid gland abnormalities.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
9/15. Extrapelvic endometriosis presenting as a hernia: clinical reports and review of the literature.endometriosis is a common gynecologic diagnosis. Typical complaints of patients with pelvic endometriosis include dysmenorrhea, menstrual irregularities, dyspareunia, and infertility. endometriosis may also occur in extrapelvic sites and cause unusual symptoms and diagnostic dilemmas. endometriosis has been described in the inguinal region, and this is illustrated in the first case history. The tender inguinal masses often fluctuate with the menstrual cycle but the condition initially may be confused with an inguinal hernia. Treatment is surgical. abdominal wall scar endometriosis, seen in the second case, has been described in patients after a wide variety of gynecologic procedures. This also is initially noted as a tender mass, usually fluctuating with menstruation, and is often confused with an incisional hernia. Again, surgery is the treatment of choice. Pathologic features of endometriosis are constant, regardless of location. Microscopically, endometrial glands and stroma, fibrosis, chronic inflammation, and old hemorrhage are seen. Familiarity with the unusual types of endometriosis is important to the general surgeon.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
10/15. breast cancer melanosis in a postmastectomy scar.Pigmented skin lesions developed in the postmastectomy scar of a 42-year-old woman, 3 years after mastectomy, clinically mimicking malignant melanoma. A histologic study of the skin showed neoplastic mucin secreting glands and melanocyte colonization. literature pertaining to melanin pigmentation of epithelial tumors not primary in the skin is reviewed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
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