1/6. Cutaneous malignant melanoma: Tabuk experience.Cutaneous melanoma (CM) has a rising morbidity and mortality in the western world but is rare in certain geographical areas including the middle east. The aim of this study is to define the pattern of CM in this environment over a period of about two decades. A review of associated histological reports, dermatology, plastic general surgical admissions and outpatient census statistic of the North West Military Hospital (N.W.A.F.H.) were carried out from January 1978 to June 1996. The clinico-therapeutic information from both the review case and newly discovered CM was then studied. The result shows that CM is probably rare in the Tabuk military environment and possibly has a low mortality among the affected individuals. The presence of only 2 cases of CM among 73,955 patients over about 20 years suggests that this neoplasm is rare in N.W.A.F.H. Surgery, with localised expert reconstruction, probably offers the best cure for uncomplicated CM in this area. It is suggested that the geographical environment, genetic attributes, custom, attitude, presence of white, painted, sun-reflecting buildings, traditional dress-code and behaviour of the indigenes probably contribute to the suppression of and protection against CM in Tabuk. It is recommended that regular, antimlanoma education awareness programmes among the indigenes and avoidance of sunbathing attitude of the expatriate community should be encouraged in order to maintain this suggested natural selection protection.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/6. Pyogenic lymphoma of the skin: a peculiar variant of primary cutaneous neutrophil-rich CD30 anaplastic large-cell lymphoma. Clinicopathological study of four cases and review of the literature.Systemic anaplastic large-cell lymphoma (ALCL) in human immunodeficiency virus (hiv)-infected individuals showing an extensive infiltrate of neutrophils has been reported and referred to as 'neutrophil-rich' CD30 ALCL. Secondary cutaneous involvement has been found in a subset of these cases. We report the clinicopathological features of four immunocompetent patients with primary cutaneous neutrophil-rich ALCL and present a new histological subtype with a dissolute growth pattern of CD30 tumour cells. Four hiv-negative patients presented with rapidly growing solitary or multiple tumours located on the face. Ulceration of the lesions with purulent discharge was a typical finding. Various inflammatory dermatoses were considered clinically in all cases. The histological hallmark was a large number of neutrophils in the infiltrate that masked neoplastic CD30 anaplastic cells. In two cases, a dissolute growth pattern of anaplastic tumour cells was observed. In two cases, a strong correlation between tumour growth and interleukin (IL)-8 cytokine pattern as well as the production of IL-8 by tumour cells was demonstrated. The diagnosis of neutrophil-rich ALCL is challenging clinically and histologically as the tumour cell compartment is masked by an extensive inflammatory infiltrate of neutrophils and other reactive cells such as histiocytes which may be mainly due to release of IL-8 by tumour cells. The term 'pyogenic' designates the typical feature of this distinct neutrophil-rich ALCL, namely abscess formation ('pyo-') by cytokines (IL-8) produced by tumour cells ('-genic'). The clinical behaviour of this type is the same as in primary cutaneous CD30 ALCL with classical histological presentation.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/6. dermatofibrosarcoma protuberans of the scalp.dermatofibrosarcoma protuberans is an uncommon tumour of the dermis and rarely occurs on the scalp; there are few known predisposing factors. A case is described of such a tumour that occurred at the site of radiotherapy for a basal cell carcinoma. Histological characteristics, behaviour and management of dermatofibrosarcoma protuberans are discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/6. Merkel cell carcinoma.A case of Merkel cell carcinoma of the cheek is described, highlighting the clinical behaviour, diagnosis and management of this uncommon tumour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/6. Recurrent oral carcinoma in Ferguson-Smith disease.A patient with multiple self-healing squamous cell carcinomas of the skin is presented. mucous membrane involvement in this condition is very uncommon and the lesions may show aggressive behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
6/6. Haemangiosarcoma following irradiation of a haemangioma of the face. (Case report).The malignant complications of irradiating benign conditions are well known and fortunately less frequent than in a previous era of widespread use of superficial roentgen therapy. However, because of the long latent period from exposure to irradiation until the development of the tumour, the clinician must continue to be alert. The behaviour and treatment of a haemangiosarcoma occurring 18 years after irradiation of a haemangioma is described.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |