1/13. Unusual recurrence of cervical adenosquamous carcinoma after conservative surgery.The use of less radical procedures for the treatment of early cervical cancers is gaining interest among physicians and young patients. Some authors have described surgical procedures aimed at reducing the surgical aggressiveness but the safety of such procedures remains debated. After a polypectomy, a young patient had a diagnosis of stage Ia(2) cervical adenosquamous carcinoma in 1995. As she wished to preserve her fertility, she underwent a cone biopsy and pelvic lymphadenectomy, without evidence of tumor spread. In 1998, at the 13th week of gestation, she had a diagnosis of a pelvic mass. The mass was a recurrence of carcinoma involving the myometrium, just underneath the peritoneum. She underwent a radical hysterectomy with bilateral oophorectomy. An ovarian metastasis was also detected at pathological exam. She received chemotherapy postoperatively and remains alive without evidence of disease. The recurrence of cervical cancer is traditionally regarded as an issue concerning the cervix, the parametria, or the lymph nodes. When the uterus is preserved we must also consider the possibility of a recurrence involving the corpus. With wider acceptance of limited therapeutic approaches we must be prepared for the detection of previously unknown patterns of recurrence and the follow-up modalities must be consequently adapted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/13. Perineural spread of squamous cell carcinoma of the lip: the importance of follow-up and collaboration.Perineural spread (PNS) of mucosal squamous cell carcinoma of the head and neck region occurs with a reported frequency of 2% to more than 27%. patients previously diagnosed with and treated for head and neck cancer should be closely followed by both their physician and their dentist in order to facilitate the coordination of care. This case history demonstrates the results that can occur when a team approach to head and neck cancer is not followed, especially in a patient who is an infrequent and somewhat reluctant health care utilizer. Despite mandibular pain, the patient, who had a history of a carcinoma of the lower lip and had developed PNS, was not referred to a dentist. In patients with a previous history of squamous cell carcinoma, sensory and/or motor changes must be closely monitored when there is a suspicion of PNS. The outcome of this case supports improved collaborations between physicians and dentists in following head and neck cancer patients.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
3/13. Cerebriform intradermal naevus (a rare form of secondary cutis verticis gyrata).BACKGROUND: Acquired cerebriform intradermal naevus (CIN) is a rare form of pseudo cutis verticis gyrata. CASE REPORT: A case of acquired CIN of the scalp in a 46-year-old male patient is presented. The clinical and histopathological presentations of CIN are described and the therapeutic possibilities are discussed. CONCLUSIONS: In each individual case the physician must decide whether to do surgery or follow a wait-and-see policy. There is little risk of malignant change of CIN, and surgical excision of such lesions often involves evident mutilation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/13. Three cases of papillary carcinoma and three of adenoma in thyroglossal duct cysts: clinical-diagnostic comparison with benign thyroglossal duct cysts.The clinical and diagnostic findings of 3 cases of papillary thyroid carcinoma in thyroglossal duct cyst (TDC) were compared to those of 3 cases of adenoma in TDC and 2 cases of benign TDC. The neck masses of the subjects with benign TDC grew slowly, whereas those of 2 patients with papillary carcinoma and 1 of the patients with adenoma grew rapidly (especially those with carcinoma). On the other hand, one case of carcinoma, and two cases of adenoma in TDC were diagnosed incidentally. Benign TDC had an anechoic pattern at US, whereas the cysts containing carcinoma and adenoma showed the presence of a mural nodule at US. Microcalcifications in the mural mass were present in one patient with carcinoma. The 3 patients with carcinoma in TDC underwent total thyroidectomy. The histology was negative in all 3 patients for thyroid cancer and thyroid nodules. However, in 2 of them it revealed the carcinoma invading the cyst wall and adjacent tissues, 1 of which also exhibited 2 metastatic lymph nodes in the central neck area. The cases reported illustrate the utility of enhancing one's clinical suspicion of carcinoma in patients bearing TDC, even when incidentally discovered. In particular, rapid growth of the cystic mass, and the presence of a mural nodule on US, especially with calcifications, must raise the physician's suspicion for a cancer arising in TDC.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/13. 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) |
6/13. Anticoagulant-induced pseudothrombocytopenia occurring after transcatheter arterial embolization for hepatocellular carcinoma.Pseudothrombocytopenia (PTCP) is the in vitro phenomenon of anticoagulant-activated platelet agglutination that results in spuriously low platelet counts. We report the case of a 65-year-old man with EDTA- and sodium citrate-dependent PTCP occurring after transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) due to hepatitis c cirrhosis. Invasion of the portal and hepatic veins by HCC formed severe trans-tumoral arterio-venous shunts that were effectively treated by TAE. Two days after the therapy, PTCP was seen on blood count and continued for 4 months. The patient received unnecessary treatment for disseminated intravascular coagulation (DIC) until the diagnosis of PTCP was established. PTCP is a rare complication but should be considered after TAE for HCC; lack of recognition may lead the physician to misdiagnosis and patient mismanagement.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/13. adenocarcinoma arising in an ileostomy. Report of two cases and review of the literature.adenocarcinoma arising in an ileostomy is rare. Two cases are reported, one of a 58-year-old woman and the other of a 54-year-old man who had each undergone a colectomy for chronic ulcerative colitis. Seven other cases previously reported in the literature are reviewed. Though the exact pathogenesis is uncertain, several possibilities, particularly with regard to antecedent dysplasia and backwash ileitis, are discussed. Routine yearly follow-up and examination of the stoma by a physician or enterostomal therapist may lead to earlier detection of this rare complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/13. adenocarcinoma of the breast associated with silicone injections.A 42-year-old woman developed inflammatory breast cancer in a breast with "silicone mastitis" 12 years after bilateral breast augmentation with liquid silicone injections. Despite aggressive local and systemic therapy, the patient died of her disease. breast cancer arising in silicone-injected breasts is reported infrequently, and physicians caring for patients with silicone breast injection augmentation should be aware of this potentially fatal association with breast cancer.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/13. An unusual cause of back pain in a young athlete. A case report.back pain in the young athlete is a common problem seen in many sport medicine clinics. Not only can this be a difficult problem for the physician to manage (due to inability to pinpoint the pathology), but it is a frustrating experience for the athlete, unable to compete or train effectively. The sport medicine physician must, therefore, always be alert and obsessed with obtaining a precise diagnosis to be followed by specific treatment. When presented with the adolescent athlete suffering with back pain, one must consider the full gamut of diagnostic possibilities. Mechanical or spondylogenic causes are most common; however, potentially more serious infective, metabolic, and neoplastic conditions should also be considered.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
10/13. Basal cell carcinoma in the groin of a black patient with femoral vessel invasion and a second primary malignancy.We have presented an unusual case of basal cell carcinoma that presented in a 76-year-old black woman. This is an atypical case in that it occurred in a black patient, and the incidence of basal cell carcinoma is low in black people. The lesion was located in the groin, which is an uncommon location for basal cell carcinoma. The femoral vessels in this patient also were invaded by the tumor, which is also a very rare occurrence. The patient in this report had a coexisting squamous cell carcinoma of the lung, which may be a common finding in black patients with basal cell carcinoma. It is extremely important for the physician to include skin cancer in the differential diagnosis of any suspicious skin lesion. This will avoid delays in treatment and decrease the overall morbidity. The physician who encounters a black patient with a basal cell carcinoma also should screen the patient for a coexisting noncutaneous malignancy.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
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