Hemangiopericytoma of meningo-fronto-naso-orbito-maxillary complex

2020 ◽  
Vol 13 (10) ◽  
pp. e239135
Author(s):  
Bhavuk Vanza ◽  
Anshul Rai ◽  
Neha Khare ◽  
HS Verma
Keyword(s):  
Oral Cavity ◽  
Local Excision ◽  
Wide Local Excision ◽  
Good Option ◽  
Maxillary Artery ◽  
Vascular Tumour ◽  
Female Predominance ◽  
Feeder Vessel

Hemangiopericytoma (HPC) is a rare vascular tumour and difficult to diagnose clinically. Incidence is reported in fourth to fifth decade of life.With female predominance, 3%–5% cases affect the oral cavity, sinus lining and meninges. The patient presented with 8×6 cm swelling on her face, evaluation reported it to be HPC. Bilateral maxillary artery embolisation, wide local excision of the lesion, preserving the left eye and its function, was done. No recurrence is reported at 1-year follow-up. Response of such lesions to radiotherapy is questionable; with no lymphadenopathy and adequate encapsulation, embolisation of feeder vessel followed by a wide local excision of the lesion seems to be a fairly good option of treatment.

scholarly journals Primary Malignant Melanoma Limited to the External Auditory Canal: A Rare Presentation

2021 ◽  
Author(s):  
Dillip Kumar Samal ◽  
C. Preetam ◽  
Anjan Kumar Sahoo
Keyword(s):  
Malignant Melanoma ◽  
Local Excision ◽  
External Auditory Canal ◽  
Wide Local Excision ◽  
Poor Prognosis ◽  
Late Presentation ◽  
Rare Presentation ◽  
Slow Growing ◽  
Disease Free

AbstractMalignant melanoma limited to the external auditory canal is very rare. These patients present relatively late as compared with melanoma involving other subsites of external ear. However, the tumor is slow-growing but shows aggressive behavior with a poor prognosis when presented late. We have a 44-year-old female who presented with a blackish lesion, which was bleeding on and off from her left ear. She was managed with wide local excision, preserving maximum part of external auditory canal cartilage. The histopathology of the lesion was suggestive of malignant melanoma. After a thorough evaluation, she was kept under close follow-up. Malignant melanoma of external auditory canal shows poor prognosis usually, mainly because of late presentation. Thus, early diagnosis is crucial, as in our case, where wide local excision was sufficing, and the patient is disease-free after 4 years of follow-up.

scholarly journals Verrucous Carcinoma of the Vulva

2021 ◽  
Vol 107 (1_suppl) ◽  
pp. 8-8
Author(s):  
DP Agbanglanon ◽  
S Jaba ◽  
GG Kietga ◽  
I M’barki ◽  
H Elkacemi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Local Excision ◽  
Wide Local Excision ◽  
Verrucous Carcinoma ◽  
Distinct Type ◽  
Lymph Node Involvement ◽  
Disease Stage ◽  
Concurrent Radiochemotherapy ◽  
Slow Growing

Introduction: Vulvar verrucous carcinoma (VC) is extremely rare, accounting for less than 1% of vulvar cancer cases. Effectively, it is characterization by a slow growing, no metastasis or lymph node involvement. The aim of this study was to report our experience with this disease Material and Methods: This is a retrospective study of patients with vulvar VC who were treated at National Institute of Oncology between 2013 and 2018. Clinicopathological characteristics, treatment and follow-up were extracted from the medical records. Results: Three cases were identified in the National Institut of Oncology. The average age at diagnosis was 66 years (± 10.02). The average time from the onset of symptoms to diagnosis was 17 months (± 12,7). All patients complained of a vulvar mass or nodule, accompanied by vulvar pruritus and/or pain, which was the reason for consultation. A preliminary pathological diagnosis of squamous cell carcinoma was made in two cases. Surgical treatment included wide local excision, radical vulvectomy with lymph node dissection in the groin. Tumor size and invasion depth ranged from 50 to 105 mm and 17 to 35 mm respectively. In the final histology, VC of the vulva staged IB (2 cases) and staged III (1 case) with marginal limits in two cases. The concurrent radiochemotherapy was performed in one case, exclusive radiotherapy in one case and only surgery in one case. Regarding toxicity after concurrent radiochemotherapy and exclusive radiotherapy we had observed respectely grade 2 proctitis with renal toxicity and grade 2 radiodermatitis. The mean follow-up was 43 months with no recurrence in all cases. The prognosis is good, with low recurrent rate if wide local excision is performed. Conclusions: Vulvar VC is a distinct type of slow-growing, tumor with unclear etiology. Surgery is the most effective treatment. Concurrent radiochemotherapy indicated depending on disease stage and risk factors.

A Case of Endometriosis in Episiotomy Scar with Anal Sphincter Involvement and Extension into Ischiorectal Fossa

2014 ◽  
Vol 6 (2) ◽  
pp. 123-125
Author(s):  
Mohan Kumar ◽  
Soma Ghoshal ◽  
Shuchi Jain ◽  
Madhu Jain
Keyword(s):  
Fecal Incontinence ◽  
Anal Sphincter ◽  
South Asian ◽  
Local Excision ◽  
Wide Local Excision ◽  
Rare Condition ◽  
Ischiorectal Fossa ◽  
Scar Endometriosis ◽  
The Ideal

ABSTRACT Episiotomy scar endometriosis is characterized by presence of endometrial tissue (glands and stroma) and is a rare condition. It may also extend and involve the anal sphincter. The ideal treatment is wide excision to prevent recurrence but it may cause fecal incontinence, if the anal sphincter is involved. We describe here a case with much deeper extension into ischiorectal fossa. She was treated with wide local excision and primary sphincteroplasty. She has remained free of recurrence up to 12 months follow-up. How to cite this article Jain S, Ghoshal S, Kumar M, Jain M. A Case of Endometriosis in Episiotomy Scar with Anal Sphincter Involvement and Extension into Ischiorectal Fossa. J South Asian Feder Obst Gyne 2014;6(2):123-125.

Vulvar melanoma: A monocentric retrospective study on 29 cases.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19036-e19036
Author(s):  
Giulio Tosti ◽  
Edoardo Botteri ◽  
Giuseppe Spadola ◽  
Federica Baldini ◽  
Massimo Mosconi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Retrospective Study ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Local Excision ◽  
Wide Local Excision ◽  
Distant Metastases ◽  
Node Biopsy ◽  
Vulvar Melanoma

e19036 Background: Vulvar melanoma (VM) represents 3-7% of melanoma in women. The 5-year survival rate ranges from 8 to 55%. Surgical excision represents the best definitive therapy but surgical radicality does not impact on recurrence or survival. Methods: Thirty women with histologically confirmed VM diagnosed between 1993 and 2009 were selected for this monocentric retrospective study. One patient with metastases at time of diagnosis was excluded from the statistical analysis. Clinical, pathological and follow-up data were collected. Cumulative incidences of events were calculated and compared across subgroups by means of the Gray test. Results: Average age at diagnosis was 62 years. Average Breslow thickness was 4.91 mm. Ulceration was present in 11 cases and was unknown in 5. One case of VM was multifocal at presentation. Eleven patients underwent a wide local excision, 11 a hemivulvectomy and 7 a radical vulvectomy Sentinel node biopsy was performed in 23 patients and at least one positive sentinel node was found in 8 cases. Eight patients received adjuvant therapy. Ten patients had a second tumor (other than melanoma); of these, a breast cancer was recorded in 5 cases. Four patients had a second primary melanoma: of the vulva (n=2), vagina (n=1), and urethra (n=1). Median follow-up among ongoing survivors was 79 months and median overall survival was 69 months. The 5-year overall survival was 55.4%. Median event free survival 34 months. Positive lymph nodal status was associated with an increased risk of loco-regional recurrences (P=0.04). Positive lymph nodal status (P=0.06), Breslow thickness > 2mm (P=0.05) and number of mitoses > 10/mm2 (P=0.04) increased the risk of distant metastases. Age, ulceration and type of surgery were not significantly associated with any type of event. Conclusions: Lymph node involvement, elevated depth of invasion and a high number of mitoses were the most important prognostic factors for locoregional recurrence and distant metastases. The same trends were observed for the overall survival, but results were not statistically significant. Conservative surgery in the form of wide local excision with adequate margins may replace vulvectomy. Sentinel node biopsy is feasible and its role in VM should be further investigated.

A Comparison of Mohs Micrographic Surgery and Wide Local Excision for Treatment of Dermatofibrosarcoma Protuberans With Long-Term Follow-up

2017 ◽  
Vol 43 (1) ◽  
pp. 98-106 ◽  
Author(s):  
Garrett C. Lowe ◽  
Oluwakemi Onajin ◽  
Christian L. Baum ◽  
Clark C. Otley ◽  
Christopher J. Arpey ◽  
...  
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Dermatofibrosarcoma Protuberans ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Long Term Follow Up

Buschke-Löwenstein tumour: a rare and challenging entity

2021 ◽  
Vol 14 (9) ◽  
pp. e244192
Author(s):  
Carlos Eduardo Costa Almeida ◽  
José Azevedo ◽  
Inês Botelho ◽  
Jaime Vilaça
Keyword(s):  
Malignant Transformation ◽  
Abdominoperineal Resection ◽  
Local Excision ◽  
Wide Local Excision ◽  
Case Reports ◽  
Verrucous Carcinoma ◽  
Treatment Algorithm ◽  
Long Term Follow Up

Buschke-Löwenstein tumour (BLT) is rare and locally aggressive, and malignant transformation is a possibility. Because there is no consensus on the best treatment approach, the authors present a treatment algorithm based on several case reports. A 57-year-old male patient resorted to surgical consultation with a giant perianal cauliflower-like mass. A BLT was diagnosed. Due to the involvement of the anal sphincter, a wide local excision saving the rectum failed. Abdominoperineal resection was performed. Malignant transformation was diagnosed, and adjuvant radiotherapy was delivered. Clinical evolution was uneventful. Aggressive behaviour despite the absence of malignancy is the hallmark of BLT. The common presentation is an anal mass with a cauliflower-like appearance. Anal verrucous carcinoma and squamous cell carcinoma are the major differential diagnoses. BLT treatment is challenging. Surgery is the first-line treatment, raging from wide local excision to abdominoperineal resection. To improve outcomes, chemoradiation can be used in combination with surgery. Long-term follow-up is mandatory.

scholarly journals Dermatofibrosarcoma protuberans: Role of wide local excision

2013 ◽  
Vol 02 (04) ◽  
pp. 232-238 ◽  
Author(s):  
Raashid Hamid ◽  
Aadil Hafeez ◽  
Ashraf M. Darzi ◽  
Inam Zaroo ◽  
Habib Owais ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Recurrence Rate ◽  
Local Excision ◽  
Wide Local Excision ◽  
Normal Skin ◽  
Dermatofibrosarcoma Protuberans ◽  
Lymph Node Involvement ◽  
Deep Fascia ◽  
Female Ratio

Abstract Objectives: The main objective of the present study was to study the outcome of surgical treatment of dermatofibrosarcoma protuberans. Materials and Methods: This study included 45 patients both retrospective and prospective from December 1995 to December 2010. Results: Out of 45 patients, 30 were males and 15 females with the male to female ratio of 2:1. Mean age of presentation was 38.4 + 13.2 years. Commonest mode of presentation was raised firm multinodular lesion with fixity to overlying skin. Site distribution was 42.22% trunk, 57.88% extremities and head and neck. None of the patients had lymph node involvement All patients underwent wide local excision. On histological examination, 8 patients had positive margins. Overall recurrence rate was 22.22%. (please clarify what is the difference between the rate of recurrence following surgery and the overall recurrence rate) Only 2 patients developed metastasis to lungs in the course of their follow‑up. Out of 45 patients, 35 remained recurrence free over a varying period of 5 months to 13 years (mean 68 months). Ten patients developed one or more local recurrences. Average time from initial treatment to recurrence was 32 months. All patients with recurrent tumors were subjected to salvage treatment, i.e., re‑excision. Average recurrence‑free period was 36 + 44 months within a mean follow‑up of 68 months. Conclusion: Because of the potential of local recurrence, therapy for DFSP should be directed toward adequate local excision of the primary lesion. Minimal resection should include a surrounding margin, comprising 3-cm margin of normal skin and removal of underlying deep fascia. Compromising on margins invites higher chances of local recurrence.

scholarly journals Unique Presentation of Squamous Cell Carcinoma as Giant Cutaneous Horn

2019 ◽  
Vol 103 (9-10) ◽  
pp. 505-508
Author(s):  
Mohammad Fazelul Rahman Shoeb ◽  
Sanna Adappa
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Local Excision ◽  
Squamous Cell ◽  
Wide Local Excision ◽  
Verrucous Carcinoma ◽  
Histopathologic Examination ◽  
Unique Case ◽  
Cutaneous Horn

Cutaneous horn is a conical, dense, and hyperkeratotic protrusion that often appears similar to the horn of an animal. Giant cutaneous horns are rare; no incidence or prevalence has been reported. The significance of cutaneous horns is that they occur in association with, or as a response to, a wide variety of underlying benign, premalignant, and malignant cutaneous diseases. Herein we report a unique case of a 60-year-old male with a giant cutaneous horn (size: 10 cm × 2 cm) projecting from the left angle of mouth, which is extremely rare. Wide local excision of the growth was done. Histopathologic examination showed verrucous carcinoma with negative margin. There is no recurrence after follow-up of 2 years.

scholarly journals Survival of Dogs Following Surgical Excision of Histologically Well-differentiated Melanocytic Neoplasms of the Mucous Membranes of the Lips and Oral Cavity

2008 ◽  
Vol 45 (6) ◽  
pp. 889-896 ◽  
Author(s):  
D. G. Esplin
Keyword(s):  
Oral Cavity ◽  
Median Survival ◽  
Local Excision ◽  
Clinical Course ◽  
Surgical Excision ◽  
Adjunct Therapy ◽  
Recurrent Tumors ◽  
Mucous Membranes ◽  
Well Differentiated

Postsurgical follow-up information was obtained on 64 dogs with 69 histologically well-differentiated melanocytic neoplasms that involved the mucous membranes of the lips and oral cavity. The patients received no adjunct therapy. Sixty one of 64 dogs (95%) were alive at the end of the study or had died of causes unrelated to the tumor, with a mean survival of 23.4 months and a median survival of 34 months after surgery. Twenty-eight dogs alive at the end of the study had a mean survival of 31.3 months after surgery. There were 2 dogs, which had recurrent tumors, that were still alive at the end of the study. All dogs that died of tumor-related causes (3) and all dogs with recurrent tumors (2) had tumors in the oral cavity. Results of this study indicate that a favorable clinical course and prolonged survival can be expected in most dogs with histologically well-differentiated melanocytic neoplasms of the mucous membranes of the lips and oral cavity, with only local excision of the lesions and no adjunct therapy.

scholarly journals Histological Peripheral Margins and Recurrence of Melanoma In Situ Treated with Wide Local Excision

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Francisco S. Moura ◽  
Lucy E. Homer ◽  
Stuart W. McKirdy
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Invasive Disease ◽  
Recurrence Rates ◽  
Curative Intent ◽  
Excision Margin ◽  
Melanoma In Situ ◽  
Peripheral Clearance

Background. The incidence of melanoma in situ (MIS) is increasing faster compared to invasive melanoma. Despite varying international practice, a minimum of 5 mm surgical excision margin is currently recommended in the UK. There is no clear guidance on the minimum histological peripheral clearance margins. Aim. This study compares the histological peripheral clearance margins of MIS using wide local excision (WLE) to the rate of recurrence and progression to invasive disease. Methods. A retrospective single-center review was performed over a 5-year period. Inclusion criteria consisted of MIS diagnosis, ≥16 years of age, and treatment with WLE with curative intent. Those patients with a recurrence of a previous MIS or with a reported focus of invasion/regression were also included. Clinicopathological data and follow-up were recorded. Results. 167 MIS were identified in 155 patients, 80% of which were lentigo maligna subtype. Of patients with completely excised MIS on histology (>0 mm), 9% had recurrence with a median time to recurrence of 36 months. Three (1.8%) cases recurred as invasive disease. Age, MIS site, MIS subtype, and histological evidence of foci of invasion/regression did not predict recurrence nor progression to invasive disease ( p > 0.05 ). The recurrence rate of MIS with a histological excision margin ≤3.0 mm was 13% compared to 3% in those with histology margins of >3.0 mm ( p = 0.049 ). Conclusion. A histological peripheral clearance of at least 3.0 mm is advocated to achieve lower recurrence rates. The follow-up duration should be reviewed due to the median recurrence occurring at 36 months in our cohort. Cumulative work on MIS needs to be collated and completed in a large multicenter study with a long follow-up period.

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