Verrucous Carcinoma of the Vulva

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.

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

Annals of Otology and Neurotology ◽

10.1055/s-0041-1735991 ◽

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.

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Buschke-Löwenstein tumour: a rare and challenging entity

BMJ Case Reports ◽

10.1136/bcr-2021-244192 ◽

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.

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Dermatofibrosarcoma protuberans: Role of wide local excision

South Asian Journal of Cancer ◽

10.4103/2278-330x.119926 ◽

2013 ◽

Vol 02 (04) ◽

pp. 232-238 ◽

Cited By ~ 7

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.

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Unique Presentation of Squamous Cell Carcinoma as Giant Cutaneous Horn

International Surgery ◽

10.9738/intsurg-d-14-00313.1 ◽

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.

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Histology as a Prognostic Factor in Early Gastric Cancer

Tumori Journal ◽

10.1177/030089169207800307 ◽

1992 ◽

Vol 78 (3) ◽

pp. 181-184

Author(s):

Massimo Ferrari ◽

Enrico Ghislandi ◽

Giuseppe Landonio ◽

Margherita Majno ◽

Tiziano Porretta ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Early Gastric Cancer ◽

Lymph Node Involvement ◽

Depth Of Invasion ◽

Undifferentiated Histology ◽

Node Involvement

Of 431 patients with gastric cancer observed in our Istitution, 23 (5.3 %) had early gastric cancer (EGC). Macroscopic presentation, histology, depth of invasion, and lymph node involvement were evaluated in all the cases. All patients underwent surgery and an intensive follow-up was performed. Five of the 23 patients progressed, and the risk factors were examined. Histology seemed to be the main prognostic factor in our study, since intestinal type of EGC was associated to a significantly better prognosis. Total gastrectomy is indicated in the proximal localization of EGC, and should perhaps be performed also in cases presenting undifferentiated histology.

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Surgical management of urachal tumors: Can the umbilicus be sparred in localized disease?

Rare Tumors ◽

10.1177/2036361319847283 ◽

2019 ◽

Vol 11 ◽

pp. 203636131984728

Author(s):

Cristian Pavelescu ◽

Alexandra Pavelescu ◽

Cristian Surcel ◽

Cristian Mirvald ◽

Mario Alvarez-Maestro ◽

...

Keyword(s):

Lymph Node ◽

Surgical Treatment ◽

Local Recurrence ◽

Distant Metastasis ◽

Lymph Node Involvement ◽

Partial Cystectomy ◽

En Bloc ◽

Node Involvement ◽

Urachal Adenocarcinoma

Urachal adenocarcinoma represents the third most common histological type of non-urotelial bladder cancer. A very low incidence of this disease and the lack of prospective studies have led to a rich and heterogeneous treatment history. Currently, the standard of care for these patients is represented by partial cystectomy en bloc with resection of the urachal ligament and total omphalectomy. The aim of this article is to present our experience and results in the management of patients with urachal adenocarcinoma. Between 2005 and 2015, 16 patients have undergone surgical treatment for urachal adenocarcinoma in “Fundeni” Clinical Institute and Madrid University Hospital “Infanta Sofia.” Partial cystectomy was performed in 11 (68.76%) patients, while radical cystectomy en bloc with omphalectomy was performed in 5 (31.25%) patients, which were not amendable to a limited resection. The Sheldon classification was used, as it provides appropriate disease staging and is the most commonly utilized. Postoperative pathological results showed that 7 (43.75%) patients had localized tumors, and more than one-third (37.5%) of the patients had locally advanced Sheldon III disease, while 3 patients had distant metastasis at the time of surgery. Lymph node involvement was present in 3 patients (18.75%). Mean follow-up time was 2.5 years, ranging from 4 months to 7.6 years. Three patients (18.75%) were lost to follow-up, without any documented signs of local or systemic recurrence and were cancer free at the time of the last evaluation. In cases with lymph node involvement, local recurrence or distant metastasis, patients underwent cisplatin- or 5-fluorouracil-based salvage chemotherapy. Surgical treatment represents the gold standard, while adjuvant chemotherapy has a limited impact on overall survival. The utility of navel resection is questionable due to the rarity of direct invasion or local recurrence.

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Accuracy of lymphatic mapping and sentinel lymph node biopsy after previous wide local excision in patients with primary melanoma

Cancer ◽

10.1002/cncr.22320 ◽

2006 ◽

Vol 107 (11) ◽

pp. 2647-2652 ◽

Cited By ~ 63

Author(s):

Christopher J. Gannon ◽

Dennis L. Rousseau ◽

Merrick I. Ross ◽

Marcella M. Johnson ◽

Jeffrey E. Lee ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Local Excision ◽

Wide Local Excision ◽

Lymphatic Mapping ◽

Primary Melanoma ◽

Lymph Node Biopsy ◽

Node Biopsy

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Laryngeal Verrucous Carcinoma: A Systematic Review

Otolaryngology ◽

10.1177/0194599816662631 ◽

2016 ◽

Vol 156 (1) ◽

pp. 38-45 ◽

Cited By ~ 6

Author(s):

Kristen A. Echanique ◽

Stuti V. Desai ◽

Emily Marchiano ◽

Eleonora F. Spinazzi ◽

Primož Strojan ◽

...

Keyword(s):

Local Excision ◽

Verrucous Carcinoma ◽

Treatment Protocol ◽

Disease Free Survival ◽

Treatment Modalities ◽

Definitive Treatment ◽

T Stage ◽

Number Of Patients ◽

Disease Free

Objective Laryngeal verrucous carcinoma (LVC) is a rare, locally invasive neoplasm comprising 1% to 3.4% of laryngeal carcinomas. Management strategies are a topic of ongoing conversation, and no definitive treatment protocol based on T stage and presentation exists. This review examines characteristics, treatment modalities, and patient outcomes of LVC. Data Sources PubMed, MEDLINE, EMBASE, and Web of Science. Methods Databases were searched through October 29, 2015, for literature detailing individual patient cases of LVC. Variables analyzed included patient demographics, tumor characteristics, tumor size, treatment, and outcomes. Results Thirty-seven articles with 369 cases were included. LVC was found more commonly in males (13.8:1), at an average age of 58.7 years, and located in the glottis (74.0%). Most patients had local disease at presentation (94.9%). The most common presenting symptom was hoarseness (92.3%). The most common primary treatment was surgery alone (72.3%), with local excision as the most common technique (56.8%). In patients with data available on both surgical modality and T stage, most patients who presented as T1 and were managed surgically underwent local excision (79.2%). Surgical treatment alone led to high rates of disease-free survival at follow-up (86.8%). A large number of patients presenting with T1 disease were disease free at follow-up (88.6%). Overall survival was 80.3%. Conclusion LVC is most often managed surgically. The extent of surgical resection may be guided by T stage, with smaller tumors resected via local excision and larger tumors via partial or total laryngectomy. Regardless of T stage or therapy, LVC has a good posttreatment prognosis.

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Relationship of immunohistochemical biomarker expression and lymph node involvement in patients undergoing surgical treatment of NSCLC with long-term follow-up

Tumor Biology ◽

10.1007/s13277-013-1599-9 ◽

2014 ◽

Vol 35 (5) ◽

pp. 4551-4559 ◽

Cited By ~ 1

Author(s):

Ana María Gómez ◽

Jose Ramón Jarabo Sarceda ◽

Jose Antonio L. García-Asenjo ◽

Cristina Fernandez ◽

Susana Hernandez ◽

...

Keyword(s):

Lymph Node ◽

Surgical Treatment ◽

Lymph Node Involvement ◽

Long Term Follow Up ◽

Node Involvement ◽

Relationship Of

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Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study

Journal of Thyroid Research ◽

10.1155/2022/9944083 ◽

2022 ◽

Vol 2022 ◽

pp. 1-8

Author(s):

Agnes Stephanie Harahap ◽

Desty Gusti Sari ◽

Marini Stephanie ◽

Alvita Dewi Siswoyo ◽

Litta Septina Mahmelia Zaid ◽

...

Keyword(s):

Lymph Node ◽

Mortality Rate ◽

Thyroid Carcinoma ◽

Distant Metastasis ◽

Disease Recurrence ◽

Lymph Node Involvement ◽

Common Type ◽

Thyroid Malignancy ◽

Node Involvement

Introduction. Thyroid cancer is the third most common cancer that occurs in children and adolescents. Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Although the mortality rate of thyroid malignancy in children is usually low, the disease recurrence is higher in children with more severe clinical presentation than in adults. This study aimed to determine the demographic and clinicopathological characteristics and outcome of pediatric and adolescent patients with thyroid malignancy in Indonesia. Methods. The retrospective study included all patients diagnosed with thyroid carcinoma aged <20 years, from January 1, 2015, to December 31, 2019. Twenty-nine subjects fulfilled the inclusion and exclusion criteria. We retrieved baseline characteristics, pathology features, TSH and fT4 status, radioactive iodine therapy data, and patients’ outcomes. Then, data were analyzed using the chi-square or Fisher’s exact method. Results. We identified 29 eligible subjects, including 3 boys and 26 girls. The most common type of thyroid carcinoma was PTC (96.5%), and follicular type (31%) was the predominant variant of PTC. Lymph node involvement occurred in 24% of patients, while distant metastasis occurred in 17.2% of patients with PTC. Twenty-four (82.7%) patients had stage 1 disease. Disease recurrence was recorded in 31% of patients during the study period with a median follow-up time of 24 months. Conclusion. PTC is the most frequent type of thyroid carcinoma among children and adolescents. This malignancy has a low mortality rate, but the recurrence rate remains high among younger patients than adults even during a short-term follow-up analysis. Distant metastasis and lymph node involvement are commonly found in this age group.

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