scholarly journals Lymphangiosis Carcinomatosa in a Patient with Giant Cutaneous SCC: Cervicopectoral Advancement Flap in Combination with Tunnel Transposition Flap from the Back as Promising Treatment Approach?

2018 ◽  
Vol 6 (12) ◽  
pp. 2376-2377
Author(s):  
Georgi Tchernev ◽  
Ilia Lozev ◽  
Ivan Pidakev ◽  
Ivanka Temelkova
Keyword(s):  
Histological Examination ◽  
Treatment Approach ◽  
Surgical Flaps ◽  
Surgical Excision ◽  
Deltoid Muscle ◽  
Radical Excision ◽  
Transposition Flap ◽  
Lymphangiosis Carcinomatosa ◽  
Tumour Formation ◽  
Lymphangitis Carcinomatosa

BACKGROUND: One of the features characterising cutaneous SCC as high-risk is lymphovascular infiltration. The diffuse lymphangitic spread of carcinogenic cells is defined as the so-called lymphangitis carcinomatosa. In some cases, it is the only and first sign to alert the presence of an underlying malignancy. Therefore, biopsy in patients with clinical data on lymphangiosis carcinomatosa is of paramount importance. CASE REPORT: We present a 77-year-old man with a progressively growing tumour formation in the area of the right shoulder, clinically suspected for SCC. During the dermatological examination, it was found that the lesion was surrounded by an infiltrated, perilesional relief shaft, which was histologically verified as lymphangitis carcinomatosa. The tumour formation was removed by radical excision and formation of a large skin-subcutaneous defect. To correct the surgical defect, a cervico-pectoral flap was performed, followed by tunnel transposition of the scapular graft through the deltoid muscle. The preoperative, ultrasound-marked artery was the arteria circumflexa scapulae dextra, which was used as the foot of the scapular graft and at the same time ensuring its blood supply. After the performed surgical flaps there remains a small uncovered surgical defect, which was left for subsequent secondary healing or full thickness mesh graft. The subsequent histological examination of the removed tumour formation detected the presence of squamous cell carcinoma. CONCLUSION: Patients with the simultaneous presence of two different pathological cutaneous changes, located in the immediate proximity often require a multidisciplinary and complex treatment approach. For tumour formations close to the area of the neck, the cervical-pectoral flap provides optimal cosmetic recovery of the surgical defect. The tunnel transposition is an individualised, unconventional and difficult to implement the approach, which however showed a good therapeutic result. On the other hand, the preoperative histological examination of reddish peritumoral localised tentacles leads to 1) diagnosis of lymphangiosis carcinomatosa as well as 2) the subsequent precise determination of the limits of surgical excision, which is a large number of cases saves the need for secondary re-excision in these patients.

CYTOLOGICAL DIAGNOSIS AS A METHOD OF SCREENING OF PRE-MALIGNANT MELANOCYTIC TUMORS AND EARLY FORMS OF SKIN MELANOMA

2018 ◽  
Vol 64 (3) ◽  
pp. 384-387
Author(s):  
Viktor Novik ◽  
D. Dreval
Keyword(s):  
Laser Therapy ◽  
Histological Examination ◽  
Clinical Data ◽  
Surgical Excision ◽  
Cytological Diagnosis ◽  
Skin Melanoma ◽  
Cytological Examination ◽  
Melanocytic Tumors ◽  
Quality Character ◽  
Atypical Nevi

Cytohistological comparisons to the account of the clinical data and revision of cytological and histological preparations on a material received from 21 patients are made. Cytomorphological features of juvenile nevi (Spitz-nevus, Reed-nevus), dysplastic and atypical nevi and early forms of melanoma are described. The establishment at cytological examination of good-quality character of melanocytic defeats at the account of the clinical data could be the basis for appointment laser therapy. At revealing of atypical melanocytes in cytological preparations patients should be referred to specialized oncological institutions for surgical excision of tumor with the subsequent histological examination. Thus cytological examination could be used in dermatological practice as a method of screening pre-malignant melanocytic tumors and skin melanoma.

Para-spermatic cord proximal-type epithelioid sarcoma

2021 ◽  
Vol 14 (1) ◽  
pp. e232385
Author(s):  
Jessica Farnan ◽  
Ellen Morrison ◽  
Derek Barrry Hennessey
Keyword(s):  
Spermatic Cord ◽  
Median Overall Survival ◽  
Palliative Chemotherapy ◽  
Epithelioid Sarcoma ◽  
Palliative Radiotherapy ◽  
Surgical Excision ◽  
Radical Excision ◽  
First Line ◽  
Left Groin ◽  
Painless Mass

Proximal-type epithelioid sarcoma is an ultra-rare, high-grade soft tissue malignancy usually presenting as a deep-seated painless mass in the proximal extremities. Most patients are diagnosed as young adults, between 20 and 40 years of age. Perineal and genital masses do occur but are extremely rare and represent a challenging tumour to diagnose and treat. Early radical excision is recommended due to its aggressive behaviour and poor prognosis. Median overall survival from initial diagnosis is 30 months. We present the case of a 22-year-old man with a left groin proximal-type epithelioid sarcoma who is sadly deceased 12 months after initial presentation despite early surgical excision, completion of both first-line and palliative chemotherapy, and palliative radiotherapy.

Subungual Exostosis of the Foot

1996 ◽  
Vol 17 (12) ◽  
pp. 758-763 ◽  
Author(s):  
Luigi de Palma ◽  
Antonio Gigante ◽  
Nicola Specchia
Keyword(s):  
Hyaline Cartilage ◽  
Fibrous Tissue ◽  
Surgical Excision ◽  
Complete Relief ◽  
Radical Excision ◽  
Initial Symptom ◽  
X Rays ◽  
Middle Zone ◽  
Deep Zone ◽  
The Third

Eleven subungual exostoses of the foot (10 on the hallux, 1 on the third toe) were studied. The initial symptom was subungual pain. When a subungual mass of fibrous tissue appeared, the nail was pushed up and in one case the mass became infected. X-rays exhibited a bone mass protruding from the terminal phalanx on the dorsomedial aspect of the toe in all cases. All patients underwent surgical excision of the lesions with partial onychectomy. Three layers were identified in five cases: a cap of fibrous tissue, a middle zone of hyaline cartilage with enchondral ossification, and a deep zone of cancellous bone. In three other cases, the histological pattern was pleomorphic and poorly characterized. The study shows that most subungual bone masses exhibited the pathological features of conventional osteochondromas. Nonetheless, a small number of lesions were pleomorphic and differed from osteochondromas, with abundant fibrous tissue merging irregularly into scattered islets of cartilage that was not organized in columns. Radical excision of the mass achieved complete relief of symptoms and recovery without recurrences in all cases.

Late results of radical excision of craniopharyngiomas in children

1975 ◽  
Vol 42 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Edward L. Katz
Keyword(s):  
High Mortality ◽  
Surgical Excision ◽  
Late Results ◽  
Radical Excision ◽  
Initial Operation ◽  
Content Type ◽  
Mortality And Morbidity ◽  
Fine Print

✓ The results of radical surgical excision of craniopharyngiomas in children operated on by Dr. Donald Matson beginning in 1950 are presented. The patients are analyzed in regard to survival and quality of survival. While 22 of 34 children so treated at the initial operation are presently alive and tumor-free, high mortality and morbidity followed in cases where reoperation was performed. Properly treated endocrinological deficits need not be a serious problem, but persistent hyperosmolality carried a grave prognosis. No predictive criteria are yet available to determine which tumors are amenable to radical surgical excision.

scholarly journals Surgical Extirpation of Glomus Tumor from Rare Localization on the Upper Extremity

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Jan Hrubý ◽  
Robert Novotný ◽  
Miroslav Špaček ◽  
Petr Mitáš ◽  
Jaroslav Hlubocký ◽  
...  
Keyword(s):  
Histological Examination ◽  
Male Patient ◽  
Glomus Tumor ◽  
Venous Malformation ◽  
Young Male ◽  
Surgical Excision ◽  
Final Diagnosis ◽  
Upper Arm ◽  
Vascular Area ◽  
Round Nucleus

Objective. To report on a very rare case of a glomus tumor manifested on the upper arm in a healthy young male patient.Case Presentation and Intervention. A 22-year-old male patient presented with bluish multifocal venous malformation on the left upper arm and was admitted for venous malformation excision. Pain, discomfort, and upper arm paraesthesia had been present for almost 6 years. Ultrasonography revealed septet tumor without blood flow in the subcutaneous region of anterior aspect of the upper arm. A multifocal venous malformation approximately 5–10 mm in diameter was excised. Histological examination showed dilated vascular area with proliferated glomus cells with round nucleus in the wall of dilated vascular structures. Based on histological examination, the final diagnosis was made as “glomangioma.”Conclusion. Histological examination is the only method that can establish final diagnosis. Currently, the only available treatment for this type of tumor is surgical excision.

scholarly journals An Interesting Case of Intramuscular Myxoma with Scapular Bone Lysis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Jérôme Tirefort ◽  
Frank C. Kolo ◽  
Alexandre Lädermann
Keyword(s):  
English Literature ◽  
Surgical Excision ◽  
Deltoid Muscle ◽  
Interesting Case ◽  
Intramuscular Myxoma ◽  
Bone Lysis ◽  
Magnetic Resonance Imaging Mri ◽  
One Year ◽  
Growing Mass

Introduction. Intramuscular myxoma is a rare benign primitive tumor of the mesenchyme founded at the skeletal muscle level; it presents itself like an unpainful, slow-growing mass. Myxomas with bone lysis are even more rare; only 7 cases have been reported in the English literature, but never at the shoulder level. Case Presentation. We describe an 83-year-old patient with a growing mass in the deltoid muscle with unique scapular lysis, without any symptom. Magnetic resonance imaging (MRI) and a biopsy were performed and the diagnosis of intramuscular myxoma has been retained. In front of this diagnosis of nonmalignant lesion, the decision of a simple follow-up was taken. One year after this decision, the patient was still asymptomatic. Conclusion. In the presence of an intramuscular growing mass with associated bone lysis, intramuscular myxoma as well as malignant tumor should be evoked. MRI has to be part of the initial radiologic appraisal but biopsy is essential to confirm the diagnosis. By consensus, the standard treatment is surgical excision but conservative treatment with simple follow-up can be an option.

scholarly journals Radical Surgical Excision and Use of Axillary Flap for Intractable Axillary Hidradenitis Suppurativa

2021 ◽  
Vol 24 (2) ◽  
pp. 51-56
Author(s):  
Munny Momotaz ◽  
Abul Kalam ◽  
Md Sazzad Khondoker ◽  
Sharmin Akter Sumi
Keyword(s):  
Medical Treatment ◽  
Hidradenitis Suppurativa ◽  
Donor Site ◽  
Surgical Excision ◽  
Donor Site Morbidity ◽  
Soft Tissue Defect ◽  
Radical Excision ◽  
Maximum Dimension ◽  
College Hospital ◽  
Excellent Outcome

Background: Current treatments for hidradenitis suppurativa (HS) include prolonged courses of antibiotics, retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolonged medical treatment pose a therapeutic challenge. We propose radical excision and reconstruction with axillary flap as a treatment option for such cases. Objectives: The purpose of the study was to see the outcome after radical surgical excision and coverage with axillary flap for intractable Hidradenitis suppurativa. Methods: This prospective observational study was carried out from July, 2014 to June,2016. Patients admitted at the Plastic Surgery Department of Dhaka Medical College Hospital with intractable Hydradenitis suppurativa were included the study population. Result:Among 20 cases, 12 cases were female and 8 cases were male. Maximum dimension of the soft tissue defect was 15x6.5 cm2 = (97.5 cm2). Maximum dimension of the flap was 17x7 cm2 = (119 cm2).Flap survived completely with minimum donor site morbidity. Result of reconstruction of 90% of the patients exhibited excellent outcome. In 10% patient’s outcome was considered good. Conclusion:With a suitable flap coverage option, the management paradigm of intractable Hydradenitis Suppurativa should shift from prolonged medical treatment to allowdecisive radical excision, which will improve the quality of life for patients. Axilary flap is the flap of choice to cover the defect. Journal of Surgical Sciences (2020) Vol. 24 (2) : 51-56

scholarly journals Sebaceous Adenoma on the Toe of a Dog at an Animal Hospital in Thonburi Area, Bangkok Province, Thailand

2021 ◽  
Vol 10 (2) ◽  
pp. 144-147
Keyword(s):  
Histological Examination ◽  
Surgical Excision ◽  
Intact Male ◽  
Sebaceous Adenoma ◽  
Left Front

A 7-year-old dog, Shih Tzu breed, intact male, came to an animal hospital in Thonburi area, Bangkok Province, Thailand with symptom of licking the left forefoot. Small lumps about 1×1×1cm (w×l×h) were found to be protruding around the left front toe. Surgical excision to remove the mass and subsequent histological examination identified the mass as sebaceous adenoma. After surgery and follow-up at 12 months, there were no obvious complications. Reports of this type concerning tumors in the paws tend to be rare. Furthermore, reports of tumor findings in this area remain unclear.

scholarly journals Cutaneous Tumour of the Left Cricothyroid Area!?

2019 ◽  
Vol 7 (4) ◽  
pp. 698-699
Author(s):  
Georgi Tchernev ◽  
Ivanka Temelkova
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Basal Cell ◽  
Histological Study ◽  
Surgical Excision ◽  
Tumour Formation ◽  
Surgical Ward ◽  
Days Of Therapy ◽  
Metastatic Process ◽  
Hernia Inguinalis

BACKGROUND: The cricothyroid area is an atypical localisation for placement of basal cell carcinomas. The main differential diagnosis for cutaneous tumours in this area is between BCC, spinocellular carcinoma and melanoma. The area is problematic about the choice of therapeutic approach, especially in the case of a vague clinical tumour type accompanied by enlarged lymph nodes in the immediate proximity. CASE REPORT: We present an 84- year- old woman with a tumour formation located next to the left cricothyroid area. The lymph node ultrasonography performed during the hospitalisation revealed the presence of an enlarged lymph node in the upper third of m. Sternocleidomastoideus. The initial ultrasound data of the lymph nodes were in the direction of an inflammatory rather than a metastatic process. Therefore 5 days of therapy with Ceftriaxone x 2 g/day was conducted. The nodular tumour formation was surgically removed by radical elliptic excision. The subsequent histological study found that it was Stage II basal cell carcinoma (T2N0M0). A surgeon's consultation was conducted due to a patient's complaint about abdominal pain, and clinical evidence of a hernia inguinalis incarcerata was established for which the patient was urgently transferred to a surgical ward. Two weeks after the antibiotic treatment, a control echography of the enlarged lymph node in the area of m. Sternocleidomastoideus was performed, which showed complete involution of the lymph node. CONCLUSION: Due to the specific anatomical features of the neck, such as a large number of lymph nodes and the resulting proximity between them and the primary tumours located in the area, it is often difficult to determine whether the lymph nodes are metastatically affected or inflammatory enlarged. In cases of missing ultrasound data for the metastatic process in the lymph nodes, surgical excision of the skin tumour with regular follow-up echographic control of the relevant lymph nodes represents an optimal therapeutic solution.

scholarly journals CONFOCAL LASER SCANNING MICROSCOPY FOR DIAGNOSES OF MELANOCYTIC SKIN NEOPLASMS

2017 ◽  
Vol 20 (6) ◽  
pp. 324-331
Author(s):  
Anna V. Sokolova ◽  
N. P Malishevskaya
Keyword(s):  
Differential Diagnosis ◽  
Confocal Microscopy ◽  
Histological Examination ◽  
Laser Scanning ◽  
Diagnostic Algorithm ◽  
Surgical Excision ◽  
Laser Scanning Microscopy ◽  
Confocal Laser ◽  
Skin Melanoma ◽  
Main Criterion

In cases of complicated differential diagnosis of benign melanocytic neoplasms and skin melanoma, clinical visual examination and superficial dermatoscopy do not always allow to make an accurate diagnosis, which is especially important in cases of suspected skin melanoma. In recent years the method of confocal microscopy (CM) has been used for non-invasive skin examination. In the present study 15 patients with suspected skin melanoma were examined by confocal laser microscopy in cases of complex differential diagnosis (18 melanocytic neoplasms in total). Ten patients were diagnosed with skin melanoma, including two amelanotic melanomas, which were subsequently confirmed by histological examination of the material obtained after surgical excision. The results of the study to determine the effectiveness of differential diagnosis of skin melanoma by laser confocal microscopy showed that differential diagnosis of skin melanoma is possible in the presence of the main criteria of malignancy: cellular atypia at the site of the dermo-epidermal junction (the first main criterion) and abnormality of papillary architecture (the second main criterion). At detection at least one of these criteria, a diagnosis of skin melanoma was made, which in all cases was confirmed by the results of histological examination. Inclusion of CM in the diagnostic algorithm of examination of patients with melanocytic neoplasms, suspicious of melanoma, makes it possible to improve the diagnosis of melanoma at early stages.

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