Sarcomas of the extremities and the pelvis: comparing local recurrence after incisional and after core-needle biopsy

Background The degree of contamination of healthy tissue with tumor cells during a biopsy in bone or soft tissue sarcomas is clearly dependant on the type of biopsy. Some studies have confirmed a clinically relevant contamination of the biopsy tract after incisional biopsies, as opposed to core-needle biopsies. The aim of our prospective study was to evaluate the risk of local recurrence depending on the biopsy type in extremity and pelvis sarcomas. Methods We included 162 patients with a minimum follow-up of 6 months after wide resection of extremity sarcomas. All diagnostic and therapeutic procedures were performed at a single, dedicated sarcoma center. The excision of the biopsy tract after an incisional biopsy was performed as a standard with all tumor resections. All patients received their follow-up after the conclusion of therapy at our center by means of regional MRI studies and, at a minimum, CT of the thorax to rule out pulmonary metastatic disease. The aim of the study was the evaluation of the influence of the biopsy type and of several other clinical factors on the rate of local recurrence and on the time of local recurrence-free survival. Results One hundred sixty-two patients with bone or soft tissue tumors of the extremities and the pelvis underwent either an incisional or a core-needle biopsy of their tumor, with 70 sarcomas (43.2%) being located in the bone. 84.6% of all biopsies were performed as core-needle biopsies. The median follow-up time was 55.6 months, and 22 patients (13.6%) developed a local recurrence after a median time of 22.4 months. There were no significant differences between incisional and core-needle biopsy regarding the risk of local recurrence in our subgroup analysis with differentiation by kind of tissue, grading of the sarcoma, and perioperative multimodal therapy. Conclusions In a large and homogenous cohort of extremity and pelvic sarcomas, we did not find significant differences between the groups of incisional and core-needle biopsy regarding the risk of local recurrence. The excision of the biopsy tract after incisional biopsy in the context of the definitive tumor resection seems to be the decisive factor for this result.

Molecular Biomarkers for Diagnosis of Oral Cancer: An Overview

Oral cancer is one of the six leading cancers in the world and is a constant threat to the health sector in developing countries as well as developed ones. Late presentation, due to lack of awareness and invasive incisional biopsy is the crucial factor for this. Nowadays, scientists are trying to find out an easy and reliable method of early diagnosis of oral cancer and molecular biomarkers might be very helpful for that. This review was aimed to evaluate the published literature on molecular biomarkers which are related to oral cancer. For this, advanced searching was applied by specific keywords in PubMed-Medline resource database and found 12466 publications were clinical trials on humans. Then after applying all inclusion criteria, 19 articles were included finally in the review. This paper uncovered that recognition of biomarkers will be useful for the early detection of oral cancer and their prognosis after treatment. We can suggest that p53, EGFR, miR-34a, miR-143 estimation is important to decide the conceivable risk of oral malignant growth advancement in the speculated oral lesion and after the curative procedure EGFR, Podoplanin and miR-21can aid us regarding the prognosis of patient.International Journal of Human and Health Sciences Vol. 06 No. 01 January’22 Page: 11-16

Oral manifestation of multiple myeloma: a case report

Multiple myeloma (MM) is a relatively uncommon oncohematological condition characterized by abnormal proliferation of plasma cells. Oral manifestations of MM can occur in soft and intraosseous parts. We present a case of a 69-year-old man diagnosed with MM and undergoing chemotherapy, referred to the dental service complaining of a nodular swelling in the maxilla. An incisional biopsy was conducted and the histopathological analysis showed a monoclonal proliferation of plasma cells with a positive CD 138 immunophenotype, which allowed the diagnosis of extramedullary plasmacytoma. The outcome of the case was unfavorable and the patient died. We emphasize the importance of diagnosing MM extramedullary disease in the maxillofacial region.

Diagnosis and Management of Invasive Fungal Wound Infections in Burn Patients

Invasive fungal wound infection (FWI) after burn injury, while uncommon, is associated with significant morbidity and mortality. There are numerous risk factors for FWI, including large burn size and incomplete excision of burn wounds. FWI can be challenging to diagnose. Close attention to changes in the physical examination and, in particular, to the appearance of burn wounds leads the burn team to be suspicious of FWI. Once FWI is suspected, histopathological evaluation of an incisional biopsy provides definitive diagnosis, while tissue culture enables identification of the causative organism to the species level and facilitates targeted antifungal therapy. Management of FWI focuses largely on aggressive surgical intervention, in addition to adjunctive systemic and topical antifungals and nonpharmacologic therapies. Treatment of FWI involves a multifaceted approach, which requires expertise from the entire multidisciplinary burn team.

Extramammary Paget’s Disease of the Vulva: Report of Two Cases

Extramammary Paget’s disease is a rare condition, affecting 6.5% of all patients with Paget’s disease. The most common extramammary site is the vulvar area. Although diagnosis in some patients is difficult to set, early diagnosis is of high importance in order to detect the irreversible progression of the lesion early and prevent distant metastasis. An 89-year-old female and a 69-year-old female presented within three months with an eczematous lesion with leukoplakia in the vulva. The incisional biopsy of the skin revealed extramammary Paget’s disease. Both patients underwent a surgical wide local excision of the lesion and the specimens were sent for histopathological examination. Extramammary Paget’s disease has a high potential for distant malignancies and local recurrence, dictating that surgical excision is the most efficient treatment. The rareness of the condition and the diagnostic difficulties underline the need for early skin biopsy, which is the most efficient diagnostic tool.

Lipoma Arborescens in a 16-year old male: A case report

Lipoma arborescens is a benign intra-articular tumor characterized by joint effusions, pain and reduced range of motion. It is rare in adults and children. We present a case of Lipoma arborescens in a 16 year old male. The work up involved plain radiographs, MRI, incisional biopsy and laboratory analysis.

Parapharyngeal Schawannnoma. Case Report

Parapharyngeal tumor lesions present a low incidence, representing between 0,5 and 0,8% of all head and neck tumors. Approximately 80% show benign behavior. The uniqueness of these lesions derives from their complex anatomical situation and the symptoms with which they usually appear, being in most cases nonspecific and almost always derived from the compressive effect produced by the lesion on the oropharynx and the oropharynx. Schwannomas of the parapharyngeal space are very rare tumors that originate from the sheath of schawnn, generally slow growing, and are usually asymptomatic. Treatment is surgical, often complex due to the anatomical location.The case of a 42-year-old female patient with a diagnosis of Schwannoma in the left parapharyngeal region, demonstrated by incisional biopsy, is presented; undergoing surgical treatment, which was carried out without complications.

Diagnostic accuracy of ultrasound-guided core needle biopsy versus incisional biopsy in soft tissue sarcoma: an institutional experience

Core needle biopsy (CNB) is gaining in importance due to its advantages in the matter of patient morbidity, time and cost. Nevertheless, controversies still exist regarding the biopsy technique of choice for the accurate diagnosis of soft tissue sarcoma (STS). This retrospective cohort study compared the diagnostic performance between ultrasound-guided CNB and incisional biopsy (IB), both performed by orthopedic surgeons. The aims of the study were to answer the following questions: (1) Is ultrasound-guided CNB a highly reliable modality for diagnosing STSs? (2) Is CNB equally useful to IB for identifying histologic subtype? (3) Had patients who underwent CNB a reduced risk of complications? One-hundred and fifty-three patients who underwent resection of soft tissue sarcoma were classified into two groups according to biopsy technique prior to surgery; CNB group (n = 95) and IB group (n = 58). The final surgical specimens were in 40 patients liposarcoma (myxoid, pleomorphic and dedifferentiated), 39 undifferentiated pleomorphic sarcoma (UPS), 33 myxofibrosarcoma, 10 synovial sarcoma, 10 leiomyosarcoma and in the remaining 21 patients different soft tissue sarcoma entities. Sarcoma location of 71 patients was in the thigh, 19 in the lower leg, 22 in the upper arm and shoulder area; 10 in the knee and gluteal region, 9 in the thoracic region, the residual 12 in other body areas. Malignancy was correctly diagnosed in 87% (83 of 95) for the CNB group and 93% (54/58) for the IB group. Correct identification rate of histologic subtype was 80% (76 of 95) in the CNB group and 83% (48 of 58) in the IB group. There were no significant differences in the correct diagnosis rates of malignancy and subtype between the two techniques. No complications were seen in the CNB group, whereas 2 patients in whom IB was performed developed pulmonary embolism and 1 patient surgical site infection. Ultrasound-guided CNB is highly accurate and not inferior to IB in diagnosing the dignity of lesions and histologic subtype in patients with suspected STSs.

1399 Anorectal Melanoma: Can Be an Unexpected Diagnosis - A Case Report

Anorectal melanoma is a rare tumour. Few cases are reported in the literature. We report a case of 51 years old male complained of anal induration, itching and bloody and suppurative discharge. Patient had symptoms for 2 years. However, patient expected his symptoms are due to recurrence of haemorrhoids. Therefore, he presented late. Then, he had noticed a progressive increase in size, discharge and two opposing ulcers. Patient had no history of abdominal pain, change in bowel habits, bleeding per rectum, history of groin lumps, incontinence nor erectile dysfunction. Patient underwent haemorrhoidectomy about 11 years ago. On examination, there was a circumferential single ulcer eroding the anus extending deep to the dentate line reaching the rectum on digital rectal examination. Also, there was no inguinal lymphadenopathy detected on exam. Incisional biopsy of the ulcer showed anorectal melanoma. Patient had abdominoperineal resection (APR) with adjuvant radiotherapy. At 12 months follow up, there were no signs of recurrence.

THE EFFICACY OF CLINICAL EXAMINATION, ULTRASONOGRAPHY AND CT SCAN IN DETECTING MALIGNANT LYMPH NODES OF THE NECK IN ORAL CANCER AND CONFIRMATION WITH FINAL HISTOPATHOLOGY REPORT

To evaluate and compare the diagnostic accuracy of detecting malignant cervical lymph nodes using Clinical evaluation, CT scan and Ultrasonography and conrmation with histopathology in patients with squamous cell carcinoma. Atotal number of 30 patients, of both sexes, with carcinoma of different regions of the oral cavity, conrmed with incisional biopsy were included in this study. We found USG to be most sensitive (83.5%), followed by CT (78.3%) and clinical evaluation (63.7%). Similarly, CT scan was found to be most specic (81.5%), followed by USG (78.2%) and clinical evaluation (60.7%).