1,720,992 research outputs found
Metatypical basal-cell carcinoma (MTC) or basosquamos carcinoma (BSC): surgical therapy
No full textAIM: Nonmelanoma skin cancer (NMSC) is the most common cancer in the world with an incidence 18-20 times greater than that of malignant melanoma. Basal cell carcinoma, which probably arises from immature pluripotential cells, is the most common malignant tumor of the skin in Caucasian. It occurs mostly on sun-exposed areas such as neck and face. MATERIAL OR STUDY: We performed a retrospective study of 327 consecutive patients, diagnosed for metatypical basal cell carcinoma. Tumors were analyzed and measured from the surgeon, excision margins were marked on the basis of palpable or visual alteration of the burden. The minimum surgical margin was equal to the short axis of the ellipse. Therapy was made according to guidelines. RESULTS: A relevant difference came out between two genders. 213 Males (65%) were affected in comparison with only 114 females (35%). Concerning areas affected, first is cervico-facial area with a prevalence of 220 cases (67,3%), second trunk 33 cases (10,1%), third other areas 29 cases (8,86%), fourth limbs 32 cases (9,80%), fifth scalp with 13 cases (4%). DISCUSSION AND CONCLUSIONS: Diagnosis is based on histological analysis. Histologically MTC is divided into two subtypes: intermediated and mixed. In the intermediate form transitional zones and tumor islets are found together, thus combining features of BCC and SCC In mixed subtype typical basal cells coexist with areas of conglomerated squamous cells, squamous pearls could be present
Comparative analysis between minimal access versus traditional accesses in carpal tunnel syndrome: A perspective randomised study
No full textIntroduction: Carpal tunnel decompression with division of the transverse carpal ligament has been a highly successful procedure for the treatment of carpal tunnel syndrome. The standard longitudinal incision technique, with a long curvilinear incision, has been the optimal treatment procedure for surgical decompression of the median nerve, for many surgeons. The aim of this study was to compare the traditional open carpal tunnel release (TOCTR) technique with the minimal-access carpal tunnel release (MACTR) technique for the treatment of carpal tunnel syndrome (CTS), presenting our experience. Materials and methods: A total of 120 patients eligible for carpal tunnel decompression were recruited into the study. The patients were randomised for treatment allocation, at a 1:1 ratio, resulting in 60 patients in group A, treated by standard TOCTR, and 60 patients in group B, treated by MACTR. To evaluate patients' outcomes we used the Boston Carpal Tunnel (BCT) questionnaire; the formed scar was evaluated according to the Vancouver scale and short- and long-term complications. Statistical analysis was performed by the chi-squared test and analysis of variance (ANOVA); Excel was the program used. Results: In our series, there was no complication related to the surgical intervention of any injury to nerve, artery or tendon structures. In each section of the BCT questionnaire, patients in group B had significantly better results than patients in group A at both 6 and 12 months' follow-up (p < 0.001). For the Vancouver scar scale, there was a significant difference between two groups' scores; group B patients had significant improvements compared with group A patients. Conclusions: In our perspective randomised study, MACTR showed statistically significant improvement compared to TOCTR. The patient tolerance is reasonably high and the procedure is compatible with the current minimal invasive trend in surgery. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Abstract
INTRODUCTION:
Carpal tunnel decompression with division of the transverse carpal ligament has been a highly successful procedure for the treatment of carpal tunnel syndrome. The standard longitudinal incision technique, with a long curvilinear incision, has been the optimal treatment procedure for surgical decompression of the median nerve, for many surgeons. The aim of this study was to compare the traditional open carpal tunnel release (TOCTR) technique with the minimal-access carpal tunnel release (MACTR) technique for the treatment of carpal tunnel syndrome (CTS), presenting our experience.
MATERIALS AND METHODS:
A total of 120 patients eligible for carpal tunnel decompression were recruited into the study. The patients were randomised for treatment allocation, at a 1:1 ratio, resulting in 60 patients in group A, treated by standard TOCTR, and 60 patients in group B, treated by MACTR. To evaluate patients' outcomes we used the Boston Carpal Tunnel (BCT) questionnaire; th
Metatypical basal-cell carcinoma (MTC) or basosquamos carcinoma (BSC): surgical therapy
No full textAIM: Nonmelanoma skin cancer (NMSC) is the most common cancer in the world with an incidence 18-20 times greater than that of malignant melanoma. Basal cell carcinoma, which probably arises from immature pluripotential cells, is the most common malignant tumor of the skin in Caucasian. It occurs mostly on sun-exposed areas such as neck and face. MATERIAL OR STUDY: We performed a retrospective study of 327 consecutive patients, diagnosed for metatypical basal cell carcinoma. Tumors were analyzed and measured from the surgeon, excision margins were marked on the basis of palpable or visual alteration of the burden. The minimum surgical margin was equal to the short axis of the ellipse. Therapy was made according to guidelines. RESULTS: A relevant difference came out between two genders. 213 Males (65%) were affected in comparison with only 114 females (35%). Concerning areas affected, first is cervico-facial area with a prevalence of 220 cases (67,3%), second trunk 33 cases (10,1%), third other areas 29 cases (8,86%), fourth limbs 32 cases (9,80%), fifth scalp with 13 cases (4%). DISCUSSION AND CONCLUSIONS: Diagnosis is based on histological analysis. Histologically MTC is divided into two subtypes: intermediated and mixed. In the intermediate form transitional zones and tumor islets are found together, thus combining features of BCC and SCC In mixed subtype typical basal cells coexist with areas of conglomerated squamous cells, squamous pearls could be present
Metatypical carcinoma. A review of 327 cases.
No full textINTRODUCTION: Metatypical cell carcinoma is a quite rare malignancy (5% of all non melanoma skin cancers), with features of basal cell carcinoma and squamous cell carcinoma. It is described as coexistence of basal cell carcinoma and squamous cell carcinoma with no transition zone between them.
MATERIALS AND METHODS: We performed a retrospective study of 327 consecutive patients, diagnosed for metatypical carcinoma. Statistical analysis was made to determinate most affected areas, gender prevalence, average age, presence of ulceration and infiltration, peripheral clearance rate.
RESULTS: A relevant difference came out between two genders. X2 test emphasized a relation between females and the presence of carcinoma on the scalp. In addition a strong correlation between mixed subtype and ulceration was evident. A strong relation between intermediate subtype and positive surgical margin was found; this data could identify a more aggressive behavior of intermediate type. DISCUSSION: Differently from melanoma that usually arises on sun exposed areas, no relation was found between sun exposion and this tumor. This characteristic stresses on the importance of other risks factor apart from sun exposition.
CONCLUSIONS: We identify some correlation between our data that cannot be explained with previous interpretation of sun exposition
Metatypical carcinoma of the head: a review of 312 cases
No full textBACKGROUND: Metatypical cell carcinoma (MTC) is a quite rare malignancy accounting for 5% of all non melanoma skin cancers, with features of basal cell carcinoma and squamous cell carcinoma. It can be described as coexistence of basal cell carcinoma and squamous cell carcinoma with no transition zone between them. AIM: Our review identified a correlation between gender and MTC affected region. MATERIALS AND METHODS: We performed a retrospective study of 312 consecutive patients, diagnosed for MTC localized on face and scalp. Statistical analysis was made to determinate most affected areas, gender prevalence, average age, presence of ulceration and infiltration and peripheral clearance rate. RESULTS: A relevant difference came out between two genders. chi(2) test emphasized a relation between males and the presence of carcinoma on the scalp. In addition a strong correlation between mixed subtype and ulceration was evident. A strong relation between intermediate subtype and positive surgical margin was found; this data could identify a more aggressive behavior of intermediate type. CONCLUSIONS: In our findings an important correlation between sun exposition and this tumor was found. Moreover, due to the difficulties that can occur in preserving the aesthetic subunits in the surgical treatment of these regions, the prevention of this pathology has an important role
ABCB5 in peripheral blood of a patient affected by multiple primary malignancies
No full textBACKGROUND: Multiple primary neoplasm malignancies syndrome (MPMN), is the presence of two or more abnormal growths of tissue, occurring simultaneously. Although the number of second malignancies is increasing, due to several factors, the presence of triple or quadruple malignancies is still very rare. PATIENT AND METHODS: We report a case of a 78-year-old man, with six primaries: a prostatic adenocarcinoma, breast cancer, two melanoma, a basal cell carcinoma, and a lymphoma in a four years period. RESULTS: The onset of MPMN is probably caused by a mutation of DNA repair genes, probably the TP53 gene. Common features of this syndrome are early rise and low tendency to metastatize. We reviewed the markers of staminality for various tumors: RNA expression of ALDH1, CD 133, and ABCB 5, extracted from the sentinel lymph node (SLN) and from the peripheral blood of the patient, was verified. CONCLUSION: People with multiple tumors represent a segment of the cancer-survivor population, which is continuously increasing (10%). Several genetic mutation can be involved in this kind of population. Our patient was positive for the expression of ABCB5, a marker for staminality of melanoma, in periphal blood
ABCB5 in peripheral blood of a patient affected by multiple primary malignancies
No full textBACKGROUND: Multiple primary neoplasm malignancies syndrome (MPMN), is the presence of two or more abnormal growths of tissue, occurring simultaneously. Although the number of second malignancies is increasing, due to several factors, the presence of triple or quadruple malignancies is still very rare. PATIENT AND METHODS: We report a case of a 78-year-old man, with six primaries: a prostatic adenocarcinoma, breast cancer, two melanoma, a basal cell carcinoma, and a lymphoma in a four years period. RESULTS: The onset of MPMN is probably caused by a mutation of DNA repair genes, probably the TP53 gene. Common features of this syndrome are early rise and low tendency to metastatize. We reviewed the markers of staminality for various tumors: RNA expression of ALDH1, CD 133, and ABCB 5, extracted from the sentinel lymph node (SLN) and from the peripheral blood of the patient, was verified. CONCLUSION: People with multiple tumors represent a segment of the cancer-survivor population, which is continuously increasing (10%). Several genetic mutation can be involved in this kind of population. Our patient was positive for the expression of ABCB5, a marker for staminality of melanoma, in periphal blood
Ear reconstruction. Tridimensionality and deception
No full textFossa and antihelix regions of the ear are often the sites of squamous cell carcinomas. A good reconstruction of these regions has to take into account tridimensionality of both cartilaginous frame and skin covering. The gold standard for re-construction of these structures involves harvesting of a cartilage graft (usually from posterior concha) and turning over of a skin flap to cover the structures.
If cartilage is not involved, the use of skin grafts alone is adequate.Whenever an important reconstruction is not operable because of patient’s general condition, fiction and optical illusion can come to our aid. We reported a case report of a patient with squamous cell carcinoma occupying almost the entire antihelix (crura) and triangular fossa. Our technique allowed us to create a fake ear, retaining, at first glance, the same structures (helix, hollow, triangular fossa) of original one. At the same time, this technique allowed us to make an aesthetically acceptable reconstruction in 15 minutes in a patient who could not stand a longer or more complex surgery. Complete healing occurred in 14 days without complications and with complete patient satisfaction
Customized mini-plate for scaphoid fractures and nonunions
Full text linkScaphoid fractures detected in the subacute stage require a more meticulous and prompt approach to prevent chronicity and regain wrist function. Oblique-type scaphoid fractures are potentially unstable and may result in detrimental sequelae. Aim of this study is to suggest an easy surgical approach to restoration of the oblique-type scaphoid fractures or nonunions by using of a customized mini-plate, italic-S shaped. This surgical intervention is associated with promising outcomes and at long-term follow-up showed to avoid the development of a carpal collapse with concomitant arthritis of the radiocarpal joint
A Single Blind Controlled Comparison of Tramadol/Paracetamol Combination and Paracetamol in Hand and Foot Surgery. A Prospective Study
No full textThe objective of this study was to compare the efficacy and effectiveness between an analgesic combination of tramadol/paracetamol (37.5+325 mg), and paracetamol monotherapy (1000 mg) for acute postoperative pain after hand and foot surgery. The study design was a single blind randomized controlled trial. A total of 114 patients who underwent hand and foot surgery under brachial plexus block were randomized to receive either paracetamol monotherapy (group P, n=57) or tramadol/paracetamol (group TP, n=57) postoperatively. The number of patients who required an extra-dose of analgesic pain score, and adverse affects were compared between the two groups. Analgesic requirement was significantly lower in those in the TP group when compared with the P group. In the TP group, the pain score after surgery was significantly lower than in the P group. Adverse effects did not significantly differ between the two groups. There were no serious adverse events in either group. The association of tramadol and paracetamol appears to have more efficacy when compared with paracetamol monotherapy for acute postoperative pain after hand and foot surgery
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