1/124. Collagenous fibroma (desmoplastic fibroblastoma).Collagenous fibroma (desmoplastic fibroblastoma) is a recently described tumor that may arise in the subcutaneous tissue or skeletal muscle. We report a case of collagenous fibroma, occurring on the forehead of a 67-year-old man. An awareness of this entity is necessary to avoid confusion with other soft tissue neoplasms, especially extraabdominal fibromatosis.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/124. Cutaneous malignant melanoma: Tabuk experience.Cutaneous melanoma (CM) has a rising morbidity and mortality in the western world but is rare in certain geographical areas including the middle east. The aim of this study is to define the pattern of CM in this environment over a period of about two decades. A review of associated histological reports, dermatology, plastic general surgical admissions and outpatient census statistic of the North West Military Hospital (N.W.A.F.H.) were carried out from January 1978 to June 1996. The clinico-therapeutic information from both the review case and newly discovered CM was then studied. The result shows that CM is probably rare in the Tabuk military environment and possibly has a low mortality among the affected individuals. The presence of only 2 cases of CM among 73,955 patients over about 20 years suggests that this neoplasm is rare in N.W.A.F.H. Surgery, with localised expert reconstruction, probably offers the best cure for uncomplicated CM in this area. It is suggested that the geographical environment, genetic attributes, custom, attitude, presence of white, painted, sun-reflecting buildings, traditional dress-code and behaviour of the indigenes probably contribute to the suppression of and protection against CM in Tabuk. It is recommended that regular, antimlanoma education awareness programmes among the indigenes and avoidance of sunbathing attitude of the expatriate community should be encouraged in order to maintain this suggested natural selection protection.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/124. Subcutaneous leiomyosarcoma on the face.BACKGROUND: Cutaneous leiomyosarcoma is a rare soft tissue sarcoma with a predilection for the lower extremities. leiomyosarcoma of the face is very rare. Subcutaneous leiomyosarcoma has a higher likelihood of recurrence and metastases than that of the superficial dermal type. OBJECTIVE: The dermatologic surgeon and pathologist should be familiar with the characters of subcutaneous leiomyosarcoma. methods: We report a case of subcutaneous leiomyosarcoma on the face with the results of histologic examination and immunohistochemical studies. RESULTS: leiomyosarcoma of the face is exceedingly rare. The deep subcutaneous type is thought to arise from the smooth muscle of the vascular wall. The neoplasm we report here has deep tumor invasion, high malignancy grade (3B), and large tumor size. Wide excision and postoperative radiotherapy were performed. CONCLUSION: Subcutaneous leiomyosarcoma has a higher likelihood of recurrence and metastases than that of the superficial dermal type. The most effective treatment is wide excision with 3-5 cm lateral margins and a depth that includes subcutaneous tissue and fascia.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
4/124. An unusually aggressive trichoblastoma.Trichogenic tumors are neoplasms of the hair germ cell that usually exhibit benign behavior. We describe a case of a large invasive trichoblastoma requiring Mohs micrographic surgery for its removal. Immunohistochemical studies performed demonstrate overlapping features of this trichogenic tumor with basal cell carcinoma.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
5/124. Serial excision of a large facial skin cancer.BACKGROUND: In the management of large facial neoplasms, the dermatologic surgeon must consider local factors affecting the success of closures. OBJECTIVE: Large facial neoplasms can be removed serially with Mohs micrographic surgery. Serial excision facilitates recruitment of adjacent normal skin for replacement of lesional skin, minimizing the risks of necrosis. methods: A large morpheaform basal cell carcinoma was excised serially. The initial defect was closed with an O to L advancement flap. The final excision and repair 2 months later consisted of a combination of primary closure with marsupialization and pursestring closure. A full-thickness skin graft was used to close the final defect. RESULTS: The patient had optimal cosmesis at 2-year follow-up. CONCLUSION: Large facial neoplasms can be excised serially. This technique, performed in the setting of Mohs micrographic surgery, takes advantage of "mechanical and biologic creep," resulting in excellent cosmesis and function.- - - - - - - - - - ranking = 3keywords = neoplasm (Clic here for more details about this article) |
6/124. Invading basal cell carcinoma of the jaw: an under-evaluated complex entity.Basal cell carcinoma (BCC) is a locally invasive neoplasm, rarely metastatic, yet capable of significant local destruction and disfigurement. Invasion into the bone is uncommon and only a few cases of invasion into facial bones, but never to the mandible or maxilla, have been described. We report three patients with BCC lesions invading their jaws, as a consequence of which either their mandible or maxilla had to be partially resected. This resulted in facial mutilation which required comprehensive multi-disciplinary therapy to restore function and esthetics. Such therapy requires a combination of modalities offered by both plastic and maxillofacial surgeons, as well as oral and dental rehabilitators.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/124. Basal cell carcinoma in association with multiple trichoepitheliomas.We report the case of a basal cell carcinoma (BCC) associated with multiple trichoepitheliomas (TEs) and include the results of histopathological and immunohistochemical studies. The patient had a large, pigmented nodule associated with 4 flesh-colored papules in the central facial area. Two of the 4 flesh-colored papules and the large pigmented nodule were excised. Histopathologically, the pigmented nodule was diagnosed as BCC and 2 of the papular lesions were diagnosed as TEs. In both the BCC and TEs, almost all of the basaloid aggregations were diffusely positive for cytokeratin (CK) 19, CK8 and CK8/18. Based on these clinicopathological observations and reports in the recent literature, these two neoplasms are considered to be highly related. BCC appears to differentiate toward follicular germinative cells, and TE is its benign counterpart.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
8/124. Microcystic adnexal carcinoma: First reported case in an African American man.Microcystic adnexal carcinoma (MAC) is a relatively uncommon adnexal neoplasm that can display aggressive local invasion. MAC occurs most commonly on the central part of the face and can be clinically asymptomatic with a benign appearance. We describe the first reported case of MAC in an African American man who was treated by Mohs micrographic surgery.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/124. Tissue-specific expression of SV40 in tumors associated with the li-fraumeni syndrome.Inactivation of wild-type p53 tumor suppressor function is the primary mechanism of tumor initiation in li-fraumeni syndrome (LFS) individuals with germline p53 mutations. Tumors derived from LFS patients frequently retain the normal p53 allele, suggesting that alternative mechanisms in addition to gene deletion must be involved in inactivating wild-type p53 protein. dna tumor viruses, such as SV40, target p53 for inactivation through the action of viral oncoproteins. We studied the probands from two unrelated LFS families, each of whom presented with multiple malignant neoplasms. Patient 1 developed an embryonal rhabdomyosarcoma (RMS) and a choroid plexus carcinoma (CPC), while patient 2 developed a CPC and subsequently presented with both an osteosarcoma (OS) and renal cell carcinoma (RCC). We utilized DNA sequence analysis and immunohistochemistry to determine p53 gene status in the germline and tumors, as well as evidence for SV40 T-antigen oncoprotein expression. Each patient harbored a heterozygous germline p53 mutation at codons 175 and 273, respectively. In patient 1, the normal p53 gene was lost while the mutant p53 allele was reduced to homozygosity in the RMS. Both normal and mutant genes were maintained in the CPC. In patient 2, normal and mutant p53 alleles were retained in both the CPC and RCC. Both specific PCR and immunostaining detected SV40 T-antigen in both CPCs and the RCC. In addition to chromosomal alterations, epigenetic mechanisms may disrupt p53 function during tumorigenesis. In two LFS patients, we found SV40 DNA sequences and viral T-antigen expression that could account for inactivation of the normal p53 protein. Inactivation of p53 or other tumor suppressors by viral proteins may contribute to tumor formation in specific tissues of genetically susceptible individuals.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
10/124. Locally aggressive solitary fibrous tumor in the infraorbital region: a case report and review of the literature.We describe a case of a soft tissue neoplasm in the infraorbital region of a 31-year-old African-American man that met histologic and immunohistochemical criteria for solitary fibrous tumor. This uncommon spindle cell neoplasm was first described in the pleura, but it has since been reported in many other soft tissue locations. The lesion was locally aggressive and successfully treated by local excision. Solitary fibrous tumor can be locally destructive and can occur in a wide variety of tissues or organs; this is the seventh published case of solitary fibrous tumor in the orofacial region.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
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