1/6. Diagnostic dilemma in high intracanalar carcinoma of the cervix.The use of colposcopy for follow up of patients with abnormal cervical smears has considerably increased the rate of detection of cervical malignancies and intraepithelial lesions in recent years. In case the lesion is situated high up in the cervical canal however, the chances of missing out the lesion are considerable. In our case the malignancy was detected only on endocervical sampling, but was missed on scrape as well as on colposcopically directed biopsy. The patient who was in perimenopausal age group, had complaints of post coital bleeding. The initial cervical scrape smear showed only squamous metaplasia. Colposcopically directed biopsy also showed the same findings. On a high index of suspicion clinically, the endocervical sampling was done with a cytobrush, which showed squamous cell carcinoma (SCC) of the cervix. Subsequent hysterectomy of the patient confirmed the diagnosis. Simultaneous endocervical sampling considerably increases the chances of finding an intracanalar lesion, particularly in older women, in whom the transitional zone (TZ) is situated high up in the cervical canal. In such a situation, even a colposcopically directed biopsy may prove inadequate. This was amply proved in our case.- - - - - - - - - - ranking = 1keywords = intraepithelial (Clic here for more details about this article) |
2/6. Ocular surface squamous neoplasia in Papillon-Lefevre syndrome.PURPOSE: To report the occurrence of ocular surface squamous neoplasia (OSSN) in a patient with Papillon-Lefevre syndrome. DESIGN: Interventional case report. methods: A 14-year-old boy presented with a progressively growing limbal lesion in the right eye for 2 months. He had associated erythematous scaly lesions on the elbows, knees, and feet with periodontosis suggestive of Papillon-Lefevre syndrome. An excision biopsy of the limbal tumor and a skin biopsy was performed. RESULTS: The limbal tumor showed features of carcinoma in situ with clear margins. The skin biopsy showed epidermal hyperplasia and hyperkeratosis with perivascular infiltrates, consistent with Papillon-Lefevre syndrome. CONCLUSIONS: Ocular surface squamous neoplasia may occur in patients with Papillon-Lefevre syndrome, an association that to the best of our knowledge has not been previously reported.- - - - - - - - - - ranking = 0.87676843980698keywords = neoplasia (Clic here for more details about this article) |
3/6. Chronic lymphocytic leukaemia, synchronous small cell carcinoma and squamous neoplasia of the urinary bladder in a paraplegic man following long-term phenoxybenzamine therapy.STUDY DESIGN: A case report. OBJECTIVE: To raise awareness among spinal cord clinicians of the possible carcinogenic effect of phenoxybenzamine and of the rare occurrence of small cell carcinoma in the neuropathic bladder. SETTING: Regional spinal injuries Centre and District General Hospital, Southport, Merseyside, United Kingdom. CASE REPORT: A 28-year-old man sustained a fracture dislocation of L-1 with consequent paraplegia (ASIA impairment scale A). phenoxybenzamine treatment enabled his indwelling catheter to be discarded in favour of a penile sheath, but it caused unacceptable dizziness and was stopped after 7 years. After 20 years, he developed chronic lymphocytic leukaemia, which was treated with chlorambucil and fludarabine. After 2 years, investigation of bilateral hydronephrosis revealed a primary small cell carcinoma of the bladder with coexistent squamous dysplasia. Uraemia supervened and, declining active treatment, the patient died 3 weeks after diagnosis. CONCLUSION: phenoxybenzamine, a known carcinogen in rodents, is likely also to be carcinogenic in humans, and patients with spinal cord injury who have received the drug for any significant period of time, need close follow-up to allow early detection of cancer. phenoxybenzamine should not be prescribed on a long-term basis, and should instead be replaced with a selective alpha-blocker.- - - - - - - - - - ranking = 0.58451229320465keywords = neoplasia (Clic here for more details about this article) |
4/6. Post-loop electrosurgical excision procedure sepsis in a human immunodeficiency virus-infected woman.BACKGROUND: Squamous intraepithelial lesions are more prevalent in women infected with the human immunodeficiency virus (hiv) compared with immunocompetent women. Loop electrosurgical excision procedure (LEEP) is commonly used to treat squamous intraepithelial lesions because it may be performed as an outpatient procedure with minimal blood loss and a low complication rate. CASE: We report a major infectious post-LEEP complication in an hiv-infected female who had an uneventful LEEP in which a cellulose hemostatic agent was used. Despite the severity of the infection, she was successfully treated with a minor surgical procedure along with broad antibiotic coverage. CONCLUSION: Although a cellulose hemostatic agent contaminated with perineal secretions may have served as a nidus for infection, use of perioperative antibiotics or cervical cleansing should be considered to prevent sepsis in immunocompromised hosts.- - - - - - - - - - ranking = 2keywords = intraepithelial (Clic here for more details about this article) |
5/6. Primary orbital aspergilloma of the exenterated orbit in an immunocompromized patient.Aspergilloma is a fungal ball that usually forms in a preformed stationary cavity, mostly in lung and paranasal sinuses. We report a rare case of primary orbital Aspergilloma following exenteration for an invasive ocular surface squamous neoplasia, clinically mimicking a recurrence of the tumor. The fungal ball showed the presence of conidiophores with a globular head and a complete row of uni and biserrate phialides, suggestive of aspergillus flavus species. The exposure to air in the orbit, possibly promoted the formation of conidiophores, which are normally seen when the organism is located in air cavities.- - - - - - - - - - ranking = 0.14612807330116keywords = neoplasia (Clic here for more details about this article) |
6/6. Metaplastic squamous epithelial downgrowth after clear corneal cataract surgery.PURPOSE: To report a case of metaplastic squamous epithelial downgrowth after cataract surgery. DESIGN: Interventional case report. methods: Clinical, laboratory, and histologic findings are presented. Our study is in compliance with institutional review board guidelines. RESULTS: A 76-year-old man developed anterior chamber inflammation five months after uncomplicated clear corneal cataract surgery. Despite antimicrobial and anti-inflammatory therapies, the inflammation persisted. An extensive examination failed to demonstrate an infectious etiology or lymphoma. Subsequently, the patient developed an incipient limbal lesion and iris mass. Immunostaining of a biopsy specimen from the iris mass indicated an epithelial-derived tumor. The prephthisical and painful eye was enucleated; histopathology of the globe revealed a contiguous lesion extending from the limbal mass to the iris tumor through the surgical incision site, a finding consistent with metaplastic squamous epithelial downgrowth. Systemic evaluation was negative. CONCLUSIONS: After intraocular surgery, metaplastic epithelial downgrowth may occur as a consequence of occult ocular surface squamous neoplasia and masquerade as chronic inflammation; clinicians should be aware of this rare complication.- - - - - - - - - - ranking = 0.14612807330116keywords = neoplasia (Clic here for more details about this article) |