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Georgi Tchernev, Ivanka Temelkova
BACKGROUND: Innovations in medicine are often due to the simplicity of a certain activity, interaction, even counteraction, or a mistake leading to a subsequent final optimal outcome. Innovations could also be due to conclusions based on targeted clinical or sporadic, as well as completely random observations. The genius of an approach or statement is often based on the "iron logic", which in turn is based on irrefutable data or facts. These are often observations or results from actions that happen right before our eyes and provide advantages or prerequisites for the better future development of things (in this case, disease) concerning certain groups of people (in these case-patients)...
July 20, 2018: Open Access Macedonian Journal of Medical Sciences
Tien Anh N Tran, Konstantinos Linos, Francine B de Abreu, John Andrew Carlson
Malignant melanoma (MM) may display highly variable phenotypic diversity, sometimes associated with loss of immunohistochemical melanocytic markers and acquisition of nonmelanocytic lineage of differentiation. Primary cutaneous MM with rhabdomyosarcomatous differentiation is extremely rare with only 5 reported cases in the literature. To date, a chronological progression of a MM to rhabdomyosarcoma has not been conclusively documented. A 96-year-old man underwent a re-excision of an "atypical fibroxanthoma" of the forearm, which revealed a small lentigo maligna melanoma associated with a dominant dermal high-grade spindle cell nodule admixed with a population of malignant polygonal epithelioid cells...
August 6, 2018: American Journal of Dermatopathology
Angelena Crown, Lauren G Scovel, Flavio G Rocha, Elliot J Scott, Debra G Wechter, Janie W Grumley
BACKGROUND: Oncoplastic breast conserving surgery (OBCS) integrates plastic surgery techniques in the resection of breast cancer and lowers the rate of re-excision while improving breast cosmesis. The goal of this study is to compare the surgical site complication rate of OBCS with that of standard BCS. METHODS: A single institution chart review evaluated all patients undergoing BCS for treatment of breast cancer. Patients treated from January 2009 to December 2010, prior to adoption of oncoplastic techniques, were identified as the standard surgery (SS) group...
June 19, 2018: American Journal of Surgery
George A Zakhem, Vitaly Terushkin, Euphemia W Mu, David Polsky, Shane A Meehan
INTRODUCTION: Biopsies of atypical melanocytic nevi are among the most commonly performed procedures by dermatologists. Margin assessment is often used to guide re-excision, but can be a point of confusion as negative margins reported in the planes of sections examined do not always reflect complete removal of a lesion. This study investigates the rates of false negative margins after both punch and shave biopsies. METHODS: We performed a retrospective analysis of 50 consecutive punch and shave biopsy specimens (1) diagnosed as DN, and (2) reported as having clear margins in the planes of section examined...
July 1, 2018: Journal of Drugs in Dermatology: JDD
Sarah M DeSnyder, Kelly K Hunt, Wenli Dong, Benjamin D Smith, Meena S Moran, Mariana Chavez-MacGregor, Yu Shen, Henry M Kuerer, Anthony Lucci
BACKGROUND: The SSO-ASTRO-ASCO consensus guideline on margins for breast-conserving surgery with whole breast irradiation in ductal carcinoma in situ (DCIS) recommended a 2-mm margin. We sought to determine the impact of guideline publication on clinician practice. METHODS: A total of 3081 members of the American Society of Breast Surgeons (ASBrS) received a survey. Respondents' clinical practice type and duration, guideline familiarity, and margin width preferences before and after publication were assessed...
July 9, 2018: Annals of Surgical Oncology
Quentin Cassar, Amel Al-Ibadi, Laven Mavarani, Philipp Hillger, Janusz Grzyb, Gaëtan MacGrogan, Thomas Zimmer, Ullrich R Pfeiffer, Jean-Paul Guillet, Patrick Mounaix
The failure to accurately define tumor margins during breast conserving surgery (BCS) results in a 20% re-excision rate. The present paper reports the investigation to evaluate the potential of terahertz imaging for breast tissue recognition within the under-explored 300 - 600 GHz range. Such a frequency window matches new BiCMOS technology capabilities and thus opens up the opportunity for near-field terahertz imaging using these devices. To assess the efficacy of this frequency band, data from 16 freshly excised breast tissue samples were collected and analyzed directly after excision...
July 1, 2018: Biomedical Optics Express
Georgi Tchernev, Ivanka Temelkova, Konstantin Stavrov
BACKGROUND: One step melanoma surgery is a new surgical approach by which specific groups of patients with cutaneous melanoma may be operated only by or within a single surgical session. Until now, the Bulgarian Society for Dermatologic Surgery (BULSDS) has presented models of clinical behaviour, in which preoperative measurement of tumour thickness in combination with echographic measurement of the locoregional lymph nodes could lead to the conduct of the so-called one-step melanoma surgery...
June 20, 2018: Open Access Macedonian Journal of Medical Sciences
Abhimanyu Kar, Sumit Gulati, Sudheer Mohammed, Mithun Valiya Valappil, Bhaviya Bhargavan Sarala, Supriyo Ghatak, Avik Bhattacharyya
Retained calculi in the cystic duct or gall bladder remnant can present as a post-cholecystectomy problem. Increased suspicion is necessary to diagnose this condition in a symptomatic post-cholecystectomy patient. Ultrasonography usually detects this condition, but magnetic resonance cholangiopancreatography is the test of choice for diagnosis as well as for surgical planning. Laparoscopic re-excision of the stump in most cases is feasible and safe. It is increasingly becoming the treatment of choice.
June 2018: Indian Journal of Surgery
Sumetha Rajendran, Arthur Harry Henderson, Stuart Gillett
The glomus tumour is a rare neoplasm derived from the glomus apparatus. Subungual sites are most common with only three published cases involving the dorsal tongue. To our knowledge, this is the first case of an intraoral malignant glomus tumour (glomangiosarcoma) to be published in English literature. We report a case of a single glomus tumour located on the posterior dorsal tongue of a middle-aged man, which was surgically excised. Immunohistological features were indicative of a glomus tumour; however, in this case, malignant features were also discovered, warranting re-excision...
July 3, 2018: BMJ Case Reports
Camelia Tamaş, Cătălina Teodora Pintilie, Ionuţ Vivi Atănăsoae, Andreea Mioara Corduneanu, Iulia Dabija, Florin Ştefan Olaru, Irina Mihaela Hreniuc, Angela Tecuceanu, Ioana Munteanu, Costel Dobre, Dan Cristian Moraru, Victor Ianole, Ioana Tamaş, Victor Vlad Costan
PURPOSE: The face is an unfortunate location for any type of tumor - malignant or not - with significant esthetic and functional outcomes. To reconstruct a facial defect may seem simple, but can be rather complicated. The aim of this study is to analyze and discuss our results in order to conclude with specific surgical strategies correlated with the morphopathological results. The most important objective for us is to offer the highest level of expertise to our patients and to prove that the symbiosis between the surgical treatment and the work of the Department of Morphopathology is essential in order to maximize the quality of medical care provided for our patients...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Noortje Pleunis, Maria E J Leermakers, Anneke A van der Wurff, Paul J J M Klinkhamer, Nicole P M Ezendam, Dorry Boll, Joanne A de Hullu, Johanna M A Pijnenborg
INTRODUCTION: The recommended pathological resection margin (8 mm) for vulvar squamous cell carcinoma (SCC) is broader than for SCC located elsewhere, and does not depend on tumor grade or lesion size. Our aim is to evaluate the resection margin in vulvar SCC in relation to local recurrence, and to determine the impact of other prognostic factors. MATERIALS AND METHODS: Data of all surgically treated patients at the Gynecological Oncology Center South with vulvar SCC, FIGO IB-IIIC, between 2005 and 2015 were analysed retrospectively...
June 6, 2018: European Journal of Surgical Oncology
Alexandra E Quimby, Diana Khalil, Stephanie Johnson-Obaseki
OBJECTIVE: Controversy exists regarding the surgical management of cutaneous melanoma and the optimal timing of reconstruction. One approach to ensuring an oncologically sound outcome is a two-stage procedure, with reconstruction delayed for negative permanent section margins. Alternatively, a single-stage excision with immediate reconstruction is advantageous because it limits both resource use and patient morbidity from multiple procedures. We sought to examine available published data on the oncologic outcomes associated with immediate versus delayed reconstruction of cutaneous melanoma in the head and neck region...
June 22, 2018: Laryngoscope
Reid Green, Meghan Woody, Anthony C Soldano, Erin Madden
Malignant tumors composed of both epithelial and melanocytic populations are exceedingly rare. Because the etiology of these malignant tumors is not yet defined, several authors have argued for the continued cataloging of these lesions. We present a 67-year-old man with a suspicious-appearing lesion on the right forearm; initial biopsy was consistent with a pigmented basal cell carcinoma. On re-excision, a collision of malignant melanoma and basal cell was identified.
July 2018: Proceedings of the Baylor University Medical Center
Chloe C Kimball, Christine I Nichols, Joshua G Vose
Objectives: Percutaneous core-needle biopsy (PCNB) is the standard of care to biopsy and diagnose suspicious breast lesions. Dependent on histology, many patients require additional open procedures for definitive diagnosis and excision. This study estimated the payer and patient out-of-pocket (OOP) costs, and complication risk, among those requiring at least 1 open procedure following PCNB. Methods: This retrospective study used the Truven Commercial database (2009-2014)...
2018: Breast Cancer: Basic and Clinical Research
Joseph J López, Jennifer N Cooper, Devin R Halleran, Katherine J Deans, Peter C Minneci
BACKGROUND: Recurrent pilonidal disease has been reported to occur in up to 30% of patients after their initial infection. Surgical resection is often performed to prevent recurrence of disease, however, morbidity after surgical excision from incision complications and disease recurrence is common. The aim of this study was to quantify major morbidity after initial pilonidal excision. PATIENTS AND METHODS: Patients with pilonidal disease who had initial excision procedures between 2011-2013 at hospitals reporting data to the Pediatric Health Information System (PHIS) were included...
June 5, 2018: Surgical Infections
M Salmivuori, N Neittaanmäki, I Pölönen, L Jeskanen, E Snellman, M Grönroos
BACKGROUND: Basal cell carcinoma (BCC) is the most common skin cancer in the Caucasian population. Eighty per cent of BCCs are located on the head and neck area. Clinically ill-defined BCCs often represent histologically aggressive subtypes, and they can have subtle subclinical extensions leading to recurrence and the need for re-excisions. OBJECTIVES: The aim of this pilot study was to test the feasibility of a hyperspectral imaging system (HIS) in vivo in delineating the preoperatively lateral margins of ill-defined BCCs on the head and neck area...
May 30, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Monica G Valero, Melissa Anne Mallory, Katya Losk, Mustafa Tukenmez, Jaeho Hwang, Kristen Camuso, Craig Bunnell, Tari King, Mehra Golshan
BACKGROUND: Reoperation after breast-conserving surgery (BCS) is common and has been partially associated with the lack of consensus on margin definition. We sought to investigate factors associated with reoperations and variation in reoperation rates across breast surgeons at our cancer center. METHODS: Retrospective analyses of patients with clinical stage I-II breast cancer who underwent BCS between January and December 2014 were conducted prior to the recommendation of 'no ink on tumor' margin...
May 21, 2018: Annals of Surgical Oncology
Maria Mihaela Pop, Silviu Cristian, Orsolya Hanko-Bauer, Dana Valentina Ghiga, Rares Georgescu
Background and aim: The purpose of breast-conserving surgery (BCS) for women with cancer is to perform an oncological radical procedure with disease-free margins at the final histological assessment and with the best aesthetic result possible. Intraoperative resected specimen ultrasound and intraoperative resected specimen mammography may reduce the rates of positive margins and reexcision among patients undergoing conserving therapy. Our objective is to compare the two methods with the histopathological results for a preset cut off and asses which parameters can influence the positive margin status...
2018: Clujul Medical (1957)
Jianqin Shen, Huiyan Li, Shi Feng, Hongguang Cui
Purpose: To report the clinical features, imaging manifestations, histopathology, and immunohistochemical features of several cases of orbital solitary fibrous tumors (SFTs) in a Chinese tertiary hospital, and to undertake a literature review of this rare disease. Methods: A non-comparative retrospective review of clinical presentations, imaging manifestations, histopathology, and immunohistochemical features as well as the management and disease outcomes of patients with orbital SFT was conducted along with a review of orbital SFT cases in the literature...
2018: Cancer Management and Research
Sambit K Mohanty, Shivani Sharma, Dinesh Pradhan, Shivani R Kandukuri, Navid Farahani, Catherine Barry, Julie M Wu, David Frishberg, Bonnie Balzer
Microphthalmia-associated transcription factor (MiTF) is used as a marker of melanocytic differentiation. However, MiTF immunoexpression has also been observed in histiocytes, macrophages, smooth muscle cells and fibroblasts, which raise the concern of fibrohistiocytic (FH) lesions being misdiagnosed as melanoma based on MiTF immunoreactivity. MiTF has been known to be positive in FH tumors, but this is the first study evaluating ninety-three fibrohistiocytic neoplasms to understand and delineate the staining pattern of MiTF in these tumors...
June 2018: Pathology, Research and Practice
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