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Katharina Welsch, Helmut Breuninger, Gisela Metzler, Franziska Sickinger, Franziska Carola Eberle, Hans-Martin Häfner, Saskia Maria Schnabl
BACKGROUND: Cutaneous sarcomas are rare and characterized by pathogenetic heterogeneity. Knowledge about local infiltration patterns and recurrence rates may be useful in improving patient care and outcomes. The objective of the present study was to compare these two characteristics in sarcomas that had been treated using the identical surgical procedure. PATIENTS AND METHODS: Between 2006-2010, 84 patients with various types of sarcoma underwent surgery followed by three-dimensional histology...
December 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Florin Daniel Călin, Diana Gheorghiu, Crîngu Antoniu Ionescu, Adrian Neacşu, Dan Bogdan Navolan, Mihai Cornel Traian Dimitriu, Andra Ionescu, Vlad Denis Constantin, Dana Cristina Terzea, Crin Marcean, Liliana Pădure, Irina Pacu
Endometrial stromal tumors are very rare, representing approximately 0.2% of uterine malignancies, having an incidence of one to two from a million of women. The diagnosis cannot be established by imaging, it is histopathological only, often necessitate supplementary immunohistochemistry tests. We report the case of a 27-year-old woman who had an initial diagnosis, in another hospital, of uterine adenomyoma, established by dilatation and uterine curettage and then by subsequently histopathological exam. This diagnosis led to an initial non-oncological surgery, with interannexial total hysterectomy...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Jean-Claude D Schwartz
Background: Oncoplastic breast-conserving surgery describes a set of techniques that allow for generous oncological resection with immediate tumor-specific reconstruction. These techniques are classically divided into either volume displacement (local breast flaps and or reduction mammaplasty/mastopexy strategies) versus volume replacement strategies (transfer of autologous nonbreast tissue from a local or distant site and, less commonly, implant placement). There have been few descriptions of merging these 2 classical approaches to facilitate breast-conserving surgery...
October 2018: Plastic and Reconstructive Surgery. Global Open
T Hølmebakk, B Bjerkehagen, I Hompland, S Stoldt, K Boye
BACKGROUND: According to guidelines, adjuvant treatment or re-excision should be considered after R1 resection of gastrointestinal stromal tumours (GISTs). However, the prognostic significance of R1 resection is uncertain and tumour rupture confounds its assessment. Here, the impact of positive margins was examined and related to rupture in a population-based cohort. METHODS: Patients undergoing surgery for non-metastatic GIST since 2000 were identified in the sarcoma database of Oslo University Hospital...
December 3, 2018: British Journal of Surgery
Lucinda Tullie, Bhumita Vadgama, Ravindar Anbarasan, Michael P Stanton, Henrik Steinbrecher
A 9-year-old boy, with previous anorectal malformation and neuropathic bladder and bowel, underwent ileocystoplasty, Monti-Mitrofanoff and appendix antegrade colonic enema procedure. The tip of the macroscopically normal appendix was sent for routine histopathology. Microscopy demonstrated a 5-mm well-differentiated neuroendocrine tumor extending into muscularis propria. K i -67 index was <2%. Due to margin involvement, the appendix conduit and surrounding skin were re-excised and a tube cecostomy was created through a separate incision...
January 2018: European Journal of Pediatric Surgery Reports
C Calabrese, D Casella, G Di Taranto, M Marcasciano, A Kothari, S Sordi, L Barellini, F Lo Torto, M Tarallo, A Perra, A Fausto, D Ribuffo
OBJECTIVE: The main goal of oncoplastic breast surgery (OBS) is to optimize cosmetic outcomes and reduce patient morbidity, while still providing an oncologically-safe surgical outcome and extending the target population of conservative surgery. Although the growing number of reported experiences with oncoplastic surgery, few studies account for the long-term outcomes. PATIENTS AND METHODS: Between January 2000 and December 2010, 1024 consecutive oncoplastic surgeries were performed and prospectively included in a database...
November 2018: European Review for Medical and Pharmacological Sciences
D W Bartenstein, J M Fisher, C Stamoulis, C Weldon, J T Huang, S E Gellis, M G Liang, B Schmidt, E B Hawryluk
BACKGROUND: Spitzoid proliferations range from Spitz nevi to melanomas, and there are few studies describing clinical features and outcomes in the pediatric population. OBJECTIVES: Determine clinical features and outcomes of a large pediatric cohort with histopathologically-confirmed Spitz tumors. METHODS: Retrospective cohort study of Boston Children's Hospital patients younger than 20 years with a histopathologic diagnosis of spitzoid proliferation from 1/1/1994 - 10/23/2012...
November 22, 2018: British Journal of Dermatology
Shiva Khoobyari, Timothy I Miller, Michi M Shinohara
In the United States, chronic ulcers affect 6.5 million people, with a cost of ≈$20 million annually. The most common etiology of chronic ulcers in the United States is venous stasis, followed by arterial insufficiency and neuropathic ulcers. Less common causes of chronic ulcers include infection, inflammatory etiologies such as vasculitis and pyoderma gangrenosum, and neoplastic causes. Obtaining skin biopsy and tissue culture can be helpful in diagnosing unusual causes of chronic ulcers; however, there are little data on the diagnostic utility of skin biopsy in rendering a definitive diagnosis of the etiology of chronic ulcers...
November 15, 2018: American Journal of Dermatopathology
Solly Thomas, Bimal Patel, Sunitha S Varghese, Selvamani Backianathan
Neurocutaneous melanoma is a rare congenital syndrome associated with congenital melanocytic nevi with meningeal melanosis or melanoma. The disease is aggressive and has a high propensity for leptomeningeal metastases. We present the case history of a man with neurocutaneous melanoma managed with radical excision followed by hypofractionated adjuvant radiotherapy. One year, eight months later, he had a recurrence of the condition with leptomeningeal spread and was managed with re-excision of the recurrent lesion...
September 10, 2018: Curēus
Meth Ruvinda Delpachitra, Clare Heal, Jennifer Banks, Pranav Divakaran, Mrinal Pawar
OBJECTIVE: To identify patient- and procedure-related risk factors for surgical site infection following minor dermatological surgery. DATA SOURCES: The MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Informit, and Scopus databases were searched for relevant literature on patient populations receiving minor surgery, where risk factors for surgical site infection were explicitly stated. STUDY SELECTION: Studies involving major dermatological surgery were excluded...
October 30, 2018: Advances in Skin & Wound Care
Péter Kelemen, Dávid Pukancsik, Mihály Újhelyi, Ákos Sávolt, Eszter Kovács, Gabriella Ivády, István Kenessey, Tibor Kovács, Alexia Stamatiou, Viktor Smanykó, Zoltán Mátrai
INTRODUCTION: Limited data is available from studies that directly compare oncoplastic breast surgery and conventional breast-conserving surgery (CBCS) procedures. The aim of this study was to compare three volume displacement oncoplastic breast-conserving surgery (OBCS) techniques to CBCS procedures, providing more evidence and facilitating the standardization of OBCS techniques. PATIENTS AND METHODS: A retrospective single-centre comparative study was performed between January 2010 and January 2017 involving 758 breast cancer patients...
October 16, 2018: European Journal of Surgical Oncology
Pauline E R Spronk, José H Volders, Petrousjka van den Tol, Carolien H Smorenburg, Marie-Jeanne T F D Vrancken Peeters
INTRODUCTION: NAC has led to an increase in breast conserving surgery (BCS) worldwide. This study aims to analyse trends in the use of neoadjuvant chemotherapy (NAC) and the impact on surgical outcomes. METHODS: We reviewed all records of cT1-4N0-3M0 breast cancer patients diagnosed between July 2011 and June 2016 who have been registered in the Dutch National Breast Cancer Audit (NBCA) (N = 57.177). The surgical outcomes of 'BCS after NAC' were compared with 'primary BCS', using a multivariable logistic regression model...
October 17, 2018: European Journal of Surgical Oncology
Frank Traub, Anthony M Griffin, Jay S Wunder, Peter C Ferguson
BACKGROUND: Soft-tissue sarcomas (STSs) are a heterogeneous group of malignant tumors that can be difficult to treat. This is particularly true after incomplete or unplanned excisions and especially for patients with American Joint Committee on Cancer stage III tumors, who are at high risk for relapse. Numerous studies have shown that an inadequate sarcoma excision is associated with a worse prognosis. However, other reports have suggested an improved prognosis for patients with an initial unplanned excision and subsequent re-excision in comparison with patients who undergo planned primary surgery...
October 15, 2018: Cancer
Alison Laws, Mantaj S Brar, Antoine Bouchard-Fortier, Brad Leong, May Lynn Quan
BACKGROUND AND OBJECTIVES: Using a 2 mm margin criteria, we evaluated the effect of intra-operative margin assessment on margin status and re-excisions following breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). METHODS: We identified patients undergoing BCS for DCIS from a prospective, population-based database. Multivariable logistic regression was used to determine the effect of specimen mammography, ultrasound and macroscopic assessment by a pathologist on margins and re-excision rates...
December 2018: Journal of Surgical Oncology
Mina M G Youssef, Alfred Namour, Omar Z Youssef, Ahmed Morsi
Oncoplastic surgery (OPS) has emerged as a new approach for extending breast conserving surgery (BCS) possibilities, reducing both mastectomy and re-excision rates, while avoiding breast deformities. OPS is based upon the integration of plastic surgery techniques for immediate reshaping after wide excision for breast cancer. This is a prospective feasibility cohort study of oncoplastic breast surgery after neoadjuvant chemotherapy that was carried at the National Cancer Institute, Cairo University and included 70 patients...
September 2018: Indian Journal of Surgical Oncology
Astrid Botty Van Den Bruele, Bharti Jasra, Carmen Smotherman, Marie Crandall, Laila Samiian
BACKGROUND: Re-excision rates after breast conservation surgery are reported to be 20%-40%. Inaccuracies with specimen orientation may affect margin assessment. This study examined whether the addition of surgeon performed intraoperative inking of the lumpectomy specimen after adoption of margin guidelines would be cost-effective. METHODS: A retrospective review of a prospective surgical database was performed from 2009 to 2017. Patients with initial lumpectomy and a preoperative diagnosis of invasive breast carcinoma or ductal carcinoma in situ (DCIS) were included...
November 2018: Journal of Surgical Research
Jun-Ying Chen, Yi-Jie Huang, Liu-Lu Zhang, Ci-Qiu Yang, Kun Wang
Purpose: The use of oncoplastic reconstruction for breast-conserving surgery (BCS) extends benefits beyond merely minimizing poor cosmetic results. However, the feasibility and oncological safety of oncoplastic surgery (OPS) are controversial. Methods: This meta-analysis aimed to compare the short-term and long-term oncological outcomes of BCS alone and BCS plus OPS. Relevant studies published before July 2017 in the Embase, the Cochrane Library, PubMed, and Web of Science databases were screened and collected...
September 2018: Journal of Breast Cancer
Giuseppe Giudice, Giorgio Favia, Angela Tempesta, Luisa Limongelli, Michelangelo Vestita
From 2005 to 2010, 20 consecutive patients with fully manifested neurofibromatosis type 1 (NF1) underwent elective neurofibroma resection at our institution (Departments of Plastic Surgery and of Odontostomatology). Specimens were photographed under optical microscope and confocal laser scanning microscopy (CLSM) with ultra-high accuracy of detail, including depth of field. Patients were followed up for a minimum of 4 years and up to a maximum of 12 years, postsurgery. While all nonrecurring lesions showed intense fluorescence, six of the seven lesions with absence of fluorescence under CLSM recurred at a mean of 5...
2018: Dermatology Research and Practice
Jennifer Marchetti Cautela, Alice Mannocci, Camilla Reggiani, Flavia Persechino, Federica Ferrari, Elena Rossi, Erika Passini, Pierantonio Bellini, Marco Meleti, Sara Wertzberger Rowan, Cristina Magnoni
The rising incidence of Non Melanoma Skin Cancers (NMSC) leads to a high number of surgical procedures worldwide. The strict compliance with international guidelines with regard to excisional margins may help decrease the number of re-excision procedures and reduce the risk of NMSC recurrence. The aim of this study was to investigate the prevalence of excisional margins as recommended by the European Academy of Dermatology and Venereology (EADV) and the European Dermatology Forum (EDF) guidelines, and the factors (demographic or clinical) that influence surgeons' compliance with these guidelines...
2018: PloS One
Batul H Al-Zubeidy, Hannah Weiss, Seema A Khan
The local therapy of breast cancer continues to evolve toward less surgery. Breast conservation is firmly in place, with recent trends toward decreased rates of re-excision. Axillary dissection is becoming a rare operation and is being replaced by sentinel node biopsy. The switch to sentinel node biopsy occurred first in patients with pathologically tumor-free nodes, and later in patients with limited nodal disease. Sentinel node biopsy is now also widely used in patients with pathologically positive nodes who receive neoadjuvant chemotherapy...
September 2018: Clinical Advances in Hematology & Oncology: H&O
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