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In the historical pursuit of soft tissue augmentation, fat has seemed a natural choice for plastic surgeons. The use of fat transfer to replace volume or camouflage soft tissues is an increasingly popular method in craniofacial surgery and facial esthetics. Craniofacial malformations undoubtedly have a certain psychosocial effect. Children of early age are particularly vulnerable to comments, teasing, and harassment related to their appearance; therefore, improving the facial image is of great importance. We believe that volumetric lipoinjection represents an excellent alternative to obtain greater facial esthetic harmony, which directly increases patient self-esteem in children and adults.

Physical examination is essential in diagnosing tendinous lesions. This is particularly true of the flexor digitorum superficialis of the little finger (FDS5), which is functionally absent in approximately 30% of the population. The objective of our study was to determine the diagnostic value of 3 clinical tests commonly used to assess the function of this tendon. Methods Patients with wounds of the FDS5 were included in this study. Under local or regional anesthesia, 3 described clinical tests were performed to assess the function of the FDS5: (i) the classic test; (ii) Stein's modified test, and (iii) Mecott's modified test. We determined sensitivity, specificity, and predictive values of all such tests. The integrity of the tendon was assessed surgically. Correlation among blinded observers was also established. Results A total of 28 subjects with a mean age of 28 years (ranging from 5 to 56) participated in this study. The classic test obtained a sensitivity of 100% and a specificity of 72%; Stein's test resulted in a sensitivity of 83% and a specificity of 95%, whereas Mecott's test reached a sensitivity of 100% and a specificity of 95%. Conclusions Among the 3 tests described and used in our study, Mecott's modified test proved to be more sensitive and specific than the other two; therefore, we consider this to be the test that should be used in determining the integrity of the FDS5.

Background Desmoid tumours are one of the rarest tumours worldwide, with an estimated yearly incidence of 2–4 new cases per million people. They are soft tissue monoclonal neoplasms that originate from mesenchymal stem cells. It seems that the hormonal and immunological changes occurring during pregnancy may play a role in the severity and course of the disease. Clinical case The case is presented on 28-year-old female in her fifth week of gestation, in whom an abdominal wall tumour was found attached to left adnexa and uterus while performing a prenatal ultrasound. The patient was followed up under clinical and ultrasonographic surveillance. When she presented with abnormal uterine activity at 38.2 weeks of gestation, she was admitted and obstetrics decided to perform a caesarean section. Tumour biopsy was taken during the procedure. Histopathology reported a desmoid fibromatosis. A contrast enhanced abdominal computed tomography scan was performed, showing a tumour of 26 cm × 20.5 cm × 18 cm, with well-defined borders in contact with the uterus, left adnexa, bladder and abdominal wall, with no evidence of infiltration to adjacent structures. A laparotomy, with tumour resection, hysterectomy and left salpingo-oophorectomy, components separation techniques, polypropylene mesh insertion, and drainage was performed. The final histopathology report was desmoid fibromatosis. There is no evidence of recurrence after 6 months follow-up. Conclusions Desmoid tumours are locally aggressive and surgical resection with clear margins is the basis for the treatment of this disease, using radiotherapy, chemotherapy and hormone therapy as an adjunct in the treatment.

ResumenAntecedentesLos tumores desmoides son neoplasias raras monoclonales de tejido blando, que surgen a partir de células madre mesenquimales. Son uno de los tumores más raros en todo el mundo, con una incidencia anual estimada de 2-4 nuevos casos por millón de personas. Los cambios hormonales e inmunológicos que ocurren durante el embarazo pueden desempeñar un papel en la severidad y curso de la enfermedad.Caso clínicoMujer de 28 años de edad, en su quinta semana de gestación, a quien, al realizar ultrasonido de control prenatal, se le encontró tumoración de pared abdominal adherida a anexos izquierdos y útero. Se dejó a la paciente en vigilancia clínica y ecográfica. Acudió con actividad uterina anormal, se ingresó a Obstetricia con 38.2 semanas de gestación, se realizó cesárea y se tomó biopsia de la tumoración. Anatomía patológica reporta fibromatosis desmoide. Se realizó tomografía axial computada contrastada, que reportó tumoración con bordes bien definidos, en contacto con el útero, anexo izquierdo, vejiga y pared abdominal; sin datos de infiltración a estructuras adyacentes de 26×20.5×18cm. Se operó de forma electiva, se realizó laparotomía exploradora, con resección tumoral, histerectomía y salpingo-ooforectomía izquierda, técnica de separación de componentes, colocación de malla de polipropileno y drenajes. El reporte definitivo de enfermedad fue fibromatosis desmoide. Seis meses después de su intervención quirúrgica no ha presentado recurrencia.ConclusiónLos tumores desmoides son localmente agresivos y la resección quirúrgica con márgenes libres representa la base en el tratamiento de esta dolencia; la radioterapia, quimioterapia y la hormonoterapia se utilizan como complemento en el tratamiento de estas pacientes.AbstractBackgroundDesmoid tumours are one of the rarest tumours worldwide, with an estimated yearly incidence of 2-4 new cases per million people. They are soft tissue monoclonal neoplasms that originate from mesenchymal stem cells. It seems that the hormonal and immunological changes occurring during pregnancy may play a role in the severity and course of the disease.Clinical caseThe case is presented on 28-year-old female in her fifth week of gestation, in whom an abdominal wall tumour was found attached to left adnexa and uterus while performing a prenatal ultrasound. The patient was followed up under clinical and ultrasonographic surveillance. When she presented with abnormal uterine activity at 38.2 weeks of gestation, she was admitted and obstetrics decided to perform a caesarean section. Tumour biopsy was taken during the procedure. Histopathology reported a desmoid fibromatosis. A contrast enhanced abdominal computed tomography scan was performed, showing a tumour of 26×20.5×18cm, with well-defined borders in contact with the uterus, left adnexa, bladder and abdominal wall, with no evidence of infiltration to adjacent structures. A laparotomy, with tumour resection, hysterectomy and left salpingo-oophorectomy, components separation techniques, polypropylene mesh insertion, and drainage was performed. The final histopathology report was desmoid fibromatosis. There is no evidence of recurrence after 6 months follow-up.ConclusionsDesmoid tumours are locally aggressive and surgical resection with clear margins is the basis for the treatment of this disease, using radiotherapy, chemotherapy and hormone therapy as an adjunct in the treatment.