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Marginal zone B-cell lymphoma (MZBCL) of mucosa-associated lymphoid tissue type is a peculiar variant of B-cell neoplasm showing distinct clinical and pathologic features. Its occurrence in children or adolescents is extremely uncommon. We describe the case of an 11-year-old boy who developed such a lymphomatous process involving primarily the skin. The tumor was characterized by a maturing plasma cell population that included immunoblasts, heavy-chain but not light-chain restriction suggestive of monoclonality, and a prevalent, focally granulomatous component of histiocytes. As an additional interesting feature, a trisomy 3 was demonstrated by fluorescence in situ hybridization analysis. The clinical, morphological, phenotypic, and genetic characteristics seen in our patient do not differ significantly from those described in primary cutaneous MZBCL occurring in adults., Case Reports, Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

Although extremely frequent elsewhere on the body, basal cell carcinomas are infrequent on the hands (< 1% of all basal cell carcinomas). Chronic sun exposure is considered as the main etiologic factor for its development but it does not explain low frequency of hand involvement. Presented here is a series of seven patients with basal cell carcinoma of the hand. All were treated by surgery alone. Clinical presentation was classical: a slowly growing chronic ulceration. None of the patients was chronically exposed to chemical agents but two of them developed their tumour in previously irradiated areas, focusing on this specific etiologic factor for basal cell carcinomas of the hands., SCOPUS: ar.j, info:eu-repo/semantics/published

Immediate breast reconstruction using implants is a currently practiced intervention. However, it is exposed to the potential adverse effects of adjuvant therapies necessitated for cancer control. Patients with implants, receiving adjuvant chemotherapy, were compared with those not necessitating chemotherapy to evaluate the real impact of this combination of treatment modalities on the final outcome. Cosmetic results were not influenced by the adjunction of chemotherapy, but a higher rate of implant infection was observed in the chemotherapy group (10.7% versus 1.5% p = 0.0084). This observation needs to be kept in mind when selecting patients for immediate breast reconstruction with implants., Comparative Study, Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

Multiple dorsal dislocations of the carpometacarpal joints are rare. Diagnosis requires a high index of suspicion, careful examination and good radiography. Treatment is controversial and is based on the presence or not of associated fractures. This paper presents a case of combined fifth and fourth finger carpometacarpal joint dorsal dislocation, successfully treated with closed reduction and percutaneous pinning. A discussion of this pattern of injury is also presented., SCOPUS: ar.j, info:eu-repo/semantics/published

Dermatofibrosarcoma protuberans is a rare mesenchimal tumour mainly characterized by its local aggressiveness and high reported recurrence rates. Classically, wide excisional surgery with at least 3 cm of free tissue margins is recommended as treatment. We present a series of 18 patients with variable gross free tissue margins but confirmed histological free margins in all cases whatever the surgical excision really was. Only one patient presented a local recurrence (5.5%) of a very large (14 cm) sarcomatous variant of dermatofibrosarcoma protuberans. Mean follow-up in this series was 52.1 months. Those results emphasize that histological rather than theoretical «golden rules» are mandatory to locally control this aggressive neoplasm., SCOPUS: ar.j, info:eu-repo/semantics/published

SCOPUS: ar.j, info:eu-repo/semantics/published

Carcinomas of the external auditory canal are rare, nevertheless they are associated with a relatively poor prognosis. Among these tumours, basal cell carcinomas are less frequent than squamous cell carcinomas. Anyway, it is difficult to determine if their prognosis is better, as in other localizations on the body. We reviewed six patients, presenting locally advanced basal cell carcinomas of the external auditory canal and considered the history of their disease, the treatment procedures and final oncological outcome. Four of the patients died of the disease within five years from surgery. They presented local recurrences even after radical surgical excision in free tissue margins. From these findings we have the impression that basal cell carcinoma of the external auditory canal behave, even after radical surgery, as an aggressive tumour associated with a really poor prognosis., SCOPUS: ar.j, info:eu-repo/semantics/published

Basal cell carcinoma represents the most common cutaneous malignancy. Most of these tumors are small, easily treated skin lesions that occur on sun-exposed skin. Giant basal cell carcinoma is a rare variant of this tumor that is most often observed on the trunk. Neglect appears to be the main causative factor for such an exceptional presentation. A patient with a T4 (17×14 cm) giant basal cell carcinoma of the left forearm treated by excisional surgery with free margins is reported., SCOPUS: ar.j, info:eu-repo/semantics/published

Large local recurrences of breast cancer require wide surgical excision and subsequent defect reconstruction. Fifteen patients having such resection and cover with pedicled flaps were reviewed. The flaps included 14 latissimus dorsi muscle, 2 rectus abdominis muscle and 1 pectoralis major muscle flap. There was only one local complication without delay in complete healing. The mean hospital stay was 11 days. All patients had dissemination of the disease in the follow-up period and 13 died of the disease (mean delay from reconstruction being 27 months). In such cases, the use of the latissimus dorsi muscle flap, if the thoracodorsal artery is present, seems to offer good tissue cover with little morbidity and allows for a quick recovery, which is mandatory since these patients have a short life expectancy. © Springer-Verlag 2002., SCOPUS: ar.j, info:eu-repo/semantics/published

Verrucous carcinoma is a rare subtype of well-differentiated squamous cell carcinoma that may occur anywhere on the skin. It is slow growing, enlarging relentlessly and invading locally. Some cases were reported to occur on chronic scar tissue but demonstrated the same clinical course than in other locations. Herein, we report on a very unusual case of cutaneous verrucous carcinoma arisen from a long-standing (40 years old) burn scar and which involved the pleura five years after the initial surgical resection. To our best knowledge, this is the first case of pleural involvement by a verrucous carcinoma originating from the skin., SCOPUS: ar.j, info:eu-repo/semantics/published

Scrotal skin calcinosis is a rare benign disease; in most cases there are no associated symptoms. A 40-year-old patient with massive involvement of the scrotum is presented. Histological examination of the excised material revealed circular deposits of calcium within the dermis without evidence of epithelialized lining. The pathogenesis is discussed regarding hypotheses presented in the literature., SCOPUS: ar.j, info:eu-repo/semantics/published

We present a series of 4 cases of fibrosarcomatous dermatofibrosarcoma protuberans. This variant, which is composed of areas of typical DFSP associated with more cellular, fascicular foci, reminiscent of fibrosarcoma, should be recognised because of its more aggressive behavior, with a significant metastatic potential (15%). Our series illustrates the clinical, morphological, immunohistochemical and cytogenetic features of this uncommon tumor, with emphasis on differential diagnosis., Case Reports, English Abstract, Journal Article, info:eu-repo/semantics/published

Metastases of thyroid carcinoma to the sternum are not so frequent and ablative surgery enables the patients to live longer with a better quality of life. After such a resection, the surgical defect has to be covered either by autogenous or artificial substitutes. We present a 62 years old patient with an asymptomatic sternal metastasis of a poorly differentiated follicular thyroid carcinoma. After radical excision, including the sternum, both clavicular heads and an upper mediastinal dissection, the defect was reconstructed in two layers, combining a Marlex mesh and a pedicled pectoralis major muscle flap. Postoperative course was uneventful and respiratory function was not disturbed., Case Reports, Journal Article, info:eu-repo/semantics/published

The authors performed a retrospective review of 53 patients with 56 completed or impending pathological fractures of the humerus. Sixteen cases were treated with a proximal and one with a distal humeral prosthesis, 38 with an intramedullary device with cement and one with plate fixation. Forty-eight patients with 51 humeral metastases were available to follow-up. No or only occasional pain was observed in 92% of the operated extremities and adequate postoperative function in 90%. No major complications occurred, except one rod migration., Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

Verrucous carcinoma is a rare, low-grade, well-differentiated squamous cell carcinoma most commonly seen on mucosa. It has been infrequently reported to occur on the skin, where it is a slow-growing and locally aggressive tumour. It is not uncommon for cutaneous verrucous carcinomas to be mistaken for the more frequent verruca vulgaris and treated accordingly. Three cases of cutaneous verrucous carcinoma are presented with the medical history and follow-up data. Surgery is the treatment of choice; these lesions may sustain a potentially anaplastic transformation after radiation therapy., Case Reports, Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

Pigmented dermatofibrosarcoma protuberans (Bednar tumor) is a rare neoplasm accounting for approximately 1-5% of all cases of dermatofibrosarcoma protuberans. The majority occurs on the trunk, and the remainders are more or less equally distributed in the upper and lower extremities and the head and neck. Microscopically it is characterized by spindled cells arranged in a tight storiform pattern and admixed with a small population of melanin-containing dendritic cells. The dendritic cells are the primary feature that distinguish this lesion from conventional dermatofibrosarcoma protuberans. We report here a case of Bednar tumor occurring on the dorsal aspect of the foot in a young female., Case Reports, Journal Article, Review, SCOPUS: ar.j, info:eu-repo/semantics/published

The possible adverse effects on cancer control due to immediate breast reconstruction have been addressed recently for both silicone-filled implants and flap reconstruction. To evaluate those possible effects after immediate breast reconstruction with saline-filled implants, 49 patients reconstructed with saline-filled breast implants at the Jules Bordet Cancer Institute were studied. Selection was only based on the possibility to find a matched patient. These patients were matched with a control group of 49 matched women with breast cancer treated in the same center by mastectomy without any type of breast reconstruction. The two groups were comparable according to age at diagnosis (within 3 years), year of diagnosis (same year), stage of the tumor, histology, and nodal status. The only difference between the two groups was that radiation therapy was applied to some of the patients who were not reconstructed (due to tumor location). The results show, in terms of local recurrences, distant metastasis, and deaths, no significant difference between the two groups, even for the irradiated patients, within a mean follow-up period of 72 months (range, 24 to 108) months., Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

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Dermatofibrosarcoma protuberans is an uncommon malignant mesenchymal tumor which is characterized by local aggressivity and recurrence. About 50 cases have been reported in the pediatric population. In the case presented, the lesion as a mass 5 mm in diameter, with normal overlying skin and no pain. The diagnosis was made by histology obtained on an incisional biopsy. Treatment was by wide local excision., SCOPUS: ar.j, info:eu-repo/semantics/published

This case report is presented to assess safety and efficiency of early suction and saline washout of extravasated cytotoxic drugs. Through multiple small skin incisions, the area of extravasation is first suctioned and subsequently extensively washed out with saline. Incisions are left open and the arm is elevated for 24 hours. A complete healing was obtained in five days without any skin or soft tissue loss. No additional treatment was needed. Early referral and surgical treatment by suction and washout is a safe and reliable treatment protocol for major cytotoxic drug extravasation injuries., SCOPUS: ar.j, info:eu-repo/semantics/published

The most classic characteristics of facio-genito-popliteal syndrome are cleft lip and/or palate, anomalies of the external genitalia and popliteal pterygium. A case of facio-genito-popliteal syndrome with bilateral choanal atresia and maxillary hypoplasia is presented. No previous report of such an association was found in the literature. (C) 2000 The British Association of Plastic Surgeons., SCOPUS: ar.j, info:eu-repo/semantics/published

The use of implants in immediate breast reconstruction is presently a common option. However, the practice should be evaluated in consideration of possible adjuvant therapies needed to control disease and to rule out negative interactions. This article discusses the effects of radiotherapy on breast implants with regard to the final cosmetic result. Six out of 124 cases of immediate breast reconstruction with implants were followed and evaluated in terms of capsular contracture and final aesthetic result after adjuvant radiotherapy and compared with the results of 118 patients who did not require irradiation. All of the patients who received irradiation demonstrated poor to fair results, with grade III to IV capsular contracture. Two patients received radiation therapy for local recurrences, which worsened their capsular contracture, emphasizing the deleterious effect of irradiation on breast implants. Statistical analysis of the results demonstrated a significant difference between the two groups in terms of capsular contracture and breast symmetry. In the selection of patient candidates for immediate breast reconstruction with implants, adjuvant radiation therapy must be considered as a contraindication, at least from an aesthetic point of view., SCOPUS: ar.j, info:eu-repo/semantics/published

Palliative care is more and more of concern in medical information. If there is no exact definition about the real place of surgery in this concept, the rule of reconstructive surgery is even less clear. The goal of this paper is to try to define, on one hand the general characteristics of palliative surgery, and on the other hand, to underline the role of reconstructive surgery in four specific indications: the head and neck area, the thorax, the pelvis and the extremities. The resection surgery, associated with flap coverage, may seems an excessive treatment in such palliative indications. Nevertheless, the results presented here tend to demonstrate that, after careful patient selection a better quality of life could be obtained with an acceptable surgery-induced morbidity (regarding preoperative disability). More than technical aspect, it is by a different approach of the problem that this type of surgery is to be distinguished., English Abstract, Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

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To evaluate the efficiency of emergency suction in extravasation injuries of contrast medium, records of 11 patients treated for extravasation injuries with a combination of suction and saline washout were reviewed. All of the patients were treated in the first 2 hours after injury. The mean extravasated volume was 55 cc. There were no surgery-related complications, and all the patients experienced a relief of their preoperative pain. Except for two patients with blisters at admission, none of them suffered skin or soft-tissue necrosis. Mean time to complete healing was 9 days. Emergency suction therapy is safe and effective in preventing the skin and soft-tissue necrosis associated with extravasation injuries of hyperosmolar contrast medium., SCOPUS: ar.j, info:eu-repo/semantics/published

SCOPUS: le.j, info:eu-repo/semantics/published

Saline-filled breast implants are currently used in breast reconstruction and augmentation. Free diffusion of electrolytes through these implants has been questioned recently and is of potentially high importance. Many questions are still unanswered about this phenomenon. Eighteen prostheses were reviewed and tested for diffusion and exchange of electrolytes and glucose in vivo. None of these implants demonstrated major variation of the inner contents from the original saline used to fill them, emphasizing the real innocuousness of such implants in terms of possible ionic pooling. Extrapolation of these results to all implants made by different manufacturers is not possible according to the sample size in the present study., SCOPUS: ar.j, info:eu-repo/semantics/published

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Palmar dislocations of the long finger metacarpophalangeal joint are extremely rare and easily missed at the first clinical examination. We describe a palmar metacarpophalangeal dislocation of the long finger following a hyperflexion injury. The presentation, aetiology and treatment are discussed. © 1998 The British Society for Surgery of the Hand., SCOPUS: ar.j, info:eu-repo/semantics/published

Paget's disease is uncommon in patients younger than 50 years of age. Multifocal giant cell tumors arising in bone affected by Paget's disease have been described previously in 37 cases. A case of a 38-year-old man with polyostotic Paget's disease and multifocal giant cell tumors responsive to steroid therapy is presented., SCOPUS: ar.j, info:eu-repo/semantics/published

Soft tissue defects of the ankle are a challenging problem. Local flaps have several disadvantages because of functional and/or cosmetic problems. Free flaps, by nature, allow a greater choice of donor sites and therefore minimize problems resulting from local flap harvesting. Passing the vascular pedicle between the tibia and the Achilles tendon for anastomoses on the posterior tibial vessels can maintain satisfactory ankle contour. Three cases of free flap reconstruction of the lateral aspect of the calcaneal region are presented and the surgical approach is detailed. All the patients were able to wear normal shoes after the reconstruction., SCOPUS: ar.j, info:eu-repo/semantics/published

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An apocrine hidrocystoma occurring on the finger of a 55-year-old man is reported. The lesion presented as a solitary, painless cystic nodule on the dorsal aspect of the middle phalanx of the index finger. Apocrine hidrocystoma is a benign tumour developed from apocrine sweat glands, but the location of the lesion was, however, not consistent with reported locations of apocrine glands in the adult., SCOPUS: ar.j, info:eu-repo/semantics/published

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We present a case of a ganglion arising from the palmar aspect of the metacarpophalangeal joint., SCOPUS: ar.j, info:eu-repo/semantics/published

A 19-year-old white man presented with an Ewing sarcoma of the left cubitus. A preoperative chemotherapy was administered according to the T9 ROSEN protocol. A wide excision was performed with a 19 cm bone defect, reconstructed in the same operating time by a non vascularized autologous fibular transfer. The postoperative chemotherapy was administered without any major problem. Both surgical and functional evolution are here presented and the osteointegration is evaluated. A discussion of this type of reconstruction is presented evaluating donor site morbidity and possible complications., SCOPUS: ar.j, info:eu-repo/semantics/published

Dermatofibrosarcoma protuberans is a slow-growing but locally aggressive malignant neoplasm of the skin. The preferential locations are on the trunk and proximal extremities but it can occur in the head and neck region in about 15% of the cases. This is a report of such a case and a review of the literature of head and neck cases attempting to analyse the profile of patients and surgical prognosis factors. The recurrence rate is important (20% to 55%) and dependent on tile free tissue margins. Those margins are at least 3 cm in all directions; this is difficult to assess in the head and neck region because of both functional and cosmetic aspects. Distant metastases are rare but related to a long recurrence history. This behaviour gives the impression that prognosis is poorer for dermatofibrosarcoma in the head and neck than within other locations., SCOPUS: ar.j, info:eu-repo/semantics/published

Between 1986 and 1993, 18 patients with complete or impending fractures of the humerus were treated using Hacketall rods in association with semi-liquid methylmetacrylate after excision of the metastatic lesion. Methylmetacrylate was always injected proximally and distally to the curetted bone through drill holes. Fourteen patients had a pathological fracture and four presented with an impending lesion. The mean age at time of surgery was 62 years (range: 42-83). The primary tumour was a breast carcinoma in 10 cases, bronchogenic squamous cell carcinoma in three cases and hypernephroma, multiple myeloma, malignant melanoma, rectal adenocarcinoma and unknown primary tumour in one case each. The left arm was involved in seven cases and the right in 11. All patients experienced immediate relief from the pre-operative pain, although three patients complained of a residual discomfort during motion. In these three cases the residual pain can easily be managed with use of oral non-morphinic drugs. The functional aspect was not evaluated in two patients who died in the early post-operative period as a result of their general condition. In 15 patients, the postoperative range of motion was at least 80% of a normal humerus mobility. One patient encountered motion limitation because of an important lymph oedema. There was no infection, one patient had a temporary radial palsy with a complete restoration after a period of 5 days. No migration of the material was observed during an average follow-up of 9 months (range: 1-24)., SCOPUS: ar.j, info:eu-repo/semantics/published

Surgical closure of leg ulcers has to be preceded by treatment of their etiologies in order to avoid recurrences. Best coverage technique is achieved with the use of a meshed split thickness skin graft, harvested with a dermatoma. Skin graft take depends on the vascular quality of the recipient bed, on the technique used and also on the post-operative care., SCOPUS: ar.j, info:eu-repo/semantics/published

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