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[A histological technique for processing excised skin tumors for continuous tumor margin control].

In the treatment of basal cell carcinoma, squamous cell carcinoma and a number of other tumors of the skin, the recurrence rate is tenfold lower if they are treated with micrographic surgery in comparison with tumors, assessed by parallel histological sections. We demonstrated this in our investigations including over 5900 cases. The rate of local recurrences in under 1%. The difference can be explained by the typical growth pattern of skin tumors. In the following article two simple methods of tissue processing are described, which can be used for formalin-fixed tissues and for fresh tissues.

Basal Cell Carcinoma↗

Magnetic resonance imaging for diagnosing skin tumors.

The depth and three-dimensional morphology of skin tumors were studied with MR imaging. This technology was found to be an effective tool not only for evaluating depth but also for determining the degree of invasion of malignant tumors in the skin and soft tissue. Of the various tumors examined, this method was particularly useful for visualizing malignant melanoma and malignant fibrous histiocytoma. Thus, it is likely that MR imaging has great potential as an auxiliary tool for the diagnosis of other types of malignant skin tumors. By means of three-dimensional displays, tumors were more clearly visualized with respect to their relationship to the surrounding tissue and the three-dimensional state of infiltration, which was particularly useful in deciding on an appropriate resection area prior to surgery. The authors expect further technologic improvements in MR imaging in the future which will serve to increase the benefits obtained in its clinical applications.

Abdominal Neoplasms↗

A scanning electron microscopical study of the two sides of polypropylene mesh (Marlex) and PTFE (Gore Tex) mesh 2 years after complete abdominal wall reconstruction. A study of 15 cases.

The use of biomaterials for the repair of abdominal wall defect is becoming common and safe. It has been 20 years since the senior author developed a method to reconstruct the very large transfixing abdominal wall defect with a combination of two biomaterials (Gore Tex) PTFE as a neo peritoneum and polypropylene superficial to this in order to give rigidity to the abdominal wall) and a superficial flap. An observation at the electron microscopy level of the two sides of the implants' surfaces was performed. At the time of a late abdominal wall surgical revision on 15 patients, the prosthesis fragments have been analyzed at the electron microscopy level. The aim of our study was to analyze the late evolution of the different sides of these prostheses. Our results showed, for the first time in vivo, that there is an impressive stability of the deep side of PTFE ultra structure after implantation, a significant difference of the two sides of PTFE at the ultrastructural level and the creation of an intermediate tissue between the two meshes. In contrast, the polypropylene invariably gave rise to adhesions and colonisation by the surrounding tissues. Findings confirmed that the structure and porosity of a biomaterial play a key role in the appearance of adhesions and their consistency.

Abdominal Wall↗

Reconstruction of abdominal wall by whole thigh flap.

Closure of extensive abdominal wall defects can be a very challenging task as there are no known large local or free vascularized flaps available that could cover the entire abdomen. Tensor fascia latae (TFL) has been widely used for abdominal wall reconstruction [Hill HL, Nahai F, Vasocnez LO. The tensor fascia lata myocutaneous free flap. Plast Reconstr Surg 1978;61:517-22]. However, the dimensions of the standard TFL flap limit its use in cases of large full thickness abdominal wall defects. Therefore, we have used an ingenious technique of raising the entire thigh skin as a fasciocutaneous flap (whole thigh flap) based on the concept of fusion of angiosomal territories, to reconstruct such a defect following excision of a large abdominal wall tumour.

Abdominal Wall↗

Platelet-derived growth factor receptor (PDGFR): a target for anticancer therapeutics.

Platelet-derived growth factors (PDGFs) and their tyrosine kinase receptors (PDGFRs) have been implicated in the pathogenesis of a number of tumor types and play an important role in angiogenesis. Tumor growth can be promoted by PDGF via autocrine stimulation of malignant cells, by overexpression or overactivation of PDGFRs, or by stimulation of angiogenesis within the tumor. These mechanisms could provide possible therapeutic targets. PDGFR blockade may also lower the interstitial fluid pressure within solid tumors and enhance drug delivery. Here we discuss the possible therapeutic roles of PDGFR antagonists in the treatment of cancer, alone and in combination with chemotherapy or other targeted agents. Extensive experimental data highlight the potential therapeutic advantage of targeting PDGFR. However, recent clinical data suggest that antagonism of this growth factor is associated with fluid accumulation that could obscure any clinical benefit. Further clinical research is required to optimise inhibition of this cytokine-receptor system.

Angiogenesis Inhibitors↗

Soft tissue sarcoma of the upper extremity.

Soft tissue sarcomas of the upper extremities are rare and hand surgeons typically encounter only one or two undiagnosed soft tissue sarcomas during their careers. It is incumbent on the physician to review repeatedly the characteristics of these tumors and remain suspicious, because these lesions typically are misdiagnosed and treatment is delayed. The most common soft tissue sarcomas of the upper extremity are the epithelioid sarcoma, synovial cell sarcoma, and malignant fibrous histiocytoma. Limb salvage surgery is the treatment of choice for soft tissue sarcomas to preserve upper extremity function. Following wide tumor resection, adjuvant therapies such as chemotherapy, external beam radiation therapy, and brachytherapy may lessen local recurrence rates, but their effect on overall survival remains unclear.

Arm↗

Malignant cutaneous tumors of the scalp: a study of demographic characteristics and histologic distributions of 398 Taiwanese patients.

BACKGROUND: The scalp is a unique anatomic region, in which pilosebaceous follicles are concentrated. OBJECTIVE: We sought to investigate demographic characteristics and histologic distributions of malignant scalp tumors. METHODS: Primary and metastatic scalp malignancies diagnosed histopathologically between 1983 and 2003 were reviewed. Age at diagnosis, sex, and histologic types were analyzed. RESULTS: A total of 398 Taiwanese patients (200 males, 198 females) were selected. Age at diagnosis ranged from 3 to 103 years. Most malignant scalp tumors (69.8%) occurred in those 50 years or older. Basal (41.2%) and squamous (16.6%) cell carcinomas were the most common histologic types. Surprisingly, metastatic tumors (12.8%) came in third, in which lung cancers were the most frequent primary tumor in both male and female patients. LIMITATIONS: In our series, the case number of metastatic scalp malignancies was underestimated because not all patients with metastatic scalp tumors received a scalp skin biopsy. CONCLUSION: Because a wide spectrum of primary and metastatic malignancies can occur on the scalp, scalp inspection should be included in general screening for either skin or internal cancers.

Adolescent↗

Nonmelanoma skin cancer.

Nonmelanoma skin cancers encompass a vast array of malignancies: adventitial, vascular, neuroendocrine, hematologic, adnexal, and epithelial. The skin is also a major site for metastasis of internal disease. With an understanding of the frequency of presentation, clinical distribution, and appearance, the clinician is able to provide an accurate diagnosis for most lesions. Because there are so many nonmelanoma skin cancers, the focus here is on those with a high frequency or significant morbidity. The treatment of nonmelanoma skin cancer is constantly evolving; therefore, emphasis is on diagnosis.

Adenocarcinoma, Sebaceous↗

Vaccines and vaccinations. The strategic issues.

The rapid proliferation of companion animal vaccines, advances in diagnostic and vaccine technology, and concerns over vaccine safety are clearly among the most important issues practicing veterinarians face as we enter the 21st century. Although many would argue that these are already issues, the future promises to be especially challenging as the vaccines we currently use and the protocols we recommend undergo unprecedented review.

Animals↗

Recent advances in the treatment of vaccine-associated sarcomas.

This article reviews the background information about vaccine-associated sarcomas followed by diagnostic procedures essential to understand how to determine the extent of the primary and metastatic tumor as well as to understand the general health of the patient. It also addresses the importance of understanding the nonmedical needs of the client who is faced with this perplexing problem.

Animals↗

Recognition and management of unusual cutaneous tumors.

This article has briefly outlined some of the more unusual cutaneous neoplasms that may be encountered in a dermatologic practice. Although rare, they must always be kept in mind and included in the differential diagnosis. Because of the highly aggressive nature of many of these tumors, delay in diagnosis and treatment could be fatal. A high level of suspicion is necessary for the correct prebiopsy diagnosis.

Carcinoma, Merkel Cell↗