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The sign of Leser-Trélat associated with primary lymphoma of the brain.

The sign of Leser-Trélat has been defined as the sudden appearance of seborrheic keratoses in number and/or size in association with an underlying malignancy. There have been only thirty-two reported cases of the sign of Leser-Trélat since it was first described in 1984. This is the first known case of primary lymphoma of the brain associated with this sign. Until Dantzig's review of the literature in 1973, the only tumor type associated with this sign had been adenocarcinomas of the gastrointestinal tract and the genitourinary tract. Since that time there have been only nine cases reported that were not adenocarcinomas; of those, only four cases have been lymphoproliferative malignancies. We wish to emphasize the need for further reports of this sign to better characterize it and to make physicians more aware of the association between this dermatologic sign and an internal malignancy.

Aged↗

[Extension of basal cell epitheliomas. Value of extemporaneous histological examination and bone scintigraphy (author's transl)].

Though basal cell epitheliomas present the advantage of lack of spread into lymph nodes and of having only local activity they can extend considerably both on the surface and in the deep tissues. Because of the difficulty in obtaining complete excision of recurrences the authors are prudent in their attitude and take all possible precautions during treatment of these lesions, including extemporaneous histological examinations and bone scintigraphy which appear to be indispensable.

Bone Neoplasms↗

[Possibilities of reconstruction by de-epithelization (author's transl)].

By definition de-epithelization is a technique by which a graft or a flap is thinned out of the split thickness or full thickness skin layer. The underlying fat tissue is thus covered more or less by corium only. The indications for this procedure are as follows: 1. A subcutaneous defect. 2. Resurfacing defects in a cavity (for example in the pharynx) 3. Subcutaneous implantation of a flap pedicle. The advantages of de-epithelization are: 1. Widening the scope of surgical technique. 2. In many cases second surgery can be avoided. 3. The way from the donor to the recipient site is shorter. 4. A large regional flap can be used not only for reconstruction of the superficial defect but also for subcutaneous filling of a hole. Possible complications are disturbances in the nutrition of the flap and formation of subcutaneous cysts and fistulas which may lead to infections. It is obvious that careful assessment of the indication and precise technique performance are mandatory. Out of 221 flap procedures done in our department since February 1979 we used the de-epithelization technique in 7 cases (3.2%).

Ear Neoplasms↗

[Malignant mesenchymal neoplasms of the oromaxillofacial area. The diagnostic problems].

Oral and maxillo-facial mesenchymal malignant neoplasms are rare. They involve nosologic, diagnostic and therapeutic problems. Clinical cases of soft and bone tissue are reported. They share difficulties in clinical, roentgenographic and histopathological diagnosis and often the disagreement between the clinical evidence and the histopathological report. The rule of the immunohistochemistry for a correct characterization of mesenchymal malignant neoplasms and the necessity for correct and early diagnostic definition in order to plain the treatment are emphasized.

Adolescent↗