A rare case of epidermoid carcinoma of the breast

A case of a 76-year-old woman who seemed to suffer from Paget's disease of the breast, is reported. The patient was submitted to surgical of the breast, is reported. The patient was submitted to surgical treatment of the lesion and histological examination of the specimen showed a rare case of epidermoid carcinoma of the breast.     

Oral lichen planus: parameters affecting accurate diagnosis and effective management

Oral lichen planus is one of the most common mucosal diseases that require management by the dental practitioner. The gingival presentation of this disease can be particularly problematic. Accurate diagnosis is of paramount importance for effective management, and tissue specimens are often required to distinguish this disease from other vesiculo-ulcerative diseases. The lichen planus patient can generally be managed with topical steroids. The use of antibiotics may be an important adjunctive consideration for patients with a concurrent significant periodontal condition. The possibility of carcinoma arising in lichen planus lesions is addressed. The learning objective of this article is to define specific parameters that contribute to the definitive diagnosis in order to promote objective, rather than empirical, treatment and to delineate specific points to address in patient education.     

Isolated lichen planus of the lip

Oral lichen planus (LP) is a relatively common disorder of unknown aetiology. Oral LP occurs most often on the buccal mucosa, but the gingivae, tongue, floor of the mouth, retromalar pads and lips may also be affected. Usually, patients have multiple sites of involvement. We report a 44-year-old patient with a 3-year history of isolated swelling of the lower lip, erosions and crusting. Histology of a biopsy from the lip revealed features of LP. Oral treatment with acitretin and low-dose steroid led to complete resolution of the lesions within 10 weeks. This is the first well-documented case of isolated LP of the lip. Diagnostic difficulties and differential diagnosis are reviewed.     

A new concept for the pathogenesis and treatment strategies for oral lichen planus

Mounting evidence points out to the immunologic basis of lichen planus (LP). Tumour necrosis factor (TNF-alpha) is a cytokine with multiple biologic activities, some of which may be relevant to the pathogenesis of LP. The present study was thus conducted to assess its production by peripheral blood leucocytes in patients with active lesions of oral lichen planus (OLP) compared to age matched healthy control volunteers. For the assessment, the quantitative immunometric sandwich technique was employed. Significantly greater amounts of TNF-alpha were found in serum samples of OLP patients compared to healthy individuals, suggesting a possible association between this cytokine and the pathogenesis of OLP and pointing out to the primary initiative role played by altered keratinocytes. This pointed out the beneficial effect of anti-TNF drugs in the management of OLP.     

Therapeutic management of oral lichen planus. Presentation of a representative case

The authors describe the more efficient therapeutical plans of oral lichen planus, reducing the tendency to relapse.     

Treatment of lichen planus and lichen nitidus with itraconazole: reports of six cases

Six patients with either lichen planus or lichen nitidus were treated with itraconazole. Two of four patients with lichen planus experienced complete clearing, and the remainder showed a partial response. Itraconazole, like griseofulvin, may prove to be an alternative treatment worth considering in patients with lichen planus or lichen nitidus who have failed other therapies.     

Atlantoaxial instability complicating radiation therapy for recurrent nasopharyngeal carcinoma. A case report

STUDY DESIGN: A case report of a patient in whom atlantoaxial instability developed secondary to repeat radiation therapy for recurrent nasopharyngeal carcinoma. OBJECTIVES: To illustrate a dramatic and previously unreported complication of local radiation to the posterior nasopharynx. SUMMARY OF BACKGROUND DATA: Nasopharyngeal carcinoma is an unusual tumor that usually is managed with local, external-beam radiation. It is not thought to involve the cervical spine directly, although local invasion of the skull base is common. METHODS: A review of the medical records and radiographs of the only patient known to develop this complication of radiation used to manage nasopharyngeal carcinoma. RESULTS: Atlantoaxial instability developed in a patient as a result of repeat radiation for a locally recurrent tumor. The instability was associated with intrusion of the anterior arch of C1 into the posterior nasopharynx and was managed successfully with a posterior stabilization using transarticular screws and supplemental wiring. CONCLUSIONS: Patients who have undergone local irradiation for nasopharyngeal carcinoma may be at risk for developing atlantoaxial instability.     

A case of small cell carcinoma of the lung associated with hypertrophic pulmonary osteoarthropathy

AIM: To investigate the mechanisms of anti-inflammatory effect of matrine (Mat), its effects on mouse splenocyte proliferation, and release of interleukin-1 (IL-1) and interleukin-6 (IL-6) from mouse peritoneal macrophages. METHODS: Splenocyte proliferation was assayed by [3H] TdR incorporation. IL-1 and IL-6 activities were measured by thymocyte proliferation assay and B9 cell proliferation MTT colorimetric method, respectively. RESULTS: Mat (125-500 mg.L-1) obviously inhibited concanavalin A (Con A, 5 mg.L-1)- and lipopolysaccarides (LPS, 10 mg.L-1)-induced splenocyte proliferation and LPS-induced release of IL-1 and IL-6 from mouse peritoneal macrophages. CONCLUSION: Mat inhibited splenocyte proliferation and release of IL-1 and IL-6 in vitro.     

Meeting the educational needs of patients with oral lichen planus

Lichen planus is a chronic oral disorder that is often painful and annoying. The patients have been described as usually over 50 years old, with a high educational level, anxious and high-strung. In previous research studies, these patients have reported unusual and highly stressful life events. Because dentists are in a position to advise their patients about chronic illness, this study was designed to (1) determine what information was given to lichen planus patients by their dentists; (2) determine what questions the patients asked their dentists; and (3) assess what educational materials would be helpful for this group of patients. A survey was sent to 151 biopsy-confirmed lichen planus patients, with a response rate of 55 percent. The results indicated that the patients were concerned about the possibility of malignancy and of contagion, and that they were frustrated by the lack of available patient education.     

A case of epidermoid tumor inside the Meckel's cave

An epidermoid tumor inside the Meckel's cave is rare. The symptoms caused by this tumor include trigeminal neuralgia, facial hypesthesia and paresis of the 3rd, 4th and 6th nerves. A case of epidermoid tumor inside Meckel's cave was presented. A 54-year-old female who had complained of 3rd nerve palsy with right facial hypesthesia since 3 years before was referred to our clinic. Magnetic resonance imaging (MRI) showed the tumor at Meckel's cave. The tumor removal was performed using the orbito-zygomatic approach. To avoid injury of the internal carotid artery and nerves inside the cavernous sinus, removal of the tumor inside the capsule was carried out leaving the capsule. Postoperatively, the tumor removal was confirmed by MRI and improvement of the 3rd and the 5th nerve palsy was obtained three months after surgery. This case suggests that the capsule of the tumor inside the Meckel's cave should be allowed to remain to avoid injury of the adjacent 4th, 5th and 6th nerves and of the internal carotid artery.     

A clinico-laboratory validation of the combined therapy of lichen ruber planus of the oral mucosa

Fifty-two patients with lichen planus were examined over the course of disease using clinical, microbiological, and histological methods. Treatment protocols aimed at normalization of microbiocenosis have been developed, based on the detected microbiological and histological changes.     

A case of difficult diagnosis of primary tubal carcinoma

Primary Fallopian tube cancer is a very un common cancer that appears between 40 and 65 years old, highly aggressive associate to a poor survival. In this work the authors explain a clinic case of primary Fallopian tube cancer in a woman of 57 years old operated for endometrial cancer. The authors display that the definitive diagnosis was possible only after the histological examination of the operating piece.     

Isolated lichen planus of the lip successfully treated with chloroquine phosphate

Solitary lesions of lichen planus (LP) are often confused with other inflammatory or malignant epithelial lesions. We describe a 51-year-old woman who had had an LP of the lower lip for 11 years. She had undergone several oral and topical therapies with little improvement. The patient had an excellent response to chloroquine phosphate within 3 months. This report represents the third case of LP exclusively localized on the lower lip.     

Psychologic factors and oral lichen planus. A psychometric evaluation of 100 cases

OBJECTIVE: The purpose of this study was to analyze the importance of psychologic factors in patients with oral lichen planus, and attempts were made to identify possible personality features characteristic of patients with oral lichen planus. STUDY DESIGN: The study involved 100 patients with oral lichen planus (group 1) and 50 control subjects (group 2). We applied the following psychometric tests to both groups: Spielberger State-Trait Anxiety Inventory, Cattell Personality Questionnaire 16PF, Hassanyeh Rating of Anxiety-Depression-Vulnerability, Beck Depression Inventory, Raskin Depression Screen, and Covi Anxiety Screen. RESULTS: The patients with oral lichen planus were found to exhibit greater anxiety, as reflected by statistically significant scores with the anxiety tests that were used (Spielberger State-Trait Anxiety Inventory, Cattell Personality Questionnaire 16PF, Hassanyeh Rating of Anxiety-Depression-Vulnerability, and Covi Anxiety Screen). The patients with oral lichen planus likewise exhibited greater depression than the controls in all 3 depression tests applied (Beck Depression Inventory, Hassanyeh Rating of Anxiety-Depression-Vulnerability, and Raskin Depression Screen) and were more vulnerable to psychic disorders on the basis of the PD subscales (vulnerability) of the Hassanyeh questionnaire. Three features (conformity to the group, astuteness, and rebelliousness) defined the personalities of our patients with oral lichen planus, according to the Cattell 16PF questionnaire. Finally, those patients with erosive lichen planus exhibited higher depression scores than patients with nonerosive lichen planus. CONCLUSIONS: Despite the higher anxiety scores observed in patients with oral lichen planus, it was not established that the observed psychologic alterations constitute a direct etiologic factor of oral lichen planus; nor was it established that such alterations are a consequence of oral lichen planus and its lesions.