Merkel cell carcinoma of the eyelid

The different methods that are available for the assessment and quantification of "brittle nails" and for the evaluation of various therapeutical approaches are compared. At this time, measurement of the swelling properties is the best documented and most reliable method for studying the treatment of brittle nails. Reliable qualitative data can also be obtained by scanning electron microscopy. Measurement of the transonychial water loss and assessment of thickness and density of nails by ultrasound have also been used successfully, but the methodology still has to be improved and the reproducibility, confirmed.     

Primary squamous cell carcinoma of the endometrium report of a case and review of the literature

A case of primary pure squamous cell carcinoma of the endometrium in a 50-year-old woman is reported. There was deep myometrial and para-cervical invasion. There is no evidence of metastases 2 years after total hysterectomy and salpingo-oophorectomy and radiation therapy. The patient is probably the youngest suffering from such a tumor. A detailed review of the literature has been carried out.     

Spinal extramedullary hematopoiesis secondary to hepatocellular carcinoma. Case report and literature review

Herpes simplex virus-1 (HSV-1) infects epidermal cells where it replicates and spreads from cell to cell. While some of the viral factors responsible for cell-to-cell spread are known, the host cell molecules and structures which are utilized by HSV-1 during spread are not well studied. Here we report that a laminin substrate reduced the ability of HSV-1 to spread from cell to cell in cultures of a human keratinocyte cell line (HaCaT). Laminin did not reduce spread of the virus by decreasing the viral replication rate. However, laminin did stimulate the formation of tight junctions between HaCaT cells, suggesting that tight junctions can affect cell-to-cell spread of HSV-1. Since laminin is an abundant component of the basement membrane in vivo, culturing cells on laminin may provide an assay which more accurately reflects the rate and mechanism of HSV-1 cell-to-cell spread in vivo.     

Meningeal carcinomatosis. Case report and review of the literature

Cadaver knee joints were mounted so that life-like forces of weight-bearing were simulated. The patello-femoral contact areas were defined under load throughout the range of movement by the dye method. During movement from extension to 90 degrees of flexion a band of contact sweeps across the patella from inferior to superior pole, but the odd facet makes no contact. At about 135 degrees of flexion separate medial and lateral contact areas form, the medial one limited to the odd facet. From extension to 90 degrees of flexion the patella holds the quadriceps tendon away from the femur, but in further degrees of flexion an extensive "tendo-femoral" contact area forms. Between 90 degrees and 135 degrees of flexion the patella rotates and the ridge between the medial and odd facets engages the femoral condyle. The odd facet is shown to be a habitual non-contact area and the ridge to be subject to high load, observations which correlate with cartilage lesions described in Part 2 of the paper.     

Cytomegalovirus prostatitis. Case report and review of the literature

We report the case of a patient undergoing chemotherapy for multiple myeloma discovered to have cytomegalovirus prostatitis. The findings of a hypoechoic prostatic lesion on ultrasound and a slightly elevated prostatic specific antigen of 4.6 ng/ml prompted a prostate biopsy. Cytopathologic examination and immunohistochemical staining demonstrated cytomegalovirus within the prostate. This virus is a common pathogen in the immunosuppressed patient, but its presence in the male genital tract is relatively rare. No previous reports of biopsy-proven cytomegalovirus prostatitis appear in the literature. The relationship of cytomegalovirus to the prostate is discussed in detail.     

Neuroendocrine (Merkel cell) carcinoma of the oral mucosa: report of a case with immunohistochemical study and review of the literature

Merkel cell carcinoma (Mcc) is an uncommon and aggressive tumour with neuroendocrine features that occur predominantly in the head and neck region. The rarity of this tumour, especially when it arises in the oral mucosa, makes both early identification and standardisation of treatment difficult, particularly as regards complementary treatment. The availability of monoclonal antibodies with restricted specificity for some antigens thought to be related to neuroendocrine carcinomas, such as Merkel cell carcinoma, and ultrastructural studies offer some new leads to investigation. This has allowed, a greater number of these tumours to be discovered, thereby increasing the chances of effective management. A case of Mcc of the floor of the mouth is reported, together with the results of cytokeratin, neuron specific enolase and chromogranin immunohistochemistry.     

Spontaneous otogenic pneumocephalus. Case report and review of the literature

Pneumocephalus is commonly seen in clinical neurosurgical practice. Typical causes include trauma, tumor, and infection. Pneumocephalus may also occur iatrogenically at the time of intracranial surgery; it is not pathological and may be seen routinely on postoperative neuroimaging. Pneumocephalus is rarely encountered in the absence of the aforementioned entities. The authors report on an elderly woman in whom spontaneous intraventricular pneumocephalus occurred because of a congenital defect in the left tegmen tympani. Eustachian tube closure and middle ear exclusion were used to obliterate the fistulous connection. This case illustrates both an unusual cause and a unique treatment for spontaneous otogenic pneumocephalus.     

Merkel cell tumor of the head and neck. Five new cases with literature review

Merkel cell carcinoma (MCC) of the skin is an uncommon, but highly aggressive neoplasm with a marked propensity for local and distant metastasis. Despite the fact that more than half of the 600 cases of MCC reported in the literature involved primary sites in the head and neck, MCC has rarely been discussed in otolaryngology publications. We present five new cases of MCC of the head and neck and summarize 89 additional cases from the literature in which detailed treatment and survival data were given. Our findings again emphasize the difficulty in making the initial histopathologic diagnosis of MCC and demonstrate the necessity of early diagnosis and multimodality treatment.     

Squamous cell carcinoma of the prostate: case report and review of literature

Carcinoma of the prostate, that is adenocarcinoma, is one of the most common malignancies in the male with an estimated incidence for 1991 of 122,000 new cases. On the other hand, squamous cell carcinoma of the prostate, with a median incidence of .5%-1% of all prostatic malignancies, has a similar clinical presentation but differs in treatment response and prognosis. We herein present one case of this histological pattern and review the literature pertaining to it.     

Unusual metastasis of renal cell carcinoma. A case report with review of the literature

BACKGROUND: The occurrence of metastasis of renal cell carcinomas in the head and neck region is extremely rare. Metastasis in the larynx, hypopharynx, and the nasal sinuses has been reported. We report here about a 55-year-old female with metastasis in the soft palate and tonsil, which occurred 10 years following tumor nephrectomy. RESULTS AND CONCLUSIONS: The incidence of metastasis in renal cell carcinomas can be observed even many years following initial curative treatment of the primary tumor. Although rare in the region of the head and neck, they can often be mistaken for benign tumors such as hemangiomas or inflammatory tissue. The treatment of choice is radical surgical resection.     

Hereditary persistence of alpha-fetoprotein. Case report and review of the literature

BACKGROUND: The issue of performing simultaneous pulmonary resection and cardiac surgery in patients with coexisting lung carcinoma and ischaemic heart disease remains controversial. We report our experience and review the literature. METHODS: Thirteen patients (male ten, female three; mean age 65 years) underwent simultaneous cardiac surgery and pulmonary resection. Lung pathology consisted of primary lung carcinoma (n = 10), benign disease (n = 2) and carcinoid (n = 1). Lung resections included pneumonectomy (n = 3), lobectomy (n = 4), segmentectomy (n = 1) and local excision (n = 5). Cardiac procedures consisted of coronary artery bypass grafting (CABG) in 11, aortic valve replacement in one and mitral valve repair with CABG in one patient. In all but one case the lung resection was performed prior to heparinization and cardiopulmonary bypass (CPB). In two patients, with suitable coronary anatomy, myocardial revascularization without CPB was performed to reduce morbidity. RESULTS: There was no hospital mortality. Postoperative blood loss and ventilation requirements were reduced in the patients who were operated on without CPB. Prolonged ventilatory support was required in two cases. All patients with benign pathology are alive. In the lung cancer group there have been five late deaths: disseminated metastatic disease (n = 3), anticoagulant related haemorrhage (n = 1) and broncho-pleural fistula (n = 1). Of the remaining five patients four are alive and disease free 7-23 months post-operatively; one patient has recurrent disease 40 months post-operatively. CONCLUSIONS: Simultaneous pulmonary resection and cardiac surgery is associated with acceptable operative morbidity and mortality. In patients with lung carcinoma long-term survival was determined by tumour stage. The avoidance of CPB may be advantageous by decreasing blood loss and ventilation requirements.     

Pitfalls of bungee jumping. Case report and review of the literature

A case of cervical spine injury related to bungee jumping is presented. Surgical intervention resulted in resolution of the patient's quadriparesis. The incidence of serious injury connected with this pastime is not inconsiderable, and it is recommended that safer jumping practices be followed. Inspection of bungee equipment and certification of instructors is now voluntary but should be mandated. Jumping heights should be limited and the use of air cushions encouraged.     

Cytogenetics of Askin's tumour. Case report and review of the literature

The eleventh cytogenetically analyzed Askin's tumour, diagnosed in a two-year-old girl, is reported. Chromosomal analysis revealed a pseudodiploid karyotype of tumour cells with translocations of t(11;22)(q24;q12) and der(4)t(2;4)(q24;q35). The observed t(11;22)(q24;q12) is not only a unique characteristic of all cytogenetically analyzed Askin's tumours but it also occurs in 92-100% of peripheral neuroepithelioma and of Ewing's sarcoma, irrespective of its osseous or extraosseous localization. This genetical similarity further supports a nosological concept according to which Askin's tumour, Ewing's sarcoma and peripheral neuroepithelioma represent phenotypic variations of the same tumour, namely the peripheral primitive neuroectodermal tumour.     

Primary carcinoma of the ureteral stump: a case report and a review of the literature

A case is reported of primary carcinoma of the ureteral stump with metastases following nephrectomy for benign disease. The occurrence of disseminated tumor at the time of diagnosis is uncommon, having been reported in only 3 previous cases. The autopsy findings are discussed and the literature is reviewed.     

Gallbladder volvulus with gangrene. Case report and review of the literature

A total of 126 cases of primary adenocarcinoma of distal (antrum and/or adjacent body) stomach were reviewed. These cases were collected from the histopathology laboratory of Asir Central Hospital, Southwestern Saudi Arabia over an 8 year period (1987-94). Only gastrectomy specimens with non-neoplastic antral mucosa available for histological examination were included. Of 126 cases, 85 (67.5%) were of the intestinal type and 41 (32.5%) were of the diffuse type. Histological examination of the non-neoplastic antral mucosa showed: gastritis in 100% of these cases; Helicobacter pylori in 103/126 cases (81.8%); multifocal atrophic gastritis (MAG) in 53/126 cases (42.1%); intestinal metaplasia (IM) in 62/126 (49.2%); and type III intestinal metaplasia in 30/62 cases (47.7%). None of these non-neoplastic changes of antral mucosa was significantly different when the prevalence of these changes in intestinal and diffuse type gastric adenocarcinoma were compared using the chi 2 test. The prevalence of these non-neoplastic lesions were calculated in a 126 dyspeptic age- and sex-matched control patients and were as follows: H. pylori 91%; gastritis 78%; MAG 7.4%; IM 19% and type III IM 1.6%. The prevalence of H. pylori bacilli and gastritis was not significantly different between the cancer patients and the controls. The prevalence of MAG, IM and type III IM was significantly higher among cancer patients compared with the control group.