Assuntos
Rinofima , Humanos , Eletrocirurgia/métodos , Ondas de Rádio , Rinofima/cirurgia , Masculino , IdosoRESUMO
Merkel cell carcinoma is an aggressive neuroendocrine tumor occasionally demonstrating aberrant differentiation to other epithelial and nonepithelial cell lines. We describe a case of Merkel cell carcinoma displaying unique patterns of differentiation in the primary focus and brain metastasis. The skin primary was almost uniformly small cell carcinoma positive for epithelial and neuroendocrine markers, with a few glial fibrillary acidic protein- and cytokeratin 20-positive cells. The neoplasm contained giant cells immunoreactive for neurofilament and negative for epithelial markers. The neck lymph node metastasis was a typical neuroendocrine Merkel cell carcinoma positive for cytokeratin 20. A solitary dural intracranial metastasis displayed features of aggressive ganglioneuroblastoma, expressing many neuronal antigens with no evidence of glial or epithelial differentiation. After total gross resection, the tumor recurred within 3 months, and the patient developed skeletal metastases and died 6 months after craniotomy.
Assuntos
Neoplasias Ósseas/secundário , Neoplasias Encefálicas/secundário , Carcinoma de Célula de Merkel/secundário , Carcinoma de Células Pequenas/secundário , Ganglioneuroblastoma/secundário , Neoplasias Cutâneas/patologia , Idoso , Biomarcadores Tumorais/metabolismo , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Neoplasias Encefálicas/cirurgia , Carcinoma de Célula de Merkel/cirurgia , Carcinoma de Células Pequenas/cirurgia , Transformação Celular Neoplásica , Evolução Fatal , Ganglioneuroblastoma/cirurgia , Células Gigantes/metabolismo , Proteína Glial Fibrilar Ácida/metabolismo , Humanos , Queratina-20/metabolismo , Linfonodos/patologia , Metástase Linfática , Masculino , Recidiva Local de Neoplasia , Proteínas de Neurofilamentos/metabolismo , Neoplasias Cutâneas/cirurgiaRESUMO
Intra-articular fractures of the proximal interphalangeal joint remain a treatment challenge for hand specialists. The purpose of this investigation was to review the results of 12 patients, 6 men and 6 women (average age, 21 y), who were treated using the nail hooks and elastic bands external dynamic traction technique for their intra-articular proximal interphalangeal joint fractures. Of the total 12 fractures, 6 involved the proximal phalanx and 6 involved the middle phalanx. The final arc of motion at the proximal interphalangeal joint averaged 89 degrees (range, 25 to 111 degrees). At the conclusion of treatment: 1 patient developed a radial deviation and 1 developed a slight ulnar deviation. All patients were able to return to their preinjury level of functioning. Nail hooks and elastic bands external dynamic traction provides an effective treatment for intra-articular proximal interphalangeal joint fractures. It is an inexpensive, easily applied, nonoperative method of treatment.