RESUMO
BACKGROUND: In 1882, the German pathologist Friedrich Daniel von Recklinghausen described a series of patients with a combination of cutaneous lesions and tumours of the peripheral and central nervous system. Succeeding this paper, all of the patients with similar symptoms were given the diagnosis "von Recklinghausen disease". In the 20th century, a distinction was made between Neurofibromatosis type 1 (NF1) and Neurofibromatosis type 2 (NF2) with the help of molecular testing. CASE REPORT: We are presenting the results from multiple surgical esthetic and reconstructive surgical procedures performed on a female patient with severe congenital neurofibromatosis during 15 years (2000-2015). The external appearance of our patient was not reflected in the general public's beauty standards. Convinced that she was unusual and unaccepted by the society, she gathered all of the strength and became our patient at 15 years of age. CONCLUSION: Transforming the patient's life in the next fifteen years improved her overall health and her life quality.
RESUMO
BACKGROUND: Lipomas are the most frequent soft -tissue tumors arising from adipose tissue. Traditionally, open surgery is a mainstay of their treatment. Recently, new treatment modalities emerge in order to decrease morbidity, to increase satisfaction rate in patents, but not to raise recurrence risk at the same time. AIM: The aim of this article is to present our experience with liposuction assisted lipoma removal in terms of efficacy, complications, risk of recurrence and patient satisfaction. METHODS: The study was prospective in which treated lipomas with vacuum suction were analyzed. Preoperative diagnosis comprised clinical exam and additional diagnostic tools as to rule out malignancy. Subcutaneous lipomas with diameter of at least 5 cm were taken into account. Tumescent liposuction technique with modification was used. RESULTS: Lipoma's size, distribution and demographics are given. Total removal with affordable rate of complication was achieved in each case. No recurrences in 12 months follow-up period were seen. Satisfaction rate in patients was high. CONCLUSION: Liposuction assisted lipoma removal is a good alternative to open approach lipectomy and we would recommend its use in selected cases where, it might be more advantageous. However, prospective randomized controlled studies are needed in order to estimate its accurate clinical value.
RESUMO
Malignant skin melanoma is a tumor deriving from transformed skin melanocytes as a result of complex interactions between genetic and environmental factors. This melanoma has a potential to metastasize early and very often it is resistant to the existing modalities of the systemic therapy. As in any other neoplasms, certain types of melanoma may skip certain stages of progression. The progression from one stage to another is accompanied by specific biological changes. Several key changes in the melanoma tumorogenesis influence the regulation of the cell proliferation and vitality, including the RAS-RAF-ERK, PI3K-AKT, and p16INK4/CDK4/RB pathways. A key role in the dissreguarity of the RAS-RAF-ERK (MAPK) pathway in the malignant melanoma development have been demonstrated by many studies. To date, the molecular genetic alterations during melanoma development have been partially known. In the pathogenesis of the malignant melanoma, there are mutations of various genes such as NRAS, BRAF, and PTEN and mutations and deletions of CDKN2A. In the past years, great advance has been made in the insights of the molecular aspects of the melanoma pathogenesis. However, this field yet poses a challenge to discover new details about the melanoma molecular characteristics. The research results are focused towards the improvement of the melanoma patients prognosis by introducing personalized targeted therapy.