Acquired Dermal Melanocytosis Associated With Diffuse Systemic Sclerosis in a White Patient.

We report a case of a 65-year-old man who developed an asymptomatic bluish spot that affected the flank and left lumbar region with the onset 10 years prior. He had a history of diffuse systemic sclerosis with anti-Scl-70-positive antibodies. The appearance of the skin lesion coincided with the onset of his disease. The skin biopsy was consistent with the diagnosis of acquired dermal melanocytosis. The relationship between the appearance of acquired pigmented macules and spots and systemic sclerosis has been known for years, although it is an infrequent finding.

Bier anaemic spots, cyanosis with urticaria-like eruption (BASCULE) syndrome on trunk and upper limbs.

Bier anaemic spots, cyanosis with urticaria-like eruption syndrome is a recently described benign vasomotor dermatosis that mainly affects the lower limbs. Histopathology shows multiple dilated dermal vessels with scattered eosinophils. We report a case on the trunk and upper limbs.

Facial follicular cysts: a case of lichen planus follicularis tumidus?

Lichen planus follicularis tumidus (LPFT) represents an uncommon variety of lichen planus (LP). Clinically, it presents with prominent purplish lesions or white-pigmented yellowish cysts and comedones. Histopathologically, it is similar to lichen planopilaris, and it is additionally characterized by follicles and cysts surrounded by a lichenoid lymphocytic infiltrate. The most common location is the retroauricular region, and it may be associated with other variants of LP. Herein, we describe the case of a 50-year-old woman with a history of lower limb hypertrophic LP who subsequently presented with multiple pink, tumid, pruritic plaques with white-yellow cysts and comedones extensively affecting the bilateral face. Histopathologic examination revealed a lichenoid infiltrate surrounding the follicles and cysts. We diagnosed LPFT and began treatment with topical corticosteroids, antihistamines, systemic corticosteroids and oral acitretin without improvement. Subsequently, the patient had an acceptable response to cyclosporine at doses of 5 mg/kg/day with remission of itching and tumidity but with residual cysts and comedones remaining. To date, the literature contains only 16 cases of LPFT. To our knowledge, this is the most severe case and is the only one with cessation of disease activity in response to cyclosporine.

[Testicular metastasis as first clinical expression of unknown origin malignant melanoma]. / Metástasis testicular como primera manifestación clínica de melanoma maligno de origen desconocido.

OBJECTIVE: To report a rare process and to stimulate clinicians and pathologists to have this possibility present in their diagnoses. METHODS: We report the case of an adult male with pain and swelling in the left inguinal region and increased volume of the homolateral testicle. CONCLUSIONS: It is appropriate to bear in mind the possibility of testicular metastasis of a primary unknown tumor in adult males since metastatic affectation can constitute the first manifestation of the disease.

Differences in polypropylene shrinkage depending on mesh position in an experimental study.

BACKGROUND: Polypropylene (PP) mesh is one of the most frequent materials used in hernia repair. We have experimentally evaluated the shrinkage of PP mesh depending on the place of implantation. METHODS: In 15 New Zealand rabbits a muscular defect measuring 3 x 3 cm was created in both pararectal sides of the abdominal wall. The defect was repaired using a PP mesh measuring 5 x 3.5 cm that was placed in the right side in the sublay location and in the left side in the onlay location. Five animals were killed on the 30th, 60th, and 90th postoperative days. Macroscopic measurement and microscopic study of the prosthesis-host tissue interfaces were performed. RESULTS: One rabbit was killed because of severe infection in the onlay mesh. Another 2 infections were tolerated in the onlay mesh side. All the prostheses were integrated in the host tissue at death. In the macroscopic evaluation the mesh areas were reduced by 25.92% on the 30th day, by 28.67% on the 60th day, and by 29.02% on the 90th day. The mesh shrinkage was greater in the onlay group than in the sublay group at the 3 time intervals. More inflammatory leukocyte and mononuclear responses also were seen in the onlay group. CONCLUSIONS: These observations support the theory of PP mesh shrinkage as a consequence of the incorporation of the biomaterial to the scarring tissue. This shrinkage is significantly more intense if the meshes are placed in the onlay position.

Metástasis testicular como primera manifestación clínica de melanoma maligno de origen desconocido / Testicular metastasis as first clinical expression of unknown origin malignant melanoma

OBJETIVO: Aportar información sobre un raro proceso y alentar a clínicos y patólogos para que tengan presente en sus diagnósticos esa posibilidad.MÉTODOS: Presentamos el caso de un varón adulto con dolor y tumefacción en región inguinal izquierda y aumento de volumen del testículo homolateral.CONCLUSIONES: Es conveniente en varones adultos tener presente la posibilidad de metástasis testicular de un tumor primario oculto ya que la afectación metastásica puede constituir la primera manifestación de la enfermedad(AU)

OBJECTIVE: To report a rare process and to stimulate clinicians and pathologists to have this possibility present in their diagnoses.METHODS: We report the case of an adult male with pain and swelling in the left inguinal region and increased volume of the homolateral testicle.CONCLUSION: It is appropriate to bear in mind the possibility of testicular metastasis of a primary unknown tumor in adult males since metastatic affectation can constitute the first manifestation of the disease(AU)

Hiperplasia adenomatoide de glándula salival mucosa. Presentación de un caso / Adenomatoid hyperplasia of mucous salivary glands. A case report

Introduccion: La hiperplasia adenomatoide de glándulasalival mucosa es una rara entidad clinico patológica descritapor Giansanti et al en 1971. Material y métodos: El caso quenosotros presentamos corresponde a una paciente de 47 añosde edad con cuadros repetitivos de dolor a nivel sublingual.Resultados: Microscópicamente las secciones muestrannumerosos lóbulos de glándula salival con acinos mucosos deapariencia normal en un estroma de tejido conectivo fibroso.Conclusiones: La hiperplasia adenomatoide de glándula salivalmucosa no puede ser diferenciada clínicamente de neoplasiasde glándula salival, siendo necesario que la lesión seaexcindida y sometida a examen microscópico

Background: Adenomatoid hyperplasia of the mucoussalivary glands is an uncommon clinicopathologic entitydescribed by Giansanti et al in 1971. Methods: The reportedcase corresponds to a 47 year-old patient complaining ofsublingual pain repeated crises. Results: Microscopic sectionsshowed numerous salivary gland lobules with normalappearing mucinous acini within a fibrous connective tissuestroma. Conclusions: Adenomatoid hyperplasia of mucoussalivary glands can not be clinically differentiated from salivarygland neoplasms. It is necessary that the lesion be excisedand submitted for microscopic examination

Adenocarcinoma y linfoma gástricos sincrónicos en el contexto de una gastropatía hipertrófica / Gastric synchronous adenocarcinoma and lymphoma in a case of hypertrophic gastrophaty. Case history

Introducción: La coexistencia de un adenocarcinomagástrico y un linfoma gástrico primario fue descrito por primeravez en 1931. Material y Metodos: Presentamos uncaso en una paciente de 40 años con epigastralgia y perdidade peso. La gastroscopia muestra un engrosamiento de plieguesgástricos. Se realiza gastrectomía total. Resultados: Elexamen histológico muestra un adenocarcinoma de patróndifuso con presencia de células en anillo de sello en el senode un infiltrado linfoide denso y difuso con presencia detípicas lesiones linfoepiteliales. Conclusiones: La presentaciónsimultanea de un adenocarcinoma gástrico y un linfomatipo M.A.L.T en un mismo paciente es muy infrecuente,siendo la infección por Helicobacter pylori un factor etiopatogénicoen el desarrollo de ambas neoplasias

Background: A case of simultaneous gastric adenocarcinomaand primary gastric lymphoma was first describedin 1931. Methods: The case we describe corresponds to a40 year-old patient suffering from epigastralgia and loss ofweight. The gastroscopy shows thickened gastric folds. Acomplete gastrectomy is performed. Results: The histologicalexamination shows an adenocarcinoma with a diffusepattern presenting signet ring cells in the core of a dense anddiffuse lymphoid infiltrate, which also presents typicallymphoepithelial lesions. Conclusions: The case of simultaneousgastric adenocarcinoma and mucous associatedlymphoid tissue lymphoma in a patient is very infrequent.The infection by Helicobacter Pylori is an etopathogenicfactor in the development of both neoplasms

Tumor mülleriano mixto maligno (carcinosarcoma heterólogo) de trompa uterina / Malignant mixed mullerian tumor of the fallopian tube (heterologous carcinosarcoma)

Introducción: El Tumor mülleriano mixto maligno esun tumor de localización ginecológica poco común. Latrompa de Falopio es la localización menos frecuente.Material y Métodos: El caso que nosotros describimoscorresponde a una paciente de 66 años con dolor abdominaly presencia de una masa pélvica en el anejo izquierdo. Serealiza histerectomía y doble anexectomía. Resultados: Laneoplasia distendía y distorsionaba la trompa de Falopioizquierda. Al corte, la trompa estaba ocupada por un tumorblando con áreas hemorrágicas. Microscópicamente eltumor estaba compuesto por elementos malignos epitelialesy estromales con focos diferenciación rabdomiosarcomatosay cartilaginosa. Conclusiones: Cuatro teorías han sidoformuladas para explicar la histogénesis tumoral de los carcinosarcomasde trompa de Falopio. La sobreexpresión dec-erbB-2 en ambos componentes, epitelial y mesenquimal,sugiere un mecanismo carcinogénico común y apoya lahipótesis de histogénesis por conversión implicando unpapel dominante del componente epitelial

Background: Malignant mixed mullerian tumor is anuncommon neoplasm of the female genital tract. The Fallopiantube is most uncommon site. Patients and Methods:The reported case corresponds to a 66 year old woman withabdominal pain. A total hysterectomy with bilateral salpingo-oophorectomy was performed. Results: The neoplasmdistended and distorted the left Fallopian tube. On cut sectionthe tube was filled and expanded by a soft tumor withhemorrhagic areas. Microscopically it was composed ofmalignant epithelial and stromal elements with foci of cartilaginousand rhabdomyosarcomatous differentiation. Conclusions:Four theories have been put forward to explain theorigins of the Fallopian tube carcinosarcomas. C-erbB-2over-expression in both epithelial and mesenchymal componentssuggests a common carcinogenic mechanism for bothcomponents and supports the conversion-histogenesis hypothesisimplicating a dominant role for epithelial component