Cortisone-induced gigantomastia during chemotherapy.

Gigantomastia is a rare, psychologically and physically disabling condition characterized by excessive breast growth. There is no universal consensus on the definition of gigantomastia, but it is most commonly described as breast enlargement that requires removal ranging from 800 to 2000 g, or even a D cup bra size. It typically occurs in the setting of marked hormonal changes such as puberty and pregnancy; however, there have also been a number of reports of gigantomastia in the setting of autoimmune diseases. Rare association of gigantomastia included medicinal aetiologies such as penicillamine, neothetazone, and cyclosporine. The mechanism of action of these pharmacological agents remains unclear. We report the first case of gigantomastia associated with cortisone in the setting of ovary cancer treated with chemotherapy cycles after hysterectomy and bilateral adnexectomy. Moreover, we propose a clinic evidence and a metabolic theory to explain this association.

Extracorporeal shock wave therapy for management of chronic ulcers in the lower extremities.

Management of chronic ulcers in the lower extremities is still a challenge for patients and health providers. Recent studies showed extracorporeal shock waves (ESW) as effective in stimulating growth factors, inducing angiogenesis and healing of fractures and injuries. This study was planned to investigate the opportunity of introducing the ESW in the treatment of chronic wounds. Thirty consecutive patients with chronic posttraumatic, venous and diabetic ulcers, unresponsive to conservative or advanced dressing treatments, were counseled about the use of ESW as alternative treatment for their wounds. Thirty-two wounds were treated and 16 wounds healed completely within six sessions of ESW. In all of the nonhealed wounds, decrease of the amount of exudates, increased percentage of granulation tissue compared with fibrin/necrotic tissue and decrease of wounds' size were statistically significant after four to six sessions of ESW (p < 0.01). Significant decrease of pain was reported (p < 0.001). Comparison with a control group of 10 patients with chronic ulcer treated on the basis of regular dressings confirmed the statistical significant improvement in the healing process (p < 0.01). ESW therapy seems to be a safe, feasible and cost-effective treatment for chronic ulcers in the lower extremities. Further research and clinical trials are necessary to evaluate dose and time intervals of sessions to standardize a protocol of treatment in the management of chronic wounds.

Lip cancer: a 10-year retrospective epidemiological study.

BACKGROUND: Lip cancer is the most frequent tumor of the oral-maxillary region. A high incidence of lip cancer has been reported among the Italian population over the past decade. MATERIALS AND METHODS: This retrospective study analyzes epidemiological data and risk factors for lip cancer among patients who presented to our department between 2000-2010. Statistical analysis for this study was calculated employing Student T and χ-square tests. RESULTS: Of 540 cases, most were found among men (82%), and those aged over 45 years (84.8%). The dominant cancer type was squamous cell carcinoma of the external lower lip (predominantly in men). We recorded high rates of chronic solar exposure, and tobacco and alcohol drinking habits in patients with squamous cell carcinoma. CONCLUSION: Individuals aged over 45 years are at higher risk for lip cancer. The high association of the examined risk factors with the rate of squamous cell carcinoma confirms their role in the development of this type of tumor.

The use of poly-lactic acid to improve projection of reconstructed nipple.

PURPOSE: Nipple-areola reconstruction represents an important step for final mammary reconstruction. Many techniques have been described. The drawback is the progressive nipple projection loss with time from 50% to over 70% of the initial projection. In this report, we evaluated the effect of injectable poly-lactic acid (PLLA) to improve projection of reconstructed nipples. RESULTS: We selected 12 patients with a residual nipple projection between 0.1 and 2 mm. The patients were injected locally inside the nipple with 0.5 ml of PLLA (dilution 1:4) every 4 weeks for 4 times. At the study end, patients were satisfied with results. No adverse effects were observed. After one year, an increase of nipple projection ranging from 0.5 to 3.5 mm was obtained with an average increase of 2.3 mm (282%) and this variation was statistically significant (p < 0.0001). CONCLUSION: The use of injectable PLLA is a simple and effective procedure to improve projection of reconstructed nipple.