Calciphylaxis with atypical localisation in a woman with end-stage renal disease.

Calciphylaxis is a rare condition characterised by painful necroses due to microvascular calcifications. It primarily affects individuals with end-stage renal disease and affected calcium-phosphate metabolism. This is a case report of a 55-year-old woman with end-stage renal disease who developed a necrotic ulcer at the breast due to calciphylaxis. Although treated with sodium thiosulfate and hyperbaric oxygen, the ulcer progressed and multiple necrotic calciphylaxis ulcers appeared. The treatment options and wound management are discussed while focusing on indications for surgical debridement.

[Hygroma following liposuction and -grafting in the gluteal area].

This case report is of a 24-year-old woman, who was referred to an orthopaedic department with sarcoma in her left thigh. Further investigations revealed, that she had previously undergone an autologous lipografting from her thighs to her gluteal area, and she had developed widespread, severe hygroma formation as a late complication to the procedure. The complication rate to liposuction and -grafting varies 7-10% with seroma being the most abundant. Knowledge of these complications is important in order to diagnose and refer the patients correctly.

[Dacryocystitis in a three-week-old girl]. / Dakryocystitis hos en tre uger gammel pige

Dacryocystocele is a rare disease, which can be difficult to distinguish from haemangioma, dermoid cyst or encephalocele. Proper diagnosis and treatment is important as the risk of complications is high. A newborn baby with dacryocystitis was referred to a department of plastic surgery with a bluish tumour in the medial corner of the eye. The girl was treated with i.v. antibiotics and the dacryocystocele disappeared in 20 days. Knowledge of the disease is important so patients quickly can be treated medically and possibly surgically in order to avoid fatal complications.

Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer.

BACKGROUND: The aim of this study was to investigate the use of sentinel lymph node dissection (SLND) in the treatment of patients with locally recurrent breast cancer. METHODS: A total of 147 patients with locally recurrent breast cancer were included from five different breast surgery departments in Denmark. Data on previous breast and axillary surgery, adjuvant treatment, second operation in the breast and axilla, and lymphoscintigraphy were collected retrospectively from the original patient files. RESULTS: SLND after recurrence (SLNDAR) was successful in 72 of 144 patients (50 %). The detection rate was significantly higher after previous SLND (66 %) compared with previous ALND (34 %) [p = 0.0001]. Thirty-seven patients (51 %) who had previous SLND had a negative sentinel node. These patients could be spared an ALND. Six patients (8 %) who had a previous ALND had a metastatic sentinel node at recurrence; 17 % of patients had a sentinel node located outside the ipsilateral axilla; and eight patients with negative sentinel node at SLNDAR underwent completion ALND. None of these patients had metastases at completion ALND, corresponding to a false negative rate of 0 %. CONCLUSIONS: SLNDAR seems to be a feasible procedure in locally recurrent breast cancer and can spare a clinically significant number of patients an unnecessary ALND and the following risk of sequelae. In patients who had previous ALND, SLNDAR identified metastases that would have been overlooked following the current guidelines. A large proportion of patients had aberrant drainage, suggesting a need for lymphoscintigraphy.