RESUMO
BACKGROUND: Invasive cases of extramammary Paget's disease have a poor prognosis, owing to its rapid progression and resistance to irradiation and chemotherapy. Morton et al. introduced a technique to identify sentinel lymph nodes by local injection of vital dyes and reported its benefit for managing the progress of malignant melanoma. OBJECTIVES: Since the rate of lymph node metastasis of extramammary Paget's disease is not uncommon (reported from 8.5% to 26%), this study tested the hypothesis that sentinel lymph node biopsy would be useful to detect lymph node metastasis in the clinically early stage of extramammary Paget's disease. MATERIALS & METHODS: Eighteen patients with primary extramammary Paget's disease were enrolled in the study. The precise location of sentinel lymph nodes was visualized using either intraoperative patent blue dye injection or indocyanine green dye injection in combination with a hand-held gamma-detecting probe after a 99mTc phytate injection. RESULTS: Of the 18 patients, sentinel lymph node metastasis was identified in 2 (Cases 2 and 15) of the 2 patients with deep invasion and in 1 (Case 12) of the 7 patients with minimal dermal invasion, however, it was absent in 9 patients who had been categorized into the intraepidermal group. CONCLUSION: This study demonstrates that extramammary Paget's disease possibly causes metastasis via regional lymphatic systems to which the lesion belongs, even in the early stages of no nodule or tumor formation, and that sentinel lymph node biopsy is useful to detect lymph node metastasis.
Assuntos
Neoplasias dos Genitais Femininos/patologia , Neoplasias dos Genitais Masculinos/patologia , Excisão de Linfonodo , Linfonodos/patologia , Doença de Paget Extramamária/secundário , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/patologia , Idoso , Idoso de 80 Anos ou mais , Axila , Corantes , Feminino , Neoplasias dos Genitais Femininos/cirurgia , Neoplasias dos Genitais Masculinos/cirurgia , Virilha , Humanos , Verde de Indocianina , Linfonodos/cirurgia , Metástase Linfática , Linfocintigrafia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Compostos de Organotecnécio , Doença de Paget Extramamária/cirurgia , Ácido Fítico , Compostos Radiofarmacêuticos , Corantes de Rosanilina , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoRESUMO
Condylomata acuminata are frequently occurring genital warts, but little is known about clinical features of the genital warts in transsexuals and their incidence. We report a case of condylomata acuminata arising on the neourethral meatus and the transplanted skin of the neovagina in a male-to-female transsexual, which was successfully treated with CO2 laser irradiation followed by topical application of imiquimod cream on the residual warts. This is a first report of using imiquimod cream for condylomata acuminata arising on the neovagina in a male-to-female transsexual.
Assuntos
Aminoquinolinas/administração & dosagem , Condiloma Acuminado/tratamento farmacológico , Condiloma Acuminado/cirurgia , Terapia a Laser , Técnicas de Ablação , Administração Tópica , Aminoquinolinas/uso terapêutico , Humanos , Masculino , Transexualidade/complicações , Resultado do Tratamento , Adulto JovemAssuntos
Anti-Infecciosos Locais/administração & dosagem , Antineoplásicos/uso terapêutico , Etanol/administração & dosagem , Melanoma/tratamento farmacológico , Picibanil/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Procedimentos Cirúrgicos de Citorredução , Virilha , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Melanoma/cirurgia , Pelve , Neoplasias Cutâneas/cirurgiaAssuntos
Derivação Arteriovenosa Cirúrgica , Hemangiossarcoma/etiologia , Transplante de Rim , Neoplasias Cutâneas/etiologia , Adulto , Antebraço , Hemangiossarcoma/metabolismo , Hemangiossarcoma/patologia , Humanos , Imuno-Histoquímica , Masculino , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologiaRESUMO
We describe a new method for the fusion of single-photon emission computed tomography (SPECT) and multidetector computed tomography (MDCT) images using an acrylic resin marker containing 99 m-Tc phytate and viewing software (Fusion Viewer Version 1.0 for Windows). This method provided the fusion of SPECT and CT images in a short time and made it easy to identify the sentinel lymph nodes in the patient with extramammary Paget's disease of the scrotum.