Squamous Cell Carcinoma of Unknown Primary that Metastasized to an Inguinal Lymph Node: A Case Report.

Carcinoma of unknown primary (CUP) is a malignant tumor with histological characteristics indicating metastasis in a patient with an unidentified primary lesion after whole-body evaluation at the time of examination. CUP incidence is similar in men and women, and average age at diagnosis is 60 years. Reports of overall incidence vary but CUP is believed to account for 1-5% of all cancers. We encountered a case of apparently metastatic squamous cell carcinoma of the inguinal region in a patient without a detectable primary lesion. We report this case and review the literature on CUP, to increase awareness of this rare lesion.

Anatomical study of pectoral intercostal perforators and clinical study of the pectoral intercostal perforator flap for hand reconstruction.

BACKGROUND: The authors have used pectoral intercostal perforator flaps to reconstruct burned or injured hands by staged transfer. This flap is designed with a narrow skin pedicle that includes intercostal perforators from the fifth to eighth intercostal spaces, with a wide flap area that lies on the upper abdomen. The distal area is thinned down to the subdermal vascular network level; thus, such flaps are called "superthin flaps" or subdermal vascular network flaps. In this article, the authors discuss the arterial networks associated with this flap and present clinical cases. METHODS: The authors performed an anatomical study using 13 cadavers to obtain angiograms and dissect the anterior chest and abdominal region. Clinically, the authors retrospectively analyzed 21 cases over 13 years. RESULTS: Anatomically, the anterior intercostal regions could be divided into three segments with regard to vascular supply to the skin and subcutaneous layer. In particular, in the fifth to eighth intercostal spaces, perforators communicated with one another to form a "latticework" pattern. In addition, the vascular territories participating in the pectoral intercostal perforator flap, that is, the intercostal perforators, the superior epigastric artery system, and the deep inferior epigastric artery system, linked with each other through choke vessels. In the authors' clinical cases, functional and aesthetic results were satisfactory. CONCLUSIONS: The pectoral intercostal perforator flap was supported by the arterial networks among perforators in the intercostal spaces and in the upper abdomen. This flap is one useful method for reconstruction of the hand region, providing good quality in terms of thinness and texture.

Fixation of intracapsular fractures of the condylar head with bioabsorbable screws.

A newly-developed fixation technique using bioabsorbable screws gave satisfactory results in fractures of the condylar head. The fracture lines ran obliquely (craniolateral to mediocaudal) on three-dimensional computed tomography. Two bioabsorbable screws were positioned vertically to the fracture lines. This technique is useful despite limited access to the condyle.