Factors in the surgical management of primary eccrine porocarcinoma: prognostic histological factors can guide the surgical procedure.

BACKGROUND: Primary eccrine porocarcinoma is a rare cutaneous neoplasm and there is no consensus concerning its surgical management. OBJECTIVES: To conduct a retrospective analysis of all the cases of eccrine porocarcinoma seen in our hospital in order to identify prognostic factors. METHODS: Clinical data were retrieved from the patients' files. Each histological sample was reviewed by the pathologist and classified into three eccrine porocarcinoma subtypes: 'infiltrative', 'pushing' and 'pagetoid' eccrine porocarcinoma, according to Robson's criteria. Statistical methods were used to estimate the recurrence risk. RESULTS: Twenty-four patients were included. The surgical margins realized were ≥ 2 cm or < 2 cm in six and 13 patients, respectively, and slow Mohs procedure was performed in two patients. Ten, seven and two patients presented with 'infiltrative', 'pushing' or 'pagetoid' eccrine porocarcinoma, respectively. Eight patients (of 23) experienced recurrences (35%). The recurrence risk was linked to the histological subtype: two out of two pagetoid eccrine porocarcinoma, four out of 10 'infiltrative' and none of seven 'pushing' eccrine porocarcinoma recurred (P=0·026). The recurrence risk was not associated with epidermal growth factor receptor status, nor the margin realized. CONCLUSIONS: The recurrence risk of 'pushing' eccrine porocarcinoma is significantly lower than for 'infiltrative' eccrine porocarcinoma. Based on these considerations, a decisional algorithm might be proposed: first step, excisional biopsy of the primary eccrine porocarcinoma and identification of the histological subtype; second step, infiltrative or pagetoid porocarcinoma should be excised with an additional modified micrographic Mohs procedure, while no additional surgery is needed for 'pushing' eccrine porocarcinoma if the first excisional biopsy is complete. Although demonstrated in a limited case series, the histological subtype might guide the surgical management of primary eccrine porocarcinoma.

[Superficial acral fibromyxoma: three cases]. / Fibromyxome acral superficiel : trois observations.

BACKGROUND: in this report of three new cases of superficial acral fibromyxoma (SAF), we discuss the clinicopathological features of this acral fibrous tumour as well as the differential diagnoses for hard nodules affecting the extremities. PATIENTS AND METHODS: these three lesions involved the standard presentation of a large solitary flesh coloured nodule causing deformation of a toenail or a fingernail. Biopsy showed the presence within a fibromyxoid tumour of proliferating fusiform cells having no atypical features and expressing CD 34 diffusely, and in more focal and less consistent fashion, epithelial membrane antigen (EMA) and CD 99. FISH testing for translocation t(17; 22) proved negative. DISCUSSION: this fairly common acral fibrous tumour is poorly known and in certain cases histology results may suggest myxoid dermatofibrosarcoma, which carries a completely different prognosis.

National multicentric evaluation of quality of pathology reports for rectal cancer in France in 2016.

The quality of pathologic assessment of rectal cancer specimens is crucial for treatment efficiency and survival. The Royal College of Pathologists (RCP) recommends evaluating the quality of the pathology report in routine practice using three quality indicators (QIs): the number of lymph nodes (LNs) analyzed (≥ 12), the rate of venous invasion (VI ≥ 30%), and peritoneal involvement (pT4a ≥ 10%). In this study, we evaluated the three QIs of the French national pathology reports and compared them with British guidelines and assessed the influence of neoadjuvant radiochemotherapy on QIs. From January 1 to December 31, 2016, all pathology reports for rectal adenocarcinoma were collected from French departments. Neoadjuvant radiochemotherapy included long-course radiotherapy with concomitant 5-FU-based chemotherapy. A total of 983 rectal cancer pathology reports were evaluated. A median of 15 LNs were analyzed and 81% of centers had ≥ 12 LNs. The rate of VI was 30% and 41% of centers had ≥ 30% VI. The rate of pT4a was 4% and 18% of centers reported ≥ 10% pT4a. None of the centers reached the threshold for the three QIs. All three QIs were lower after radiochemotherapy compared to surgery alone. In conclusion, in French routine practice, the values of two of the three QIs (LNs analyzed and VI) were globally in line with RCP guidelines. However, the rate of pT4a was very low, particularly after radiochemotherapy, suggesting its low value in rectal cancer.

Primary monophasic synovial sarcoma of the pancreas.

We report a case of synovial sarcoma of the pancreas in a 44-year-old male who presented with multiple episodes of retroperitoneal hemorrhage; the diagnosis was confirmed by histology. The patient underwent distal pancreatectomy without complication, and the hospital stay was nine days. No adjuvant treatment was administered. The patient is alive at 1 year.

The lowest-energy ligand to metal charge-transfer absorption band of trans-[OsO2(malonate)2]2-.

The resolved structure of the lowest-energy oxo to osmium charge-transfer absorption band of trans-[OsO2(malonate)2]2- is analyzed on the basis of the exact molecular Ci symmetry determined from the structure of a crystal used for spectroscopy. The multiple progressions observed in the polarized spectra are rationalized in terms of the deviations from idealized D4h point group symmetry and compared to the spectra observed for complexes with D2h symmetry such as trans-[OsO2(oxalate)2]2- that show only a single dominant progression for this transition.