Sebaceous carcinoma of the vulva: a case report and review of the literature.

Sebaceous carcinoma is a rare malignant cutaneous neoplasm that is most commonly arises in the ocular region. Although it can occur in extraocular sites, sebaceous carcinoma is rarely encountered in the vulva. The use of immunohistochemical staining is very crucial to exclude other differential diagnoses including primary cutaneous and metastatic neoplasms. Unlike ocular sebaceous carcinoma, little is known about the clinical behavior and the prognostic factors in vulvar sebaceous carcinoma. Herein, we present a case of vulvar sebaceous carcinoma in a 27-year-old female, who presented with a labial tumor with lung metastases. To the best of our knowledge, only 11 similar cases were previously reported in the literature.

Pelvic Radiation-Induced Sarcoma With Rhabdomyoblastic Differentiation Following Treatment of Cervical Cancer.

Radiation-induced sarcomas (RIS) are a rare long-term complication of radiation therapy, with a reported incidence of 2.5-5.5%. They usually develop several years following exposure to radiotherapy. The most common reported subtypes are undifferentiated pleomorphic sarcoma, angiosarcoma, and leiomyosarcoma. Breast cancer is the most common primary malignancy preceding RIS, followed by uterine cervical carcinoma. Only a few cases of RIS with rhabdomyoblastic differentiation have been reported in the literature, usually following the treatment of retinoblastoma. Herein, we report a rare case of RIS with rhabdomyoblastic differentiation in the pelvic region developing 12 years after cervical cancer radiation therapy.

Prevalence and special clinical and biochemical characteristics of familial type 1 (insulin dependent) diabetes mellitus in pediatric patients in a tertiary care setting.

BACKGROUND AND OBJECTIVES: The hereditable nature of type 1 diabetes mellitus (T1DM) makes it a condition that is in some cases shared among siblings. Studies that focus on the epidemiology of T1DM among siblings are scarce. The primary focus of the study is to estimate the prevalence of familial T1DM among siblings and the secondary focus is to identify the presence of any special clinical or biochemical characteristics specific to this entity. METHODS: In a retrospective cross-sectional study, the charts of 308 children (>1 year) diagnosed with type 1 diabetes mellitus in a Saudi tertiary care setting were reviewed. The patients who have one sibling or more with T1DM were included. The prevalence of familial T1DM among siblings was calculated, and specific clinical and biochemical characteristics were investigated. Data were analyzed using Statistical Package for the Social Sciences software version 22 (IBM SPSS Statistics for Windows). The control group includes all patients with type I DM who were excluded for sibling with DM. RESULTS: The prevalence of familial T1DM among siblings was estimated at 15.9%. Seventy-four percent of the patients with a positive family history of diabetes mellitus had one affected sibling only. The clinical presentation showed no significant differences relative to the age of presentation, gender, parental consanguinity, diabetic ketoacidosis at presentation, and its number of episodes. For the biochemical characteristics, autoantibody tests revealed no statistically significant difference, but the mean initial HbA1c levels were lower in patients who had diabetic siblings. CONCLUSION: The prevalence of familial T1DM was found to be higher than that reported in other studies. No specific clinical or biochemical features were found to characterize familial T1DM among siblings.

Adamantinoma-Like Ewing Sarcoma of the Parotid Gland: Report of Two Cases and Review of Literature.

Adamantinoma-like Ewing sarcoma (ALES) is a rare variant of Ewing sarcoma. It demonstrates heterogeneous morphologic pattern and complex immunophenotypic profile, with a peculiar combination of epithelial and neuroendocrine differentiation. ALES is rarely reported in the head and neck areas, including the parotid salivary gland. Till now, only 10 cases of ALES have been reported in the salivary glands. Herein, we report two cases of ALES involving the parotid gland, adding some valuable insight to the recently reported cases at this site.

Ilizarov bone transport after massive tibial trauma: Case report.

INTRODUCTION: This is a case report of extreme lengthening of the tibia of about 14.5cm using bone transport technique following road traffic accident trauma to the lower limbs. The management of the subsequent massive skeletal defects was challenging to orthopedic surgeons. Based on reported cases, the highest tibial lengthening was 22cm using bifocal transport, while the highest unifocal tibial lengthening reached 14.5cm. CASE PRESENTATION: A 20-year-old male driver was brought to the emergency department after a road traffic accident. The patient had a right Gustilo IIIA segmental open tibia fracture with bone loss and other severe injuries. The tibial defect was 14.5cm and the patient was then admitted for Ilizarov application six months after the accident. Although this case was particularly complicated, full limb length was restored. DISCUSSION: The management of this case was directed to correct the deformities and achieve equal length of both limbs to restore the normal function. Several new techniques have been developed recently to fill large bone defects. Limb lengthening using bone transport technique by application of Ilizarov ring fixator has been suggested as the leading option in filling massive bone gaps. CONCLUSION: The use of bone transport technique using Ilizarov external rings has proved to be a minimally invasive and reliable method in managing massive bone defects. Accurate application of the Ilizarov frame and proper transport of the middle segment are important factors alleviating the risk for deviation of the transported segment. However, due to the need for regular follow-ups and monitoring, it demands high compliance from the patient to achieve optimal results.