Double trouble: a case of bilateral multiple epidermal inclusion cysts after reduction mammaplasty.

Epidermal inclusion cysts (EIC) of the breast are uncommon and can occur after previous surgery or trauma. Here we discuss a case of massive bilateral multiple EIC of the breast presenting seven years after reduction mammaplasty. This report highlights the importance of accurate diagnosis and management of this rare condition.

Skin deep: Cutaneous manifestation of PIP implant rupture.

PIP (Poly Implant Prothèse, France) implants were readily employed for breast reconstruction until withdrawn from the market in 2010. These implants have an early and increased risk of rupture compared to non-PIP implants. This report outlines a significant cutaneous manifestation of PIP-implant rupture not previously described in the literature. This patient developed significant cutaneous xanthomatous inflammation with sinus tract formation that has yet to resolve despite explantation. Further investigation is warranted to elucidate the aetiology of this clinical sign and the optimal management of the cutaneous manifestation.

Myxofibrosarcoma in the Thenar Eminence.

Myxofibrosarcoma is a rare cause of swelling in the upper extremities. The rarer form arising in the deep tissues can present a diagnostic difficulty. The treatment of high-grade myxofibrosarcoma in the extremity requires tissue diagnosis, accurate staging, careful multidisciplinary agreement on treatment, accurate execution of that treatment, and finally regular specialist surveillance. The treatment must be planned on an individual basis, weighing the risk of distant metastasis against the potential for severe functional impairment should radical excision or amputation be performed. The grade of tumor, clinical stage as well as the site, local extent, and the comorbidity of the patient influence the decision.We present the case of an elderly woman with an expanding high-grade myxofibrosarcoma within the thenar musculature of the nondominant hand. She presented with early signs of complex regional pain syndrome, leading to a treatment dilemma. We feel this case has important learning points on assessing objectives, risks, and outcomes in the management of these types of cases, and it highlights the role of multidisciplinary involvement in sarcoma management.