Indeterminate dendritic cell tumor in the pancreas.

Indeterminate dendritic cell tumor (IDCT) is an extremely rare hematologic neoplastic disorder with proliferation of indeterminate dendritic cells. In the vast majority of cases, IDCTs are restricted to the skin or lymph nodes. To our knowledge, we report the first case of IDCT in the pancreas. Due to the rarity of extracutaneous IDCT, guidelines or treatment recommendations addressing their management are missing. We performed a review of literature to compare our experience to the management of other extracutaneous IDCT. Histopathological examination confirms the diagnosis of IDCT in electron microscopy and/or immunohistochemistry. Specific features are the lack of Birbeck granules and the nonreaction to Langerin antibodies. Concerning the aftercare of extracutaneous IDCT, we recommend a dermatological examination to rule out an additional cutaneous manifestation as well as annual blood examinations due to the association between IDCT and hematologic malignancies.

Surgical Treatment of Distal Femur Fractures in Geriatric Patients.

INTRODUCTION: The treatment of distal femur fractures in geriatric patients is challenging and has a high perioperative morbidity and mortality. Treatments have evolved significantly in the past decades. The aim of our study was to analyze local and systemic morbidity and mortality, as well as functional results in this frail cohort treated with distal femur locking plates. MATERIALS AND METHODS: In this single-institution case series, we retrospectively analyzed the data of patients aged 65 years and older with fractures of the distal femur between March 2013 and March 2018. All patients were operated with distal femur locking plates. Points of interest included perioperative morbidity, mortality, weight-bearing status, and care-dependency after hospital discharge. RESULTS: We assessed 49 patients (median age: 86.5 years) with 52 distal femur fractures (AO type A 77%, type C 15%, type B 8%). A total of 30 (58%) periprosthetic fractures with 4 (8%) interimplant femur fractures were documented. The perioperative morbidity was 64%, and the 3-month and 1-year mortality rates were 29% and 35%, respectively. The local complication rate was 6% with no documented implant failure. Of the patients who were living at home before the surgery, 62% required long-term accommodation in residential or nursing homes after dicharge from the hospital or short-term rehabilitation. CONCLUSIONS: Geriatric patients with distal femur fractures face a high perioperative mortality. Osteosynthesis with distal femur locking plates is a reliable technique that can be used in various fracture patterns including periprosthetic and interimplant fractures.