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1.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(10): 1294-1297, 2020 Oct 15.
Artigo em Chinês | MEDLINE | ID: mdl-33063496

RESUMO

Obejective: To investigate the feasibility and effectiveness of the distal curved incision approach of lunula in treating subungual glomus tumor in nail root. Methods: Between March 2017 and October 2019, 16 patients (16 fingers) with subungual glomus tumor in nail root were treated. There were 2 males and 14 females with an average age of 35.3 years (range, 21-67 years). The disease duration ranged from 5 months to 17 years, with a median duration of 15 months. There were 6 cases of thumb, 3 cases of index finger, 2 cases of middle finger, 4 cases of ring finger, and 1 case of little finger. All of them showed typical "triad syndromes", and the cold sensitivity test and Love test were positive before operation. Each patient removed the nail, the tumor was exposed under the nail bed via the distal curved incision approach of lunula. After the tumor was removed completely, the nail bed was reducted in situ without suturing. The self-made nail template was pressurized and fixed on the surface of the nail bed with suture. The conditions of nail bed healing, pain, and growth of nail were observed after operation. Results: All wounds of the nail bed with laceration healed by first intention. Postoperative pathological results confirmed the diagnosis of subungual glomus tumor in all the patients. All cases were followed up 3-26 months with an average of 15 months. The pain symptom disappeared and no obvious pain occurred during dressing change in all cases; and the cold sensitivity test and Love test were negative. The nails recovered smoothly with satisfactory appearance, and no obvious complications such as longitudinal ridge deformities or recurrences was observed. Conclusion: The treatment of subungual glomus tumor in nail root via the distal curved incision approach is an effective method, which can easily operated, resect the tumor completely, protect the nail bed effectively, and also has a significant effect on preventing postoperative nail deformity.


Assuntos
Tumor Glômico , Doenças da Unha , Neoplasias Cutâneas , Adulto , Idoso , Feminino , Tumor Glômico/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Unha/cirurgia , Unhas/cirurgia , Recidiva Local de Neoplasia , Neoplasias Cutâneas/cirurgia , Adulto Jovem
2.
Medicine (Baltimore) ; 99(39): e22252, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991421

RESUMO

A 31-year-old male patient with psoriasis received administration of traditional Chinese medicine (TCM) during a disease course of 14 years. He showed multiple keratoma together with squamous cell carcinoma (SCC) in left lower limbs. After admission, the conditions were stable after treatment, and received surgery for treating SCC. The skin defect was treated using full-thickness skin graft. The postoperative survival of the flap was satisfactory, and the conditions of psoriasis were well controlled. In this case, we presented the feasibility of graft in the donor site from a psoriatic lesion. Besides, we analyzed the possibility of SCC and keratinizing lesions.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Cutâneas/cirurgia , Transplante de Pele/métodos , Retalhos Cirúrgicos/transplante , Adulto , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Humanos , Masculino , Medicina Tradicional Chinesa , Psoríase/complicações , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/patologia
3.
HNO ; 68(9): 695-697, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32728760

RESUMO

A rare finding of primary cutaneous CD4+ small to medium-sized T­cell lymphoma (SMPTCL) in a fifteen-year-old patient is reported. This is a rare tumor entity for which there is currently no standardized treatment recommendation. At the interdisciplinary tumor board, the decision was made to resect the tumor and reconstruct the defect with a nasolabial advancement flap in a two-stage process. Follow-up examinations, currently over 3 years, have shown the patient to be free of recurrences.


Assuntos
Linfoma Cutâneo de Células T , Linfoma de Células T , Neoplasias Cutâneas , Adolescente , Linfócitos T CD4-Positivos , Humanos , Linfoma de Células T/diagnóstico , Linfoma de Células T/cirurgia , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/cirurgia , Recidiva Local de Neoplasia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia
4.
Medicine (Baltimore) ; 99(27): e19893, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629624

RESUMO

A wide range of therapeutic options are available for the treatment of Bowen disease. However, few studies have been conducted on wide excision using various resurfacing methods. The objectives of this study were:One hundred forty-eight lesions were studied. All lesions were histopathologically confirmed as Bowen disease. Lesions were classified by anatomical site and treatment modality and their dimensions were measured. Punch biopsy was reperformed when a treated lesion was considered to have possibly recurred. Recurrence rates were then compared. Preoperative and intraoperative photos and follow-up images were also taken.The most common site of Bowen disease was the head and neck region. Wide excision was found to provide good outcomes with minimal tumor recurrence. Recurrence after cryotherapy occurred relatively quickly (mean 0.2 years, median 0.2 years) while recurrence after wide excision occurred at a mean 2.5 years. Treatment modality was significantly associated with recurrence (P < .05).The optimal treatment for Bowen disease has not been determined. Wide excision provided lower recurrence than other treatment modalities. Providers should be aware of the multiple treatment options available and select the method most appropriate for each patient. The limitations of our study are that it was retrospectively designed and conducted at a single institution.


Assuntos
Doença de Bowen/cirurgia , Criocirurgia/estatística & dados numéricos , Lasers de Gás/uso terapêutico , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Cutâneas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , República da Coreia/epidemiologia , Estudos Retrospectivos
5.
Cancer Invest ; 38(7): 415-423, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32643437

RESUMO

The aim of the study was to investigate if there was an association between intraoperative NSAID use and recurrence or survival. A cohort of patients who underwent sentinel lymph node biopsy for the treatment of cutaneous melanoma was retrospectively recruited. After applying inclusion and exclusion criteria, 516 were included (NSAIDs = 307). The 10-year melanoma-specific survival was 63.2%. Log-rank test showed no statistically significant differences in time to treatment failure, melanoma-specific survival, disease-free survival, and overall survival between the study groups. The current study did not support the use of intraoperative NSAIDs in preventing death or recurrence in patients with melanoma.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Melanoma/patologia , Melanoma/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Idoso , Estudos de Coortes , Feminino , Humanos , Isoxazóis/uso terapêutico , Estimativa de Kaplan-Meier , Cetorolaco/uso terapêutico , Masculino , Melanoma/mortalidade , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Período Perioperatório , Piroxicam/análogos & derivados , Piroxicam/uso terapêutico , Estudos Retrospectivos , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/mortalidade , Resultado do Tratamento
6.
Dermatol Online J ; 26(4)2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32621679

RESUMO

Mohs micrographic surgery (MMS) is a breakthrough surgical technique that has changed the management of neoplasms in dermatology. Through continued practice and evolution, MMS now can successfully treat a variety of rare non-melanocytic cutaneous malignancies for which achieving remission and the optimal aesthetic result after surgery was previously challenging. Mohs micrographic surgery has utility for conditions besides melanoma. Herein, we discuss this versatility of Mohs micrographic surgery. Specifically, Mohs micrographic surgery can be successfully used for cases such as dermatofibrosarcoma protuberans, atypical fibroxanthomas, extramammary Paget disease, Merkel cell carcinoma, sebaceous carcinoma, and microcystic adnexal carcinoma.


Assuntos
Cirurgia de Mohs , Neoplasias Cutâneas/cirurgia , Humanos
7.
Am Surg ; 86(9): 1208-1211, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32683914

RESUMO

Atypical spindle cell lipomatous neoplasm, also known as well-differentiated spindle cell liposarcoma, represents a newly discovered entity of adipocytic tumors. Recent research has shown this tumor variant to be more related to spindle cell lipoma, rather than the originally hypothesized atypical lipomatous tumor spectrum. Here we present a case of a 58-year-old man with a history of chronic lymphocytic leukemia with an enlarging mass on the posterior left shoulder, initially hypothesized to be a benign lipoma. However, magnetic resonance imaging showed a large, multiseptated, heterogeneous mass concerning for soft tissue sarcoma. After resection, pathologic analysis showed cells closely resembling spindle cell lipoma, with additional cellular and fascicular zones containing lipoblasts and mitotic figures. Molecular analysis showed no MDM2 amplification. This lack of amplification indicates this tumor is distinctly different from an atypical lipomatous tumor, which characteristically displays MDM2 amplification. However, tumor expression of RB1 was normal. The majority of atypical spindle cell lipomatous neoplasms are associated with RB1 deletions. We conclude that we have a unique example of an atypical spindle cell lipomatous tumor.


Assuntos
Procedimentos Cirúrgicos Dermatológicos/métodos , Leucemia Linfocítica Crônica de Células B/complicações , Lipossarcoma/cirurgia , Neoplasias Cutâneas/cirurgia , Biópsia , Diagnóstico Diferencial , Humanos , Leucemia Linfocítica Crônica de Células B/diagnóstico , Lipossarcoma/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico
8.
Hautarzt ; 71(8): 597-606, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32583034

RESUMO

Cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers of the Caucasian population and accounts for 20% of all skin tumours. An S3 guideline of the German Guideline Program in Oncology has been available since 2019. The diagnosis is based on the clinical examination. Excision and histological confirmation is required for all clinically suspicious lesions to allow prognostic assessment and correct treatment. The therapy of first choice is complete excision with histological control of the surgical margin. In cSCC with risk factors such as tumor thickness >6 mm, sentinel lymph node biopsy may be discussed, but there is currently no clear evidence of its prognostic and therapeutic relevance. Adjuvant radiation therapy may be considered in cases of high risk of recurrence and should be tested in cases of inoperable tumors. The indication for electrochemotherapy should also be considered in the treatment of local or locoregional recurrence. The immune checkpoint inhibitor cemiplimab is approved for the treatment of inoperable or metastasized cSCC. In case of contraindications, chemotherapeutic agents, epidermal growth factor receptor (EGFR) inhibitors or palliative radiotherapy can be used. Since the evidence is low in these cases, a systemic therapy should be used preferentially within clinical studies. Follow-up care should be risk-adapted and includes a dermatological control, supplemented by ultrasound examinations in high-risk patients.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/cirurgia , Procedimentos Cirúrgicos Dermatológicos/métodos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/cirurgia , Carcinoma de Células Escamosas/patologia , Humanos , Recidiva Local de Neoplasia , Guias de Prática Clínica como Assunto , Prognóstico , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/patologia , Resultado do Tratamento
12.
Int J Surg ; 79: 206-212, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32497751

RESUMO

The rapidly spreading coronavirus infection (COVID-19) worldwide has contracted all aspects of health systems. Developing countries that mostly have a weaker healthcare system and insufficient resources are likely to be the most hardly affected by the pandemic. Cancers are frequently diagnosed in late stages with higher case-fatality rates compared to those in high-income countries. Delayed diagnosis, lack of cancer awareness, low adherence to treatment, and unequal or limited access to treatment are among the challenging factors of cancer management in developing countries. Elective cancer surgeries are often considered to be postponed during COVID-19 pandemic to preserve valuable hospital resources such as personal protection equipment, hospital bed, intensive care unit capacity, and manpower to screen and treat the affected individuals. However, specific considerations to defer cancer surgery in developing countries might need to be carefully adjusted to counterbalance between preventing COVID-19 transmission and preserving patients 'long-term life expectancy and quality of life.


Assuntos
Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento , Neoplasias/cirurgia , Pneumonia Viral/epidemiologia , Betacoronavirus , Neoplasias da Mama/cirurgia , Infecções por Coronavirus/transmissão , Assistência à Saúde , Transmissão de Doença Infecciosa/prevenção & controle , Procedimentos Cirúrgicos Eletivos , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Controle de Infecções , Unidades de Terapia Intensiva/organização & administração , Corpo Clínico Hospitalar/provisão & distribução , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/transmissão , Qualidade de Vida , Neoplasias Cutâneas/cirurgia , Neoplasias de Tecidos Moles/cirurgia
13.
J Zoo Wildl Med ; 51(2): 357-362, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32549565

RESUMO

Techniques for anesthesia of green sea turtles (Chelonia mydas) are required for medical treatment. The use of spinal anesthesia has been reported in a few species of turtles for different purposes. The objective of this study was to evaluate the use of 2% lidocaine for spinal anesthesia of green sea turtles undergoing surgical removal of cutaneous fibropapillomas. Ten free-ranging green turtles presenting with cutaneous fibropapillomas were included in the study. Animals were accidentally captured or rescued by local fishermen and brought to the Ubatuba Research Base (Sao Paulo, Brazil) of the Brazilian Sea Turtle Conservation Program for rehabilitation. Animals were administered 2% lidocaine (0.2 ml/10 cm of carapace) in the epidural/subarachnoid space of the tail and monitored throughout surgery. The technique was effective for all animals, with fast onset of motor and sensory blockade (3 ± 1.76 min) and relatively fast recovery time (83.9 ± 16.2 min). Fibropapillomas were removed from all animals with no signs of pain (i.e., no behavioral response during surgical procedure, such as head and forelimb movement, showing discomfort) and they were all rehabilitated and successfully returned to their natural habitat. The technique was considered effective, safe, and affordable for use on green turtles undergoing surgical removal of cutaneous fibropapillomas.


Assuntos
Raquianestesia/veterinária , Anestésicos Locais/administração & dosagem , Lidocaína/administração & dosagem , Papiloma/veterinária , Neoplasias Cutâneas/veterinária , Tartarugas/cirurgia , Animais , Animais Selvagens/cirurgia , Brasil , Papiloma/cirurgia , Neoplasias Cutâneas/cirurgia
16.
J Surg Oncol ; 122(2): 263-272, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32430916

RESUMO

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare low-grade tumor. Little is known about best treatment of primary and relapsed disease (RD). METHODS: Treatment and outcome of 40 patients with DFSP prospectively registered within the CWS-96 and -2002P trials and the registry SoTiSaR (1996-2016) were analysed. RESULTS: Median age was 8 years (range, 0.64-17.77). Fluorescence in situ hybridization analysis to detect COL1A1-PDGFB fusion genes was positive in 86% (12/14) of evaluated patients. Primary resection was performed in all patients. Patients had IRS group I (n = 28), II (n = 9), and III (n = 2); not available (n = 1). To achieve complete remission (CR), a secondary resection was performed in 18 patients resulting in microscopically complete (R0, n = 34/40) and microscopically incomplete (R1, n = 5/40) resection. All patients achieved CR. The 5-year event-free survival (EFS) and overall survival was 86% (±12; CI, 95%) and 100% (±0; CI, 95%), respectively. R0 resection/IRS I was significantly favorable for the 5-year EFS. Local relapse occurred after a median time of 1.1 years (range, 0.04-5.1) in 15% (6/40) after CR. All patients with RD underwent resection and achieved CR. Three patients had fibrosarcomatous DFSP, two were alive after R0 resection. CONCLUSION: Complete surgical resection is mandatory to prevent relapse of DFSP.


Assuntos
Dermatofibrossarcoma/tratamento farmacológico , Dermatofibrossarcoma/cirurgia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/cirurgia , Adolescente , Adulto , Antineoplásicos/administração & dosagem , Criança , Dermatofibrossarcoma/genética , Feminino , Humanos , Mesilato de Imatinib/administração & dosagem , Hibridização in Situ Fluorescente , Masculino , Proteínas de Fusão Oncogênica/genética , Prognóstico , Intervalo Livre de Progressão , Sistema de Registros , Estudos Retrospectivos , Neoplasias Cutâneas/genética , Adulto Jovem
17.
Facial Plast Surg ; 36(2): 133-140, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32413920

RESUMO

Basal cell carcinoma, squamous cell carcinoma, and melanoma represent the three most common skin cancers that occur on the face. The most common surgical treatments for facial skin cancers are Mohs' surgery and standard local excision. The effective utilization of either of these techniques is based on tumor and patient risk stratification incorporating known risk factors for occult invasion and local recurrence, combined with patient comorbidities, expectations, and desires. Best available evidence highlights multiple and consistent risk factors for each specific skin cancer type, and dictate local control rates reported in the literature. Recognizing gaps in the literature, we compare and review surgical treatment guidelines and data for standard local excision versus Mohs' surgery for cutaneous nonmelanoma and melanoma skin cancer. This article serves as a resource for optimal therapeutic decision making for surgical management of skin cancer on the face.


Assuntos
Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Melanoma/cirurgia , Neoplasias Cutâneas/cirurgia , Humanos , Cirurgia de Mohs , Recidiva Local de Neoplasia/cirurgia
18.
Facial Plast Surg ; 36(2): 141-147, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32413921

RESUMO

High-risk nonmelanoma skin cancers of the head and neck may be identified through a variety of tumor risk factors, including location on the lips or ears, size > 2 cm, recurrence, patient immunocompromised status, poor tumor differentiation, > 6 mm thickness, Clark level V depth of invasion, and presence of perineural spread. Surgical excision is the mainstay of treatment, with Mohs' micrographic surgery typically preferred to standard surgical excision. When reconstructing these defects, ensuring negative margins is of utmost importance and delaying reconstruction until confirmation of margins is recommended. Attention to the impact of immunosuppression and adjunct radiation therapy on wound healing is important for an optimal cosmetic outcome. As with all high-risk cancer patients, close follow-up and surveillance of these patients is imperative.


Assuntos
Recidiva Local de Neoplasia/cirurgia , Neoplasias Cutâneas/cirurgia , Humanos , Cirurgia de Mohs , Cicatrização
19.
Facial Plast Surg ; 36(2): 148-157, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32413922

RESUMO

There is considerable variation in the surgical management of patients with large facial defects after excision of skin malignancy. The surrounding facial subunits as well as local, regional, and distant soft-tissue flaps can be considered in more complicated facial defects. We place an emphasis on the versatility of adjacent tissue advancement and transposition flaps in the treatment of these defects. We also focus on the secondary reconstructive efforts necessary to achieve the best functional and aesthetic outcomes for patients.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Neoplasias Cutâneas/cirurgia , Estética Dentária , Face , Humanos , Retalhos Cirúrgicos
20.
Facial Plast Surg ; 36(2): 166-175, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32413924

RESUMO

Periocular skin is highly prone to malignancies, especially basal cell and squamous cell carcinomas. Because of the complex anatomy and eye-protecting functions of the periocular tissues, treatment of these cancers requires special considerations. Mohs micrographic surgery is usually the treatment of choice, whenever possible, in order to enhance margin control while limiting collateral damage to nearby normal structures. Cancer excision, whether by Mohs or other techniques, will leave a complex defect that requires careful anatomical and functional reconstruction. This study presents some of the challenges of treating periocular skin cancer and associated reconstructive surgery and provides an intellectual framework for addressing these challenges. The key topics are adherence to anatomical landmarks and aesthetic units, proper distribution of tension, and matching the correct reconstructive approach, that is, type of flap or graft, to the defect at hand. This review is not meant to be exhaustive, but it will provide both basic and advanced considerations.


Assuntos
Carcinoma Basocelular/cirurgia , Neoplasias Palpebrais/cirurgia , Neoplasias Cutâneas/cirurgia , Estética Dentária , Humanos , Cirurgia de Mohs
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