Breast implant-associated squamous cell carcinoma in a male patient: A case report and review of the medical literature.

Background: Primary squamous cell carcinoma (SCC) of the breast is a rare tumor type. The diagnosis of this tumor type is more frequently made only after microscopy evaluation. Breast implant-associated SCC is rarer with medical literature review indicating only 18 cases reported in female individuals. Case presentation: We reported an unusual case that a man found a 3-cm sized mass on his left breast at first, who had a implant surgery 18 years previously to reconstruct the deformed left breast, as related to the Poland's syndrome. More than 1 year after the mass was detected, the size of the mass gradually increased to 20 cm with swelling and severe pain, and the patient was admitted to our hospital. The patient underwent surgical excision of the tumor, followed by removal of the implant, complete capsulectomy, and sentinel lymph node biopsy. The microscopy evaluation demonstrated the tumor as moderately and poorly differentiated invasive SCC. Follow-up at 12 months after showed multiple metastases, including the skin of the chest, axillary lymph nodes and pleura. Conclusion: Breast implant-associated SCC can occur in male patients. Therefore, it should be considered when the clinical manifestation or histopathological appearance is not typical of other breast neoplasms. Malignant transformation of normal epithelial cells takes about 18 years, after which rapid evolution follows leading to fast growth of the tumor.

[Effectiveness of upper eyelid rotation flap via blepharoplasty incision for correction of mild to moderate epicanthus].

Objective: To evaluate an modified epicanthoplasty which can reduce epicanthic scar in blepharoplasty with mild to moderate epicanthus, by using upper eyelid rotation flap via blepharoplasty incision. Methods: A clinical data of 34 patients with mild and moderate epicanthus (trial group), who were treated with blepharoplasty and epicanthoplasty by using upper eyelid rotation flap, between July 2016 and October 2017, was retrospectively analyzed. And 38 patients who were treated with blepharoplasty and epicanthoplasty by using traditional "Z" plastic method were recruited as control group. There was no significant difference in age and degree of epicanthus between 2 groups ( P>0.05). The lengths of palpebral fissure were measured at preoperation and at 6 days and 6 months after operation, and the length difference between pre- and post-operation was calculated to evaluate the improvement degree. The effectiveness was evaluated with reference to the scale of epicanthus orthopedics. Results: All incisions of 2 groups healed by first intention, and all patients were followed up 6 months. The epicanthi of 2 groups were significantly corrected. The inner canthus of trial group had no incision; and there were scars at inner canthus of control group, with obvious hyperplasia in 6 cases. The improvement degree of the length of palpebral fissure in trial group and control group were 3.63%±0.07%, 3.70%±0.05% and 4.64%±0.09%, 4.46%±0.10% at 6 days and 6 months after operation, respectively. There was no significant difference between 2 groups ( t=0.005, P=0.996; t=0.287, P=0.871). The effectiveness was excellent in 20 cases, good in 12 cases, and poor in 2 cases in trial group, with an excellent and good rate of 94.12%; meanwhile, the effectiveness was excellent in 16 cases, good in 16 cases, and poor in 6 cases in control group, with an excellent and good rate of 84.21%. There was no significant difference between 2 groups ( χ2=0.796, P=0.372). Conclusion: The modified epicanthoplasty by using upper eyelid rotation flap via blepharoplasty incision can significantly reduce epicanthic scar with simple operation and satisfactory effectiveness.

Failure of Ibuprofen to prevent progressive dermal ischemia after burning in guinea pigs.

OBJECTIVE: It is controversial whether the use of prostaglandin inhibitors could prevent progressive dermal ischemia in the postburn stasis zone. This study evaluated the effect of Ibuprofen on preventing postburn dermal ischemia using an animal model of India ink perfusion and skin transparent preparation techniques. METHODS: The closely clipped backs of the guinea pigs were bathed in 75 degrees C water for 10s. Ibuprofen-treated groups were fed intragastrically with Ibuprofen (12.5mg/kg) every 6h. All animals were perfused with 70% India ink via a cervical artery cannula at 16 kPa constant pressure at 0, 8, 16, 24h postburn. Skin transparent preparations were made, and 6-keto-PGF(1 alpha) and T x B(2) levels in skin tissue were assessed. RESULTS: India ink filling rates in skin capillary plexuses decreased gradually with postburn time elapsing (P<0.01). 6-keto-PGF(1 alpha) and T x B(2) levels in two groups increased. The increase of T x B(2) was dominant, which was related to postburn dermal ischemia (r=0.742, P<0.01). Though levels of 6-keto-PGF(1 alpha) and T x B(2) decreased in Ibuprofen-treated groups, India ink filling rates showed no significant difference between controls and experimental groups (P>0.05). The results were also confirmed by observation of skin transparent preparations. CONCLUSION: This study suggests that Ibuprofen has no preventive effect on progressive dermal ischemia after burning.

[Surgical treatment for gyncomastia].

OBJECTIVE: To introduce different surgical treatment for gyncomastia at different grades. METHODS: 37 cases with gynecomastia were divided into three grades as: grade I with fat as main tissue, grade II with proliferated fibro-gland as main tissue, grade III with big and ptosis breasts and sagging skin. Different surgical methods were chosen according to the different grades of gyncomastia. These include liposuction, subareolar fibroglandular tissue removing, combined technique of the two methods, and breasts resection with free transplantation of nipple-areola complex. RESULTS: All patients were satisfied for the appearance of post-operative flat male chest. Complications, such as scar, numbness of nipple and areola were acceptable for them. CONCLUSIONS: Different surgical methods should be chosen for the gynecomastia at different grades. It can improve both the physical and psychological problems for patients.

[Reconstruction of chest wall deformity in Poland's syndrome with soft silicone prosthesis].

OBJECTIVE: To explore a method for reconstruction of Poland's chest wall deformity. METHODS: The customized, textured silicone prosthesis was fabricated from a soft silicone polymer that approximated to the softness of the pectoralis major muscle. A lateral incision of 6 cm on the affected chest was made. After a subcutaneous pocket above the ribs was created through the incision, the prosthesis was placed in the pocket. RESULTS: Since October 2000, chest wall reconstruction for Poland's syndrome deformity has been performed in 7 male patients (18 to 45 years) with the customized soft silicone prosthesis. Follow-up for 3 to 17 months showed that all patients were satisfied with the aesthetical results. Seroma occurred in 2 patients, and needle aspiration was used to solve the problem. CONCLUSION: This method is simple and less traumatic. The reconstructed chest wall approximates to the softness and appearance of the contralateral pectoralis muscle.

[Preparation of porcine acellular dermal matrix by low concentration of trypsin digestion and repeated freeze-thaw cycles].

OBJECTIVE: To establish a new method for the preparation of porcine acellular dermal matrix. METHODS: The antigenicity of the porcine dermis was weakened by removing epidermal and dermal cells from the porcine skin through the digestion with low-concentration trypsin and repeated freeze-thaw cycles. Split thickness porcine skin was treated with 0.05% trypsin to remove the cells from the epidermis and dermis. Repeated freeze-thaw cycles were employed to further weed out the residual cells within the dermis. The prepared acellular dermis was then examined grossly, as well as histologically, and also by immunohistochemical method. RESULTS: No cell could be identified in the prepared porcine acellular dermal matrix. The integral basement membrane was preserved on the surface of dermal matrix with compact dermal matrix collagen structure. CONCLUSION: Low concentration trypsinization and repeated freeze-thaw cycles seemed to be a simple and effective method for the preparation of xenogeneic acellular dermal matrix.