Basal cell carcinosarcoma: a report of 4 cases and review of the literature.

BACKGROUND: To describe the features of 4 cases of basal cell carcinosarcoma and systematically review previously reported cases. METHODS: Four cases of basal cell carcinosarcoma were identified from the practice of the authors. A search of the literature revealed an additional 40 cases, variously described in small series and single case reports. The clinical and pathological features of these 44 cases are described. RESULTS: Basal cell carcinosarcoma is largely a tumor of elderly men (male:female 3:1, average age: 76 years). The majority of these lesions are relatively small (<25 mm). Heterologous elements are common, particularly an osteosarcomatous component, which is present in 45% of cases. Although there are relatively limited follow-up data, only 1 case formally reported in the literature has shown distant metastasis. CONCLUSIONS: Despite relatively high reported rates of local recurrence and metastasis for "carcinosarcoma" as an unrefined entity, it seems that the subgroup of basal cell carcinosarcoma has a relatively good prognosis, with adequate local excision being curative in the majority of cases. Recognition of this entity is critical for accurate diagnosis and its separation from other types of carcinosarcoma may have significant prognostic implications.

Sexual trauma--an unusual cause of a vesicovaginal fistula.

A 20-year-old nullipara presented with a post-coital vesicovaginal fistula in the trigone of the bladder. She had normal genital development and no other cause was found. The fistula was repaired by vaginal route.

Preoperative embolization of aberrant systemic artery in sequestration of lung.

A 40-year-old man presented with left lower lobe pneumonia that failed to resolve on antibiotic therapy. Computed tomography revealed intralobar sequestration of the left lower lobe supplied by a large artery from the descending aorta. The aberrant artery was embolized using polyvinyl alcohol particles. The sequestered tissue was resected 3 weeks later. Identification and control of the aberrant artery is essential to avoid inadvertent injury and massive hemorrhage.

Forgotten needle--an unusual cause of chronic pelvic pain.

CASE REPORT: A case presented with chronic pelvic pain since a Fothergills repair 9 years back. Over the years she had received multiple courses of antibiotics and anti-inflammatory drugs to no avail. RESULTS: Thorough evaluation revealed the presence of a foreign body in the form of a surgical needle in the cervix.

Twin reversed arterial perfusion: report of four cases.

Twin reversed arterial perfusion (TRAP sequence), or acardiaus, is a rare and serious complication of monozygotic multiple gestation. The acardiac fetus suffers from lethal anomalies. The normal co-twin also runs a high risk of perinatal morbidity and mortality due to heart failure and prematurity. Four cases of acardius are presented. The role of sonography in the condition's diagnosis and management is discussed.

Pregnancy associated aplastic anemia: maternal and fetal outcome.

AIM: To study the maternal and fetal outcome in cases of aplastic anemia associated with pregnancy. METHOD: Retrospective analysis of seven cases of aplastic anemia diagnosed during pregnancy. RESULT: Four patients had an overall successful pregnancy outcome. These were all cases of non-severe aplastic anemia. There was one case each of intrauterine and neonatal death in the severe aplastic anemia group. There was one maternal mortality. CONCLUSION: Maternal and fetal outcome is poor in severe aplastic anemia.