RESUMO
Pterygium Colli or "palmate neck" is a congenital malformation that is most often part of a polimalformative syndrome. This deformity is a source of aesthetic and social embarrassment. Its correction is surgical. We present the case of a pterygium colli in a patient with Noonan syndrome. He had a significant excess of skin with posterior skin laxity, causing significant social discomfort and imposing a vicious attitude, the head bent forward. We performed a posterolateral resection of this excess by resecting two posterior triangular flaps with a resulting t-shaped scar. The results were satisfactory; the excess skin was almost completely resorbed with minimal scarring. However, this technique did not correct the low lateral hairline implantation, and there were still two lateral flaps for which the patient did not wish to have a repeat surgery.
RESUMO
The use of blood liquid biopsy is increasingly being incorporated into the clinical setting of gastrointestinal cancers care. Clonal hematopoiesis (CH) occurs naturally as a result of the accumulation of somatic mutations and the clonal proliferation of hematopoietic stem cells with normal aging. The identification of CH-mutations has been described as a source of biological noise in blood liquid biopsy. Incorrect interpretation of CH events as cancer related can have a direct impact on cancer diagnosis and treatment. This review summarizes the current understanding of CH as a form of biological noise in blood liquid biopsy and the reported clinical significance of CH in patients with GI cancers.