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Sample records for adnexal skin carcinomas

  1. Adnexal carcinomas of the head and neck

    PubMed Central

    Güerrissi, Jorge O.; Quiroga, Juan Pablo

    2008-01-01

    Adnexal carcinomas of the skin are rare and they derive from structures such as sweat glands, sebaceous glands, and hair follicles. Adnexal tumors represent 1–2% of skin cancers. Between 1998 and 2004, eight patients with malignant adnexal tumors of the head and neck were treated in the Plastic Surgery Service in Argerich Hospital in Buenos Aires, Argentina. Four (50%) of them had malignant cylindromas, two (25%) had sebaceous carcinoma, and the other two (25%) syringoid eccrine carcinoma. Tumor resection and local flaps were made in all cases. In one case, a radical neck dissection with superficial parotidectomy was performed to treat the metastatic cervical nodes. Local recurrence observed in two cases (25%) was associated with distant metastasis and death of the patients. In other six cases, the survival rate was 75% after five years. PMID:19753272

  2. [Adnexal neoplasms in the context of skin cancer: trichilemmal carcinoma. Apropos of a case].

    PubMed

    Pérez-Martínez, Ignacio Jaime; Mantilla-Morales, Alejandra; Cruz-Esquivel, Iván; Gallegos-Hernández, José Francisco

    2013-01-01

    The trichilemmal carcinoma is a rare malignant neoplasm, whose origin lies in the annexes of the skin, because of its low prevalence often confused with other dermal tumors, the differential diagnosis is not easy and is usually made by exclusion; in theory, its behavior is slow with little tendency to send both regional lymph node metastasis and systemic. Due to the limited number of cases there is no consensus on the prognosis, although it is generally considered good. The aim of this report is to show a case that, contrary to previous reports, the clinical presentation is aggressive with large soft tissue tumor infiltration around the site of origin in a patient without risk factors for skin cancer. Male patient, 65 years old with cytologic diagnosis of carcinoma in a preprarotideal facial tumor, characteristics at diagnosis were infiltration of the facial skin, ear, and parotid gland. Complete block resection was performed, radical parotiroidectomy and radical neck dissection; the soft tissue defect was covered with a pediculated flap. The evolution was satisfactory it follow-up short though. We evaluated the experience in the literature regarding the prognosis and treatment of these patients. Trichilemmal carcinoma can be fully invasive behavior prognosis is difficult to know and probably depends on the clinical stage at diagnosis.

  3. Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature.

    PubMed

    Zhou, Rong-Rong; Zhao, Qi-Ming; Zhang, Xu-Dong; Gan, Jing-Bing

    2015-09-01

    Microcystic adnexal carcinoma (MAC) is a rare and locally aggressive adenocarcinoma with low-grade malignancy. The present study describes the first reported case and treatment of a Chinese male with a MAC located on the nasal dorsum and nosewing. A 44-year-old man presented with a nasal deformity caused by local repeated infections following an accidental injury to the nose 20 years previously. The nose had been injured by a brick, and treatment at a local hospital 12 years previously had resulted in a nasal scar and a gradually enlarging mass. A physical examination revealed a hypertrophic deformity of the nose and an indurated scar plaque, measuring 2.0×2.0 cm, on the nasal dorsum and nosewing. Microscopic examination revealed a tumor consisting of solid cell nests and a cystic structure with a capsular space. In addition, ductal cells of an adnexal cell origin were visible in the outer epithelium. The medial portion exhibited a microductal structure and invasion of deeper tissues without evident atypia. The tumor cells presented normal nuclear to cytoplasmic ratios and minimal mitotic activity. Pathological examination verified that the tumor was a MAC of low-grade malignancy. A complete surgical resection was performed via Mohs micrographic surgery (MMS), and reconstruction was achieved using an expanded rotational forehead skin flap. No tumor recurrence was detected after a three-year follow-up period. Therefore, for effective treatment of similar MAC cases, complete surgical resection using MMS is recommended, and successful reconstruction may be achieved using an expanded skin flap.

  4. Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

    PubMed Central

    ZHOU, RONG-RONG; ZHAO, QI-MING; ZHANG, XU-DONG; GAN, JING-BING

    2015-01-01

    Microcystic adnexal carcinoma (MAC) is a rare and locally aggressive adenocarcinoma with low-grade malignancy. The present study describes the first reported case and treatment of a Chinese male with a MAC located on the nasal dorsum and nosewing. A 44-year-old man presented with a nasal deformity caused by local repeated infections following an accidental injury to the nose 20 years previously. The nose had been injured by a brick, and treatment at a local hospital 12 years previously had resulted in a nasal scar and a gradually enlarging mass. A physical examination revealed a hypertrophic deformity of the nose and an indurated scar plaque, measuring 2.0×2.0 cm, on the nasal dorsum and nosewing. Microscopic examination revealed a tumor consisting of solid cell nests and a cystic structure with a capsular space. In addition, ductal cells of an adnexal cell origin were visible in the outer epithelium. The medial portion exhibited a microductal structure and invasion of deeper tissues without evident atypia. The tumor cells presented normal nuclear to cytoplasmic ratios and minimal mitotic activity. Pathological examination verified that the tumor was a MAC of low-grade malignancy. A complete surgical resection was performed via Mohs micrographic surgery (MMS), and reconstruction was achieved using an expanded rotational forehead skin flap. No tumor recurrence was detected after a three-year follow-up period. Therefore, for effective treatment of similar MAC cases, complete surgical resection using MMS is recommended, and successful reconstruction may be achieved using an expanded skin flap. PMID:26622465

  5. Urothelial Carcinoma with shadow cell, lipid cell and sebaceous (skin adnexal) differentiation: Clinicopathological and immunohistochemical study of 10 cases.

    PubMed

    Behzatoğlu, Kemal

    2015-10-01

    We discuss the histological and immunohistochemical features of 6 cases of urothelial carcinomas of lipid cell variant and 4 cases with shadow cell differentiation, one of which showed additionally sebaceous differentiation, one of which shows additional sebaceous differentiation, from our archive cases from the last 15 years. Conventional urothelial carcinoma (UC) was seen in all lipid cell variant cases, and micropapillary carcinoma was seen in 3. The ratio of the lipid cell component was between 10% and 40% in these 6 cases. Typical histologic features of the lipid cell variant include lipoblast-like cells with a notched nuclear appearance, abundant vacuoles, an eccentric nucleus, and pagetoid spread in some areas. GATA3 and pancytokeratin AE1/AE3 immunohistochemical staining were positive in all cases. Adipophilin was positive in various degrees in 5 of the 6 lipid cell variant cases but was also positive in the case with sebaceous differentiation. α-methylacyl-CoA racemase was positive in the lipid cell areas and negative or focal weakly positive in the conventional UC areas in 4 of the 6 cases. Vimentin, S-100 protein, and PAX8 were negative in the lipid cell component. Follow-up information was available for all cases with follow-up ranging from 6 to 84 months (mean, 34 months). Four patients died of the disease. One pT4 patient who had been followed up for 6 months lives with the disease, whereas another is disease free. In conclusion, the lipid cell variant is a rare UC variant that usually presents at an advanced stage, and tumor cells are histologically similar to lipoblasts, resemble sebaceous differentiation, and show positive immunohistochemical staining with adipophilin.

  6. Immunohistochemical study of calretinin in normal skin and cutaneous adnexal proliferations.

    PubMed

    González-Guerra, Elena; Kutzner, Heinz; Rutten, Arno; Requena, Luis

    2012-07-01

    Calretinin is a calcium-binding protein member of the EF-hand family. The presence of calretinin has been demonstrated in certain stages of the cellular cycle in a wide variety of normal and neoplastic tissues. The main aims of our study were (1) to investigate what structures of the normal skin and cutaneous adnexal proliferations express immunoreactivity for calretinin and (2) to determine the value of immunohistochemical expression for calretinin as a marker for follicular, sebaceous, apocrine, and eccrine differentiation in cutaneous adnexal proliferations. We studied 139 biopsy specimens, including 10 cases of normal skin of different locations and 129 benign and malignant cutaneous adnexal proliferations. In normal skin, we found that calretinin is expressed in the innermost cell layer of the outer root sheath in anagen hair follicle, in both the duct and sebolemma of the sebaceous gland, in the secretory portion of eccrine glands, and in mast cells of the stroma. In cutaneous adnexal proliferations, we found strong immunoreactivity for calretinin in tricholemmal cysts, tricholemmomas/inverted follicular keratoses, tumors of follicular infundibulum, and in some basal cell carcinomas. Focal positivity was also seen in trichoadenomas, trichoblastomas/trichoepitheliomas, pilomatricomas, proliferating tricholemmal tumors, pilar sheath acanthomas, trichofolliculomas, follicular hybrid cysts, cutaneous mixed tumors, steatocystomas, sebaceous hyperplasias, and sebaceomas. These results demonstrate that immunohistochemical study for calretinin may be helpful to identify the innermost cell layer of the outer root sheath in anagen hair follicle and the cutaneous adnexal proliferations showing differentiation toward this structure. Calretinin immunoreactivity supports eccrine differentiation in some sweat gland neoplasms, and it is also useful in identifying neoplasms with ductal sebaceous differentiation.

  7. Expression of p75 neurotrophin receptor in desmoplastic trichoepithelioma, infiltrative basal cell carcinoma, and microcystic adnexal carcinoma.

    PubMed

    Jedrych, Jaroslaw; McNiff, Jennifer M

    2013-05-01

    The histological discrimination between desmoplastic trichoepithelioma, infiltrative basal cell carcinoma, and microcystic adnexal carcinoma encountered in small biopsies is challenging when only morphological criteria are applied. The objective of this study is to test the use of p75 neurotrophin receptor (p75NTR) as an adjunct aid in classification of these tumors. Immunohistochemistry for p75NTR antigen was performed on routinely processed biopsies of 37 desmoplastic trichoepitheliomas, 11 infiltrative basal cell carcinomas, and 9 microcystic adnexal carcinomas diagnosed by morphological criteria in conjunction with results of CK20 immunostains. Cases were analyzed for the extent and intensity of p75NTR expression. Diffuse immunoreactivity was defined as involving >90% of tumor cells. Of the 37 desmoplastic trichoepitheliomas, 35 (94%) displayed strong diffuse immunoreactivity of tumor cells, proving high sensitivity of the marker to detect this tumor. However, despite the fact that diffuse p75NTR expression reached statistical significance in differentiating desmoplastic trichoepithelioma from infiltrative basal cell carcinoma (Fisher exact test P < 0.0001) and microcystic adnexal carcinoma (P < 0.0016), specificity of the stain is unsatisfactory because strong diffuse expression of p75NTR by neoplastic cells was observed in 4 (36%) cases of infiltrative basal cell carcinomas and 4 (44%) cases of microcystic adnexal carcinoma. This study demonstrates a significant difference in p75NTR expression in selected sclerosing neoplasms of the skin. Nevertheless, the practical value of p75NTR as an adjunct marker in the differential diagnosis of these tumors seems to be limited because of significant overlap in amount of p75NTR immunoreactivity.

  8. Skin adnexal neoplasms—part 1: An approach to tumours of the pilosebaceous unit

    PubMed Central

    Alsaad, K O; Obaidat, N A; Ghazarian, D

    2007-01-01

    Skin adnexal neoplasms comprise a wide spectrum of benign and malignant tumours that exhibit morphological differentiation towards one or more types of adnexal structures found in normal skin. Most adnexal neoplasms are relatively uncommonly encountered in routine practice, and pathologists can recognise a limited number of frequently encountered tumours. In this review, the first of two, the normal histology of the skin adnexal structures is reviewed, and the histological features of selected but important benign and malignant tumours and tumour‐like lesions of pilosebaceous origin discussed, with emphasis on the diagnostic approach and pitfalls in histological diagnosis. PMID:16882696

  9. Sclerosing ductal carcinoma of the clitoris with microcystic adnexal carcinoma-like features.

    PubMed

    DuPont, Nefertiti C; Mabuchi, Seiji; Ries, Savita; Berman, Michael L

    2009-03-01

    Primary clitoral malignancies are rare and most are invasive squamous cell carcinomas. Microcystic adnexal carcinoma (MAC) is an indolent, rare dermatologic carcinoma that typically affects the head and neck region. A 23-year-old nulligravid Hispanic female presented with a 9-month history of an enlarging periclitoral mass. After surgical resection, the mass was diagnosed as a MAC. MAC is a cutaneous carcinoma rarely found on the vulva. It is a slow growing but locally aggressive carcinoma that is best treated with surgical resection. Sclerosing ductal carcinomas may have MAC-like features, and the diagnosis and management of one case is provided here.

  10. A salivary gland adenocarcinoma mimicking a microcystic adnexal carcinoma.

    PubMed

    Basile, John R; Lin, Yi-Ling

    2010-04-01

    The microcystic adnexal carcinoma (MAC) is a rare, slow-growing but locally aggressive neoplasm arising in the midface and lips of middle-aged adults. The MAC is histologically characterized by deeply infiltrating nests and islands of basaloid or squamous cells forming cysts and ductal structures, proliferating in a dense sclerotic stroma and occasionally exhibiting perineural invasion. We describe a salivary gland adenocarcinoma arising in the lower lip, characterized by ductal structures and cords, 3-5 cell layers in thickness, set in a dense fibrous stroma and also invading nerves, thus mimicking a MAC in both its clinical and its histopathologic appearance. The diagnostic dilemma presented by this lesion is discussed, along with a differential diagnosis and brief review of the literature.

  11. Microcystic adnexal carcinoma of the cheek—a case report with dermatoscopy and dermatopathology

    PubMed Central

    Inskip, Mike; Magee, Jill

    2015-01-01

    We present a case report of a microcystic adnexal carcinoma on the cheek of a 67-year-old man. Clinical, dermatoscopic and dermatopathologic images are presented. A search of the literature has not discovered any previously published dermatoscopy images of microcystic adenexal carcinoma. PMID:25692080

  12. Rare Skin Adnexal and Melanocytic Tumors Arising in Ovarian Mature Cystic Teratomas: A Report of 3 Cases and Review of the Literature.

    PubMed

    Moulla, Alexandra A; Magdy, Nesreen; Francis, Nicholas; Taube, Janis; Ronnett, Brigitte M; El-Bahrawy, Mona

    2016-09-01

    Mature teratoma of the ovary is the most common primary ovarian tumor accounting for 15% (10%-20%) of all ovarian neoplasms. Skin and skin adnexal structures are the most common elements identified in mature teratomas. Benign and malignant skin tumors can arise in ovarian teratomas, the most common being epithelial tumors. Melanocytic and adnexal tumors developing in a teratoma are rare and can be easily overlooked. We report 3 cases and review melanocytic and skin adnexal tumors encountered in ovarian teratomas.

  13. T-Cadherin Expression in the Epidermis and Adnexal Structures of Normal Skin

    PubMed Central

    Buechner, Stanislaw; Erne, Paul; Resink, Therese J.

    2016-01-01

    Background T-cadherin is an atypical glycosylphosphatidylinositol-anchored member of the cadherin superfamily of adhesion molecules. The role of T-cadherin in biology of the skin is poorly understood. Expression of T-cadherin in basal keratinocytes and dermal blood vessels of the healthy epidermis has been demonstrated, but studies on expression in skin appendages are rare. Methods We conducted an immunohistochemical analysis of T-cadherin expression in the epidermis and adnexal structures of normal skin. Results T-cadherin expression is restricted to basal keratinocytes of the epidermis. The basal cell layer of sebaceous glands was T-cadherin positive, whereas sebocytes were negative. Within apocrine glands, only myoepithelial cells were T-cadherin positive. In contrast, both the secretory coils and excretory ducts of eccrine glands were T-cadherin positive. In terminal hair follicles, the outer root sheath layers strongly expressed T-cadherin throughout different regions of the follicle, with the strongest immunoreactivity at the bulge and suprabulbar regions. T-cadherin and CK15 stem cell marker similarly localized within the bulge and suprabulbar region. T-cadherin and CD34 stem cell marker similarly localized at the suprabulbar level. Conclusion The specific patterns of T-cadherin expression in the epidermis and adnexal structures suggest an important guardian role in skin homeostasis. PMID:27904857

  14. GATA3 Expression in Normal Skin and in Benign and Malignant Epidermal and Cutaneous Adnexal Neoplasms.

    PubMed

    Mertens, Richard B; de Peralta-Venturina, Mariza N; Balzer, Bonnie L; Frishberg, David P

    2015-12-01

    Initial investigations reported GATA3 to be a sensitive and relatively specific marker for mammary and urothelial carcinomas. Recently, GATA3 expression has been described in several other epithelial tumors. However, there has been only limited investigation of GATA3 expression in cutaneous epithelial tumors. The objective of this study was to examine the immunohistochemical expression of GATA3 in a wide variety of cutaneous epithelial neoplasms. GATA3 expression was evaluated in 99 benign and 63 malignant cutaneous epithelial tumors. GATA3 was consistently and usually strongly expressed in clear cell acanthoma, trichofolliculoma, trichoepithelioma, trichilemmoma, sebaceous adenoma, sebaceoma, apocrine hidrocystoma, apocrine tubular papillary adenoma, hidradenoma papilliferum, and syringocystadenoma papilliferum. Hidradenomas exhibited variable positive staining. Most poromas, syringomas, chondroid syringomas, cylindromas, and spiradenomas were negative or only focally and weakly positive. Focal staining was present in all pilomatrixomas. Thirteen of 14 basal cell carcinomas, 21 of 24 squamous carcinomas, and all 6 sebaceous carcinomas exhibited positive staining. The 1 apocrine carcinoma, both mucinous carcinomas, and 2 of 3 microcystic adnexal carcinomas also exhibited positive staining, whereas the 1 eccrine porocarcinoma and the 1 adenoid cystic carcinoma were negative. One of 11 Merkel cell carcinomas exhibited focal weak staining. Our findings demonstrate that GATA3 is expressed in a wide variety of benign and malignant cutaneous epithelial neoplasms. In addition to carcinomas of breast and urothelial origin and other more recently described GATA3-positive tumors, the differential diagnosis of a metastatic tumor of unknown primary origin that expresses GATA3 should also include a carcinoma of cutaneous epithelial origin.

  15. p75 Neurotrophin receptor differentiates between morphoeic basal cell carcinoma and desmoplastic trichoepithelioma: insights into the histogenesis of adnexal tumours based on embryology and hair follicle biology.

    PubMed

    Krahl, D; Sellheyer, K

    2010-07-01

    Tumour development is frequently described in the basic pathology literature as a recapitulation of embryogenesis. However, a link between the embryology of the skin and the histogenesis of adnexal tumours has been largely overlooked. The low-affinity p75 neurotrophin receptor (p75NTR) has a profound role in hair follicle biology. We therefore speculated that it is involved in the histogenesis of follicular adnexal tumours. One of the most challenging diagnoses in dermatopathology is differentiating morphoeic basal cell carcinoma from desmoplastic trichoepithelioma. To describe the expression pattern of p75NTR during cutaneous embryogenesis, in the adult hair follicle and in morphoeic basal cell carcinoma and desmoplastic trichoepithelioma. Evaluation of the staining pattern for p75NTR was performed using standard immunohistochemical techniques. For comparison, we examined staining for cytokeratin 20 which highlights Merkel cells. All 17 desmoplastic trichoepitheliomas were immunoreactive with > 80% of the cells stained, whereas 12 of the 14 (86%) morphoeic basal cell carcinomas were p75NTR negative. In the two positive cases of morphoeic basal cell carcinoma < 30% of cells were labelled. In the late bulbous hair peg stage and in the postnatal anagen hair follicle p75NTR highlights the outer root sheath. Our results support the classification of desmoplastic trichoepithelioma as a follicular hamartoma mimicking the outer root sheath. In contrast, the lack of p75NTR expression in morphoeic basal cell carcinoma favours a concept of this tumour as a more primitive follicular lesion with the characteristics of a carcinoma and not a hamartoma. We suggest including p75NTR as a tool in the differential diagnosis between morphoeic basal cell carcinoma and desmoplastic trichoepithelioma.

  16. Adnexal germ cell carcinoma with bone metastases in pregnant women: case report and review.

    PubMed

    Tenorio-Guadalupe, María Del Rosario; Arsentales-Montalva, Valeria; Yonz-Buendía, Yessabell Sonia; Fiestas-Saldarriaga, Fabián; Pimentel-Álvarez, Patricia

    2016-08-24

    Germ cell carcinoma during pregnancy is rare. However, its detection has increased due to the use of ultrasound fetal monitoring in the antenatal care program. In this article, we present the case of a Germ cell carcinoma during pregnancy is rare. However, its detection has increased due to the use of ultrasound fetal monitoring in the antenatal care program. In this article, we present the case of a pregnant 27-year-old diagnosed with an adnexal germ cell carcinoma at six weeks of gestation, whose initial approach was local resection (suboptimal cytoreduction). Four weeks after surgery, the patient presented with grade IV peripheral neuropathy in the lower limbs; magnetic resonance imaging scan indicated an infiltrative lesion at D5. The local medical board decided on chemotherapy starting on the 19th week of gestation. The rest of the pregnancy period was uneventful and the patient had a cesarean section at 34 weeks of gestation and a live newborn with no complications. Unfortunately, four days after caesarean section, the patient died of a septic shock with respiratory focus.

  17. CD3+ and BLA.36+ cells do not occur in the epidermis and adnexal epithelia of normal skin from the dorsolateral trunk of cats.

    PubMed

    Tranchina, Michelle M; Scott, Danny W; McDonough, Sean P

    2010-10-01

    A small population of resident T-lymphocytes is present in the normal epidermis of humans, mice, and rats. However, resident epidermal lymphocytes have not been reported in the normal skin of the cat. Skin-biopsy specimens from the normal skin of the dorsolateral trunk from 30 cats were examined histologically and immunohistochemically for the presence of lymphocytes, CD3+ cells, and BLA.36+ cells in epidermis and adnexal epithelia. All examinations were negative. It appears that lymphocytes occur rarely, if at all, in the epidermis and adnexal epithelial of normal cat skin. Hence, the presence of lymphocytes in these structures should be considered abnormal. Copyright © 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  18. Lymphoepithelioma-like carcinoma of the skin: a case with lymph node metastases at presentation.

    PubMed

    Hall, Gillian; Duncan, Alison; Azurdia, Richard; Leonard, Niamh

    2006-06-01

    We report a case of a primary lymphoepithelioma-like carcinoma (LELC) of the skin. The patient was a 73-year-old man with a lump on his back for 18 months. A biopsy and subsequent excision was performed. He also had axillary node clearance for metastatic disease. The tumor was composed of islands of pleomorphic cells with a lymphocytic infiltrate. Differential diagnoses included squamous cell carcinoma, adnexal carcinoma, Merkel cell tumors, lymphoepithelial lesions, lymphomas, and skin metastases. The histopathologic and immunohistochemical features were those of a LELC of the skin. It was negative for Epstein-Barr virus. Just over 30 cases of primary LELCs arising in the skin have been reported with only 1 documented fatality. We report a case with extensive vascular involvement and bilateral lymph node metastases.

  19. Comparative analysis of cytokeratin 15, TDAG51, cytokeratin 20 and androgen receptor in sclerosing adnexal neoplasms and variants of basal cell carcinoma.

    PubMed

    Evangelista, Mara Therese P; North, Jeffrey P

    2015-11-01

    Desmoplastic trichoepithelioma (DTE), morpheaform basal cell carcinoma (BCC) and microcystic adnexal carcinoma (MAC) are sclerosing adnexal neoplasms with overlapping histopathologic features. We compared cytokeratin 15, (CK15), T-cell death-associated gene 51 (TDAG51), cytokeratin 20 (CK20) and androgen receptor (AR) in differentiating these tumors and assessed their expression in BCC subtypes. Fifteen DTE, 15 infundibulocystic BCC, 18 micronodular BCC, 18 morpheaform BCC and 6 MAC were assessed for CK15, TDAG51, CK20 and AR expression. Quantitative CK15 staining was higher in DTE compared with BCC (p < 0.0001) and MAC (p = 0.02). Quantitative TDAG51 staining was higher in DTE than BCC (p < 0.0001). The CK20+AR- immunophenotype was 100% sensitive and specific in diagnosing DTE. The CK20-AR+ immunophenotype was 95.24% specific and 83.33% sensitive for BCC. The CK20-AR- immunophenotype was 83.33% sensitive and 90.91% specific for MAC. CK15, CK20 and AR were positive in 87, 53 and 67% of infundibulocystic BCC cases, respectively. Combination of CK20 and AR best differentiated these sclerosing adnexal neoplasms. Greater positivity for CK15 and TDAG51 generally favors benign lesions. Infundibulocystic BCC has higher CK20 and lower AR immunopositivity than other BCC variants and a high degree of CK15 and TDAG51 positivity. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Prophylactic salpingectomy and prophylactic salpingoophorectomy for adnexal high-grade serous epithelial carcinoma: A reappraisal.

    PubMed

    Oliver Perez, M Reyes; Magriñá, Javier; García, Alvaro Tejerizo; Jiménez Lopez, Jesus Salvador

    2015-12-01

    At present, there is no effective screening of ovarian cancer. Primary prevention may be the only strategy to decrease the mortality from ovarian cancer, not only in women at high risk but also at low risk. Several recent studies have identified the distal fimbriae end of the fallopian tubes as primary precursor of High-grade serous carcinoma. Serous tubal intraepithelial carcinomas and occult invasive serous carcinomas have been identified in 2-17% of the fallopian tubes of BRCA1/2 positive women undergoing risk-reducing salpingo-oophorectomy. Removal of the fallopian tubes with ovarian preservation has been suggested as a reasonable strategy that could reduce the risk of developing ovarian carcinoma in both low and high-risk women. It has been proposed after childbearing in women at high risk to be followed by bilateral oophorectomy at a later date. Bilateral salpingectomy is also suggested for low risk women, at the time of other benign gynaecologic surgery as a primary preventive strategy. Some studies have shown a risk reduction of ovarian cancer in women with bilateral prophylactic salpingectomy. Current research regarding bilateral salpingoophorectomy as primary prevention approach of ovarian cancer is reviewed here. In addition, the potential use of bilateral salpingectomy as prevention approach of ovarian cancer is discussed.

  1. An extraordinary case of axillary contracture: trapped healthy skin and its adnexes under contracted scar.

    PubMed

    Nisanci, Mustafa; Sahin, Ismail; Guzey, Serbulent

    2014-01-01

    Although striking improvements have been achieved in overall management of burn injury, postburn contractures are still an ongoing challenge to burn surgeons. Axillary adduction contracture is one of the most common types of these disabling postburn complications that usually result from suboptimal treatment after acute burns. An unusual and complicated case of axillary contracture in which the unburned, healthy axillary dome skin was trapped as a cystic mass under the scarred area was reconstructed by transfer of a big (17×13-cm) thoracodorsal artery perforator flap after contracture release. The result was satisfactory in terms of function and acceptable cosmetically. The underlying reasons for the inadequate treatment the patient received after surviving a severe electrical injury were discussed.

  2. An Extraordinary Case of Axillary Contracture: Trapped Healthy Skin and Its Adnexes Under Contracted Scar

    PubMed Central

    Nisanci, Mustafa; Sahin, Ismail; Guzey, Serbulent

    2014-01-01

    Although striking improvements have been achieved in overall management of burn injury, postburn contractures are still an ongoing challenge to burn surgeons. Axillary adduction contracture is one of the most common types of these disabling postburn complications that usually result from suboptimal treatment after acute burns. An unusual and complicated case of axillary contracture in which the unburned, healthy axillary dome skin was trapped as a cystic mass under the scarred area was reconstructed by transfer of a big (17 × 13-cm) thoracodorsal artery perforator flap after contracture release. The result was satisfactory in terms of function and acceptable cosmetically. The underlying reasons for the inadequate treatment the patient received after surviving a severe electrical injury were discussed. PMID:25058781

  3. Talimogene Laherparepvec and Nivolumab in Treating Patients With Refractory Lymphomas or Advanced or Refractory Non-melanoma Skin Cancers

    ClinicalTrials.gov

    2017-10-09

    Adenoid Cystic Carcinoma; Adnexal Carcinoma; Apocrine Carcinoma; Eccrine Porocarcinoma; Extraocular Cutaneous Sebaceous Carcinoma; Hidradenocarcinoma; Keratoacanthoma; Malignant Sweat Gland Neoplasm; Merkel Cell Carcinoma; Microcystic Adnexal Carcinoma; NK-Cell Lymphoma, Unclassifiable; Non-Melanomatous Lesion; Paget Disease; Papillary Adenocarcinoma; Primary Cutaneous Mucinous Carcinoma; Refractory Anaplastic Large Cell Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Refractory Mycosis Fungoides; Refractory Primary Cutaneous T-Cell Non-Hodgkin Lymphoma; Refractory T-Cell Non-Hodgkin Lymphoma; Sezary Syndrome; Signet Ring Cell Carcinoma; Skin Basal Cell Carcinoma; Skin Basosquamous Cell Carcinoma; Skin Squamous Cell Carcinoma; Spiradenocarcinoma; Squamous Cell Carcinoma of Unknown Primary Origin; Stage III Skin Cancer; Stage IV Skin Cancer; Sweat Gland Carcinoma; Trichilemmocarcinoma; Vulvar Squamous Cell Carcinoma

  4. Secondary mucinous carcinoma of the skin.

    PubMed

    Frances, Laura; Cuesta, Laura; Leiva-Salinas, Maria; Bañuls, Jose

    2014-04-16

    We report a case of a woman who presented with a cystic-appearing nodule on her left nipple. After cutaneous biopsy and gynecological staging study, she was diagnosed with skin invasion of mucinous carcinoma of the breast. We describe the main features of this rare tumor and the controversies in its diagnosis because primary and metastatic mucinous carcinomas in skin are histologically indistinguishable.

  5. Tumor thickness and adnexal extension of superficial basal cell carcinoma (sBCC) as determinants of treatment failure for methylaminolevulinate (MAL)-photodynamic therapy (PDT), imiquimod, and 5-fluorouracil (FU).

    PubMed

    Roozeboom, Marieke H; van Kleef, Lotte; Arits, Aimee H M M; Mosterd, Klara; Winnepenninckx, Veronique J L; van Marion, Arienne M W; Nelemans, Patty J; Kelleners-Smeets, Nicole W J

    2015-07-01

    Noninvasive treatments are frequently used in treatment of superficial basal cell carcinoma (sBCC) because of better cosmetic results, lower costs, and less burden on health care services when compared with surgical excision. However, probability of treatment failure is higher after noninvasive therapies and may depend on histologic tumor characteristics. We sought to investigate whether tumor thickness and adnexal extension are determinants of treatment failure in sBCC treated with topical methylaminolevulinate-photodynamic therapy, imiquimod, or 5-fluorouracil. Data were derived from a randomized controlled trial on the effectiveness of methylaminolevulinate photodynamic therapy, imiquimod, and 5-fluorouracil for treatment of sBCC (ISRCTN79701845). For tumors with treatment failure (n = 112) and a randomly selected control group of tumors without treatment failure (n = 224) data on tumor thickness and adnexal extension were retrospectively collected. Treatment failure was defined as a clinically and histologically persistent or recurrent tumor within 1-year posttreatment. Tumor thickness of included patients ranged from 0.2 to 1.0 mm. Tumor thickness and adnexal extension of sBCC were not significantly associated with treatment failure of methylaminolevulinate photodynamic therapy, imiquimod, or 5-fluorouracil. Follow-up period of 1 year is a limitation. There seems to be no need to determine tumor thickness or adnexal extension in sBCC before treatment. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  6. [Adnexal torsion: three cases].

    PubMed

    Sánez, Henry Aristóteles Mateo; Taboada-Pérez, Grecia Carolina; Hernández-Arroyo, Lysandra; Mateo-Madrigal, Melissa; Mateo-Madrigal, Victoria

    2013-05-01

    Adnexal torsion is a gynecological emergency caused by the torsion of the ovary over its pedicle producing lymphatic and venous stasis, later it develops into ischemia and necrosis, when is not treated. Until recently, the treatment for adnexal torsion has been adnexectomy. This paper report three cases treated successfully with conservative treatment. It is essential to establish a protocol for adnexal torsion management where radical treatments are abandoned and conservative surgeries, such as detorsion and plication, are performed. We suggest as a first choice management adnexal detorsion, in case malignity is suspected to have intraoperative pathologic analysis, and based on the results to decide to preserve the adnexal or remove it for definitive cure.

  7. Secretory Carcinoma of the Skin Harboring ETV6 Gene Fusions: A Cutaneous Analogue to Secretory Carcinomas of the Breast and Salivary Glands.

    PubMed

    Bishop, Justin A; Taube, Janis M; Su, Albert; Binder, Scott W; Kazakov, Dmitry V; Michal, Michal; Westra, William H

    2017-01-01

    Mammary analogue secretory carcinoma is a low-grade salivary gland carcinoma that exhibits analogous features to secretory carcinoma of the breast including the presence of a t(12;15) translocation resulting in the ETV6-NTRK3 gene fusion. Rare cases of purported secretory carcinoma of the skin adnexa have been reported, but their relationship to true secretory carcinoma of the breast and salivary glands is unclear, as they generally do not harbor ETV6 rearrangements. Cases of cutaneous neoplasms with histologic features identical to secretory carcinoma of the breast and salivary glands were identified from the consultation files of 3 academic medical institutions. Immunohistochemistry was performed for S100 protein, mammaglobin and STAT5a. Break-apart fluorescence in situ hybridization was used evaluate for disruption of the ETV6 gene. Six cases of cutaneous secretory carcinoma were identified. The tumors arose in 4 women and 2 men, ranging from 24 to 71 years in age (mean, 47 y). The carcinomas presented in the skin of the axilla (n=4), ventral neck (n=1), and cheek (n=1). The tumors arose in the superficial dermis in association with adnexal structures. None of the patients had a prior or concurrent breast or salivary gland tumor. They were histologically characterized by well-circumscribed but unencapsulated proliferations of bland, eosinophilic cells arranged in microcysts and follicles with intraluminal secretions. Ectopic breast or salivary gland tissue was not identified. The cases were diffusely positive for S100 protein (6 of 6), mammaglobin (6 of 6), and STAT5a (5 of 5). All 6 cases harbored rearrangements of ETV6. All tumors were treated by simple excision alone. No recurrences or metastases developed in the 2 cases with follow-up. Secretory carcinoma of the skin represents a phenotypic, immunohistochemical, and genetic counterpart to secretory carcinoma of the breast and salivary glands. This tumor entity is less anatomically restricted than previously

  8. Basal cell carcinoma in skin of color.

    PubMed

    Ahluwalia, Jesleen; Hadjicharalambous, Elena; Mehregan, Darius

    2012-04-01

    Non-melanoma skin cancer most commonly affects Caucasians, and only rarely affects darker-skinned individuals. However, skin cancer in these groups is associated with greater morbidity and mortality. Ultraviolet radiation is the major etiologic factor in basal cell carcinoma (BCC) and likely plays a pivotal role in the development of other forms of skin cancer. Yet it is commonly thought among patients as well as physicians that darker pigmentation inherently affords complete protection from skin cancer development. This low index of suspicion results in delayed diagnoses and poorer outcomes. This review follows a detailed computer search that cross-matched the diagnosis of BCC with skin color type in a large commercial dermatopathology facility. The reported skin types, all Fitzpatrick skin types IV, V, and VI, and histories were confirmed. A predominance of pigmented BCCs was found in sun-exposed areas of these older individuals. Although less common in darker-skinned ethnic groups, BCC does occur and can pose significant morbidity. Thus, it is essential that dermatologists are familiar with the epidemiology and clinical presentation of all cutaneous malignancies in darker skin so that these patients are fully aware of risks as well as prevention of the disease.

  9. Nonmelanoma skin cancer.

    PubMed

    Dubas, Lauren E; Ingraffea, Adam

    2013-02-01

    Nonmelanoma skin cancer (NMSC) is the most common form of malignancy in humans. The incidence of NMSC continues to increase despite increased awareness and sun-protective measures. If neglected or mismanaged, NMSC can cause significant morbidity and even death. The most common forms of NMSC on the head and neck include basal cell carcinoma, squamous cell carcinoma, sebaceous carcinoma, eccrine porocarcinoma, Merkel cell carcinoma, atypical fibroxanthoma, and microcystic adnexal carcinoma. Surgery is the mainstay of treatment (standard excision, Mohs micrographic surgery, curettage); however, other modalities exist, including radiation, topical immunomodulators, photodynamic therapy, and new systemic medications.

  10. Expression of gelatinase A and TIMP-2 mRNAs in desmoplastic fibroblasts in both mammary carcinomas and basal cell carcinomas of the skin.

    PubMed Central

    Poulsom, R; Hanby, A M; Pignatelli, M; Jeffery, R E; Longcroft, J M; Rogers, L; Stamp, G W

    1993-01-01

    AIMS--To compare the localisation of mRNAs for the basement membrane degrading enzyme gelatinase A (72 kilodalton type IV collagenase) and its inhibitor TIMP-2 in carcinomas of the breast and basal cell carcinomas of the skin which have little or no ability to metastasize. METHODS--In situ hybridisation was performed on formalin fixed, paraffin wax embedded blocks using 35S-labelled riboprobes on 16 mammary carcinomas, three fibroadenomas, and a benign phyllodes tumour, and on 15 basal cell carcinomas of the skin (BCC). RESULTS--Labelling for both mRNAs was detectable in 14 of 16 mammary carcinomas and in 13 of 15 BCC, most often over organising desmoplastic fibroblasts in the stroma around invasive epithelial aggregates. Some sparse labelling was seen over malignant epithelial cells in six of the mammary carcinomas but not in the BCC. Some expression of gelatinase A mRNA was also seen in fibroblasts of breast lobules adjacent to the mammary carcinomas and around engulfed adnexal elements in the BCC, but not in unaffected breast tissues, fibroadenomas, the phyllodes tumour or unaffected skin. CONCLUSIONS--Maximal expression of gelatinase A and TIMP-2 mRNAs occurs in malignant neoplasms as part of the host response to the presence of established neoplastic cells rather than as an initial response to invasion. The degree to which this is present suggests this may be a highly relevant mechanism modulating tumour differentiation, growth and progression, possibly entailing uptake via specific receptors on the tumour cell surface. Images PMID:8391548

  11. Ultrasound of adnexal masses.

    PubMed

    Joshi, Mukund; Ganesan, Karthik; Munshi, Harsha Navani; Ganesan, Subramania; Lawande, Ashwin

    2008-04-01

    Current advancements in imaging technology, especially three-dimensional/four-dimensional ultrasound and contrast-enhanced imaging, have increased the diagnostic yield of adnexal masses. The benefit of ultrasound is the characterization of an adnexal mass, suggesting the probable etiology of the mass. Masses may be divided as solid, cystic, or complex. It is predominantly the solid and complex masses that need a thorough evaluation. The role of color-flow imaging is now gaining importance and criteria for distinguishing between benign and malignant masses are often possible. Availability of a scoring system enables the differentiation of small adnexal masses. Several benign lesions may present as complex masses but can be distinguished and diagnosed on sonography. The availability of 3D ultrasound has been of great use to understand spatial relations and vascular morphology. Sonography allows a more detailed assessment of morphologic features of an adnexal mass. With a benign-appearing adnexal mass on sonography, the need for any further diagnostic tests is often obviated.

  12. Metallothionein immunolocalization in actinic skin nonmelanoma carcinomas.

    PubMed

    Borges Júnior, Paulo C; Ribeiro, Rosy I M A; Cardoso, Sérgio V; Berbet, Alceu L C; Rocha, Ademir; Espindola, Foued S; Loyola, Adriano M

    2007-06-01

    Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most frequent skin cancer. Its pathogeny is linked to genotoxic effects of actinic radiation exposure, especially to ultraviolet wavelength. Metallothionein (MT) is a low-molecular weight protein with high affinity for heavy metal. Its intracellular function has been related to heavy metals and free-radical detoxification, although many studies linked MT to protective action against actinic mutagenesis. In other way, overexpression in malignant tumors has been related to worse prognosis. We aimed to evaluate MT immunohistochemical expression in skin cancer associated to actinic radiation. Twenty-six BCC cases, 20 SCC, and 6 normal skin fragments were investigated. Immunohistochemical assay were performed by streptavidin-biotin-peroxidase technique with standard monoclonal antibody (E9). In normal skin, immunostaining was observed in basal layer of the epithelium. In the epithelium adjacent to tumors, suprabasal layer was also intensely labeled. Mean MT immunostaining indices were 18.5+21.2% for BCC and 69.1+14.4% for SCC. This difference was statistically significant. Higher MT expression in SCC as compared with BCC suggests association with tumoral aggressiveness.

  13. [Non-surgical treatment of skin carcinomas and their precursors].

    PubMed

    Lourari, Siham; Paul, Carle; Meyer, Nicolas

    2011-01-01

    The skin carcinomas are the most common skin cancers and adult cancers. Risk factors for skin cancer are known. Surgery is the treatment of choice for skin carcinomas. There are several alternative therapies for the treatment of skin cancer and precancerous lesions: radiotherapy, cryosurgery, curettage, electrocautery, photodynamic therapy, topical imiquimod, and topical 5-fluorouracil. The management of skin cancer and precancerous lesions has been the subject of recommendations for good practice in diagnosis and therapy. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  14. Distant Skin Metastases from Carcinoma Buccal Mucosa: A Rare Presentation

    PubMed Central

    Srinivasan, Shashank; Leekha, Nitin; Gupta, Sweety; Mithal, Umang; Arora, Vandana; De, Sudarsan

    2016-01-01

    Cancer of the oral cavity makes up approximately 30% of all head and neck region tumors. Skin metastasis is rare with an incidence ranging between 0.7% and 2.4%. Skin metastasis usually occurs in the neck, scalp, and over the skin near the primary site. We report a patient with carcinoma left buccal mucosa who presented with distant skin metastases to the right side chest wall. PMID:27512210

  15. Vismodegib induces significant clinical response in locally advanced trichoblastic carcinoma.

    PubMed

    Lepesant, P; Crinquette, M; Alkeraye, S; Mirabel, X; Dziwniel, V; Cribier, B; Mortier, L

    2015-10-01

    Patients with advanced basal cell carcinoma due to local extension or metastatic disease were previously at a therapeutic impasse. Targeted inhibition of the sonic hedgehog pathway by vismodegib represents a new therapeutic strategy. Adnexal carcinomas are rare malignant skin tumours derived from epithelial annexes. Conventional treatment of adnexal tumours is based on surgical excision. Although the radiosensitivity of adnexal carcinomas has not been established, radiotherapy could be offered alone or in combination in locally advanced or inoperable disease. Chemotherapy represents a therapeutic option in the treatment of metastatic adnexal tumours. Currently there is no effective treatment for these tumours when they become metastatic or unresectable, and treatment is palliative. Sunitinib represents a new therapeutic strategy, with efficiency described in the literature for a small number of patients. However, its efficacy is partial, and its tolerance is not always good. We report a patient with trichoblastic carcinoma, initially diagnosed as basal cell carcinoma, treated effectively with vismodegib. The remarkable response we have observed in this patient suggests an encouraging therapeutic role of vismodegib in trichoblastic carcinoma that should be evaluated in a carefully designed trial.

  16. Primary adenoid cystic carcinoma of the skin metastatic to the lymph nodes: immunohistochemical study of a new case and literature review.

    PubMed

    Rocas, Delphine; Asvesti, Catherine; Tsega, Artemis; Katafygiotis, Patroklos; Kanitakis, Jean

    2014-03-01

    Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare adnexal skin tumor first described in 1975, of which merely 62 cases have so far been studied in detail and reported in the English literature. PCACC is usually regarded as apocrine in origin/differentiation, but its precise histogenesis is still not well known. PCACC has in most cases a rather indolent course but can produce local recurrences and, more rarely, regional (lymph node) and distant (pulmonary) metastases. We report herein a Greek woman with a long-standing PCACC that grew slowly over several years and produced metastasis in the regional lymph nodes, highlighting the potentially aggressive course of this tumor. The primary and metastatic tumors were studied immunohistochemically and proved to express several (sweat gland-related) antigens (such as keratin 7, epithelial membrane antigen, CD10, and CD117) but neither hormonal receptors nor p63 or Gross Cystic disease Fluid Protein 15. The salient clinicopathologic features of this rare cutaneous adnexal tumor are reviewed.

  17. [Basal cell carcinoma, squamous cell carcinoma and premalignant skin lesions--how to treat?].

    PubMed

    Pitkänen, Sari; Jeskanen, Leila; Ylitalo, Leea

    2014-01-01

    Increasing exposure to UV radiation is considered the most important etiologic factor of nonmelanoma skin cancers. Consequently, exposed areas such as the scalp and face, are the primary areas for developing non-melanoma skin cancers. Once a patient has presented with one tumor, additional lesions are common. The diagnosis is based on typical clinical picture and biopsy or excision for histopathological analysis. Various non-surgical treatment options have been established. Superficial basal cell carcinoma, superficial carcinoma in situ and all actinic keratoses are preferentially treated non-surgically. Most other basal cell and squamous cell carcinomas should be surgically removed.

  18. Epidermoid carcinoma of the skin mimicking breast cancer.

    PubMed

    Melo Neto, Baltasar; Oliveira, Giuliano da Paz; Vieira, Sabas Carlos; Leal, Livio Rodrigues; Melo Junior, José Andrade de Carvalho; Vieira, Cyro Franklin

    2013-01-01

    Nonmelanoma skin cancer is the most frequent cancer in the world. Squamous cell cancer often occurs in sun-exposed areas, such as the head and neck. When it involves the breast and ulce-rates, invading the glandular parenchyma, it may mimic breast cancer. Confirmation by means of histopathological examination, combined with clinical examination, is a critical instrument for the accuracy of the diagnosis. We report a case of an epidermoid carcinoma located on the breast skin, initially diagnosed as breast cancer.

  19. Psammomatous Squamous Cell Carcinoma of the Skin.

    PubMed

    Schuler, Andrew; Smith, Emily; Chen, Stephanie; Chan, May P; Harms, Paul W

    2017-09-20

    Psammoma bodies (PBs) are concentric, lamellated calcifications commonly observed in malignancies such as papillary thyroid carcinoma and serous carcinoma of the ovary in which they may serve prognostic value. PBs are rare in cutaneous squamous cell carcinoma (cSCC), with only 1 previously reported case. Here, we present 3 cases of cSCC displaying PBs. One case occurred in the setting of end-stage renal disease, whereas the other 2 cases were in patients who did not have comorbid conditions that might predispose to hypercalcemia and dystrophic calcification. All 3 tumors demonstrated classic immunophenotypic findings of cSCC. Our findings indicate that PBs are a rare but recurrent phenomenon in cSCC, with unknown prognostic significance. The potential for PB formation in cSCC should be kept in mind, as this may represent a diagnostic pitfall in tumors with limited sampling or unusual morphologies.

  20. Skin metastasis of hypopharyngeal carcinoma to the nasal tip.

    PubMed

    Shindo, Masahisa; Yoshida, Yuichi; Tominaga, Kyoko; Yamamoto, Osamu

    2013-06-01

    Head and neck squamous cell carcinoma (SCC) rarely metastasizes to the skin. Metastases to the nasal tip from hypopharyngeal malignancies are extremely rare. We present a patient with nasal tip metastasis from hypopharyngeal SCC. A 74-year-old man with hypopharyngeal and esophageal carcinomas had a red nodule on his nasal tip (so-called "clown nose"). Histopathologically, atypical squamoid cell nests had proliferated in a lobular fashion from the dermis to subcutaneous tissue. Those atypical cells were identical to primary tumor cells in the hypopharynx. Based on these findings, a diagnosis of skin metastasis from hypopharyngeal SCC was made. In patients with malignant disease, biopsy should be performed for any suspicious skin lesion. In a patient like ours, "clown nose" might be a symptom of cutaneous metastasis. When clinicians note a "clown nose", they should consider malignancies in the neck and chest areas.

  1. Treatment of Malignant Cutaneous Adnexal Neoplasms.

    PubMed

    Bernárdez, C; Requena, L

    2017-10-05

    Malignant cutaneous adnexal neoplasms form a group of rare, typically low-grade-malignancy carcinomas with follicular, sebaceous, apocrine, or eccrine differentiation or a combination of the first 3 subtypes. Their clinical presentation is usually unremarkable, and biopsy is required to establish the differentiation subtype and the definitive diagnosis. Due to their rarity, no clear consensus has been reached on which treatment is most effective. Mohs micrographic surgery is considered to be the best option to prevent recurrence in the majority of patients. Radiotherapy and chemotherapy have been studied in very few cases and have rarely been shown to be effective. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Sebaceous Gland Carcinoma of the Lower Eyelid Reconstructed with a Composite Flap: A Case Report

    PubMed Central

    Durairaj, Alagar Raja; Kothandaraman, Kanmani; Rajamanohar, Vimal Chander; Prabakaran, Aarthi

    2016-01-01

    Sebaceous gland carcinomas are skin adnexal tumours occurring in the periocular region of elderly females. It is an uncommon malignancy usually involving the upper eyelid and has an indolent course. Mainstay of treatment is surgical excision. Here we present a case of a sebaceous gland carcinoma of the lower eyelid for which wide local excision was done and the lower eyelid reconstructed using a composite flap of nasal chondromucosal graft with a nasolabial flap. PMID:27504351

  3. [Expression of promyelocytic leukaemia protein in Bowen's disease, skin squamous cell carcinoma and basal cell carcinoma].

    PubMed

    Wang, Qiongyu; Ma, Huiqun; Wang, Shijie; Ma, Yunyun; Zou, Xingwei; Li, Ruilian

    2013-07-01

    To investigate the expression of promyelocytic leukaemia (PML) protein of PML protein in Bowen's disease (BD), skin squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) and explore the role of PML in the pathogenesis of these diseases. PML protein in normal skin tissues and lesions of Bowen's disease, SCC and BCC were detected with immunohistochemistry. Normal skin tissues did not express PML protein. In BCC, PML showed rather low expressions in the skin lesions (8.69% in cell nuclei and 4.35% in cytoplasm). The lesions in BD and SCC (grade I and II) showed obvious overexpression of PML protein in the cell nuclei and cytoplasm, and its expression in the cell nuclei of these lesions was significantly higher than that in grade III-IV SCC. PML protein may play an important role in the early stage of SCC, and its overexpression may contribute to the carcinogenesis and metastasis of SCC.

  4. [Merkel cell carcinoma of the skin. 2 clinical cases].

    PubMed

    Mazzoni, A; Boschi, L; Ismail, I; Raducci, A

    1990-04-30

    Merkel cell carcinoma of the skin is a tumor generally found in elderly people. This neoplasm involves primarily the dermis; it is locally aggressive often metastatizing to the lymph nodes and, sometimes, diffusely in the body. It must be considered in the diagnostic approach of the cutaneous neoplastic nodules. The clinical, histologic and ultrastructural features of two cases are presented and compared with previously reported examples.

  5. MRI of Adnexal Masses in Pregnancy

    PubMed Central

    Telischak, Nicholas A.; Yeh, Benjamin M.; Joe, Bonnie N.; Westphalen, Antonio C.; Poder, Liina; Coakley, Fergus V.

    2009-01-01

    OBJECTIVE The objective of this article is to provide a practical review of the incremental benefit of MRI in the assessment of adnexal masses in pregnancy. CONCLUSION MRI can assist sonographic assessment of adnexal masses in pregnancy by depicting the characteristic findings of exophytic leiomyoma, red degeneration of leiomyoma, endometrioma, decidualized endometrioma, and massive ovarian edema. Accordingly, MRI should be considered as a useful adjunct when sonography is inconclusive or insufficient to guide management of adnexal masses discovered in pregnancy. PMID:18647903

  6. Metastatic transitional cell carcinoma presenting with skin metastasis.

    PubMed

    Açıkgöz, Onur; Ölçücüoğlu, Erkan; Kasap, Yusuf; Yığman, Metin; Güneş, Zeki Ender; Gazel, Eymen

    2015-01-01

    Transitional cell carcinomas (TCC) of upper urinary system account for 5% of all TCCs. The incidence of such metastases ranges from 0.18% to 2%. Experimental studies reported a general unsatisfactory survival time following skin metastasis. We report in this paper a case of metastatic urinary system TCC, which had become evident with a skin lesion in the right hypogastric region. A 60-year-old female patient with a history of being operated upon due to renal pelvic TCC was admitted to our outpatient clinic with complaints of red skin lesion in the near vicinity of the operational incision scar for 3 months. Her medical history revealed nothing but nephroureterectomy operation on the upper urinary system; moreover, it was learned that she had been ignoring what was recommended to her for routine controls. Thoraco-abdominal computed tomographic (CT) examination performed on the basis of aforementioned findings depicted a mass lesion of 24*20 mm dimension with high contrast uptake detected within the subcutaneous fat tissue in the right abdominal wall. The skin lesion depicted in CT was surgically excised. The pathological examination of the excised material was reported to be compatible with TCC. The patient was referred due to abdominal lesion to medical oncology after the operation. Followed up under chemotherapy protocol, the patient died 3 months after the metastasectomy operation. Skin metastasis of upper urinary system TCCs, especially renal pelvic TCCs, are quite rare conditions. Among the likely skin sites of metastasis for genitourinary system TCCs are head, face, extremities, suprapubic region and abdomen. Taking into consideration the low survival rates, the importance of early diagnosis of recurrences and/or distant metastases should be better appreciated. These patients die soon after the skin metastasis even with the administration of aggressive therapy. Similarly, our patient died 90 days after the diagnosis of skin metastasis despite the oncologic

  7. Metastatic transitional cell carcinoma presenting with skin metastasis

    PubMed Central

    Açıkgöz, Onur; Ölçücüoğlu, Erkan; Kasap, Yusuf; Yığman, Metin; Güneş, Zeki Ender; Gazel, Eymen

    2015-01-01

    Transitional cell carcinomas (TCC) of upper urinary system account for 5% of all TCCs. The incidence of such metastases ranges from 0.18% to 2%. Experimental studies reported a general unsatisfactory survival time following skin metastasis. We report in this paper a case of metastatic urinary system TCC, which had become evident with a skin lesion in the right hypogastric region. A 60-year-old female patient with a history of being operated upon due to renal pelvic TCC was admitted to our outpatient clinic with complaints of red skin lesion in the near vicinity of the operational incision scar for 3 months. Her medical history revealed nothing but nephroureterectomy operation on the upper urinary system; moreover, it was learned that she had been ignoring what was recommended to her for routine controls. Thoraco-abdominal computed tomographic (CT) examination performed on the basis of aforementioned findings depicted a mass lesion of 24*20 mm dimension with high contrast uptake detected within the subcutaneous fat tissue in the right abdominal wall. The skin lesion depicted in CT was surgically excised. The pathological examination of the excised material was reported to be compatible with TCC. The patient was referred due to abdominal lesion to medical oncology after the operation. Followed up under chemotherapy protocol, the patient died 3 months after the metastasectomy operation. Skin metastasis of upper urinary system TCCs, especially renal pelvic TCCs, are quite rare conditions. Among the likely skin sites of metastasis for genitourinary system TCCs are head, face, extremities, suprapubic region and abdomen. Taking into consideration the low survival rates, the importance of early diagnosis of recurrences and/or distant metastases should be better appreciated. These patients die soon after the skin metastasis even with the administration of aggressive therapy. Similarly, our patient died 90 days after the diagnosis of skin metastasis despite the oncologic

  8. Rippled Pattern Extraocular Sebaceous Carcinoma: A Rare Case Report with Brief Review of Literature

    PubMed Central

    K., Amita; S., Vijayshankar; S.N., Shobha

    2013-01-01

    Sebaceous carcinoma (SC) is a highly aggressive malignant adnexal tumor of sebaceous gland origin, accounting for less than 1% of cutaneous. Extraocular sebaceous carcinomas are more aggressive than their ocular counterpart with a predilection for the skin of head and neck, trunk, salivary glands and extremities in decreasing order of frequency. Rippled effect literally means “gradually spreading effect”. In histopathology it describes the unique arrangement of tumor cells in palisading pattern. The tumors in which rippled effect has been reported include adnexal tumors like trichoblastoma, trichomatricoma, trichoblastoma with sebaceous differentiation, trichoblastoma with apocrine differentiation, sebaceoma, basal cell carcinoma, fibrohistiocytic tumors, mesenchymal tumors and melanocytic tumors. We report the first case of extra ocular sebaceous carcinoma with rippled effect with emphasis on the fact that differentiation from other tumors demonstrating rippled effect is important in view of different treatment protocols. PMID:24298500

  9. Squamous cell carcinoma arising in previously burned or irradiated skin

    SciTech Connect

    Edwards, M.J.; Hirsch, R.M.; Broadwater, J.R.; Netscher, D.T.; Ames, F.C.

    1989-01-01

    Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5, 10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation.

  10. Radiation-induced skin carcinomas of the head and neck

    SciTech Connect

    Ron, E.; Modan, B.; Preston, D.; Alfandary, E.; Stovall, M.; Boice, J.D. Jr. )

    1991-03-01

    Radiation exposures to the scalp during childhood for tinea capitis were associated with a fourfold increase in skin cancer, primarily basal cell carcinomas, and a threefold increase in benign skin tumors. Malignant melanoma, however, was not significantly elevated. Overall, 80 neoplasms were identified from an extensive search of the pathology logs of all major hospitals in Israel and computer linkage with the national cancer registry. Radiation dose to the scalp was computed for over 10,000 persons irradiated for ringworm (mean 7 Gy), and incidence rates were contrasted with those observed in 16,000 matched comparison subjects. The relative risk of radiogenic skin cancer did not differ significantly between men or women or by time since exposure; however, risk was greatest following exposures in early childhood. After adjusting for sex, ethnic origin, and attained age, the estimated excess relative risk was 0.7 per Gy and the average excess risk over the current follow-up was 0.31/10(4) PY-Gy. The risk per Gy of radiation-induced skin cancer was intermediate between the high risk found among whites and no risk found among blacks in a similar study conducted in New York City. This finding suggests the role that subsequent exposure to uv radiation likely plays in the expression of a potential radiation-induced skin malignancy.

  11. Poorly differentiated squamous cell carcinoma arising in tattooed skin.

    PubMed

    Sarma, Deba P; Dentlinger, Renee B; Forystek, Amanda M; Stevens, Todd; Huerter, Christopher

    2010-01-01

    Introduction. Tattoos have increasingly become accepted by mainstream Western society. As a result, the incidence of tattoo-associated dermatoses is on the rise. The presence of a poorly differentiated squamous cell carcinoma in an old tattooed skin is of interest as it has not been previously documented. Case Presentation. A 79-year-old white homeless man of European descent presented to the dermatology clinic with a painless raised nodule on his left forearm arising in a tattooed area. A biopsy of the lesion revealed a poorly differentiated squamous cell carcinoma infiltrating into a tattoo. The lesion was completely excised and the patient remains disease-free one year later. Conclusion. All previous reports of squamous cell carcinomas arising in tattoos have been well-differentiated low-grade type or keratoacanthoma-type and are considered to be coincidental rather than related to any carcinogenic effect of the tattoo pigments. Tattoo-associated poorly differentiated invasive carcinoma appears to be extremely rare.

  12. Poorly Differentiated Squamous Cell Carcinoma Arising in Tattooed Skin

    PubMed Central

    Sarma, Deba P.; Dentlinger, Renee B.; Forystek, Amanda M.; Stevens, Todd; Huerter, Christopher

    2010-01-01

    Introduction. Tattoos have increasingly become accepted by mainstream Western society. As a result, the incidence of tattoo-associated dermatoses is on the rise. The presence of a poorly differentiated squamous cell carcinoma in an old tattooed skin is of interest as it has not been previously documented. Case Presentation. A 79-year-old white homeless man of European descent presented to the dermatology clinic with a painless raised nodule on his left forearm arising in a tattooed area. A biopsy of the lesion revealed a poorly differentiated squamous cell carcinoma infiltrating into a tattoo. The lesion was completely excised and the patient remains disease-free one year later. Conclusion. All previous reports of squamous cell carcinomas arising in tattoos have been well-differentiated low-grade type or keratoacanthoma-type and are considered to be coincidental rather than related to any carcinogenic effect of the tattoo pigments. Tattoo-associated poorly differentiated invasive carcinoma appears to be extremely rare. PMID:21274289

  13. Low-Molecular-Weight Hydrophilic and Lipophilic Antioxidants in Nonmelanoma Skin Carcinomas and Adjacent Normal-Looking Skin.

    PubMed

    Grammenandi, Konstantina; Kyriazi, Maria; Katsarou-Katsari, Alexandra; Papadopoulos, Othon; Anastassopoulou, Ioanna; Papaioannou, Georgios T; Sagriotis, Alexandros; Rallis, Michail; Maibach, Howard I

    2016-01-01

    Low-molecular-weight antioxidants are some of the most efficient agents of the skin defense mechanism against environmental factors, such as cosmic rays, smoke, and pollutants. The total skin concentrations of hydrophilic ascorbic and uric acids, as well as lipophilic α-tocopherol, β-carotene, and ubiquinol-10 antioxidants were determined by an HPLC-EC detector from 18 biopsies of human nonmelanoma skin carcinomas and 18 biopsies from skin areas adjacent to carcinomas. No significant differences in the concentrations of lipophilic antioxidants in both carcinomas and normal-looking skin areas adjacent to carcinomas were observed. On the contrary, ascorbic and uric acid concentrations were found to be 18 and 36% lower in carcinomas than in normal-looking skin areas, respectively. No statistical significance was observed between antioxidant concentrations and age, sex, phototype, profession, site of tumor, frequency, and time of UV light exposure either. Accordingly the antioxidant concentrations in both cancerous skin and adjacent normal-looking areas were found to be much higher than in normal skin, in contrast to literature data.

  14. Nodular Basal cell carcinoma arising in a split-thickness skin graft of the scalp.

    PubMed

    Angelos, Tyler M; Larsen, Michael T; Janz, Brian A

    2013-10-01

    We present the first known case of basal cell carcinoma arising in a split-thickness skin graft in the United States. The apparent low incidence of basal cell carcinoma in split-thickness skin graft attests to its unique environment and could possibly be attributed to the following: (1) the donor sites for split-thickness skin grafts are usually areas that are not subjected to heavy sun exposure; (2) individuals with skin grafts may not live as long on average, or their skin grafts may be subsequently excised with further reconstructive procedures; and (3) cases may be underreported. Because basal cell carcinomas have a fairly benign course, many patients either do not present to a physician or are not reported. This case shows that a split-thickness skin graft can have an adequate microenvironment for the development of basal cell carcinoma.

  15. [Current recommendations in the treatment of basal cell carcinoma and squamous cell carcinoma of the skin].

    PubMed

    Kunte, C; Konz, B

    2007-05-01

    The incidence of the most common tumors of the skin, basal cell carcinoma and squamous cell carcinoma, has risen rapidly in recent years. Dermatologists see in their daily practice many different clinical and histological variants of these tumors. They must be able to develop therapeutic strategies adapted to the tumor and the patient. Surgical excision remains the standard treatment. Micrographic histological evaluation should be employed in difficult locations, for large tumors and when there is increased risk of recurrence or metastasis. For initial or superficial lesions, other approaches such as radiation therapy, as well as curettage, cryosurgery, laser therapy and photodynamic therapy can be employed. An additional option is topical treatment with imiquimod or 5-flourouracil.

  16. Skin cancer in organ transplant recipients.

    PubMed

    Kempf, Werner; Mertz, Kirsten D; Hofbauer, Günther F L; Tinguely, Marianne

    2013-01-01

    Organ transplant recipients (OTR) are at a significantly increased risk for developing a wide variety of skin cancers, particularly epithelial skin cancer, Merkel cell carcinoma and Kaposi's sarcoma. Melanoma, skin adnexal neoplasm and cutaneous lymphomas are also more common in OTR and may differ in their clinicopathologic presentation from tumors in immunocompetent patients. The accuracy of clinical diagnosis of suspected premalignant and malignant skin lesions in OTR is modest. Therefore, histopathological diagnosis is an essential element for the diagnostic workup of skin cancers and, in addition, provides important information on prognosis. Squamous cell carcinoma and intraepithelial neoplasias (actinic keratosis, squamous cell carcinoma in situ or Bowen's disease) are the most common forms of skin cancer in OTR. The risk of Merkel cell carcinoma and Kaposi's sarcoma is dramatically increased in OTR. Merkel cell carcinoma shows a highly aggressive course. Kaposi's sarcoma tends to spread to extracutaneous sites. Primary cutaneous lymphomas developing after organ transplantation are rare. The spectrum of cutaneous B cell lymphomas in OTR, in particular, differs significantly from that of the general population, with a predominance of Epstein-Barr virus-driven posttransplant lymphoproliferative disorder. This review discusses the clinical and histopathological aspects of skin cancers in OTR, the impact of dermatopathological analysis on prognosis and the understanding of the pathogenesis of these neoplasms.

  17. Papillary thyroid carcinoma with an uncommon spread of hematogenous metastases to the choroid and the skin.

    PubMed

    Bucerius, Jan; Meyka, Susanne; Michael, Bangard; Biersack, Hans-Jürgen; Eter, Nicole

    2008-01-01

    Papillary carcinoma is the most common malignancy of the thyroid gland with initial lymphogenic metastatic spread in many cases. Hematogenous spread may affect the lung, bone and brain. We present a case of hematogenous metastases of papillary thyroid carcinoma both in the choroid and the skin, which are reported in the literature to be rare sites of metastases in primary differentiated thyroid carcinoma. This finding is even more remarkable, as the reported patient presented without any other disseminated hematogenous metastases at the time of diagnosis of both of these metastases. With this background, papillary carcinoma of the thyroid should be considered in the differential diagnosis of choroidal or skin metastasis of unknown origin.

  18. The Role of Infectious Agents in the Etiology of Ocular Adnexal Neoplasia

    PubMed Central

    Verma, Varun; Shen, Defen; Sieving, Pamela C.; Chan, Chi-Chao

    2008-01-01

    Given the fact that infectious agents contribute to around 18% of human cancers worldwide, it would seem prudent to explore their role in neoplasms of the ocular adnexa: primary malignancies of the conjunctiva, lacrimal glands, eyelids, and orbit. By elucidating the mechanisms by which infectious agents contribute to oncogenesis, the management, treatment, and prevention of these neoplasms may one day parallel what is already in place for cancers such as cervical cancer, hepatocellular carcinoma, gastric mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma. Antibiotic treatment and vaccines against infectious agents may herald a future with a curtailed role for traditional therapies of surgery, radiation, and chemotherapy. Unlike other malignancies for which large epidemiological studies are available, analyzing ocular adnexal neoplasms is challenging as they are relatively rare. Additionally, putative infectious agents seemingly display an immense geographic variation that has led to much debate regarding the relative importance of one organism versus another. This review discusses the pathogenetic role of several microorganisms in different ocular adnexal malignancies, including human papilloma virus in conjunctival papilloma and squamous cell carcinoma, human immunodeficiency virus in conjunctival squamous carcinoma, Kaposi sarcoma-associated herpes virus or human herpes simplex virus-8 (KSHV/HHV-8) in conjunctival Kaposi sarcoma, Helicobacter pylori (H. pylori,), Chlamydia, and hepatitis C virus in ocular adnexal mucosa-associated lymphoid tissue lymphomas. Unlike cervical cancer where a single infectious agent, human papilloma virus, is found in greater than 99% of lesions, multiple organisms may play a role in the etiology of certain ocular adnexal neoplasms by acting through similar mechanisms of oncogenesis, including chronic antigenic stimulation and the action of infectious oncogenes. However, similar to other human malignancies

  19. Actinic keratosis with atypical basal cells (AK I) is the most common lesion associated with invasive squamous cell carcinoma of the skin.

    PubMed

    Fernández-Figueras, M T; Carrato, C; Sáenz, X; Puig, L; Musulen, E; Ferrándiz, C; Ariza, A

    2015-05-01

    Progression from actinic keratosis (AK) to invasive squamous cell carcinoma (iSCC) of the skin is thought to occur after the development of full thickness epidermal neoplasia, as in the classic pathway of cervical cancer. Nevertheless, cutaneous iSCC may also directly arise from a proliferation of atypical basaloid cells limited mostly to the epidermal basal layer (AK I), akin to what happens in the 'differentiated pathway' of iSCC of the vulva, oral cavity and other locations. To evaluate the prevalence of classic and differentiated pathways in the development of cutaneous iSCC. The epidermis adjacent to and overlying iSCC, assumed to be representative of pre-existing lesions, was histologically studied in 196 skin biopsy specimens showing iSCC. AK I, AK II and AK III lesions overlying iSCC were present in 63.8%, 17.9% and 18.4% of cases respectively. The corresponding percentages in the epidermis adjacent to iSCC were 77.9%, 6.6% and 8.3% respectively (stage could not be assessed in 8.1% of cases). Focal epidermal ulceration overlying iSCC was seen in 32% of AK I, 28.6% of AK II and 33.3% of AK III instances. Adnexal involvement by atypical keratinocytes (proliferative AK) was present more frequently in cases with overlying AK I (39/125, 31.2%) than with AK II (8/35, 22.9%) and AKII I (5/36, 13.9%). Direct invasion from proliferating basaloid atypical keratinocytes limited to the epidermal basal layer (AK I), known as the differentiated pathway, was the most common form of progression to cutaneous iSCC in our series. On the other hand, stepwise progression from AK I to AK II and AK III (classic pathway) was seen to be operative in a substantial proportion of iSCC cases. All AK lesions, irrespective of intraepidermal neoplasia thickness, are therefore potentially invasive and tumour advance along adnexal structures might facilitate iSCC development from AK I lesions. © 2014 European Academy of Dermatology and Venereology.

  20. Progression of skin lesions from normal skin to squamous cell carcinoma.

    PubMed

    Krouse, Robert S; Alberts, David S; Prasad, Anil R; Yozwiak, Michael; Bartels, Hubert G; Liu, Yun; Bartels, Peter H

    2009-02-01

    To assess the changes in the nuclear chromatin pattern concomitant with progressive sun damage in skin biopsies ranging from sun-exposed, normal-appearing skin to squamous cell carcinoma (SCC). Biopsies were taken from 140 cases with sun-exposed but histopathologically normal skin, from 20 cases visually assessed as pre-actinic keratosis (pre-AK) or early AK, from 30 cases of AK, and from 21 cases of SCC. A total of 21,094 nuclei were recorded from these biopsies. High-resolution digital imagery was recorded, and features descriptive of the nuclear chromatin pattern were computed. Both supervised learning and unsupervised learning algorithms were employed to derive progression plots. With increased sun exposure, the proportion of nuclei exhibiting changes in the nuclear chromatin pattern rises notably. Using karyometry, no significant differences could be substantiated between nuclei collected from early AK sites and AK lesions. Cases of SCC fell into 2 distinct groups. A larger group (approximately 66.7% of cases) had characteristics similar to AK. A smaller group (approximately 33.3% of cases) represented much more progressed lesions. Karyometric assessment can provide a numeric measure of progression for sun damage and of the deviation from normal in both AK and SCC lesions.

  1. [Changes in the optical characteristics of the skin of patients with basal cell carcinoma].

    PubMed

    Zhuravel', V G

    1997-01-01

    Skin optical characteristics were investigated in connection with large-size tumors and inflammatory infiltrates in 54 patients suffering from basal cell carcinoma. It was found that large size of tumor involves higher light absorption in the skin, lower light conduction and increased photoluminescence. Also, cutaneous tissues look brighter more often when light passes through them. Inflammation in foci of lesions also involves higher light conduction and photoluminescence in the skin.

  2. Application of Robotics in Adnexal Surgery

    PubMed Central

    Tusheva, Olga A; Gargiulo, Antonio R; Einarsson, Jon I

    2013-01-01

    This review discusses in detail robotic tubal reanastomosis as one of the classic reproductive surgery procedures. Other applications of robotics in adnexal surgery are also reviewed, including adult and pediatric adnexectomy, resection of endometriosis, benign ovarian mass resection, early ovarian cancer resection and staging, ovarian transposition, and treatment of ovarian remnant syndrome and ovarian vein syndrome. PMID:23687555

  3. Impaired skin barrier function in mice with colon carcinoma induced by azoxymethane and dextran sodium sulfate.

    PubMed

    Yokoyama, Satoshi; Hiramoto, Keiichi; Koyama, Mayu; Ooi, Kazuya

    2015-01-01

    We have previously reported that impaired skin barrier function was induced by small intestinal injury in mice. Therefore, we postulated that other intestinal diseases might also influence skin barrier function. In this study, we evaluated the skin barrier function of hairless mice with colon carcinoma that was induced by azoxymethane (AOM) and dextran sodium sulfate (DSS). In mice treated with these drugs, we observed elevated transepidermal water loss and reduced skin hydration levels, compared to those in the control mice. In addition, plasma nitrogen di/trioxide (NO2(-)/NO3(-)) levels were significantly elevated, and expression of type I collagen was significantly reduced in the treated mice, compared to those in control. These results suggest that impaired skin barrier function occurs in mice when colon carcinoma is present.

  4. Neglected skin cancer in the elderly: a case of basosquamous cell carcinoma of the right shoulder

    PubMed Central

    Bisgaard, Erika; Tarakji, Michael; Lau, Frank; Riker, Adam

    2016-01-01

    Skin cancer remains the most common cancer worldwide, and basal cell carcinoma represents the largest portion of non-melanomatous skin cancers with over 3 million cases diagnosed annually. Locally advanced disease is frequently seen in the elderly posing clinical challenges regarding proper treatment. We report on an 86-year-old female presenting with fatigue, anemia and a large ulcerated skin lesion along the right upper back. A biopsy of the lesion revealed a basosquamous cell carcinoma. She underwent a wide local excision with complex wound reconstruction. Neglected skin cancers in the elderly can present difficult clinical scenarios. There are associated adjuvant therapies that should be considered following resection, such as local radiation therapy and other novel therapies. Newer therapies, such as with vismodegib, may also be considered. A comprehensive, multimodal approach to treatment should be considered in most cases of locally advanced, non-melanoma skin cancers. PMID:27534889

  5. Neglected skin cancer in the elderly: a case of basosquamous cell carcinoma of the right shoulder.

    PubMed

    Bisgaard, Erika; Tarakji, Michael; Lau, Frank; Riker, Adam

    2016-08-17

    Skin cancer remains the most common cancer worldwide, and basal cell carcinoma represents the largest portion of non-melanomatous skin cancers with over 3 million cases diagnosed annually. Locally advanced disease is frequently seen in the elderly posing clinical challenges regarding proper treatment.We report on an 86-year-old female presenting with fatigue, anemia and a large ulcerated skin lesion along the right upper back. A biopsy of the lesion revealed a basosquamous cell carcinoma. She underwent a wide local excision with complex wound reconstruction.Neglected skin cancers in the elderly can present difficult clinical scenarios. There are associated adjuvant therapies that should be considered following resection, such as local radiation therapy and other novel therapies. Newer therapies, such as with vismodegib, may also be considered. A comprehensive, multimodal approach to treatment should be considered in most cases of locally advanced, non-melanoma skin cancers.

  6. Skin cancer associated with the use of sorafenib and sunitinib for renal cell carcinoma.

    PubMed

    Breaker, Kathryn; Naam, Mary; La Rosa, Francisco G; Flaig, Insley P; Flaig, Thomas W

    2013-07-01

    Several case series have reported an association between sorafenib and the development of skin cancer, but they differ in the reported rapidity of skin cancer onset and the frequency of recurrence with ongoing multikinase inhibitor (MKI) treatment. To compare the presentation and incidence of skin cancer in patients with renal cell carcinoma (RCC) treated with sorafenib and sunitinib. This retrospective study reviewed the records of 69 patients with RCC treated with sorafenib or sunitinib at the University of Colorado Hospital between January 2005 and July 2009. Seven patients treated with MKI developed skin cancer (5 (13.5%) with sorafenib, 2 (6.3%) with sunitinib; 5 squamous cell carcinomas (SCC), 3 basal cell carcinomas (BCC)); all developed in sun-exposed areas during first-line MKI therapy. The median time from the start of MKI therapy until observation of a skin cancer lesion was 13.5 months. We observed more cases of skin cancer during sorafenib treatment than during sunitinib treatment for advanced RCC; median MKI treatment duration before the identification of skin cancer was longer than 1 year. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  7. Endocrine Mucin-Producing Sweat Gland Carcinoma, a Histological Challenge

    PubMed Central

    Salama, Samih; Gohla, Gabriella; Alowami, Salem

    2017-01-01

    Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare adnexal tumor of the skin with low-grade cytological features and neuroendocrine differentiation. It has a predilection for the skin of the eyelid, but has also been reported in the face and rarely extra-facial locations. The tumor is seen more frequently in women and on average affects the elderly. It is histologically and immunohistochemically analogous to solid papillary carcinoma of the breast/endocrine ductal carcinoma in situ with a nodular, solid, papillary, and/or cribriforming architecture, neuroendocrine differentiation, and mucin production. Since it was first described by Flieder et al. in 1997, less than 60 cases have been reported in literature. We describe the morphological and immunohistochemical features of another case with a review of the common histological differential diagnoses and emphasize the salient features that help distinguish this rare neoplasm. PMID:28299221

  8. Citrus consumption and risk of basal cell carcinoma and squamous cell carcinoma of the skin.

    PubMed

    Wu, Shaowei; Cho, Eunyoung; Feskanich, Diane; Li, Wen-Qing; Sun, Qi; Han, Jiali; Qureshi, Abrar A

    2015-10-01

    Animal experiments have demonstrated the photocarcinogenic properties of furocoumarins, a group of naturally occurring chemicals that are rich in citrus products. We conducted a prospective study for citrus consumption and risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin based on data from 41530 men in the Health Professionals Follow-up Study (1986-2010) and 63759 women in the Nurses' Health Study (1984-2010) who were free of cancers at baseline. Over 24-26 years of follow-up, we documented 20840 incident BCCs and 3544 incident SCCs. Compared to those who consumed citrus products less than twice per week, the pooled multivariable-adjusted hazard ratios were 1.03 [95% confidence interval (95% CI): 0.99-1.08] for BCC and 1.14 (95% CI: 1.00-1.30) for SCC for those who consumed two to four times per week, 1.06 (95% CI: 1.01-1.11) for BCC and 1.15 (95% CI: 1.02-1.28) for SCC for five to six times per week, 1.11 (95% CI: 1.06-1.16) for BCC and 1.22 (95% CI: 1.08-1.37) for SCC for once to 1.4 times per day and 1.16 (95% CI: 1.09-1.23) for BCC and 1.21 (95% Cl: 1.06-1.38) for SCC for 1.5 times per day or more (P trend = 0.001 for BCC and 0.04 for SCC). In contrast, consumption of non-citrus fruit and juice appeared to be inversely associated with risk of BCC and SCC. Our findings support positive associations between citrus consumption and risk of cutaneous BCC and SCC in two cohorts of men and women, and call for further investigations to better understand the potential photocarcinogenesis associated with dietary intakes. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Merkel cell polyomavirus is present in common warts and carcinoma in situ of the skin.

    PubMed

    Mertz, Kirsten D; Pfaltz, Madeleine; Junt, Tobias; Schmid, Mirka; Fernandez Figueras, Maria Teresa; Pfaltz, Katrin; Barghorn, André; Kempf, Werner

    2010-10-01

    Polyomaviruses have been linked to diseases of immunosuppressed patients. We sought to determine the prevalence of Merkel cell polyomavirus in benign epithelial skin neoplasms and nonmelanoma skin cancer of immunosuppressed renal transplant recipients and long-term dialysis patients. Merkel cell polyomavirus DNA was detected by polymerase chain reaction (PCR) in 2 (10%) of 20 patients, in carcinomas in situ (Bowen's disease). In one of our patients with Merkel cell polyomavirus-positive carcinoma in situ, 9 (39.1%) of 23 skin lesions at various anatomical locations tested positive for Merkel cell polyomavirus sequences by PCR, including all of his common warts (4/4), half of his carcinoma in situ lesions (3/6), and 2 of his 3 seborrheic keratoses. In a second cohort of immunosuppressed renal transplant recipients, Merkel cell polyomavirus DNA was found in 1 (6.3%) of 16 common warts and in 2 (9.5%) of 21 carcinomas in situ. In immunocompetent individuals, Merkel cell polyomavirus DNA was found in 2 (6.7%) of 30 common warts and in 2 (8.3%) of 24 carcinomas in situ. DNA of other human polyomaviruses was not detected in any of the investigated skin neoplasms. We conclude that common warts and carcinomas in situ can be positive for Merkel cell polyomavirus in immunosuppressed as well as immunocompetent individuals. Remarkably, some of the Merkel cell polyomavirus-positive common warts did not contain human papillomavirus. Furthermore, Merkel cell polyomavirus can be found in various skin neoplasms of the same individual.

  10. Benign adnexal masses in the adolescent.

    PubMed

    Powell, Jill K

    2004-10-01

    Adnexal masses are common in adolescents. Certain conditions will require immediate intervention, including possible torsion, medically refractory tuboovarian abscess, intra-abdominal hemorrhage with hemodynamic instability, or possible ectopic pregnancy. Further evaluation of other masses, including additional imaging or tumor markers may be indicated, especially if masses are complex, solid, or have features characteristic of benign or malignant neoplasms. Otherwise, expectant management and surveillance allow for spontaneous resolution of most masses, especially cystic masses, and prevents unnecessary surgical intervention with its potential risks and sequelae. Laparoscopy can be done in many patients, and conservative, adnexal-sparing surgery should be encouraged when possible. In addition, physicians should be familiar with signs and symptoms of postoperative complications to allow for early diagnosis and intervention.

  11. Family history of skin cancer is associated with increased risk of cutaneous squamous cell carcinoma.

    PubMed

    Asgari, Maryam M; Warton, E Margaret; Whittemore, Alice S

    2015-04-01

    The contribution of family history to cutaneous squamous cell carcinoma (SCC) risk has not been systematically quantified. To examine the association between self-reported family history of skin cancer and SCC risk. Cases (n = 415) with a pathology-verified SCC and 415 age-, gender-, and race-matched controls were identified within a large integrated health care delivery system. Family history and skin cancer risk factors were ascertained by survey. Odds ratios (ORs) for associations of SCC with family history of skin cancer were estimated using conditional logistic regression adjusted for environmental and innate SCC risk factors. Any known family history of skin cancer was associated with a four-fold higher risk of SCC, adjusting for known environmental and innate SCC risk factors (OR, 4.0; confidence interval [CI]: 2.5-6.5). An unknown family history of skin cancer showed similar risk for SCC (OR, 3.9; CI: 2.4-6.5). In models including skin cancer type, the strongest association was for family history of basal cell carcinoma (OR, 9.8; CI: 2.6-36.8) and for multiple skin cancer types (OR, 10.5; CI: 3.7-29.6). Family history of skin cancer is an important independent risk factor for cutaneous SCCs.

  12. Multiple skin cancers in a single patient: Multiple pigmented Bowen's disease, giant basal cell carcinoma, squamous cell carcinoma.

    PubMed

    Saini, Ravi; Sharma, Nidhi; Pandey, Kritika; Puri, K J P S

    2015-01-01

    Basal cell carcinoma (BCC) and squamous cell carcinoma are the most common type of nonmelanoma skin cancers (NMSCs). Bowen's disease (BD), a premalignant condition, has a marginal potential (3-5%) to progress to invasive carcinoma. We report here a rarest of a rare case of multiple pigmented BD with overlying squamous cell cancer along with a giant neglected BCC on the scalp of a 76-year-old man. The occurrence of multiple BD and NMSC in a single patient compelled us to explore the following hypothesis: (1) The multiple precancerous and cancerous lesions can be due to common etiopathogenesis. Chronic ultraviolet exposure, immunosupresssion, human papillomavirus infection, dietary factors, and environmental factors including arsenic exposure were probed in to. (2) There is evolution of precancerous lesions into a different type of cancers in different time frame. (3) The new cancerous lesions are subsequent cancers that developed after neglected untreated primary cancer.

  13. Repair of UV dimers in skin DNA of patients with basal cell carcinoma.

    PubMed

    Segerbäck, Dan; Strozyk, Malgorzata; Snellman, Erna; Hemminki, Kari

    2008-09-01

    Epidemiologic studies suggest that exposure to sunlight is the primary etiologic agent for basal cell carcinoma. Formation of UV-induced DNA damage is believed to be a crucial event in the process leading to skin cancer. In this study, repair of photoproducts in DNA was followed in the skin of patients with basal cell carcinoma and control subjects. The subjects were exposed to 800 J/m(2) Commission Internationale de 1'Eclairag of solar-simulating radiation on buttock skin. Biopsies were taken at 0 hour, 24 hours, and 3 weeks after the exposure. Two cyclobutane pyrimidine dimers, TT=C and TT=T, were measured using a sensitive (32)P-postlabeling assay. Initial levels of both TT=C and TT=T differed between individuals in both groups. The levels of TT=T in patients with basal cell carcinoma and controls were similar (9.9 +/- 4.0 and 9.2 +/- 2.9 products per 10(6) normal nucleotides), whereas the level of TT=C was significantly lower in controls than in patients with basal cell carcinoma (6.2 +/- 3.1 versus 10.9 +/- 4.5 products per 10(6) normal nucleotides). The fractions of TT=T remaining after 24 hours and 3 weeks were significantly higher in patients with basal cell carcinoma (72% and 11%) compared with controls (48% and 5%). A slower removal in patients with basal cell carcinoma than in controls was indicated also for TT=C (52% versus 42% remaining at 24 hours); however, the difference between groups was not significant. When including data from our previously reported small-scale study, the fraction of dimers remaining at 24 hours was significantly higher in patients with basal cell carcinoma for both TT=C and TT=T. The data suggest that patients with basal cell carcinoma have a reduced capacity to repair UV-induced DNA lesions.

  14. Distribution of lectin UEA-I in trichilemmal carcinoma, squamous cell carcinoma, and other epithelial tumors of the skin.

    PubMed

    Ko, T; Muramatsu, T; Shirai, T

    1996-06-01

    Trichilemmal carcinoma (TLC) is a cutaneous appendage tumor. In some cases, the histological distinction between TLC and squamous cell carcinoma (SCC) is difficult with hematoxylin & eosin staining. In the present study, in order to establish a simple and reliable method for distinguishing between TLC and SCC, we examined the lectin Ulex europaeus agglutinin-I (UEA-I)-binding patterns of TLC (4 cases), SCC (10 cases), malignant proliferating trichilemmal cyst (MPTC) (3 cases), Bowen's disease (4 cases), Bowen's carcinoma (4 cases), actinic keratosis (4 cases), basal cell carcinoma (8 cases), and eccrine porocarcinoma (1 case). In normal skin samples, UEA-I was strongly positive in the outer root sheath cells of the hair follicle and weakly positive in the granular layers of the epidermis. UEA-I stained the tumor cells of TLC clearly and some MPTC and Bowen's disease cells weakly. This result indicates that histochemical staining with UEA-I is a simple and useful method for distinguishing between TLC and SCC of the skin.

  15. Depth and Patterns of Adnexal Involvement in Primary Extramammary (Anogenital) Paget Disease: A Study of 178 Lesions From 146 Patients.

    PubMed

    Konstantinova, Anastasia M; Shelekhova, Ksenya V; Stewart, Colin J; Spagnolo, Dominic V; Kutzner, Heinz; Kacerovska, Denisa; Plaza, Jose A; Suster, Saul; Bouda, Jiri; Pavlovsky, Michal; Kyrpychova, Liubov; Michal, Michal; Guenova, Emmanuella; Kazakov, Dmitry V

    2016-11-01

    Extramammary Paget disease (EMPD) is a rare neoplasm usually presenting in the anogenital area, most commonly in the vulva. Adnexal involvement in primary EMPD is a very common feature and serves as a pathway for carcinoma to spread into deeper tissue. The depth of carcinomatous spread along the appendages and the patterns of adnexal involvement were studied in 178 lesions from 146 patients with primary EMPD. Hair follicles and eccrine ducts were the adnexa most commonly affected by carcinoma cells. The maximal depth of involvement was 3.6 mm in this series. When planning topical therapy or developing novel local treatment modalities for EMPD, this potential for significant deep spread along adnexa should be taken into account.

  16. An immunohistochemical panel to differentiate metastatic breast carcinoma to skin from primary sweat gland carcinomas with a review of the literature.

    PubMed

    Rollins-Raval, Marian; Chivukula, Mamatha; Tseng, George C; Jukic, Drazen; Dabbs, David J

    2011-08-01

    Approximately 25% of patients with breast cancer develop cutaneous metastases. Sweat gland carcinomas (SGCs) account for about 0.05% of all cutaneous neoplasms. Cutaneous metastases of breast carcinoma (CMBCs) (especially the ductal type) can be difficult to distinguish from SGCs. Treatment and prognoses for these 2 types of tumors differ radically, making accurate histologic diagnosis crucial. Although a few studies attempt to differentiate these entities employing immunohistochemical (IHC) studies (some of which we review here), to date, no panel of IHC stains exists, to our knowledge, to distinguish these entities. To devise a panel of IHC stains to distinguish CMBC from SGC. Twelve cases of ductal CMBCs (11 not otherwise specified type, and 1 basal phenotype), 11 cases of SGCs (5 eccrine carcinomas, 3 porocarcinomas, and 3 microcystic adnexal carcinomas), 2 benign sweat gland neoplasm cases, and 2 primary breast cancer cases were retrieved and analyzed with the following IHC panel: mammaglobin, gross cystic disease fluid protein (GCDFP) 15, p63, basal cytokeratins (CK5, CK14, and CK17), androgen receptor, and PAX5. The p63 was only weakly expressed in 1 of 12 CMBC cases (8.3%), whereas it was strongly expressed in 10 of 11 SGC cases (90.9%) (P < .001). Basal cytokeratins demonstrated a similar immunoprofile in the SGC group, with 10 of 11 cases (90.9%) expressing all 3 markers, and a variable immunoprofile in the CMBC group with 0% (CK14) (P < .001) to 16.7% (2 of 12 cases; CK5 and CK17) (P < .001) expression. Mammaglobin was expressed in 8 of 12 cases (66.7%) of CMBC. Together, these 5 IHC stains were combined to make a panel that was 100% sensitive and 91% specific in distinguishing between CMBC and SGC.

  17. Signet-ring cell carcinoma of the gallbladder with skin metastases.

    PubMed

    Krunic, Aleksandar L; Chen, Helen M; Lopatka, Keith

    2007-08-01

    Cutaneous metastasis from gallbladder cancer is extremely rare. We present a case of signet-ring cell carcinoma of the gallbladder metastatic to the skin in a 38-year-old man. The skin nodules on the face, scalp and perianal area occurred approximately 1 year after the resection of the neoplasm. Skin metastases from gastrointestinal cancers are usually detected around surgical scars or on the abdominal wall, especially in the periumbilical region, and rarely present at other sites. Multiple imaging studies revealed the presence of metastatic bony involvement in the spine and left orbit. Visceral metastases have not been demonstrated in our patient in 20 months of follow up since the initial diagnosis of gallbladder cancer was made. We also briefly discuss other primary and metastatic skin tumours with signet-ring cell morphology.

  18. Study on the effect of blood content on diffuse reflectance spectra of basal cell carcinoma skin tissue.

    PubMed

    Nan, Miaoqing; He, Qingli

    2013-01-01

    Diffuse reflectance spectrum as a noninvasive method has been widely used to study the optical properties of cutaneous skin tissue. In this work, we optimized an eight-layered optical model of basal cell carcinoma skin tissue to study its optical properties. Based on the model, the diffuse reflectance spectra were reconstructed in visible wavelength range by Monte Carlo methods. After different blood contents were added to the optical model, the contribution of blood to diffuese reflectance spectra was investigated theoretically. The ratios of basal cell carcinoma skin and normal skin tissue were also calculated for both experimental result and rebuilt results to testify the theoretical reasonability of the model and methods.

  19. [Carcinoma of the skin of the external auditory meatus].

    PubMed

    Jesić, S; Radulović, R; Djerić, D; Nesić, V; Dimitrijević, M; Petrović, Z; Arsović, N; Arsić-Mandarić, Z

    2004-01-01

    Carcinoma of the external meatus is a rare disease and a challenge to treat. Demographic and clinical characteristics of this disease are discussed for 14 patients treated in the Institute of Otorhinolaryngonlogy and Maxillofacial Surgery during the period 1993-2003. using four different clasification of the disease. All patients were treated surgically with postoperative radiotherapy. Five years survival is 100% for the II and II stage of the disease for all clasifications, and 75% for the III stage according to Pitsburg clasiffication. Reccurence of the disease in the first year after treatment is 66.6% and, 84% in the second year. The diagnostic protocol is clinical examination, computed tomography of the temporal bone, nuclear magnetic resonance of the temporal bone and endocranium, ultrasound examination of the neck and parotid region and tumor biopsy. The surgical approach could be less radical, through mastoid, with postoperative

  20. Genetic skin diseases predisposing to basal cell carcinoma.

    PubMed

    Castori, Marco; Morrone, Aldo; Kanitakis, Jean; Grammatico, Paola

    2012-01-01

    Basal cell carcinoma (BCC) is the commonest cancer in humans. Predisposing factors reflect common genetic variations and environmental influences in most cases. However, an underlying Mendelian disorder should be suspected in a specific subset of patients, namely those with multiple, early onset lesions. Some specific conditions, including Gorlin, Bazex-Dupré-Christol and Rombo syndromes, and Xeroderma Pigmentosum, show BCC as a prominent feature. In addition, BCC may represent a relatively common, although less specific, finding in many other genodermatoses. These include disorders of DNA replication/repair functions (Bloom, Werner, Rothmund-Thomson and Muir-Torre syndromes), genodermatoses affecting the folliculo-sebaceus unit (Brooke-Spiegler, Schöpf-Schulz-Passarge and Cowden syndromes), immune response (cartilage-hair hypoplasia and epidermodysplasia verruciformis) and melanin biosynthesis (oculocutaneous albinism and Hermansky-Pudlak syndrome), and some epidermal nevus syndromes. Further conditions occasionally associated with BCCs exist, but the significance of the association remains to be proven.

  1. Interstitial brachytherapy of periorificial skin carcinomas of the face: A retrospective study of 97 cases

    SciTech Connect

    Rio, Emmanuel . E-mail: e-rio@nantes.fnclcc.fr; Bardet, Etienne; Ferron, Christophe; Peuvrel, Patrick; Supiot, Stephane; Campion, Loic; Beauvillain De Montreuil, Claude; Mahe, Marc Andre; Dreno, Brigitte

    2005-11-01

    Purpose: To analyze outcomes after interstitial brachytherapy of facial periorificial skin carcinomas. Patients and Methods: We performed a retrospective analysis of 97 skin carcinomas (88 basal cell carcinomas, 9 squamous cell carcinomas) of the nose, periorbital areas, and ears from 40 previously untreated patients (Group 1) and 57 patients who had undergone surgery (Group 2). The average dose was 55 Gy (range, 50-65 Gy) in Group 1 and 52 Gy (range, 50-60 Gy) in Group 2 (mean implantation times: 79 and 74 hours, respectively). We calculated survival rates and assessed functional and cosmetic results de visu. Results: Median age was 71 years (range, 17-97 years). There were 29 T1, 8 T2, 1 T3, and 2 Tx tumors in Group 1. Tumors were <2 cm in Group 2. Local control was 92.5% in Group 1 and 88% in Group 2 (median follow-up, 55 months; range, 6-132 months). Five-year disease-free survival was better in Group 1 (91%; range, 75-97) than in Group 2 (80%; range, 62-90; p = 0.23). Of the 34 patients whose results were reassessed, 8 presented with pruritus or epiphora; 1 Group 2 patient had an impaired eyelid aperture. Cosmetic results were better in Group 1 than in Group 2 with, respectively, 72% (8/11) vs. 52% (12/23) good results and 28 (3/11) vs. 43% (10/23) fair results. Conclusions: Brachytherapy provided a high level of local control and good cosmetic results for facial periorificial skin carcinomas that pose problems of surgical reconstruction. Results were better for untreated tumors than for incompletely excised tumors or tumors recurring after surgery.

  2. Merkel cell carcinoma (primary neuroendocrine carcinoma of skin) mimicking basal cell carcinoma with review of different histopathologic features.

    PubMed

    Succaria, Farah; Radfar, Arash; Bhawan, Jag

    2014-02-01

    Merkel cell carcinoma (MCC) is a rare but highly aggressive malignancy, which often has typical histopathologic and immunohistochemical (IHC) features. Sometimes the diagnosis is missed because of atypical histological or aberrant IHC findings. A case of MCC that showed irregular lobules of basaloid cells with keratotic areas on the initial shave biopsy is being reported. IHC showed positive staining for high-molecular weight cytokeratin but negative staining for cytokeratin 20, findings consistent with basal cell carcinoma. Subsequent excision specimen showed histopathologic features more typical of MCC. IHC still was negative for cytokeratin 20 but positive for synaptophysin. Review of the literature shows other examples of MCC with basal cell carcinoma-like features. Various other histopathologic differentiations of MCC include those that demonstrate squamous cell and eccrine carcinoma features and those that show melanocytic, lymphomatous, sarcomatous, muscular, and atypical fibroxanthoma-like features. Different histopathologic patterns and mimics of MCC are reviewed to help prevent dermatopathologists from misdiagnosing this aggressive tumor.

  3. Expression of CD95 (Fas) in sun-exposed human skin and cutaneous carcinomas.

    PubMed

    Filipowicz, Ewa; Adegboyega, P; Sanchez, R L; Gatalica, Zoran

    2002-02-01

    Carcinomas of the skin are by far the most common human malignancies. Continuous exposure to ultraviolet (UV) light facilitates the development of precancerous lesions (actinic keratosis [AK]) that may progress to invasive squamous carcinomas. Apoptosis, triggered by the activation of CD95 (Fas), is one of the most important defense mechanisms against UV light-induced carcinogenesis in experimental models, but the dynamics of CD95 expression in patients with sun-induced lesions are largely unknown. The authors studied the expression of CD95 (Fas) in biopsy samples of normal skin (not exposed to sun) and compared it with chronically sun-exposed skin (as evidenced by solar elastosis), AK, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), and keratoacanthomas (KA). Normal skin keratinocytes expressed CD95 in cytoplasmic membranes and intercellular bridges in the basal layer. In chronically sun-exposed keratinocytes (solar elastosis, no evidence of dysplasia), CD95 expression was up-regulated and was observed throughout the entire thickness of the epidermis. However, in actinic keratosis there was a complete absence of Fas in approximately two-thirds of the cases (8 of 12). In invasive SCC, CD95 was expressed focally and weakly only at the sites of contact with stromal lymphocytes. Keratoacanthomas consistently expressed CD95 at the interface with the inflammatory cells. No staining was observed in BCC. CD95 (Fas) up-regulation in chronically sun-exposed keratinocytes indicates an important role in the control of sun-induced damage. Further sun exposure results, however, in significant down-regulation of this defense mechanism, proportional to the degree of dysplasia. Copyright 2002 American Cancer Society. DOI 10.1002/cncr.10277

  4. Skin carcinoma of the head and neck with perineural invasion.

    PubMed

    Balamucki, Christopher J; Mancuso, Anthony A; Amdur, Robert J; Kirwan, Jessica M; Morris, Christopher G; Flowers, Franklin P; Stoer, Charles B; Cognetta, Armand B; Mendenhall, William M

    2012-01-01

    The aim of the study was to update the experience treating cutaneous squamous cell and basal cell carcinomas of the head and neck with incidental or clinical perineural invasion (PNI) with radiotherapy (RT). From 1965 to 2007, 216 patients received RT alone or with surgery and/or chemotherapy. The 5-year overall, cause-specific, and disease-free survivals for incidental and clinical PNIs were 55% vs 54%, 73% vs 64%, and 67% vs 51%. The 5-year local control, local-regional control, and freedom from distant metastases for incidental and clinical PNIs were 80% vs 54%, 70% vs 51%, and 90% vs 94%. On univariate and multivariate (P = .0038 and .0047) analyses, clinical PNI was a poor prognostic factor for local control. The rates of grade 3 or higher complication in the incidental and clinical PNI groups were 16% and 36%, respectively. Radiotherapy plays a critical role in the treatment of this disease. Clinical PNI should be adequately irradiated to include the involved nerves to the skull base. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Human skin carcinoma arising from kidney transplant-derived tumor cells.

    PubMed

    Verneuil, Laurence; Varna, Mariana; Ratajczak, Philippe; Leboeuf, Christophe; Plassa, Louis-François; Elbouchtaoui, Morad; Schneider, Pierre; Sandid, Wissam; Lebbé, Celeste; Peraldi, Marie-Noelle; Sigaux, François; de Thé, Hugues; Janin, Anne

    2013-09-01

    Tumor cells with donor genotype have been identified in human skin cancer after allogeneic transplantation; however, the donor contribution to the malignant epithelium has not been established. Kidney transplant recipients have an increased risk of invasive skin squamous cell carcinoma (SCC), which is associated with accumulation of the tumor suppressor p53 and TP53 mutations. In 21 skin SCCs from kidney transplant recipients, we systematically assessed p53 expression and donor/recipient origin in laser-microdissected p53+ tumor cells. In one patient, molecular analyses demonstrated that skin tumor cells had the donor genotype and harbored a TP53 mutation in codon 175. In a kidney graft biopsy performed 7 years before the skin SCC diagnosis, we found p53+ cells in the renal tubules. We identified the same TP53 mutation in these p53+ epithelial cells from the kidney transplant. These findings provide evidence for a donor epithelial cell contribution to the malignant skin epithelium in the recipient in the setting of allogeneic kidney transplantation. This finding has theoretical implications for cancer initiation and progression and clinical implications in the context of prolonged immunosuppression and longer survival of kidney transplant patients.

  6. Human skin carcinoma arising from kidney transplant–derived tumor cells

    PubMed Central

    Verneuil, Laurence; Varna, Mariana; Ratajczak, Philippe; Leboeuf, Christophe; Plassa, Louis-François; Elbouchtaoui, Morad; Schneider, Pierre; Sandid, Wissam; Lebbé, Celeste; Peraldi, Marie-Noelle; Sigaux, François; de Thé, Hugues; Janin, Anne

    2013-01-01

    Tumor cells with donor genotype have been identified in human skin cancer after allogeneic transplantation; however, the donor contribution to the malignant epithelium has not been established. Kidney transplant recipients have an increased risk of invasive skin squamous cell carcinoma (SCC), which is associated with accumulation of the tumor suppressor p53 and TP53 mutations. In 21 skin SCCs from kidney transplant recipients, we systematically assessed p53 expression and donor/recipient origin in laser-microdissected p53+ tumor cells. In one patient, molecular analyses demonstrated that skin tumor cells had the donor genotype and harbored a TP53 mutation in codon 175. In a kidney graft biopsy performed 7 years before the skin SCC diagnosis, we found p53+ cells in the renal tubules. We identified the same TP53 mutation in these p53+ epithelial cells from the kidney transplant. These findings provide evidence for a donor epithelial cell contribution to the malignant skin epithelium in the recipient in the setting of allogeneic kidney transplantation. This finding has theoretical implications for cancer initiation and progression and clinical implications in the context of prolonged immunosuppression and longer survival of kidney transplant patients. PMID:23979160

  7. Oblimersen in Treating Patients With Merkel Cell Carcinoma

    ClinicalTrials.gov

    2013-06-03

    Recurrent Neuroendocrine Carcinoma of the Skin; Stage I Neuroendocrine Carcinoma of the Skin; Stage II Neuroendocrine Carcinoma of the Skin; Stage III Neuroendocrine Carcinoma of the Skin; Stage IV Neuroendocrine Carcinoma of the Skin

  8. Gastrointestinal Stromal Tumor: May Mimic Adnexal Mass

    PubMed Central

    Karaca, Nilay; Akpak, Yaşam Kemal; Tatar, Zeynep; Batmaz, Gonca; Erken, Aslihan

    2016-01-01

    Gastrointestinal stromal tumors (GISTs) are rare tumor of the gastrointestinal tract. GISTs occur in the entire gastrointestinal tract and may also arise from the retroperitoneum, omentum and mesenteries. They are originated from gastrointestinal pacemaker cells (Cajal’s interstitial cells) and range from benign tumors to sarcomas at all sites of occurrence. Diagnosis of GIST could be deceptive because of their similarity in appearance to gynecological neoplasms. We would like to present a case of a woman with GIST in the small intestine giving a imprint of an adnexal mass was diagnosed correctly during surgery. The diagnosis and treatment of GIST has been reformed over the past years. It is crucial to separate GISTs from possible misdiagnosis because their prognosis and treatment could be unlike clearly. The purpose of this case is to evaluate this rarely seen clinical entity, and thus, make some contribution to the literature. PMID:26383211

  9. Pattern of HPV infection in basal cell carcinoma and in perilesional skin biopsies from immunocompetent patients

    PubMed Central

    2012-01-01

    Background The association between human papillomavirus (HPV) infection and non-melanoma skin cancers (NMSCs) such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) is not yet fully understood. We analysed the prevalence and spectrum of cutaneous beta-HPV types and mucosal/genital HPV types in paired biopsies (tumour and corresponding perilesional skin) obtained from 50 BCC immunocompetent patients. A small group of SCC patients (n=9) was also included. We also evaluated some previously postulated risk factors for HPV infection in NMSC patients. Results All biopsies were negative for mucosal/genital HPV types. Overall, beta-HPV DNA was detected more often in SCC compared to BCC patients (78% vs 55% of total samples). The frequency of infection increased with the patient’s age [OR=4.88 (95% CI 1.29-18.39)]. There was no significant correlation between beta-HPV positivity and sex, skin type and UV exposure. The prevalence of beta-HPV species 1 types was significantly higher than those belonging to other beta-HPV species in biopsies from BCC (p=0.022) but not from SCC subjects (p=0.091). There was no significant difference in the overall prevalence of beta-HPV infection and the number of viral types between tumour lesions and perilesional skin. BCC samples were significantly more likely to be infected with beta-HPV species 1 types compared to perilesional skin (p=0.036) and showed a higher frequency of mixed infections (p=0.028). Conclusions These findings demonstrate that beta-HPV types belonging to species 1 are the most common HPV types detected in the skin of BCC patients. Moreover beta-1-HPV types and mixed infections are significantly more frequent in tumour samples than in healthy perilesional skin. Our results suggest that beta-1-HPVs as well as co-infection with more than one viral type could be important in NMSC and in particular in BCC. Further studies aimed to compare the biological activity of viral types in tumours and in healthy skin

  10. Pattern of HPV infection in basal cell carcinoma and in perilesional skin biopsies from immunocompetent patients.

    PubMed

    Zakrzewska, Krystyna; Regalbuto, Elisa; Pierucci, Federica; Arvia, Rosaria; Mazzoli, Sandra; Gori, Alessia; de Giorgi, Vincenzo

    2012-12-17

    The association between human papillomavirus (HPV) infection and non-melanoma skin cancers (NMSCs) such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) is not yet fully understood. We analysed the prevalence and spectrum of cutaneous beta-HPV types and mucosal/genital HPV types in paired biopsies (tumour and corresponding perilesional skin) obtained from 50 BCC immunocompetent patients. A small group of SCC patients (n=9) was also included. We also evaluated some previously postulated risk factors for HPV infection in NMSC patients. All biopsies were negative for mucosal/genital HPV types. Overall, beta-HPV DNA was detected more often in SCC compared to BCC patients (78% vs 55% of total samples). The frequency of infection increased with the patient's age [OR=4.88 (95% CI 1.29-18.39)]. There was no significant correlation between beta-HPV positivity and sex, skin type and UV exposure. The prevalence of beta-HPV species 1 types was significantly higher than those belonging to other beta-HPV species in biopsies from BCC (p=0.022) but not from SCC subjects (p=0.091). There was no significant difference in the overall prevalence of beta-HPV infection and the number of viral types between tumour lesions and perilesional skin. BCC samples were significantly more likely to be infected with beta-HPV species 1 types compared to perilesional skin (p=0.036) and showed a higher frequency of mixed infections (p=0.028). These findings demonstrate that beta-HPV types belonging to species 1 are the most common HPV types detected in the skin of BCC patients. Moreover beta-1-HPV types and mixed infections are significantly more frequent in tumour samples than in healthy perilesional skin. Our results suggest that beta-1-HPVs as well as co-infection with more than one viral type could be important in NMSC and in particular in BCC.Further studies aimed to compare the biological activity of viral types in tumours and in healthy skin (viral replication and expression

  11. Expression of desmosomal proteins in acantholytic squamous cell carcinoma of the skin.

    PubMed

    Jurčić, Vesna; Kukovič, Jernej; Zidar, Nina

    2015-08-01

    Acantholytic (adenoid) squamous cell carcinoma (ASCC) is a subtype of squamous cell carcinoma (SCC) in which neoplastic tumour cells form gland-like structures. Little is known about the pathogenetic mechanisms of ASCC. We hypothesised that they may be related to the compositon of desmosomes. We analysed the immunohistochemical expression of desmosomal proteins in 5 cases of ASCC of the skin, in comparison to 5 cases of conventional SCC of the skin. The most consistent findings were loss of desmoglein 1 (DSG 1), desmoglein 3 (DSG3), desmocollin 1 (DSC1), desmocollin 2 (DSC2), desmocollin 3 (DSC 3), and plakophilin 1 (PKP 1), and decreased expression of desmoplakin 1 (DP 1) and plakoglobin (PG). In conventional well to moderately differentiated SCC, the expression of desmosomal proteins was decreased, but membranous staining was mostly preserved with patterns similar to normal epidermis. Our results suggest that loss of desmosomal cadherins and decreased expression of desmosomal plaque proteins might be responsible for the formation of gland-like structures in ASCC. It seems that desmosomal cadherins, which correspond to the transmembrane core of desmosomes, are predominantly affected in ASCC, while DP 1 and PG, which correspond to cytoplasmic plaque of desmosomes, probably play a lesser role in maintenance of tumour cell cohesion. Our results also indicate that, in addition to previously described verrucous and spindle cell carcinoma, ASCC is another subtype of SCC with a characteristic expression pattern of desmosomal proteins.

  12. ETV6 rearrangement in a case of mammary analogue secretory carcinoma of the skin.

    PubMed

    Chang, Michael D; Arthur, Allison K; García, Joaquín J; Sukov, William R; Shon, Wonwoo

    2016-11-01

    Mammary analog secretory carcinoma of salivary glands is a relatively recently recognized entity that harbors the ETV6-NTRK3 fusion transcript. To date, only rare cases of mammary analog secretory carcinoma of the skin have been reported. A 57-year-old man presented with a 6.0 cm cystic mass in the axilla, involving the dermis and superficial subcutis. Microscopically, the tumor exhibited nodular aggregation of tubular and microcystic structures embedded in the dense fibrotic and hyalinized stroma. Characteristic 'colloid-like' eosinophilic secretory material was present within intraluminal spaces. Tumor cells were largely characterized by vesicular nuclei with inconspicuous nucleoli and pink vacuolated cytoplasm. With respect to immunohistochemistry, tumor cells were intensely positive for AE1/AE3, Cam 5.2, and CK7, whereas Ber-EP4 and CEA were completely negative. A dual color break-apart fluorescence in situ hybridization probe identified rearrangement of the ETV6 gene locus on chromosome 12. The patient is alive with no evidence of recurrent disease or metastasis 3 years after the initial surgery. In conclusion, we report a rare example of mammary analog secretory carcinoma of the skin with ETV6 rearrangement. Awareness of this unique cutaneous tumor and subsequent reporting of additional cases is necessary for better characterization of its completely clinicopathologic spectrum.

  13. Diagnosis of squamous cell carcinoma of human skin by Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Pereira, Riziene d. M. F.; Martin, Airton A.; Tierra-Criollo, Carlos J.; Santos, Ivan D.

    2004-07-01

    The development of a technique that gives early diagnosis and is non-invasive is of crucial importance for public health. Raman spectroscopy is a technique that can full fill these requirements. The main goal of this work was to use the FT-Raman spectroscopy to differentiate between normal skin and the squamous cell carcinoma (SCC) tissues in vitro. The samples used in this study were collected by traditional human biopsy of skin tissue. The samples removed from the patients were washed in physiologic serum and frozen in liquid nitrogen. The FT-Raman device used was the RFS 100- Bruker, with a 1064nm from the Nd:YAG as an excitation source. After the Raman measurement the samples were submitted for histopathological study for comparation. The Raman spectra in the normal tissue showed the presence of vibrational bands in 860 cm-1 and 939 cm-1 with higher intensity than in the carcinoma spectra. These modes were assigned to the vibration of proline and hydroxiproline. The shift region of 1555 to 1560 cm-1 showed a difference of intensity to the samples of squamous cell carcinoma, which were attributed to the nucleic acid.

  14. Cutaneous Human Papillomaviruses Found in Sun-Exposed Skin: Beta-papillomavirus Species 2 Predominates in Squamous Cell Carcinoma

    PubMed Central

    Forslund, Ola; Iftner, Thomas; Andersson, Kristin; Lindelöf, Bernt; Hradil, Eva; Nordin, Peter; Stenquist, Bo; Kirnbauer, Reinhard; Dillner, Joakim; de Villiers, Ethel-Michele

    2013-01-01

    Background A spectrum of cutaneous human papillomaviruses (HPVs) is detectable in nonmelanoma skin cancers, as well as in healthy skin, but the significance that the presence of these types of HPV DNA has for the pathogenesis of skin cancer remains unclear. Methods We studied 349 nonimmunosuppressed patients with skin lesions (82 with squamous cell carcinomas, 126 with basal cell carcinomas, 49 with actinic keratoses, and 92 with benign lesions). After superficial skin had been removed by tape, paired biopsy samples—from the lesion and from healthy skin from the same patient—were tested for HPV DNA. Risk factors for HPV DNA were analyzed in multivariate models. Results Overall, 12% of healthy skin samples were positive for HPV DNA, compared with 26% of benign lesions, 22% of actinic keratoses, 18% of basal cell carcinomas, and 26% of squamous cell carcinomas. HPV DNA was associated with sites extensively exposed to the sun, both for the lesions (odds ratio [OR], 4.45 [95% confidence interval {CI}, 2.44–8.11]) and for the healthy skin samples (OR, 3.65 [95% CI 1.79–7.44]). HPV types of Beta-papillomavirus species 2 predominate in squamous cell carcinomas (OR, 4.40 [95% CI, 1.92–10.06]), whereas HPV types of Beta-papillomavirus species 1 are primarily found in benign lesions (OR, 3.47 [95% CI, 1.72–6.99]). Conclusions Cutaneous HPV types are primarily detected at sites extensively exposed to the sun. HPV types of Beta-papillomavirus species 2, but not of species 1, are associated with squamous cell carcinoma. PMID:17703418

  15. Molecular classification of basal cell carcinoma of skin by gene expression profiling.

    PubMed

    Jee, Byul A; Lim, Hyoseob; Kwon, So Mee; Jo, Yuna; Park, Myong Chul; Lee, Il Jae; Woo, Hyun Goo

    2015-12-01

    Non-melanoma skin cancers (NMSC) including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are more common kinds of skin cancer. Although these tumors share common pathological and clinical features, their similarity and heterogeneity at molecular levels are not fully elaborated yet. Here, by performing comparative analysis of gene expression profiling of BCC, SCC, and normal skin tissues, we could classify the BCC into three subtypes of classical, SCC-like, and normal-like BCCs. Functional enrichment and pathway analyses revealed the molecular characteristics of each subtype. The classical BCC showed the enriched expression and transcription signature with the activation of Wnt and Hedgehog signaling pathways, which were well known key features of BCC. By contrast, the SCC-like BCC was enriched with immune-response genes and oxidative stress-related genes. Network analysis revealed the PLAU/PLAUR as a key regulator of SCC-like BCC. The normal-like BCC showed prominent activation of metabolic processes particularly the fatty acid metabolism. The existence of these molecular subtypes could be validated in an independent dataset, which demonstrated the three subgroups of BCC with distinct functional enrichment. In conclusion, we suggest a novel molecular classification of BCC providing insights on the heterogeneous progression of BCC.

  16. Sonic hedgehog pathway dysregulation in skin basal-cell carcinoma of a Polish population.

    PubMed

    Lesiak, Aleksandra; Sobolewska-Sztychny, Dorota; Danilewicz, Marian; Rogowski-Tylman, Michal; Sysa-Jedrzejowska, Anna; Sobjanek, Michal; Olejniczak-Staruch, Irmina; Narbutt, Joanna

    2013-01-01

    Sonic hedgehog (Shh) pathway impairment plays a key role in the pathogenesis of basal-cell carcinomas (BCC), the most frequent skin tumor among Caucasians. Shh, Smo, and Gli2 family proteins are necessary for adequate and controlled cell proliferation. The aim of this study was to evaluate Shh, Smo, and Smo expression in BCC skin biopsies taken from sun-exposed areas. 41 BCC skin biopsies and 22 healthy skin specimens (the control group) taken from the same areas served as material for the study. All specimens were immunohistochemically stained with monoclonal antibodies directed against the chosen proteins. Shh and Smo expression (cytoplasmic pattern) were recorded semiquantitatively using a four-grade score (0-3). Gli2 expression (nuclear pattern) was determined using an image analysis system (semiautomatic function). The immunoexpression of the Shh and Smo proteins significantly increased in the BCC group, as compared with the normal controls (for Shh, the mean intensity was 1.67 in BCC vs. 1.17 in the control group, p < 0.001; for Smo, the mean intensity was 1.46 in BCC vs. 0.99 in the control group, p < 0.001). The staining for Gli2 in the BCC group was completely negative, but indicated the presence of Gli2 in the control patients (1.15 Gli2+ cells/100 cells). Sonic hedgehog pathway dysregulation may play an important role in skin cancerogenesis leading to BCC development.

  17. PKK suppresses tumor growth and is decreased in squamous cell carcinoma of the skin.

    PubMed

    Poligone, Brian; Gilmore, Elaine S; Alexander, Carolina V; Oleksyn, David; Gillespie, Kathleen; Zhao, Jiyong; Ibrahim, Sherrif F; Pentland, Alice P; Brown, Marc D; Chen, Luojing

    2015-03-01

    Non-melanoma skin cancer represents the most common cancer in the United States. Squamous cell carcinoma (SCC) of the skin is a subtype of NMSC that shows a greater potential for invasion and metastasis. The current study identifies the protein kinase C-associated kinase (PKK), which is also known as the receptor-interacting protein kinase 4, as a suppressor of tumor growth in SCC of the skin. We show that expression of PKK is decreased in human SCC of the skin compared with normal skin. Further, suppression of PKK in human keratinocytes leads to increased cell proliferation. The use of RNA interference to reduce PKK expression in keratinocytes leads to an increase in S phase and in proteins that promote cell cycle progression. Consistent with the results obtained from cell culture, there is a marked increased tumorigenesis after PKK knockdown in a xenotransplant model and in soft agar assays. The loss of tumor suppression involves the NF-κB and p63 pathways. NF-κB is inhibited through inhibition of inhibitor of NF-κB kinase function and there is increased nuclear TP63 activity after PKK knockdown. This study opens new avenues both in the discovery of disease pathogenesis and for potential treatments.

  18. PKK Suppresses Tumor Growth and is Decreased in Squamous Cell Carcinoma of the Skin

    PubMed Central

    Poligone, Brian; Gilmore, Elaine S.; Alexander, Carolina; Oleksyn, David; Gillespie, Kathleen; Zhao, Jiyong; Ibrahim, Sherrif; Pentland, Alice P.; Brown, Marc; Chen, Luojing

    2014-01-01

    Non-melanoma skin cancer (NMSC) represents the most common cancer in the United States. Squamous cell carcinoma (SCC) of the skin is a sub-type of NMSC that shows a greater potential for invasion and metastasis. The current study identifies the Protein Kinase C-associated Kinase (PKK), which is also known as the Receptor-Interacting Protein Kinase 4 (RIPK4), as a suppressor of tumor growth in SCC of the skin. We show that expression of PKK is decreased in human SCC of the skin compared to normal skin. Further, suppression of PKK in human keratinocytes leads to increased cell proliferation. Use of RNA interference to reduce PKK expression in keratinocytes leads to an increase in S phase and in proteins that promote cell cycle progression. Consistent with the results obtained from cell culture, there is a dramatic increased tumorigenesis after PKK knockdown in a xenotransplant model and in soft agar assays. The loss of tumor suppression involves the NF-κB and p63 pathways. NF-κB is inhibited through inhibition of IKK function and there is increased nuclear TP63 activity after PKK knockdown. This study opens new avenues both in the discovery of disease pathogenesis and for potential treatments. PMID:25285922

  19. Follicular variant papillary thyroid carcinoma with a twist

    PubMed Central

    Nwaeze, Obinna; Obidike, Stephen; Mullen, Dorinda; Aftab, Fuad

    2015-01-01

    Background We report an adnexal lesion, which turned out to be a metastasis to the scalp from a left sided follicular variant papillary thyroid cancer. The patient has had history of right multi-nodular goiter 10 years prior to presentation. Case presentation A 75-year old lady presented with a cutaneous lesion about 1 year post left total thyroidectomy for FVPTC. She underwent surgical excision of the lesion and histology revealed it to be metastases from a thyroid carcinoma. Discussion Cutaneous metastases from thyroid carcinomas are relatively uncommon in clinical practice. A worldwide literature review reveals that follicular carcinoma has a greater preponderance than papillary carcinoma for cutaneous metastasis and that the majority of skin metastases from either papillary or follicular thyroid cancer are localized to the head and neck, with the scalp as the commonest site. Conclusion Skin metastasis from papillary and follicular thyroid carcinoma is an uncommon occurrence and these lesions should be differentiated from primary skin tumors. They are very important to recognize as early recognition can lead to accurate and prompt diagnosis leading to timely treatment. The scalp has been found to be the commonest site of cutaneous metastasis that may appear benign. PMID:25651538

  20. Basal cell carcinoma vs basaloid squamous cell carcinoma of the skin: an immunohistochemical reappraisal.

    PubMed

    Webb, David V; Mentrikoski, Mark J; Verduin, Lindsey; Brill, Louis B; Wick, Mark R

    2015-04-01

    Typical cutaneous basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are morphologically dissimilar. It is well known, however, that poorly differentiated SCC may assume a basaloid phenotype, complicating the histologic distinction between these 2 neoplasms. Selected immunohistochemical stains have been used in the past to aid in that differential diagnosis. In the current study, additional markers were evaluated to determine whether they would be helpful in that regard. Twenty-nine cases of metatypical (squamoid) BCC (MBCC) and 25 examples of basaloid SCC (BSCC) were studied using the antibodies Ber-EP4 and MOC-31 as well as a plant lectin preparation from Ulex europaeus I (UEA-1). The resulting immunostains were interpreted independently by 3 pathologists, and the results showed that MBCCs demonstrated strong and diffuse staining for Ber-EP4 (25/29) and MOC-31 (29/29). In contrast, BSCCs tended to be only sporadically reactive for both markers (4/25 and 1/25 cases, respectively). Labeling for UEA-1 was observed in almost all BSCCs (24/25), but only 6 of 29 cases of MBCC showed limited, focal staining with that lectin. These data suggest that MOC-31 is a useful marker in the specified differential diagnosis, especially when used together with UEA-1.

  1. Necessity of Distinguishing Verrucous Carcinoma From Verrucous Skin Lesion Overlaying Residual Skin Staples in an Area of Sensory Loss: A Case Report

    PubMed Central

    Tokiyoshi, Takahiro; Hashikawa, Kazunobu; Terashi, Hiroto

    2015-01-01

    Objective: Verrucous skin lesions on the feet in diabetic neuropathy is a condition usually induced by chronic mechanical stimulation of the feet of patients with diabetic neuropathy and usually occurs at weight-bearing sites. We here present a rare case involving a man with verrucous skin lesions on the feet in diabetic neuropathy at an unusual, non–weight-bearing site. Methods: A 58-year-old man with diabetic neuropathy presented with a verrucous skin lesion overlaying residual skin staples and an amputation stump of the second metatarsal bone on the dorsal foot. Results: The biopsy findings were inconclusive and suggested the necessity of distinguishing the lesion from verrucous carcinoma. The lesion was resected, and the residual skin staples were simultaneously removed. Investigation of the excisional biopsy confirmed our diagnosis of verrucous skin lesions on the feet in diabetic neuropathy. Conclusions: Verrucous skin lesions on the feet in diabetic neuropathy is often difficult to distinguish from verrucous carcinoma; in this case, the unusual location of the lesion could be attributed not only to sensory loss but also to the presence of an amputation stump and the persistence of the residual skin staples. PMID:26171095

  2. Necessity of Distinguishing Verrucous Carcinoma From Verrucous Skin Lesion Overlaying Residual Skin Staples in an Area of Sensory Loss: A Case Report.

    PubMed

    Sakakibara, Shunsuke; Tokiyoshi, Takahiro; Hashikawa, Kazunobu; Terashi, Hiroto

    2015-01-01

    Verrucous skin lesions on the feet in diabetic neuropathy is a condition usually induced by chronic mechanical stimulation of the feet of patients with diabetic neuropathy and usually occurs at weight-bearing sites. We here present a rare case involving a man with verrucous skin lesions on the feet in diabetic neuropathy at an unusual, non-weight-bearing site. A 58-year-old man with diabetic neuropathy presented with a verrucous skin lesion overlaying residual skin staples and an amputation stump of the second metatarsal bone on the dorsal foot. The biopsy findings were inconclusive and suggested the necessity of distinguishing the lesion from verrucous carcinoma. The lesion was resected, and the residual skin staples were simultaneously removed. Investigation of the excisional biopsy confirmed our diagnosis of verrucous skin lesions on the feet in diabetic neuropathy. Verrucous skin lesions on the feet in diabetic neuropathy is often difficult to distinguish from verrucous carcinoma; in this case, the unusual location of the lesion could be attributed not only to sensory loss but also to the presence of an amputation stump and the persistence of the residual skin staples.

  3. Skin microtopography as a measure of photoaging and risk of squamous cell carcinoma of the skin in a US population.

    PubMed

    Kuklinski, Lawrence Fitzgerald; Zens, Michael Scot; Perry, Ann E; Green, Adele C; Karagas, Margaret R

    2017-01-01

    Skin microtopography as a measure of photoaging is a noninvasive approach to measuring chronic ultraviolet radiation exposure and reflects the degree of dermal elastosis in populations of European descent in the subtropics. Less is known about the utility of this approach in populations at different latitudes, and whether it relates to skin cancer risk. A population-based case-control study of 342 squamous cell carcinoma (SCC) cases and 331 age- and gender-matched controls were evaluated for histologic evidence of solar damage and severity of photoaging based on microtopography on a six-grade scale. Odds ratios (OR) for SCC associated with degree of photoaging were estimated using logistic regression analysis adjusted for potentially confounding factors. After adjustment for known risk factors, SCC was associated with increasing photoaging grade (OR = 1.7, 95% CI = 0.9-3.0 for severe photoaging; OR = 2.8, 95% CI = 1.6-5.0 for very severe photoaging). Associations remained among those with actinic keratosis (OR = 3.4, 95% CI = 0.9-12.4 for severe photoaging, OR = 5.7, 95% CI = 1.7-19.6 for very severe photoaging). There was limited statistical power, particularly for subgroup analyses. Our findings provide further evidence of microtopography as an independent, objective indicator of risk of SCC. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Basal cell carcinoma of the skin (part 1): epidemiology, pathology and genetic syndromes.

    PubMed

    Correia de Sá, Tiago Ribeiro; Silva, Roberto; Lopes, José Manuel

    2015-11-01

    Basal cell carcinoma (BCC) is the most common skin cancer worldwide with increasing incidence, but difficult to assess due to the current under registration practice. Despite the low mortality rate, BCC is a cause of great morbidity and an economic burden to health services. There are several risk factors that increase the risk of BCC and partly explain its incidence. Low-penetrance susceptibility alleles, as well as genetic alterations in signaling pathways, namely SHH pathway, also contribute to the carcinogenesis. BCC associate with several genetic syndromes, of which basal cell nevus syndrome is the most common.

  5. Squamous Cell Carcinoma of the Skin and Coal Tar Creosote Exposure in a Railroad Worker

    PubMed Central

    Carlsten, Chris; Hunt, Stephen Carl; Kaufman, Joel D.

    2005-01-01

    A 50-year-old male railroad worker presented to his primary care physician with an erythematous, tender skin lesion on the right knee; a biopsy of this lesion revealed squamous cell carcinoma in situ. The site of the lesion was sun-protected but had been associated with 30 years of creosote-soaked clothing. In this article, we review dermal and other malignancies associated with creosote, along with creosote occupational exposures and exposure limits. This is a unique case, given the lack of other, potentially confounding, polyaromatic hydrocarbons and the sun-protected location of the lesion. PMID:15626654

  6. Basal cell carcinoma of the skin (part 2): diagnosis, prognosis and management.

    PubMed

    Correia de Sá, Tiago Ribeiro; Silva, Roberto; Lopes, José Manuel

    2015-11-01

    Basal cell carcinoma (BCC) is a heterogeneous malignant neoplasm with different biological and clinical behaviors, often slow growing and rarely metastatic and conveying an excellent prognosis. However, BCC is the most frequent skin cancer worldwide and can cause great morbidity, as most occur in high visible areas of the body, often relapse and may invade and destroy local tissues. This review aims to present a concise and updated overview of BCC histopathology and clinical presentation and progression. We also present a summary of currently available treatment options and some of the new promising agents.

  7. ATR-FTIR Spectroscopy for the Assessment of Biochemical Changes in Skin Due to Cutaneous Squamous Cell Carcinoma

    PubMed Central

    Lima, Cássio A.; Goulart, Viviane P.; Côrrea, Luciana; Pereira, Thiago M.; Zezell, Denise M.

    2015-01-01

    Nonmelanoma skin cancers represent 95% of cutaneous neoplasms. Among them, squamous cell carcinoma (SCC) is the more aggressive form and shows a pattern of possible metastatic profile. In this work, we used Fourier transform infrared spectroscopy (FTIR) spectroscopy to assess the biochemical changes in normal skin caused by squamous cell carcinoma induced by multi-stage chemical carcinogenesis in mice. Changes in the absorption intensities and shifts were observed in the vibrational modes associated to proteins, indicating changes in secondary conformation in the neoplastic tissue. Hierarchical cluster analysis was performed to evaluate the potential of the technique to differentiate the spectra of neoplastic and normal skin tissue, so that the accuracy obtained for this classification was 86.4%. In this sense, attenuated total reflection (ATR)-FTIR spectroscopy provides a useful tool to complement histopathological analysis in the clinical routine for the diagnosis of cutaneous squamous cell carcinoma. PMID:25811925

  8. Tetraspanin CD151 plays a key role in skin squamous cell carcinoma

    PubMed Central

    Li, Qinglin; Yang, Xiuwei H.; Xu, Fenghui; Sharma, Chandan; Wang, Hong-Xing; Knoblich, Konstantin; Rabinovitz, Isaac; Granter, Scott R.; Hemler, Martin E.

    2012-01-01

    Here we provide the first evidence that tetraspanin CD151 can support de novo carcinogenesis. During two-stage mouse skin chemical carcinogenesis, CD151 reduces tumor lag time and increases incidence, multiplicity, size, and progression to malignant squamous cell carcinoma (SCC), while supporting both cell survival during tumor initiation and cell proliferation during the promotion phase. In human skin SCC, CD151 expression is selectively elevated compared to other skin cancer types. CD151 support of keratinocyte survival and proliferation may depend on activation of transcription factor STAT3, a regulator of cell proliferation and apoptosis. CD151 also supports PKCα-α6β4 integrin association and PKC-dependent β4 S1424 phosphorylation, while regulating α6β4 distribution. CD151-PKCα effects on integrin β4 phosphorylation and subcellular localization are consistent with epithelial disruption to a less polarized, more invasive state. CD151 ablation, while minimally affecting normal cell and normal mouse functions, markedly sensitized mouse skin and epidermoid cells to chemicals/drugs including DMBA (mutagen) and camptothecin (topoisomerase inhibitor), as well as to agents targeting EGFR, PKC, Jak2/Tyk2, and STAT3. Hence, CD151 ‘co-targeting’ may be therapeutically beneficial. These findings not only support CD151 as a potential tumor target, but also should apply to other cancers utilizing CD151-laminin-binding integrin complexes. PMID:22824799

  9. Automatic detection of basal cell carcinoma using telangiectasia analysis in dermoscopy skin lesion images.

    PubMed

    Cheng, Beibei; Erdos, David; Stanley, Ronald J; Stoecker, William V; Calcara, David A; Gómez, David D

    2011-08-01

    Telangiectasia, dilated blood vessels near the surface of the skin of small, varying diameter, are critical dermoscopy structures used in the detection of basal cell carcinoma (BCC). Distinguishing these vessels from other telangiectasia, that are commonly found in sun-damaged skin, is challenging. Image analysis techniques are investigated to find vessels structures in BCC automatically. The primary screen for vessels uses an optimized local color drop technique. A noise filter is developed to eliminate false-positive structures, primarily bubbles, hair, and blotch and ulcer edges. From the telangiectasia mask containing candidate vessel-like structures, shape, size and normalized count features are computed to facilitate the discrimination of benign skin lesions from BCCs with telangiectasia. Experimental results yielded a diagnostic accuracy as high as 96.7% using a neural network classifier for a data set of 59 BCCs and 152 benign lesions for skin lesion discrimination based on features computed from the telangiectasia masks. In current clinical practice, it is possible to find smaller BCCs by dermoscopy than by clinical inspection. Although almost all of these small BCCs have telangiectasia, they can be short and thin. Normalization of lengths and areas helps to detect these smaller BCCs. © 2011 John Wiley & Sons A/S.

  10. Automatic detection of basal cell carcinoma using telangiectasia analysis in dermoscopy skin lesion images

    PubMed Central

    Cheng, Beibei; Erdos, David; Stanley, Ronald J.; Stoecker, William V.; Calcara, David A.; Gómez, David D.

    2011-01-01

    Background Telangiectasia, dilated blood vessels near the surface of the skin of small, varying diameter, are critical dermoscopy structures used in the detection of basal cell carcinoma (BCC). Distinguishing these vessels from other telangiectasia, that are commonly found in sun-damaged skin, is challenging. Methods Image analysis techniques are investigated to find vessels structures found in BCC automatically. The primary screen for vessels uses an optimized local color drop technique. A noise filter is developed to eliminate false-positive structures, primarily bubbles, hair, and blotch and ulcer edges. From the telangiectasia mask containing candidate vessel-like structures, shape, size and normalized count features are computed to facilitate the discrimination of benign skin lesions from BCCs with telangiectasia. Results Experimental results yielded a diagnostic accuracy as high as 96.7% using a neural network classifier for a data set of 59 BCCs and 152 benign lesions for skin lesion discrimination based on features computed from the telangiectasia masks. Conclusion In current clinical practice, it is possible to find smaller BCCs by dermoscopy than by clinical inspection. Although almost all of these small BCCs have telangiectasia, they can be short and thin. Normalization of lengths and areas helps to detect these smaller BCCs. PMID:23815446

  11. Excision repair of pyrimidine dimers induced by simulated solar radiation in the skin of patients with basal cell carcinoma

    SciTech Connect

    Alcalay, J.; Freeman, S.E.; Goldberg, L.H.; Wolf, J.E. )

    1990-11-01

    One prominent lesion induced in DNA by ultraviolet (UV) radiation is the cyclobutyl pyrimidine dimer formed between adjacent pyrimidines on the same DNA strand. We investigated whether people who have developed basal cell carcinoma on sun-exposed skin have an altered ability to repair UV-induced pyrimidine dimers in DNA. Twenty-two patients with at least one basal cell carcinoma, aged 31-84 years, and 19 healthy volunteers, aged 25-61 years, took part in the study. Both groups were given one minimal erythema dose (MED) of simulated solar radiation on the lower back. DNA was extracted from the irradiated skin 0 to 6 h later, and the number of UV-induced pyrimidine dimers was determined using a dimer-specific endonuclease. At time 0, the average number of dimers per unit of DNA was similar in the two groups. After 6 h, an average of 22 +/- 4% of the dimers were removed in the group with basal cell carcinoma compared to 33 +/- 4% in the cancer-free group. In the basal cell carcinoma group, only 23% of the patients repaired more than 30% of the dimers after 6 h, compared with 53% of the cancer-free subjects (p less than 0.05). We conclude that patients who develop basal cell carcinoma on sun-exposed skin may have a decreased ability to repair pyrimidine dimers induced in skin exposed to simulated solar radiation.

  12. Decreased expression of the mitochondrial solute carrier SLC25A43 in basal cell carcinoma compared with healthy skin.

    PubMed

    Prosén, Sara; Eremo, Anna Göthlin; Tsegai, Alexander Duarte; Lindberg, Magnus; Tina, Elisabet

    2017-08-01

    Basal cell carcinoma is the most common type of cancer in fair-skinned individuals, and its incidence is rapidly increasing. The aim of the present study was to investigate the gene and protein expression of the mitochondrial solute carrier family 25 member 43 (SLC25A43) in basal cell carcinoma. SLC25A43 has previously been identified to be genetically altered and associated with cell proliferation in human epidermal growth factor receptor 2-positive breast cancer. However, the knowledge about SLC25A43 is limited, and its role in other cancers is unknown. The SLC25A43 gene and protein expression was analysed in 14 basal cell carcinomas and healthy skin samples from the same individuals by quantitative polymerase chain reaction and immunohistochemistry, respectively. The results demonstrated a significantly lower (≥50%) SLC25A43 gene expression in all carcinomas compared with that in healthy skin. In addition, SLC25A43 protein expression was absent in >90% of all visual fields in the basal cell carcinomas, and the H-score was significantly lower in tumours compared with the adjacent epidermis. These results demonstrate that SLC25A43 expression is altered at the gene and protein levels in basal cell carcinoma. The underlying mechanisms and the clinical relevance of these data must be elucidated in additional experimental and clinical studies.

  13. Squamous cell carcinomas of the skin explore angiogenesis-independent mechanisms of tumour vascularization.

    PubMed

    Pastushenko, Ievgenia; Gracia-Cazaña, Tamara; Vicente-Arregui, Sandra; Van den Eynden, Gert G; Ara, Mariano; Vermeulen, Peter B; Carapeto, Franciso José; Van Laere, Steven J

    2014-01-01

    Aims. To evaluate the vascularization in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin. Methods. We performed CD31 (i.e., panendothelial marker) and CD105 (i.e., proliferating endothelium marker) immunostaining on samples of 70 SCCs and 70 BCCs of the skin. We evaluated the relative blood vessel area using the Chalkley counting method in each histologic subtype of these tumours. We calculated the degree of proliferation of blood vessel endothelium dividing CD105-Chalkley score by CD31-Chalkley score. Results. We found significantly higher peritumoral and intratumoral blood vessel area in SCC when compared to BCC (both with CD31 and CD105). Chalkley counts differed significantly between groups with different BCC histologic subtypes and SCC with different grade of differentiation. Surprisingly, the degree of proliferation of blood vessel endothelium was higher in BCC when compared to SCC. Conclusions. While SCC exhibited significantly higher intratumoral and peritumoral blood vessel areas compared to BCC, the relatively low rate of proliferating endothelium in this tumour type suggests the existence of endothelial-sprouting-independent mechanisms of vascularization in SCC.

  14. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results.

    PubMed

    Maciel, Paula Curitiba; Veiga-Filho, Joel; Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing.

  15. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results*

    PubMed Central

    Maciel, Paula Curitiba; Veiga-Filho, Joel; de Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    BACKGROUND Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. OBJECTIVE To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. METHODS Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. RESULTS Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. CONCLUSION Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing. PMID:25054746

  16. Five Year Retrospective Case Series of Adnexal Torsion

    PubMed Central

    Joy, Smitha; Nayar, Jayashree

    2014-01-01

    Aims and Objectives: Adnexal torsion is a rare gynaecological emergency that requires an early surgical intervention to save the adnexa from irreversible damage .Our study is about clinical presentation and management approach of adnexal torsion in a tertiary care centre. Study Design: Retrospective study. Materials and Methods: Review of case records during the five years of 2008 November -2013 November in Amrita Institute of Medical Sciences, Kochi, India. Results: Adnexal torsion was found mainly in the reproductive age. Ultrasound was the most commonly used imaging modality. Benign tumours predispose to torsion. Torsion occurred during postovulatory period in many cases. Polycystic ovaries were a risk factor for unexplained torsion in younger age groups. Diagnosis of adnexal torsion was mostly intra operative by direct visualisation of the rotated adnexa. Laparoscopy was the preferred method of surgical intervention. Ovarian conservation was tried in majority of the child bearing age groups. Conclusion: Adnexal torsion is a rare emergency which requires a high index of clinical suspicion for diagnosis as the symptoms are non specific. Imaging helps in diagnosis but most of them are diagnosed intra operatively. Laparoscopic conservative surgery is the preferred surgical approach especially in younger age groups. An early surgical intervention helps in salvaging the adnexa and prevents further complications. PMID:25653994

  17. Study on the Effect of Blood Content on Diffuse Reflectance Spectra of Basal Cell Carcinoma Skin Tissue

    PubMed Central

    He, Qingli

    2013-01-01

    Diffuse reflectance spectrum as a noninvasive method has been widely used to study the optical properties of cutaneous skin tissue. In this work, we optimized an eight-layered optical model of basal cell carcinoma skin tissue to study its optical properties. Based on the model, the diffuse reflectance spectra were reconstructed in visible wavelength range by Monte Carlo methods. After different blood contents were added to the optical model, the contribution of blood to diffuese reflectance spectra was investigated theoretically. The ratios of basal cell carcinoma skin and normal skin tissue were also calculated for both experimental result and rebuilt results to testify the theoretical reasonability of the model and methods. PMID:24023527

  18. Nonlinear spectral imaging of human normal skin, basal cell carcinoma and squamous cell carcinoma based on two-photon excited fluorescence and second-harmonic generation

    NASA Astrophysics Data System (ADS)

    Xiong, S. Y.; Yang, J. G.; Zhuang, J.

    2011-10-01

    In this work, we use nonlinear spectral imaging based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) for analyzing the morphology of collagen and elastin and their biochemical variations in basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and normal skin tissue. It was found in this work that there existed apparent differences among BCC, SCC and normal skin in terms of their thickness of the keratin and epithelial layers, their size of elastic fibers, as well as their distribution and spectral characteristics of collagen. These differences can potentially be used to distinguish BCC and SCC from normal skin, and to discriminate between BCC and SCC, as well as to evaluate treatment responses.

  19. Skin cancer (Basal cell carcinoma, squamous cell carcinoma, and malignant melanoma): new cases, treatment practice, and health care costs in new brunswick, Canada, 2002-2010.

    PubMed

    Pilgrim, Wilfred; Hayes, Robert; Hanson, Dana W; Zhang, Bin; Boudreau, Bonnie; Leonfellner, Suzanne

    2014-10-01

    In Canada, there is no formal process for registering nonmelanoma skin cancer (NMSC); thus, the epidemiology, treatment practices, and associated health costs are not well known. To investigate trends in new cases of skin cancer, treatment practices, and health care costs in New Brunswick, Canada. Data were extracted from the Provincial Cancer Registry and New Brunswick administrative health databases for 2002-2010. New cases: Basal Cell Carcinoma (BCC) was the most common skin cancer diagnosed, and incidence rates significantly increased between 1992 and 2010.Treatment practice: Dermatologists managed the majority (45%) of the overall skin cancer treatments.Health care costs: NMSC accounted for ∼80% of the health care costs for skin cancer and was dominated by BCC. Development of best practice treatment guidelines for NMSC in New Brunswick would improve future health care efficiencies, and standard protocols for registering new cases of NMSC in Canada would strengthen surveillance and reporting capacity.

  20. Geographic variation and risk of skin cancer in US women. Differences between melanoma, squamous cell carcinoma, and basal cell carcinoma.

    PubMed

    Qureshi, Abrar A; Laden, Francine; Colditz, Graham A; Hunter, David J

    2008-03-10

    Occurrences of melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) have been associated with varying geography. Our goal was to evaluate differences in risk of these skin cancers according to residence at varying UV indices at 3 time points. Prospective 1984-2002 study of 84 836 female nurses who lived in different UV index regions of the United States at birth and at 15 or 30 years of age. The outcome measure was diagnosis of melanoma, SCC, or BCC. During the 18-year study, 420 cases of melanoma, 863 cases of SCC, and 8215 cases of BCC occurred. At 30 years of age, age-adjusted risks for SCC were 1.47 (95% confidence interval [CI], 1.22-1.76) and 1.90 (95% CI, 1.51-2.36) for women residing in states with a UV index of 6 (medium) and 7 or more (high), respectively. Although elevated, the age-adjusted risk of BCC at 30 years of age associated with residence in these states was substantially less. Although the risk of melanoma was not elevated for women living in these states at 30 years of age, it was significantly elevated among women living in states with UV indices of 6 at birth and at 15 years of age. There was no material change in risk estimates with multivariate adjustment. For women who reported living in states with UV indices of 7 or more at all 3 time points, the multivariate risk of SCC was highest. The risk of SCC is independently affected by residence in locations with medium and high UV indices; the gradient of risk is weaker for BCC; and the risk of melanoma does not change significantly across this gradient.

  1. A case of epidermodysplasia verruciformis with squamous cell carcinomas on non-sun-exposed areas of skin.

    PubMed

    Ansarin, Habib; Tajziehchi, Leila; Shaianfar, Nasrin

    2007-04-01

    Epidermodysplasia verruciformis is an inherited disorder, characterized by multiple plane warts, pityriasis versicolor-like lesions, defects of cell-mediated immunity, and tendency to develop skin malignancies, primarily on sun-exposed areas. In this article, we present a case of epidermodysplasia verruciformis with multiple plane warts, pityriasis versicolor-like lesions, and squamous cell carcinomas on non-sun-exposed areas of skin. After acitretin prescription, significant improvement was found in plane warts, but not in pityriasis versicolor-like lesions.

  2. 21 CFR 866.6050 - Ovarian adnexal mass assessment score test system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ovarian adnexal mass assessment score test system... immunological Test Systems § 866.6050 Ovarian adnexal mass assessment score test system. (a) Identification. An ovarian/adnexal mass assessment test system is a device that measures one or more proteins in serum or...

  3. 21 CFR 866.6050 - Ovarian adnexal mass assessment score test system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ovarian adnexal mass assessment score test system... immunological Test Systems § 866.6050 Ovarian adnexal mass assessment score test system. (a) Identification. An ovarian/adnexal mass assessment test system is a device that measures one or more proteins in serum or...

  4. 21 CFR 866.6050 - Ovarian adnexal mass assessment score test system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ovarian adnexal mass assessment score test system... immunological Test Systems § 866.6050 Ovarian adnexal mass assessment score test system. (a) Identification. An ovarian/adnexal mass assessment test system is a device that measures one or more proteins in serum or...

  5. Laser-induced fluorescence and reflectance spectroscopy for the discrimination of basal cell carcinoma from the surrounding normal skin tissue.

    PubMed

    Drakaki, E; Kaselouris, E; Makropoulou, M; Serafetinides, A A; Tsenga, A; Stratigos, A J; Katsambas, A D; Antoniou, C

    2009-01-01

    The object of this study was to investigate whether laser-induced skin autofluorescence (LIF) and/or light reflectance spectra could provide a useful contrast between basal cell carcinoma (BCC) tissues and the surrounding healthy skin. Unstained human skin samples, excised from humans undergoing biopsy examination, were irradiated with a nitrogen laser (lambda = 337 nm) for excitation of autofluorescence and a tungsten halogen lamp for the reflectance measurements. The ex vivo spectroscopic results were correlated with the histopathology images to distinguish the areas of BCC from those of the surrounding health skin. A simple spectral analysis technique was also applied for better skin diagnosis. In conclusion, it seems that LIF and reflectance spectra could be used to differentiate neoplastic from normal skin tissue using an appropriate classification model analysis. Copyright 2009 S. Karger AG, Basel.

  6. Macro-environment of breast carcinoma: frequent genetic alterations in the normal appearing skins of patients with breast cancer.

    PubMed

    Moinfar, Farid; Beham, Alfred; Friedrich, Gerhard; Deutsch, Alexander; Hrzenjak, Andelko; Luschin, Gero; Tavassoli, Fattaneh A

    2008-05-01

    Genetic abnormalities in microenvironmental tissues with subsequent alterations of reciprocal interactions between epithelial and mesenchymal cells play a key role in the breast carcinogenesis. Although a few reports have demonstrated abnormal fibroblastic functions in normal-appearing fibroblasts taken from the skins of breast cancer patients, the genetic basis of this phenomenon and its implication for carcinogenesis are unexplored. We analyzed 12 mastectomy specimens showing invasive ductal carcinomas. In each case, morphologically normal epidermis and dermis, carcinoma, normal stroma close to carcinoma, and stroma at a distant from carcinoma were microdissected. Metastatic-free lymphatic tissues from lymph nodes served as a control. Using PCR, DNA extracts were examined with 11 microsatellite markers known for a high frequency of allelic imbalances in breast cancer. Losses of heterozygosity and/or microsatellite instability were detected in 83% of the skin samples occurring either concurrently with or independently from the cancerous tissues. In 80% of these cases at least one microsatellite marker displayed loss of heterozygosity or microsatellite instability in the skin, which was absent in carcinoma. A total of 41% of samples showed alterations of certain loci observed exclusively in the carcinoma but not in the skin compartments. Our study suggests that breast cancer is not just a localized genetic disorder, but rather part of a larger field of genetic alterations/instabilities affecting multiple cell populations in the organ with various cellular elements, ultimately contributing to the manifestation of the more 'localized' carcinoma. These data indicate that more global assessment of tumor micro- and macro-environment is crucial for our understanding of breast carcinogenesis.

  7. Single-Site Laparoscopic Management of a Large Adnexal Mass

    PubMed Central

    Scribner, Dennis R.; Weiss, Patrice M.

    2013-01-01

    Introduction: Single-site laparoscopy is gaining acceptance in many surgical fields including gynecology. The purpose of this report is to demonstrate the technique and outcome for removing a large adnexal mass through a single site. Case Description: A 41-y-old female was referred to gynecology oncology for increased abdominal girth for 3 mo. An ultrasound confirmed a benign-appearing, 37-cm left adnexal mass. The mass was removed through a single-site laparoscopic incision with the aid of drainage and a morcellator. The operating time was 84 min. The patient was discharged 2 h and 35 min later with full return to normal activity in 5 d. Conclusion: Large, benign-appearing adnexal masses can be managed safely with superior cosmetic results using single-site laparoscopy. PMID:23925036

  8. TIPE2 regulates tumor-associated macrophages in skin squamous cell carcinoma.

    PubMed

    Li, Xin

    2016-04-01

    Tumor-associated macrophages (TAMs) play an essential role in the immunology, growth, invasion, and metastases of skin squamous cell carcinoma (SCC). However, the molecular mechanisms underlying the activation and regulation of TAMs by SCC are not completely understood. Here, in a Transwell co-culture system, we found that SCC cells induced polarization of macrophages to a M2 phenotype, evident by expression of surface markers CD163, CD206, and CD301, as well as reduction of cellular iNOS levels and augmentation of cellular arginase levels. Moreover, tumor necrosis factor (TNF)-alpha-induced protein 8-like 2 (TIPE2) was induced in macrophages by co-culturing with SCC cells. Depletion of TIPE2 in macrophages abolished the effects of co-cultured SCC cells on phenotypic modification of macrophages. Furthermore, patients with SCC were divided into two groups based on TIPE2 levels in TAMs at the time of tumor resection. We found that patients with high-TIPE2 TAMs had an overall poor 5-year survival. Together, our data suggest a previously unappreciated role of TIPE2 in the crosstalk between skin SCC and TAMs and highlight TIPE2 as a promising novel target for skin SCC treatment.

  9. Testosterone metabolism of fibroblasts grown from prostatic carcinoma, benign prostatic hyperplasia and skin fibroblasts

    SciTech Connect

    Schweikert, H.U.; Hein, H.J.; Romijn, J.C.; Schroeder, F.H.

    1982-02-01

    The metabolism of (1,2,6,7-3H)testosterone was assessed in fibroblast monolayers derived from tissue of 5 prostates with benign hyperplasia (BPH), 4 prostates with carcinoma (PC), and 3 biopsy samples of skin, 2 nongenital skin (NG) and 1 genital skin. The following metabolites could be identified: androstanedione androstenedione, dihydrotestosterone, androsterone, epiandrosterone, androstane-3 alpha, 17 beta-diol and androstane-3 beta, 17 beta-diol. Testosterone was metabolized much more rapidly in fibroblasts originating from prostatic tissue than in fibroblasts derived from NG. A significantly higher formation of 5 alpha-androstanes and 3 alpha-hydroxysteroids could be observed in fibroblasts from BPH as compared to PC. 17-ketosteroid formation exceeded 5 alpha-androstane formation in BPH, whereas 5 alpha-reduction was the predominant pathway in fibroblasts grown from PC and NG. Since testosterone metabolism in fibroblasts of prostatic origin therefore resembles in many aspects that in whole prostatic tissue, fibroblasts grown from prostatic tissues might be a valuable tool for further investigation of the pathogenesis of human BPH and PC.

  10. RasGRP1 Transgenic Mice Develop Cutaneous Squamous Cell Carcinomas in Response to Skin Wounding

    PubMed Central

    Diez, Federico R.; Garrido, Ann A.; Sharma, Amrish; Luke, Courtney T.; Stone, James C.; Dower, Nancy A.; Cline, J. Mark; Lorenzo, Patricia S.

    2009-01-01

    Models of epidermal carcinogenesis have demonstrated that Ras is a critical molecule involved in tumor initiation and progression. Previously, we have shown that RasGRP1 increases the susceptibility of mice to skin tumorigenesis when overexpressed in the epidermis by a transgenic approach, related to its ability to activate Ras. Moreover, RasGRP1 transgenic mice develop spontaneous papillomas and cutaneous squamous cell carcinomas, some of which appear to originate in sites of injury, suggesting that RasGRP1 may be responding to signals generated during the wound-healing process. In this study, we examined the response of the RasGRP1 transgenic animals to full-thickness incision wounding of the skin, and demonstrated that they respond by developing tumors along the wounded site. The tumors did not present mutations in the H-ras gene, but Rasgrp1 transgene dosage correlated with tumor susceptibility and size. Analysis of serum cytokines showed increased levels of granulocyte colony-stimulating factor in transgenic animals after wounding. Furthermore, in vitro experiments with primary keratinocytes showed that granulocyte colony-stimulating factor stimulated Ras activation, although RasGRP1 was dispensable for this effect. Since granulocyte colony-stimulating factor has been recently associated with proliferation of skin cancer cells, our results may help in the elucidation of pathways that activate Ras in the epidermis during tumorigenesis in the absence of oncogenic ras mutations. PMID:19497993

  11. Paediatric ocular and adnexal injuries requiring hospitalisation in Western Australia.

    PubMed

    Yardley, Anne-Marie E; Hoskin, Annette K; Hanman, Kate; Sanfilippo, Paul G; Lam, Geoffrey C; Mackey, David A

    2017-05-01

    The aim was to investigate the characteristics and outcomes of ocular and adnexal injuries requiring hospitalisation in children in Perth, Western Australia. This is a hospital-based retrospective review of children admitted to Princess Margaret Hospital for Children with diagnoses of ocular and/or adnexal trauma from 2002-2013. Hospital charts were reviewed for demographic information, injury and management details, follow-up and visual outcome. Final visual acuity was categorised into three groups: 6/12 or better, from 6/12 to 6/60, worse than 6/60. Ordinal logistic regression was used to compute odds ratios and predicted probabilities for each category of final visual outcome. Over the 12-year time period, 482 children were admitted with ocular or adnexal injuries - an average of 40 admissions per year. The mean age of the cohort was 7.1 years (range 0.09 to 16.47 years) with a male to female ratio of 2.6:1.0. There were 185 closed-globe injuries, 72 open-globe injuries and 293 adnexal injuries. Fourteen per cent of the cohort sustained a combined globe and adnexal injury. Children in the up to five-year age group were most susceptible to injury. Eighty-two per cent of the group had a final visual acuity of 6/12 or better. Factors associated with poor visual outcomes included younger age (p < 0.01), open-globe injury (p < 0.01) and lens injury (p < 0.01). Based on the outcomes of our review, paediatric ocular and adnexal trauma are significant causes for hospital attendance in childhood. Identifying associated risk factors will help develop injury prevention strategies to promote eye safety for children. © 2016 Optometry Australia.

  12. Trends in Non-Melanoma Skin Cancer (Basal Cell Carcinoma and Squamous Cell Carcinoma) in Canada: A Descriptive Analysis of Available Data.

    PubMed

    Abbas, Mariam; Kalia, Sunil

    2016-01-01

    Despite its increased incidence and status as the most prevalent cancer in Canada, there is a paucity of epidemiological data on non-melanoma skin cancer (NMSC). To assess trends of keratinocyte carcinomas (KC) in Canada over 5 decades. Articles published from 1960 to 2015 on NMSC in Canada were identified through MEDLINE. Six articles met our search criteria. Overall, KC has increased. However, the rate of increase in the past decade has slowed down and decreased in younger age cohorts. Men had higher incidences of KC. In both sexes, the basal cell carcinoma and squamous cell carcinoma ratio was ≥2.5:1. Keratinocyte carcinomas were most commonly located on the head and neck, and increasing rates are occurring on the trunk. The methods of registering skin cancer cases vary among different provinces. Keratinocyte carcinomas incidence is overall increasing; however, there may be evidence that the incidence is leveling off and decreasing in younger age cohorts. © The Author(s) 2015.

  13. Diagnosis and Management of Adnexal Masses in Pregnancy

    PubMed Central

    Yakasai, Ibrahim Adamu; Bappa, Lawal Abdullahi

    2012-01-01

    Widespread use of ultrasound in early pregnancy has led to the detection of incidental adnexal masses more frequently. This article reviews the diagnosis and management options for adnexal masses in pregnancy. The availability of high-resolution ultrasound has made observation to be a viable option in some cases. However, for those masses suspicious of malignancy, at risk of torsion, rupture, or clinically symptomatic, surgical treatment is warranted. Laparoscopy has been successfully used in pregnancy and is safe in experienced and trained hands in properly equipped units. PMID:23741580

  14. Pigmented squamous cell carcinoma of the cheek skin probably arising from solar keratosis.

    PubMed

    Terada, Tadashi; Yamagami, Jun; Fugimoto, Atsushi; Tanaka, Kyoko; Sugiura, Makoto

    2003-07-01

    We report a rare case of pigmented squamous cell carcinoma (SCC) of the cheek skin probably arising from solar keratosis. An 80-year-old man was referred to our clinic because of a black skin nodule in the right cheek. The nodular lesion was 1 cm in diameter, dome-shaped, hard, sharply demarcated, partially erosive and telangiectatic at the border. The lesion was completely excised under the clinical diagnosis of probable seborrheic keratosis. Microscopically, cutaneous horn and mildly atypical squamous epithelia suggestive of previous solar keratosis were present in the surface of the lesion. The lesion consisted of atypical squamous cells with keratinization and intercellular bridges, and it was regarded as SCC. The SCC cells were seen to invade lightly into the upper dermis, where lymphocytic infiltrations and melanophages were noted. Characteristically, heavy deposition of melanin pigment was recognized in the SCC cells as well as in proliferated dendritic and pigment blockade melanocytes that were scattered or colonized within the SCC cell nests. Masson-Fontana stain revealed numerous melanin granules in the SCC cells, as well as in dendritic and pigment blockade melanocytes. Immunohistochemically, the SCC cells were positive for cytokeratins and epithelial membrane antigen, and negative for S-100 protein and HMB45 antigen. Dendritic and pigment blockade melanocytes were negative for cytokeratins, epithelial membrane antigen, and HMB45 antigen, but positive for S-100 protein. The present case suggests that SCC cells of the skin may induce proliferation of melanocytes. The differential diagnosis and the histogenesis of pigmented SCC of the skin are discussed.

  15. Non-melanoma Skin Cancer in Canada Chapter 4: Management of Basal Cell Carcinoma.

    PubMed

    Zloty, David; Guenther, Lyn C; Sapijaszko, Mariusz; Barber, Kirk; Claveau, Joël; Adamek, Tamara; Ashkenas, John

    2015-01-01

    Basal cell carcinoma (BCC) is the most common malignancy. Growth of BCCs leads to local destruction of neighbouring healthy skin and underlying tissue and can result in significant functional and cosmetic morbidity. To provide guidance to Canadian health care practitioners regarding management of BCCs. Literature searches and development of graded recommendations were carried out as discussed in the accompanying Introduction. Although BCCs rarely metastasize, they can be aggressive and disfiguring. This chapter describes the natural history and prognosis of BCCs. Risk stratification is based on clinical features, including the site and size of the tumour, its histologic subtype (nodular vs sclerosing), and its history of recurrence. Various options should be considered for BCC treatment, including cryosurgery, curettage, and topical or photodynamic approaches, as well as fixed-margin surgery and Mohs micrographic surgery. Stratification of recurrence risk for individual BCCs determines the most appropriate therapeutic course. © The Author(s) 2015.

  16. Clear cell variant of squamous cell carcinoma of skin: A report of a case.

    PubMed

    Lawal, Ahmed Oluwatoyin; Adisa, Akinyele Olumuyiwa; Olajide, Mofoluwaso A; Olusanya, Adeola Adenike

    2013-01-01

    Clear cell squamous cell carcinoma (SCC) is a rare variant of SCC of skin in which ultraviolet radiation has been suggested as possible etiology. This case is that of a 62-year-old male concrete block maker/bricklayer who presented with a 6 months history of a non-healing ulcer on the left side of his face. Histology showed features of malignant epithelial neoplasm composed of islands of large oval to polyhedral malignant squamous cells with eosinophilic to amphophilic cytoplasm and vesicular nuclei and there were areas showing clear cell differentiation and isolated areas of keratin pearl formation. The lesion was also negative for periodic acid schiff, mucicarmine, and alcian blue stains but was strongly positive for AE1/AE3 (immuno-stain). This case showed an aggressive and bizarre clinical presentation but more report of cases are needed to have a better characterization of the clinical presentation and prognosis of this variant of SCC.

  17. Increased caffeine intake is associated with reduced risk of basal cell carcinoma of the skin.

    PubMed

    Song, Fengju; Qureshi, Abrar A; Han, Jiali

    2012-07-01

    Studies in animals suggest that caffeine administration helps prevent squamous cell skin cancer development, but there have been limited epidemiologic studies on the association between caffeine consumption and skin cancer risk. Using data from the Nurses' Health Study and the Health Professionals Follow-up Study, we prospectively examined risks of basal cell carcinoma (BCC, 22,786 cases), squamous cell carcinoma (SCC, 1,953 cases), and melanoma (741 cases) in relation to caffeine intake. Cox proportional hazard models were used to calculate relative risks (RR) and 95% confidence intervals (CI). The amount of caffeine intake from all dietary sources was inversely associated with BCC risk. Compared with the lowest quintile, the highest quintile had the lowest risk (RR, 0.82 in women; 95% CI:,0.77-0.86 and RR, 0.87 in men; 95% CI, 0.81-0.94; Ptrend<0.0001 in both). A significant inverse association was also found between caffeinated coffee consumption and BCC risk. Compared with individuals who consumed caffeinated coffee less than 1 cup per month, women who consumed more than 3 cups/d had the lowest risk (RR, 0.79; 95% CI, 0.74-0.85; Ptrend<0.0001) and the RR for men was 0.90 (95% CI, 0.80-1.01; Ptrend=0.003). Caffeine from other dietary sources (tea, cola, and chocolate) was also inversely associated with BCC risk. Decaffeinated coffee consumption was not associated with a similar decrease in BCC risk. In contrast, caffeine intake was not found to be inversely associated with risks of SCC or melanoma. Our findings argue that caffeine intake in men and women is inversely associated with risk of BCC. ©2012 AACR.

  18. 5-Fluorouracil shell-enriched solid lipid nanoparticles (SLN) for effective skin carcinoma treatment.

    PubMed

    Khallaf, Rasha A; Salem, Heba F; Abdelbary, Ahmed

    2016-11-01

    The effective treatment of skin carcinoma is warranted for targeting the chemotherapeutic agents into tumor cells and avoiding unwanted systemic absorption. This work was dedicated to the purpose of engineering highly penetrating shell-enriched nanoparticles that were loaded with a hydrophilic chemotherapeutic agent, 5-fluorouracil (5-FU). Varying ratios of lecithin and poloxamer188 were used to produce shell-enriched nanoparticles by enabling the formation of reversed micelles within this region of the SLN. The localization of 5-FU within the shell region of the SLN, was confirmed using 5-FU nanogold particles as a tracer. SLN were introduced within sodium carboxy methylcellulose hydrogel, and then applied onto the skin of mice-bearing Ehrlich's ascites carcinoma. The mice were treated with the gel twice daily for 6 weeks. The transmission electron microscope (TEM) revealed the formation of uniform nanoparticles, which captured reversed micelles within their shell region. The SLNs' had particle size that ranged from 137 ± 5.5 nm to 800 ± 53.6, zeta potential of -19.70 ± 0.40 mV and entrapment efficiency of 47.92 ± 2.34%. The diffusion of the drug-loaded SLN (269.37 ± 10.92 μg/cm(2)) was doubled when compared with the free drug (122 ± 3.09 μg/cm(2)) when both diffused through a hydrophobic membrane. SLN-treated mice exhibited reduced inflammatory reactions, with reduced degrees of keratosis, in addition to reduced symptoms of angiogenesis compared to 5-FU-treated mice. SLN possesses the capacity to be manipulated to entrap and release hydrophilic antitumor drugs with ease.

  19. Toad skin extract cinobufatini inhibits migration of human breast carcinoma MDA-MB-231 cells into a model stromal tissue.

    PubMed

    Nakata, Munehiro; Mori, Shuya; Kamoshida, Yo; Kawaguchi, Shota; Fujita-Yamaguchi, Yoko; Gao, Bo; Tang, Wei

    2015-08-01

    Toad skin extract cinobufatini study has been focused on anticancer activity, especially apoptosis-inducing activity by bufosteroids. The present study examined effect of the toad skin extract on cancer cell migration into model stromal tissues. Human breast carcinoma cell line MDA-MB-231 was incubated in the presence or absence of toad skin extract on a surface of reconstituted type I collagen gel as a model stromal tissue allowing the cells to migrate into the gel. Frozen sections were microscopically observed after azan staining. Data showed a decrease of cell number in a microscopic field and shortening of cell migration into the model stromal tissue in a dose dependent manner. This suggests that toad skin extract may possess migration-preventing activity in addition to cell toxicity such as apoptosis-inducing activity. The multifaceted effects including apoptosis-inducing and cancer cell migration-preventing activities would improve usefulness of toad skin extract cinobufatini as an anticancer medicine.

  20. The role of DAMPS in ALA-PDT for skin squamous cell carcinoma (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Wang, Xiuli; Wang, Xiaojie; Ji, Jie; Zhang, Haiyan; Shi, Lei

    2016-03-01

    5-Aminolevulinic acid mediated photodynamic therapy (ALA-PDT) is an established local approach for skin squamous cell carcinoma. It is believed that dangerous signals damage-associated molecular patterns (DAMPs) play an important role in ALA-PDT. In this study, we evaluated in vitro and in vivo expressions of major DAMPs, calreticulin (CRT), heat shock proteins 70 (HSP70), and high mobility group box 1 (HMGB1), induced by ALA-PDT using immunohistochemistry, western blot, and ELISA in a squamous cell carcinoma (SCC) mouse model. The role of DAMPs in the maturation of DCs potentiated by ALA-PDT-treated tumor cells was detected by FACS and ELISA. Our results showed that ALA-PDT enhanced the expression of CRT, HSP70, and HMGB1. These induced DAMPs played an important role in activating DCs by PDT-treated tumor cells, including phenotypic maturation (upregulation of surface expression of MHC-II, CD80, and CD86) and functional maturation (enhanced capability to secrete IFN-γ and IL-12). Furthermore, injecting ALA-PDT-treated tumor cells into naïve mice resulted in complete protection against cancer cells of the same origin. Our findings indicate that ALA-PDT can upregulate DAMPs and enhance tumor immunogenicity, providing a promising strategy for inducing a systemic anticancer immune response.

  1. Safe and cost-effective laparoscopic removal of adnexal masses.

    PubMed

    Quinlan, D J; Townsend, D E; Johnson, G H

    1997-02-01

    To evaluate laparoscopic removal of adnexal masses using a plastic bag to avoid peritoneal spillage. An observational study. A university-affiliated private hospital. Thirty-one women (mean age 48.7 yrs) with adnexal masses. Laparoscopic removal of adnexal masses ranging from 3 to 12 cm (18 complex, 5 septated cystic masses, 8 persistent simple cysts). The masses were placed in plastic sandwich bag and removed through the umbilical incision. Hospital costs, length of stay and operating times were compared with those of 24 patients undergoing the removal of similar masses by laparotomy. Three masses were functional cysts, 4 were tubal cysts, 4 were endometriomas, and 20 were benign ovarian neoplasms. There were no malignancies. Peritoneal spillage occurred during one ovarian cystectomy. The only complication was bleeding from the cannula site. Comparing laparoscopy and laparotomy, average operating time was 73.45 minutes (range 34-148 min) and 81 minutes, average length of hospital stay was 17.4 hours (range 6-73 hrs) and 2.92 days, and average hospital cost was $2401 and $3539, respectively. Laparoscopic access provides a cost-effective method of removing adnexal masses with a very small risk of peritoneal spillage. When managed in this manner, rather than laparotomy, the cost reduction was significant.

  2. Autofluorescence analysis of dermatitis and squamous cell carcinoma in paraffin wax-embedded skin samples.

    PubMed

    Choi, J H; Jeong, K H; Sung, J Y; Kim, N I; Shin, M K

    2015-03-01

    Recent research has investigated the use of autofluorescence (AF) for distinguishing between normal and cancerous tissues according to different fluorescence characteristics. To analyze if AF can help differentiate cancerous lesions from other nonneoplastic lesions, such as dermatitis, in each layer of the skin ex vivo. Paraffin wax-embedded tissue samples were obtained from patients who were histopathologically diagnosed with squamous cell carcinoma (SCC), psoriasis, chronic dermatitis (lichen simplex chronicus, prurigo nodularis) or acute dermatitis (atopic dermatitis). AF intensity was measured in four layers of the epidermis (corneal, granular, spinous and basal) and two layers of the dermis (papillary and reticular). AF was highest in all layers of psoriasis samples compared with all layers of all other groups. Higher AF values were seen in SCC compared with all skin layers of acute and chronic dermatitis; this finding was especially true in the corneal layer, papillary dermis and reticular dermis. This ex vivo AF study provides basic data for future in vivo studies of AF as a noninvasive diagnostic tool. © 2014 British Association of Dermatologists.

  3. Baicalein mediates inhibition of migration and invasiveness of skin carcinoma through Ezrin in A431 cells

    PubMed Central

    2011-01-01

    Background Ezrin is highly expressed in skin cancer and promotes tumor metastasis. Ezrin serves as a promising target for anti-metastasis therapy. The aim of this study is to determine if the flavonoid bacailein inhibits the metastasis of skin cancer cells through Ezrin. Methods Cells from a cutaneous squamous carcinoma cell line, A431, were treated with baicalein at 0-60 μM to establish the non-cytotoxic concentration (NCC) range for baicalein. Following treatment with baicalein within this range, total Ezrin protein (both phosphorylated and unphosphorylated forms) and phosphorylated-Ezrin (phos-Ezrin) were detected by western blotting, and Ezrin RNA was detected in A431 cells using reverse transcription-polymerase chain reaction (RT-PCR). Thereafter, the motility and invasiveness of A431 cells following baicalein treatment were determined using wound-healing and Boyden chamber invasion assays. Short-interfering RNA (si-RNA) specifically targeting Ezrin was transfected into A431 cells, and a si-RNA Ezrin-A431 cell line was established by G418 selection. This stable cell line was transiently transfected with Ezrin and mutant Ezrin plasmids, and its motilityand invasiveness was subsequently determined to clarify whether bacailein inhibits these processes through Ezrin. Results We determined the range of NCCs for baicalein to be 2.5-40 μM in A431 cells. Baicalein displayed a dose- and time-dependent inhibition of expressions of total Ezrin and phos-Ezrin within this range NCCs. In addition, it exerted this inhibitory effect through the reduction of Ezrin RNA transcript. Baicalein also inhibited the motility and invasiveness of A431 skin carcinoma cells within the range of NCCs, in a dose- and time-dependent manner. A431 cell motility and invasiveness were inhibited by 73% and 80% respectively when cells were treated with 20 μM baicalein. However, the motility and invasiveness of A431 cells containing the Ezrin mutant were not effectively inhibited by baicalein

  4. Criteria for selection of laparoscopy for women with adnexal mass.

    PubMed

    Barreta, Amilcar; Sallum, Luis Felipe; Sarian, Luis Otávio; Bastos, Joana Fróes Bragança; Derchain, Sophie

    2014-01-01

    We compared the indication of laparoscopy for treatment of adnexal masses based on the risk scores and tumor diameters with the indication based on gynecology-oncologists' experience. This was a prospective study of 174 women who underwent surgery for adnexal tumors (116 laparotomies, 58 laparoscopies). The surgeries begun and completed by laparoscopy, with benign pathologic diagnosis, were considered successful. Laparoscopic surgeries that required conversion to laparotomy, led to a malignant diagnosis, or facilitated cyst rupture were considered failures. Two groups were defined for laparoscopy indication: (1) absence of American College of Obstetrics and Gynecology (ACOG) guideline for referral of high-risk adnexal masses criteria (ACOG negative) associated with 3 different tumor sizes (10, 12, and 14 cm); and (2) Index of Risk of Malignancy (IRM) with cutoffs at 100, 200, and 300, associated with the same 3 tumor sizes. Both groups were compared with the indication based on the surgeon's experience to verify whether the selection based on strict rules would improve the rate of successful laparoscopy. ACOG-negative and tumors≤10 cm and IRM with a cutoff at 300 points and tumors≤10 cm resulted in the same best performance (78% success=38/49 laparoscopies). However, compared with the results of the gynecology-oncologists' experience, those were not statistically significant. The selection of patients with adnexal mass to laparoscopy by the use of the ACOG guideline or IRM associated with tumor diameter had similar performance as the experience of gynecology-oncologists. Both methods are reproducible and easy to apply to all women with adnexal masses and could be used by general gynecologists to select women for laparoscopic surgery; however, referral to a gynecology-oncologist is advisable when there is any doubt.

  5. Weekly Carboplatin Reduces Toxicity During Synchronous Chemoradiotherapy for Merkel Cell Carcinoma of Skin

    SciTech Connect

    Poulsen, Michael Walpole, Euan; Harvey, Jennifer; Dickie, Graeme; O'Brien, Peter; Keller, Jacqui; Tpcony, Lee; Rischin, Danny

    2008-11-15

    Purpose: The toxicity of radiotherapy (RT) combined with weekly carboplatin and adjuvant carboplatin and etoposide was prospectively assessed in a group of patients with high-risk Stage I and II Merkel cell carcinoma of the skin. This regimen was compared with the Trans-Tasman Radiation Oncology Group 96:07 study, which used identical eligibility criteria but carboplatin and etoposide every 3 weeks during RT. Patients and Methods: Patients were eligible if they had disease localized to the primary site and lymph nodes, with high-risk features. RT was delivered to the primary site and lymph nodes to a dose of 50 Gy and weekly carboplatin (area under the curve of 2) was given during RT. This was followed by three cycles of carboplatin and etoposide. A total of 18 patients were entered into the study, and their data were compared with the data from 53 patients entered into the Trans-Tasman Radiation Oncology Group 96:07 study. Results: Involved lymph nodes (Stage II) were present in 14 patients (77%). Treatment was completed as planned in 16 patients. The weekly carboplatin dose was delivered in 17 patients, and 15 were able to complete all three cycles of adjuvant carboplatin and etoposide. Grade 3 and 4 neutrophil toxicity occurred in 7 patients, but no cases of febrile neutropenia developed. Compared with the Trans-Tasman Radiation Oncology Group 96:07 protocol (19 of 53 cases of febrile neutropenia), the reduction in the febrile neutropenia rate (p = 0.003) and decrease in Grade 3 skin toxicity (p = 0.006) were highly statistically significant. Conclusion: The results of our study have shown that weekly carboplatin at this dosage is a safe way to deliver synchronous chemotherapy during RT for MCC and results in a marked reduction of febrile neutropenia and Grade 3 skin toxicity compared with the three weekly regimen.

  6. Immunomodulatory Effectiveness of Fish Oil and omega-3 Fatty Acids in Human Non-melanoma Skin Carcinoma Cells.

    PubMed

    Rehman, Khurram; Mohd Amin, Mohd Cairul Iqbal; Yuen, Ng Pei; Zulfakar, Mohd Hanif

    2016-01-01

    Fish oil is composed of various fatty acids among which omega-3 fatty acids are considered as most beneficial. The effects of fish oil on the activity of a topical anticancer drug, imiquimod, and the immunomodulatory activity of omega-3 fatty acids was investigated in human basal and squamous cell carcinoma cell lines. Imiquimod-fish oil mixture exhibited higher carcinoma cell growth inhibition and immunomodulatory activity than imiquimod alone, especially against squamous cell carcinoma cells. Omega-3 fatty acids exhibited growth inhibition of both basal cell and squamous cell carcinoma cell lines and modulated the immune response. Omega-3 fatty acids of fish oil serve as inducers of interleukin-10, an anti-inflammatory cytokine, and as suppressors of interleukin-6 and tumor necrosis factor-alpha, which not only depress tumor growth but also adequately control the inflammatory side effects of imiquimod. Thus, imiquimod administration with fish oil could be beneficial for inhibition of non-melanoma skin carcinoma cells but further in vivo studies are needed to understand their role in skin cancer.

  7. Oral Rigosertib for Squamous Cell Carcinoma

    ClinicalTrials.gov

    2016-05-18

    Head and Neck Squamous Cell Carcinoma; Anal Squamous Cell Carcinoma; Lung Squamous Cell Carcinoma; Cervical Squamous Cell Carcinoma; Esophageal Squamous Cell Carcinoma; Skin Squamous Cell Carcinoma; Penile Squamous Cell Carcinoma

  8. Selective in situ protein expression profiles correlate with distinct phenotypes of basal cell carcinoma and squamous cell carcinoma of the skin.

    PubMed

    Stelkovics, E; Kiszner, G; Meggyeshazi, N; Korom, I; Varga, E; Nemeth, I; Molnar, J; Marczinovits, I; Krenacs, T

    2013-07-01

    Non-melanoma skin cancer is the most common malignancy that shows increasing incidence due to our cumulative exposure to ultraviolet irradiation. Its major subtypes, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) differ in pathobiology, phenotype and clinical behavior, which must be reflected at the molecular level. In this study, protein expression profiles of BCC and SCC were tested in tissue microarrays and correlated with that of actinic keratosis, Bowen's disease, seborrheic keratosis and normal epidermis by detecting 22 proteins involved in cell interactions, growth, cell cycle regulation or apoptosis. The significantly more reduced collagen XVII, CD44v6, pan-Desmoglein levels and more evident E-Cadherin delocalization in BCC compared to SCC correlated with the de novo dermal invasion of BCC against the progressive invasion from in situ lesions in SCC development. EGFR was also expressed at a significantly higher level in SCC than in BCC. The upregulated cell communication protein connexin43 in BCC could contribute to the protection of BCC from metastatic invasion. Elevated cell replication in BCC was underlined by the increased topoisomerase IIα and reduced p21(waf1) and p27(kip1) positive cells fractions compared to SCC. Compared to differentiated keratinocytes, caspase-8 and -9 were equally upregulated in skin carcinoma subtypes for either mediating apoptosis induction or immune escape of tumor cells. Hierarchical cluster analysis grouped SCC and actinic keratosis cases exclusively together in support of their common origin and malignant phenotype. BCC cases were also clustered fully together. Differentially expressed proteins reflect the distinct pathobiology of skin carcinoma subtypes and can serve as surrogate markers in doubtful cases.

  9. UV-specific p53 and PTCH mutations in sporadic basal cell carcinoma of sun-exposed skin.

    PubMed

    Ratner, D; Peacocke, M; Zhang, H; Ping, X L; Tsou, H C

    2001-02-01

    UVB irradiation is known to produce DNA damage at mutation hotspots in the p53 tumor suppressor gene, leading to the development of skin cancers. Mutations in the PTCH tumor suppressor gene, which is known to be responsible for the development of nevoid basal cell carcinoma syndrome, have also been identified in sporadic basal cell carcinomas (BCCs). We describe the case of an 80-year-old welder in whom 3 novel p53 mutations, as well as UV-specific PTCH mutations, were detected in two BCC samples from sun-exposed skin. The simultaneous presence of UV-specific p53 and PTCH mutations in the same BCC sample has not previously been reported.

  10. Pegylated liposomal doxorubicin in combination with hyperthermia for treatment of skin metastases of breast carcinoma: a case report.

    PubMed

    Dvorák, J; Zoul, Z; Melichar, B; Jandík, P; Mergancová, J; Hrncírová, I; Urminská, H; Petera, J

    2001-04-01

    Incorporation of doxorubicin hydrochloride into pegylated liposomes (PLD) may decrease chemotherapy side effects and increase the activity. Hyperthermia could further potentiate its effectiveness. A patient with skin metastases of breast carcinoma was treated with intravenous infusion of PLD (Caelyx) in combination with ultrasound hyperthermia. Each cycle consisted of infusion of 40 mg PLD absolute dose, followed by 2 fractions of hyperthermia 41-43 degrees C for 45 min 1 and 48 h after infusion. A complete remission was observed after the combination treatment with no significant toxicity. Present observations suggest that the combination of PLD with hyperthermia of skin metastases of breast carcinoma may be an active and well tolerated treatment. Copyright 2001 S. Karger GmbH, Freiburg

  11. Survival after squamous cell and basal cell carcinoma of the skin: A retrospective cohort analysis.

    PubMed

    Rees, Judy R; Zens, M Scot; Celaya, Maria O; Riddle, Bruce L; Karagas, Margaret R; Peacock, Janet L

    2015-08-15

    A retrospective cohort analysis of survival after keratinocyte cancer (KC) was conducted using data from a large, population-based case-control study of KC in New Hampshire. The original study collected detailed information during personal interviews between 1993 and 2002 from individuals with squamous (SCC) and basal (BCC) cell carcinoma, and controls identified through the Department of Transportation, frequency-matched on age and sex. Participants without a history of non-skin cancer at enrolment were followed as a retrospective cohort to assess survival after either SCC or BCC, or a reference date for controls. Through 2009, cancers were identified from the New Hampshire State Cancer Registry and self-report; death information was obtained from state death certificate files and the National Death Index. There were significant differences in survival between those with SCC, BCC and controls (p = 0.040), with significantly greater risk of mortality after SCC compared to controls (adjusted hazard ratio [HR] 1.25; 95% confidence interval 1.01-1.54). Mortality after BCC was not significantly altered (HR 0.96; 95% CI 0.77-1.19). The excess mortality after SCC persisted after adjustment for numerous personal risk factors including time-varying non-skin cancer occurrence, age, sex and smoking. Survival from the date of the intervening cancer, however, did not vary (HR for SCC 0.98; 95% CI 0.70-1.38). Mortality also remained elevated when individuals with subsequent melanoma were excluded (HR for SCC 1.30; 95% CI 1.05-1.61). Increased mortality after SCC cannot be explained by the occurrence of intervening cancers, but may reflect a more general predisposition to life threatening illness that merits further investigation.

  12. Lgr5-positive cells are cancer stem cells in skin squamous cell carcinoma.

    PubMed

    Liu, Shunli; Gong, Zhenyu; Chen, Mingrui; Liu, Benli; Bian, Donghui; Wu, Kai

    2014-11-01

    Cancer stem cells (CSCs) in most human tumors are commonly identified and enriched using similar strategies for identifying normal stem cells, including flow cytometry assays for side population, high aldehyde dehydrogenase (ALDH) activity, and CD133 positivity. Thus, development of a method for isolating a specific cancer using cancer-specific characteristic appears to be potentially important. Here, we reported extremely high Lgr5 levels in the specimen from skin squamous cell carcinoma (SCC) in patients. Using SCC cell line A431, we detected high Lgr5 and CD133 levels in ALDH-high or side population from these cancer cells. To figure out whether Lgr5 is a marker of CSCs in SCC, we transfected A431 cells with a Lgr5-creERT-2A-DTR/Cag-Loxp-GFP-STOP-Loxp-RFP plasmid and purified transfected cells (tA431) based on GFP by flow cytometry. 4-Hydroxytamoxifen (4-OHT) was given to label Lgr5-positive cells with RFP, for comparison to GFP-positive Lgr5-negative cells. Lgr5-positive cells grew significantly faster than Lgr5-negative cells, and the fold increase in growth of Lgr5-positive vs Lgr5-negative cells is significantly higher than SP vs non-SP, or ALDH-high vs ALDH-low, or CD133-positive vs CD133-negative cells. Moreover, in Lgr5-negative population, Lgr5-positive re-appeared in culture with time, suggesting that Lgr5-positive cells can be regenerated from Lgr5-negative cells. Furthermore, the growth of tA431 cells significantly decreased upon a single dose of diphtheria toxin (DT)/4-OHT to eliminate Lgr5-positive cell lineage, while multiple doses of DT/4-OHT nearly completely inhibited tA431 cell growth. Taken together, our data provide compelling data to demonstrate that Lgr5-positive cells are CSCs in skin SCC.

  13. Host characteristics, sun exposure, indoor tanning and risk of squamous cell carcinoma of the skin.

    PubMed

    Veierød, Marit B; Couto, Elisabeth; Lund, Eiliv; Adami, Hans-Olov; Weiderpass, Elisabete

    2014-07-15

    Use of indoor tanning devices increases risk of cutaneous malignant melanoma, but the association with risk of squamous cell carcinoma (SCC) of the skin is unclear. Cohort studies of SCC risk are rare and we aimed to assess the association between SCC risk and host characteristics, sun exposure, and indoor tanning in a population-based cohort of Norwegian and Swedish women conjunctly with SCC incidence data from national cancer registries. Host characteristics and exposure to sun and indoor tanning devices before 50-years old were recorded by questionnaire at inclusion (30-50 years) in 1991/92. Multivariable relative risks (RRs) and 95% confidence intervals (CIs) were estimated by Poisson regression. During follow-up of 106,548 women through December 2009, SCC was diagnosed in 141 women. Skin sensitivity to acute sun exposure was the most important pigmentation characteristic (RR = 2.73, 95% CI 1.47-5.05, for red with pain/red with pain and blisters versus brown). We found no consistent associations with sunburns and bathing vacations in the first five age decades, but a significant positive trend for bathing vacations summarized over ages 10-49 years (Ptrend  = 0.02). We also found significantly increased risks of SCC following indoor tanning at age 40-49 years (RR = 2.17, 95% CI 1.29-3.67, for ≥ 1 time/month versus never) and indoor tanning summarized over ages 10-49 years (Ptrend  = 0.001). RR for ever versus never use of indoor tanning over ages 10-49 years was 1.93 (95% CI 1.27-2.95). Propensity to burn was an important host characteristic, and bathing vacations and indoor tanning summarized over ages 10-49 years increased SCC risk.

  14. Updates on the Molecular Pathology of Selected Ocular and Ocular Adnexal Tumors: Potential Targets for Future Therapy.

    PubMed

    Stagner, Anna M; Jakobiec, Frederick A

    2016-01-01

    Ophthalmic pathologic studies of retinoblastoma first definitively elucidated a genetic etiology for cancer three decades ago. Advances in DNA sequencing, protein expression profiling, and the exploration of epigenetics have since led to categorization of tumors and clinical prognostication based on genetic aberrancy. There are now many neoplasms that are defined by a characteristic genetic signature. In the past several years alone, much has been discovered in regard to the original tumor-suppressor gene initially defined in retinoblastoma as well as in other intraocular tumors such as medulloepithelioma. Our further understanding of ocular adnexal tumors that result in substantial morbidity and mortality, such as sebaceous carcinoma, has also benefited from a genetic approach. In this article, we review the clinicopathologic features of the foregoing three entities--retinoblastoma, medulloepithelioma, and sebaceous carcinoma--in order to highlight discoveries in their underlying abnormal molecular genetic functioning.

  15. Screening of urocanic acid isomers in human basal and squamous cell carcinoma tumors compared with tumor periphery and healthy skin.

    PubMed

    Decara, Juan Manuel; Aguilera, José; Abdala, Roberto; Sánchez, Purificación; Figueroa, Félix L; Herrera, Enrique

    2008-10-01

    Trans-urocanic acid is a major chromophore for ultraviolet (UV) radiation in human epidermis. The UV induces photoisomerization of trans-urocanic acid (tUCA) form to cis-urocanic acid (cUCA) and has been reported as an important mediator in the immunosuppression induced by UV. This immunomodulation has been recognized as an important factor related to skin cancer development. This is the first time that UCA isomers have been measured in epidermis of skin biopsies from patients with squamous cell carcinoma (SCC) and with basal cell carcinoma (BCC) and compared with the tumor periphery and biopsies of healthy photoexposed and non-photoexposed skin as controls. The UCA isomers were separated and quantified by high performance liquid chromatography. Analysis of UCA in healthy skin showed significant increase in total UCA content in non-photoexposed body sites compared with highly exposed skins. In contrast, the percentage of cUCA was higher in photoexposed body sites. Maximal levels of cUCA were found in cheek, forehead and forearm and lower levels in abdomen and thigh. No differences were found in total UCA concentration between the tumor samples and healthy photoexposed skin. However, differences were found in relation between isomers. Higher levels of cUCA were detected in SCC biopsies (44% of total UCA) compared with samples of BCC and that of healthy photoexposed skin (30%). These results suggest that the UV radiation exposure, a main factor in development of SCC can be mediated, apart from direct effect to cells (DNA damage), by immunosuppression pathways mediated by high production of cUCA.

  16. Genomic analysis identifies new drivers and progression pathways in skin basal cell carcinoma.

    PubMed

    Bonilla, Ximena; Parmentier, Laurent; King, Bryan; Bezrukov, Fedor; Kaya, Gürkan; Zoete, Vincent; Seplyarskiy, Vladimir B; Sharpe, Hayley J; McKee, Thomas; Letourneau, Audrey; Ribaux, Pascale G; Popadin, Konstantin; Basset-Seguin, Nicole; Ben Chaabene, Rouaa; Santoni, Federico A; Andrianova, Maria A; Guipponi, Michel; Garieri, Marco; Verdan, Carole; Grosdemange, Kerstin; Sumara, Olga; Eilers, Martin; Aifantis, Iannis; Michielin, Olivier; de Sauvage, Frederic J; Antonarakis, Stylianos E; Nikolaev, Sergey I

    2016-04-01

    Basal cell carcinoma (BCC) of the skin is the most common malignant neoplasm in humans. BCC is primarily driven by the Sonic Hedgehog (Hh) pathway. However, its phenotypic variation remains unexplained. Our genetic profiling of 293 BCCs found the highest mutation rate in cancer (65 mutations/Mb). Eighty-five percent of the BCCs harbored mutations in Hh pathway genes (PTCH1, 73% or SMO, 20% (P = 6.6 × 10(-8)) and SUFU, 8%) and in TP53 (61%). However, 85% of the BCCs also harbored additional driver mutations in other cancer-related genes. We observed recurrent mutations in MYCN (30%), PPP6C (15%), STK19 (10%), LATS1 (8%), ERBB2 (4%), PIK3CA (2%), and NRAS, KRAS or HRAS (2%), and loss-of-function and deleterious missense mutations were present in PTPN14 (23%), RB1 (8%) and FBXW7 (5%). Consistent with the mutational profiles, N-Myc and Hippo-YAP pathway target genes were upregulated. Functional analysis of the mutations in MYCN, PTPN14 and LATS1 suggested their potential relevance in BCC tumorigenesis.

  17. Inhibitory effect of berberine on human skin squamous cell carcinoma A431 cells.

    PubMed

    Li, D X; Zhang, J; Zhang, Y; Zhao, P W; Yang, L M

    2015-09-08

    Berberine (BBR) is a natural alkaloid with significant anti-tumor activity against many types of cancer cells. In this study, we investigated the molecular mechanisms employed by BBR to repress the proliferation and growth of skin squamous cell carcinoma A431 cells. Berberine was reported to inhibit the proliferation of A431 cells in a dose- and time-dependent manner and was observed to induce a series of biochemical events, including the loss of mitochondrial membrane potential, release of cytochrome-c to cytosol, induction of proteins of the Bcl-2 family and caspases, and the cleavage of poly(ADP)-ribose polymerase. This suggested its ability to induce apoptosis. The results of a wound healing test revealed that berberine inhibited the migration of A431 cells. Ezrin was transfected into A431 cells by RNA interference. The level of expression of Ezrin in the transfected A431 cells was observed to decrease with berberine treatment, which suggested that berberine might inhibit the invasion of A431 cells through Ezrin. The results of this study demonstrated that berberine could potentially inhibit proliferation, induce apoptosis, and inhibit the invasion of A431 cells.

  18. First International Consensus Report on Adnexal Masses: Management Recommendations.

    PubMed

    Glanc, Phyllis; Benacerraf, Beryl; Bourne, Tom; Brown, Douglas; Coleman, Beverly G; Crum, Christopher; Dodge, Jason; Levine, Deborah; Pavlik, Edward; Timmerman, Dirk; Ueland, Frederick R; Wolfman, Wendy; Goldstein, Steven R

    2017-03-07

    The First International Consensus Conference on Adnexal Masses was convened to thoroughly examine the state of the science and to formulate recommendations for clinical assessment and management. The panel included representatives of societies in the fields of gynecology, gynecologic oncology, radiology, and pathology and clinicians from Europe, Canada, and the United States. In the United States, there are approximately 9.1 surgeries per malignancy compared to the European International Ovarian Tumor Analysis center trials, with only 2.3 (oncology centers) and 5.9 (other centers) reported surgeries per malignancy, suggesting that there is room to improve our preoperative assessments. The American College of Obstetricians and Gynecologists Practice Bulletin on "Management of Adnexal Masses," reaffirmed in 2015 (Obstet Gynecol 2007; 110:201-214), still states, "With the exception of simple cysts on a transvaginal ultrasound finding, most pelvic masses in postmenopausal women will require surgical intervention." The panel concluded that patients would benefit not only from a more conservative approach to many benign adnexal masses but also from optimization of physician referral patterns to a gynecologic oncologist in cases of suspected ovarian malignancies. A number of next-step options were offered to aid in management of cases with sonographically indeterminate adnexal masses. This process would provide an opportunity to improve risk stratification for indeterminate masses via the provision of alternatives, including but not limited to evidence-based risk-assessment algorithms and referral to an "expert sonologist" or to a gynecologic oncologist. The panel believed that these efforts to improve clinical management and preoperative triage patterns would ultimately improve patient care.

  19. A giant ancient schwannoma mimicking an adnexal mass

    PubMed Central

    Karaköse, Oktay; Pülat, Hüseyin; Oğuz, Serhat; Zihni, İsmail; Özçelik, Kazım Çağlar; Yalta, Tülin Deniz; Eken, Hüseyin

    2016-01-01

    Abstract Introduction: Ancient schwannoma is a rare tumor of the peripheral nerve sheath. As degenerative properties are defined histologically, it can be wrongly interpreted as malignant. Case presentation: The case presented here is of a giant ancient schwannoma with a pelvic retroperitoneal location, which was mimicking an adnexal mass. Conclusion: In the rarely seen cases in the retroperitoneum, it may reach very large dimensions. PMID:27472696

  20. Chromosome 17 aneusomy detected by fluorescence in situ hybridization in vulvar squamous cell carcinomas and synchronous vulvar skin.

    PubMed

    Carlson, J A; Healy, K; Tran, T A; Malfetano, J; Wilson, V L; Rohwedder, A; Ross, J S

    2000-09-01

    Vulvar squamous cell carcinoma (SCC) affects a spectrum of women with granulomatous vulvar diseases, human papillomavirus (HPV) infections, and chronic inflammatory vulvar dermatoses. To determine whether there is evidence of chromosomal instability occurring in synchronous skin surrounding vulvar SCCs, we investigated abnormalities in chromosome 17 copy number. Samples of SCC, vulvar intraepithelial neoplasia (VIN), and surrounding vulvar skin were obtained from all vulvar excisions performed for squamous neoplasia at Albany Medical College from 1996 to 1997. Histological categorization, fluorescent in situ hybridization (FISH) for the alpha satellite region of chromosome 17, DNA content by image analysis, and Ki-67 labeling were evaluated. Controls of normal vulvar skin not associated with cancer were used for comparison. One hundred ten specimens were obtained from 33 patients with either SCC or VIN 3 and consisted of 49 neoplastic, 52 nonneoplastic, and 9 histologically normal vulvar skin samples. The majority of SCCs (88%) and a minority (18%) of VIN 3 excisions were associated with lichen sclerosus. Normal vulvar skin controls did not exhibit chromosome 17 polysomy (cells with more than four FISH signals), whereas 56% of normal vulvar skin associated with cancer did. Moreover, the frequency of polysomy significantly increased as the histological classification progressed from normal to inflammatory to neoplastic lesions. The largest mean value and variance for chromosome 17 copy number was identified in SCCs (2.4 +/- 1.0) with intermediate values identified, in decreasing order, for SCC in situ (2.1 +/- 1.0), VIN 2 (2.1 +/- 0.8), lichen sclerosus (2.0 +/- 0.5), lichen simplex chronicus (1.9 +/- 0.4), and normal skin associated with SCC (1.8 +/- 0.4) compared with control vulvar skin (1.5 +/- 0. 05). Concordance of chromosome 17 aneusomy between cancers and synchronous skin lesions was found in 48% of patients. Loss of chromosome 17 was identified 5% of all

  1. Radiological reasoning: imaging characterization of bilateral adnexal masses.

    PubMed

    Lee, Susanna I

    2006-09-01

    A 46-year-old woman presented with bilateral adnexal masses on pelvic sonography, a complex cystic mass on the right, and a homogeneously hypoechoic, solid-appearing mass on the left. Pelvic MRI showed a T1 hypointense, T2 hyperintense, nonenhancing mass in the right ovary and a homogeneously T1 hyperintense lesion with mixed T2 signal in the left ovary. Fat-saturated T1-weighted sequences showed the left ovarian lesion to be an endometrioma containing a high concentration of hemoglobin breakdown products and revealed other endometriotic implants in the right ovary, broad ligament, and cul-de-sac. Follow-up pelvic sonography 9 weeks later showed resolution of the right complex cystic ovarian mass, indicating that it was a physiologic hemorrhagic cyst. Imaging features of benign and malignant ovarian masses overlap. If imaging is inconclusive in characterizing an adnexal mass as benign, the mass will be resected rather than followed up because of the concern for a rapidly growing ovarian cancer. Thus, the goal of imaging is to identify unequivocally the benign lesions that can be left untreated. Pelvic MRI provides a powerful adjunct to pelvic sonography in characterizing adnexal masses as benign.

  2. Primary cutaneous histiocytoid carcinoma with distant metastasis.

    PubMed

    Philips, Rebecca; Langston, Leila; Hwang, Helena; Vandergriff, Travis; Trynosky, Tanya; Berlingeri-Ramos, Alma C

    2017-04-01

    Distinguishing primary cutaneous adnexal carcinoma from metastatic carcinoma of unknown primary can be a diagnostic challenge due to the frequent overlap of histologic and immunohistochemical features. A 58-year-old man presented with a tender, indurated plaque on axillary skin. Biopsy revealed infiltrating atypical cells throughout the dermis, without connection to the epidermis. Tumor cells had a histiocytoid appearance and displayed mild pleomorphism. The tumor was discohesive and had areas with a single file pattern. Signet ring cells were also present. Cells were reactive with CK7, CK5/6, p63, GATA3, GCDFP-15 and Her 2-neu. Additional studies were negative, including TTF-1, CDX2, E-cadherin, mammaglobin, estrogen receptor and progesterone receptor. Thorough clinical and radiologic evaluation failed to identify an occult primary extracutaneous malignancy; however, regional lymphadenopathy, widespread osteoblastic lesions and multiple subcentimeter liver hypodensities were noted. Considering the clinical and histopathologic features, the diagnosis of primary cutaneous histiocytoid carcinoma with distant metastasis was favored.

  3. Photodynamic therapy of murine non-melanoma skin carcinomas with diode laser after topical application of aluminum phthalocyanine chloride

    NASA Astrophysics Data System (ADS)

    Kyriazi, Maria; Alexandratou, Eleni; Yova, Dido; Rallis, Michail; Trebst, Tilmann

    2007-07-01

    The aim of this work is to study pharmacokinetics and photodynamic efficiency of aluminium phthalocyanine chloride (AlClPc) in dimethylsulfoxide/Tween 80/water solution, after topical application on hairless mice bearing non-melanoma skin carcinomas. The concentration of photosensitizer in normal skin and tumor biopsies 1-6 hours after application was assessed by fluorescence spectroscopy of chemical extractions. The concentration of photosensitizer was 40 times higher in tumor than in normal skin even 1 h after application. For photodynamic therapy (PDT) AlClPc was excited by a diode laser emitting at 670 nm, 1 h after application. Seven different combinations of therapeutic parameters were chosen. The efficiency was assessed as the percentage of complete tumor remission, the tumor growth retardation and the cosmetic outcomes. The highest complete remission 60% was achieved with the combination of 75 mW/cm2 with 150 J/cm2. No recurrence rate was observed in any treatment parameters group and the cosmetic outcome in all completely treated tumors was excellent. The results show that the effectiveness of PDT is highly dependent on fluence rate. In addition, they are promising for further investigation of this PDT scheme in preclinical studies mainly in non-melanoma skin carcinomas up to 7mm.

  4. Squamous cell and basal cell carcinoma of the skin in relation to radiation therapy and potential modification of risk by sun exposure.

    PubMed

    Karagas, Margaret R; Nelson, Heather H; Zens, Michael S; Linet, Martha; Stukel, Therese A; Spencer, Steve; Applebaum, Katie M; Mott, Leila; Mabuchi, Kiyohiko

    2007-11-01

    Epidemiologic studies consistently find enhanced risk of basal cell carcinoma of the skin among individuals exposed to ionizing radiation, but it is unclear whether the radiation effect occurs for squamous cell carcinoma. It is also not known whether subgroups of individuals are at greater risk, eg, those with radiation sensitivity or high ultraviolet radiation exposure. We analyzed data from a case-control study of keratinocyte cancers in New Hampshire. Incident cases diagnosed in 1993-1995 and 1997-2000 were identified through a state-wide skin cancer surveillance system, and controls were identified through the Department of Transportation and Center for Medicare and Medicaid Service Files (n = 1121 basal cell carcinoma cases, 854 squamous cell carcinoma cases, and 1049 controls). We found an association between history of radiation treatment and basal cell carcinoma. The association was especially strong for basal cell carcinomas arising within the radiation treatment field (odds ratio = 2.6; 95% confidence interval = 1.5-4.3), and among those treated with radiation therapy before age 20 (3.4; 1.8-6.4), those whose basal cell carcinomas occurred 40 or more years after radiation treatment (3.2; 1.8-5.8), and those treated with radiation for acne (11; 2.7-49). Similar age and time patterns of risk were observed for squamous cell carcinoma, although generally with smaller odds ratios. For basal cell carcinoma, early exposure to radiation treatment was a risk factor largely among those without a history of severe sunburns, whereas for squamous cell carcinoma, radiation treatment was a risk factor primarily among those with a sun-sensitive skin type (ie, a tendency to sunburn). Radiation treatment, particularly if experienced before age 20, seems to increase the long-term risk of both basal and squamous cell carcinomas of the skin. These risks may differ by sun exposure or host response to sunlight exposure.

  5. Correlation of skin toxicity and hypertension with clinical benefit in advanced hepatocellular carcinoma patients treated with sorafenib.

    PubMed

    Shin, Sun Young; Lee, Yu Jeung

    2013-11-01

    The purpose of this study was to identify the correlation of skin toxicity and hypertension with clinical benefit in advanced hepatocellular carcinoma (HCC) patients treated with sorafenib by analyzing medical records retrospectively. Data from medical records was statistically analyzed to identify a correlation of skin toxicity and hypertension with treatment response and prognosis in advanced HCC patients who had received sorafenib at the Asan Medical Center from July 2010 to June 2012. This study investigated prognostic factors for overall survival and the correlation between the development of skin toxicities and hypertension. A total of 99 patients receiving sorafenib were included in this study. 29 patients who developed skin toxicities Grade 2 or higher showed significantly longer survival than the 70 patients who developed skin toxicities less than Grade 2 or those without skin toxicity (p = 0.024). However, development of hypertension was not related to survival (p = 0.262). In a multivariate analysis, skin toxicities were found to be good prognostic factors for overall survival (hazard ratio, 0.320; 95% CI, 0.119 - 0.861; p = 0.024) as well as low α-fetoprotein level (hazard ratio, 0.195; 95% CI, 0.076 - 0.500; p = 0.001). On the other hand, no correlation was found between the development of skin toxicities and hypertension (p = 0.109). Skin toxicities that are common adverse reactions in advanced HCC patients treated with sorafenib may be used as surrogate markers for clinical benefit. Therefore, early detection and proper management of these toxicities is crucial for continuing treatment with sorafenib.

  6. POMC and TP53 genetic variability and risk of basal cell carcinoma of skin: Interaction between host and genetic factors.

    PubMed

    Rizzato, Cosmeri; Scherer, Dominique; Rudnai, Peter; Gurzau, Eugen; Koppova, Kvetoslava; Hemminki, Kari; Canzian, Federico; Kumar, Rajiv; Campa, Daniele

    2011-07-01

    Basal cell carcinoma (BCC) of the skin is the most common neoplasm among the Caucasian population of the western world. Ultraviolet (UV) radiation-induced p53 activation promotes cutaneous pigmentation by increasing transcriptional activity of pro-opiomelanocortin (POMC) in the skin. Induction of POMC/α-melanocyte-stimulating hormone (α-MSH) activates the melanocortin 1 receptor (MC1R), resulting in skin pigmentation. The tumor suppressor p53 is a key player in stress responses that preserve genomic stability, responding to a variety of insults including DNA damage, hypoxia, metabolic stress and oncogene activation. Malfunction of the p53 pathway is an almost universal hallmark of human tumors. Polymorphisms in the gene encoding p53 (TP53) alter its transcriptional activity, which in turn may influence the UV radiation-induced tanning response. The aim of the present work is to test association between POMC and TP53 genetic variability, the possible interplay with host factors and the risk of basal cell carcinoma of skin. We covered the variability of the two genes we used 17 tagging polymorphisms in 529 BCC cases and 532 healthy controls. We have also tested the possible interactions between the genetic variants and three known risk factors for BCC: skin complexion, sun effect and skin response to sun exposure. We did not observe any statistically significant association between SNPs in these two genes and BCC risk overall, nor interactions of SNPs with known BCC risk factors. However we found that, in the group of subjects with lower sun exposure, carriers of one copy of the C allele of the TP53 SNP rs12951053 had a decreased risk of BCC (OR=0.28, 95% CI 0.12-0.62, P=0.002). We have observed that the interplay of an environmental risk factor and one polymorphism in TP53 gene could modulate the risk of BCC. Copyright © 2011 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

  7. C/EBPα Expression Is Downregulated in Human Nonmelanoma Skin Cancers and Inactivation of C/EBPα Confers Susceptibility to UVB-Induced Skin Squamous Cell Carcinomas

    PubMed Central

    Thompson, Elizabeth A.; Zhu, Songyun; Hall, Jonathan R.; House, John S.; Ranjan, Rakesh; Burr, Jeanne A.; He, Yu-Ying; Owens, David M.; Smart, Robert C.

    2012-01-01

    Human epidermis is routinely subjected to DNA damage induced by UVB solar radiation. Cell culture studies have revealed an unexpected role for C/EBPα (CCAAT/enhancer-binding protein-α) in the DNA damage response network, where C/EBPα is induced following UVB DNA damage, regulates the G1 checkpoint, and diminished or ablated expression of C/EBPα results in G1 checkpoint failure. In the current study we observed that C/EBPα is induced in normal human epidermal keratinocytes and in the epidermis of human subjects exposed to UVB radiation. The analysis of human skin precancerous and cancerous lesions (47 cases) for C/EBPα expression was conducted. Actinic keratoses, a precancerous benign skin growth and precursor to squamous cell carcinoma (SCC), expressed levels of C/EBPα similar to normal epidermis. Strikingly, all invasive SCCs no longer expressed detectable levels of C/EBPα. To determine the significance of C/EBPα in UVB-induced skin cancer, SKH-1 mice lacking epidermal C/EBPα (CKOα) were exposed to UVB. CKOα mice were highly susceptible to UVB-induced SCCs and exhibited accelerated tumor progression. CKOα mice displayed keratinocyte cell cycle checkpoint failure in vivo in response to UVB that was characterized by abnormal entry of keratinocytes into S phase. Our results demonstrate that C/EBPα is silenced in human SCC and loss of C/EBPα confers susceptibility to UVB-induced skin SCCs involving defective cell cycle arrest in response to UVB. PMID:21346772

  8. Low-dose methotrexate enhances aminolevulinate-based photodynamic therapy in skin carcinoma cells in vitro and in vivo.

    PubMed

    Anand, Sanjay; Honari, Golara; Hasan, Tayyaba; Elson, Paul; Maytin, Edward V

    2009-05-15

    To improve treatment efficacy and tumor cell selectivity of delta-aminolevulinic acid (ALA)-based photodynamic therapy (PDT) via pretreatment of cells and tumors with methotrexate to enhance intracellular photosensitizer levels. Skin carcinoma cells, in vitro and in vivo, served as the model system. Cultured human SCC13 and HEK1 cells, normal keratinocytes, and in vivo skin tumor models were preconditioned with methotrexate for 72 h and then incubated with ALA for 4 h. Changes in protoporphyrin IX (PpIX) levels and cell survival after light exposure were assessed. Methotrexate preconditioning of monolayer cultures preferentially increased intracellular PpIX levels 2- to 4-fold in carcinoma cells versus normal keratinocytes. Photodynamic killing was synergistically enhanced by the combined therapy compared with PDT alone. Methotrexate enhancement of PpIX levels was achieved over a broad methotrexate concentration range (0.0003-1.0 mg/L; 0.6 nmol/L-2 mmol/L). PpIX enhancement correlated with changes in protein expression of key porphyrin pathway enzymes, approximately 4-fold increase in coproporphyrinogen oxidase and stable or slightly decreased expression of ferrochelatase. Differentiation markers (E-cadherin, involucrin, and filaggrin) were also selectively induced by methotrexate in carcinoma cells. In vivo relevance was established by showing that methotrexate preconditioning enhances PpIX accumulation in three models: (a) organotypic cultures of immortalized keratinocytes, (b) chemically induced skin tumors in mice; and (c) human A431 squamous cell tumors implanted subcutaneously in mice. Combination therapy using short-term exposure to low-dose methotrexate followed by ALA-PDT should be further investigated as a new combination modality to enhance efficacy and selectivity of PDT for epithelial carcinomas.

  9. Predictors of skin-related quality of life after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma.

    PubMed

    Chen, Tina; Bertenthal, Daniel; Sahay, Anju; Sen, Saunak; Chren, Mary-Margaret

    2007-11-01

    To identify predictors of skin-related quality of life (QOL) after treatment of nonmelanoma skin cancer (NMSC). Prospective cohort study of consecutive patients with NMSC diagnosed in 1999 and 2000. University-affiliated private practice and a Veterans Affairs clinic. A total of 633 patients who responded to a questionnaire before treatment. Skin-related QOL, measured with the 16-item version of Skindex-16, a validated measure. Skindex-16 scores vary from 0 (best QOL) to 100 (worst QOL) and are reported in 3 domains: symptoms, emotional effects, and effects on functioning. Controlling for treatment group, the strongest independent predictor of skin-related QOL after treatment of NMSC was pretreatment skin-related QOL. Other patient characteristics that predicted better QOL included less comorbidity and better mental health status. No tumor or care characteristic (including location of tumor, size of tumor, site of therapy, or training level of treating clinician [attending physician, resident, or nurse practitioner]) was found to predict better skin-related QOL after treatment of NMSC. Patients with better pretreatment skin-related QOL, less comorbidity, and better mental health status had better skin-related QOL after treatment of NMSC. These findings may be useful for pretreatment assessment and counseling.

  10. Risks of different skin tumor combinations after a first melanoma, squamous cell carcinoma and basal cell carcinoma in Dutch population based cohorts: 1989 - 2009.

    PubMed

    van der Leest, R J T; Hollestein, L M; Liu, L; Nijsten, T; de Vries, E

    2017-09-12

    Skin cancer patients are primarily at increased risk of developing subsequent skin cancers of the same type. Shared risk factors might also increase the occurrence of a different type of subsequent skin cancer. To investigate risks of different skin tumor combinations after a first melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). All melanoma and SCC patients included in the national Netherlands Cancer Registry (NCR) and all BCC patients included in the regional Eindhoven Cancer Registry (ECR) between 1989 and 2009 were followed until diagnosis of a subsequent different skin cancer (melanoma, SCC or BCC), date of death or end of study. Cumulative risks, Standardized Incidence Ratios (SIR) and Absolute Excess Risks (AER) of subsequent skin cancers were calculated. A total of 50,510 melanoma patients and 64,054 patients with a SCC of the skin were included (national data NCR). The regional data of the ECR consisted of 5,776 melanoma patients, 5,749 SCC patients and 41,485 BCC patients. The 21-year cumulative risk for a subsequent melanoma after a first SCC or BCC was respectively 1.7% and 1.3% for males and 1.3% and 1.2% for females; SCC after melanoma or BCC was 4.6% and 9.3% (males) and 2.6% and 4.1% (females); BCC after melanoma or SCC was respectively 13.2% and 27.8% (males) and 14.9% and 21.1% (females). SIRs and AERs remained elevated up to 21 years after the first melanoma, SCC or BCC. This large population based study investigating risks of developing a different subsequent cutaneous malignancy showed high cumulative risks of mainly KC and markedly increased relative and absolute risks of all tumor combinations. These estimates confirm a common carcinogenesis and can serve as a base for follow-up guidelines and patient education aiming for an early detection of the subsequent cancers. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Subsequent squamous- and basal-cell carcinomas in kidney-transplant recipients after the first skin cancer: cumulative incidence and risk factors.

    PubMed

    Wisgerhof, Hermina C; Edelbroek, Jeroen R J; de Fijter, Johan W; Haasnoot, Geert W; Claas, Frans H J; Willemze, Rein; Bavinck, Jan N Bouwes

    2010-05-27

    The risk of skin cancer is highly increased in kidney-transplant recipients (KTR), but the risk of subsequent skin cancers is less well studied. The aim of this study was to estimate the cumulative incidence of subsequent squamous- and basal-cell carcinomas (BCCs) and to analyze potential risk factors. All histologically confirmed skin cancers between 1966 and 2006 were included in the study and counted. Cumulative incidences of subsequent squamous- and BCCs were calculated using Kaplan-Meier survival analyses. For the analyses of risk factors, we used Cox proportional hazard analyses. A total of 239 (13%) of 1906 KTR developed skin cancer of whom 222 were diagnosed in our hospital. Altogether 167 (75%) of these 222 patients developed multiple skin cancers. The cumulative incidence of a second skin cancer increased from 32%, 1 year, to 59%, 3 years, and 72%, 5 years after the first skin cancer. KTR who started with squamous-cell carcinoma (SCC) mainly developed SCC and recipients who started with BCC mainly developed BCC as second skin cancer. Immunosuppression with azathioprine in combination with prednisone was associated with a significantly increased risk of subsequent SCCs but not with subsequent BCCs. Skin cancer multiplicity is common in KTR. Patients with a first skin cancer are at increased risk for more skin cancers and need to be carefully checked for subsequent skin cancers.

  12. Lymphoepithelioma-Like Carcinoma of the Skin Treated with Wide Local Excision and Chemoradiation Therapy: A Case Report and Review of the Literature

    DTIC Science & Technology

    2012-01-01

    like carcinoma of the skin: new case of an exceedingly rare primary skin tumor,” Dermatology Online Journal, vol. 14, no. 8, article 12, 2008. [9] R...Experimental Dermatology , vol. 18, no. 1, pp. 83–86, 1993. [3] S. Takayasu, M. Yoshiyama, S. Kurata, and H. Terashi, “Ly- mphoepithelioma-like carcinoma of...the skin,” Journal of Dermatology , vol. 23, no. 7, pp. 472–475, 1996. [4] G. Hall, A. Duncan, R. Azurdia, and N. Leonard, “Lymp- hoepithelioma-like

  13. Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion

    PubMed Central

    Jung, Sung Il; Park, Hee Sun; Yim, Younghee; Jeon, Hae Jeong; Yu, Mi Hye; Kim, Young Jun

    2015-01-01

    Objective To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion. Materials and Methods This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance. Results Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively). Conclusion Use of a coronal reformation with transverse CT images improves detection of adnexal torsion. PMID:26175583

  14. Family History of Skin Cancer is Associated with Early-Onset Basal Cell Carcinoma Independent of MC1R Genotype

    PubMed Central

    Berlin, Nicholas L.; Cartmel, Brenda; Leffell, David J.; Bale, Allen E.; Mayne, Susan T.; Ferrucci, Leah M.

    2015-01-01

    Background As a marker of genetic susceptibility and shared lifestyle characteristics, family history of cancer is often used to evaluate an individual’s risk for developing a particular malignancy. With comprehensive data on pigment characteristics, lifestyle factors, and melanocortin-1 receptor (MC1R) gene sequence, we sought to clarify the role of family history of skin cancer in early-onset basal cell carcinoma (BCC). Materials and Methods Early onset BCC cases (n=376) and controls with benign skin conditions (n=383) under age 40 were identified through Yale Dermatopathology. Self-report data on family history of skin cancer (melanoma and non-melanoma skin cancer), including age of onset in relatives, was available from a structured interview. Participants also provided saliva samples for sequencing of MC1R. Results A family history of skin cancer was associated with an increased risk of early-onset BCC (OR 2.49, 95% CI 1.80–3.45). In multivariate models, family history remained a strong risk factor for early-onset BCC after adjustment for pigment characteristics, UV exposure, and MC1R genotype (OR 2.41, 95% CI 1.74–3.35). Conclusions Risk for BCC varied based upon the type and age of onset of skin cancer among affected relatives; individuals with a first-degree relative diagnosed with skin cancer prior to age 50 were at highest risk for BCC (OR 4.79, 95% CI 2.90–7.90). Even after taking into account potential confounding effects of MC1R genotype and various lifestyle factors that close relatives may share, family history of skin cancer remained strongly associated with early-onset BCC. PMID:26381319

  15. Family history of skin cancer is associated with early-onset basal cell carcinoma independent of MC1R genotype.

    PubMed

    Berlin, Nicholas L; Cartmel, Brenda; Leffell, David J; Bale, Allen E; Mayne, Susan T; Ferrucci, Leah M

    2015-12-01

    As a marker of genetic susceptibility and shared lifestyle characteristics, family history of cancer is often used to evaluate an individual's risk for developing a particular malignancy. With comprehensive data on pigment characteristics, lifestyle factors, and melanocortin 1 receptor (MC1R) gene sequence, we sought to clarify the role of family history of skin cancer in early-onset basal cell carcinoma (BCC). Early onset BCC cases (n=376) and controls with benign skin conditions (n=383) under age 40 were identified through Yale dermatopathology. Self-report data on family history of skin cancer (melanoma and non-melanoma skin cancer), including age of onset in relatives, was available from a structured interview. Participants also provided saliva samples for sequencing of MC1R. A family history of skin cancer was associated with an increased risk of early-onset BCC (OR 2.49, 95% CI 1.80-3.45). In multivariate models, family history remained a strong risk factor for early-onset BCC after adjustment for pigment characteristics, UV exposure, and MC1R genotype (OR 2.41, 95% CI 1.74-3.35). Risk for BCC varied based upon the type and age of onset of skin cancer among affected relatives; individuals with a first-degree relative diagnosed with skin cancer prior to age 50 were at highest risk for BCC (OR 4.79, 95% CI 2.90-7.90). Even after taking into account potential confounding effects of MC1R genotype and various lifestyle factors that close relatives may share, family history of skin cancer remained strongly associated with early-onset BCC. Copyright © 2015. Published by Elsevier Ltd.

  16. Human polyomaviruses and incidence of cutaneous squamous cell carcinoma in the New Hampshire skin cancer study.

    PubMed

    Gossai, Anala; Waterboer, Tim; Hoen, Anne G; Farzan, Shohreh F; Nelson, Heather H; Michel, Angelika; Willhauck-Fleckenstein, Martina; Christensen, Brock C; Perry, Ann E; Pawlita, Michael; Karagas, Margaret R

    2016-06-01

    Squamous cell carcinoma (SCC) of the skin is a malignancy arising from epithelial keratinocytes. Experimental and epidemiologic evidence raise the possibility that human polyomaviruses (PyV) may be associated with the occurrence of SCC. To investigate whether the risk for SCC was associated with PyV infection, seropositivity to 10 PyV types was assessed following diagnosis in a population-based case-control study conducted in the United States. A total of 253 SCC cases and 460 age group and gender-matched controls were included. Antibody response against each PyV was measured using a multiplex serology-based glutathione S-transferase capture assay of recombinantly expressed VP1 capsid proteins. Odds ratios (OR) for SCC associated with seropositivity to each PyV type were estimated using logistic regression, with adjustment for potentially confounding factors. SCC cases were seropositive for a greater number of PyVs than controls (P = 0.049). Those who were JC seropositive had increased odds of SCC when compared to those who were JC seronegative (OR = 1.37, 95% CI: 0.98-1.90), with an increasing trend in SCC risk with increasing quartiles of seroreactivity (P for trend = 0.04). There were no clear associations between SCC risk and serostatus for other PyV types. This study provides limited evidence that infection with certain PyVs may be related to the occurrence of SCC in the general population of the United States. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  17. Incidence trends and survival of skin melanoma and squamous cell carcinoma in Cluj County, Romania.

    PubMed

    Şuteu, Ofelia; Blaga, Mihaiela L; Nicula, Florian; Şuteu, Patricia; Coza, Ovidiu; Achimaş-Cadariu, Patriciu; Coza, Daniela

    2017-09-01

    The aim of this study was to determine the incidence trends of cutaneous melanoma (CM) and squamous cell carcinoma (SCC) in Cluj County, from 1998 to 2011, and the 5-year net survival between 2006 and 2010. Data on all cases of CM and SCC between 1998 and 2011 were obtained from Cluj Cancer Registry. Incidence rates were age standardized by the direct method Age Standardized Incidence Rate (ASIR), using the world standard population. Trends and annual percentage change (APC) of incidence rates were calculated by joinpoint regression analysis. The Pohar-Perme estimator was used to examine the 5-year net survival of cases diagnosed during 2006-2010 and followed up until December 2015. A total of 580 cases of CM and 397 cases of SCC were reported. During 1998-2011, the ASIR of CM increased significantly by 7.8% APC in male patients and by 7.42% APC in female patients, and the ASIR for SCC increased by 9.40% APC in male patients. In female patients, the incidence of SCC increased by 12.65% APC during 2002-2011. The 5-year net survival during 2006-2010 was 0.64 in men and 0.75 in women for CM and 0.86 and 1.00, respectively, for SCC. Survival rates showed an improving trend during 2006-2010, and were generally lower in men. Survival from both entities decreased with age and was lower in rural areas and in advanced stages in both sexes. This study reveals a rising incidence of cutaneous cancers in concordance with international trends. These data support the important role of primary and secondary prevention of skin cancers, focusing not only on melanoma, due to its lower survival, but also on SCC, in order to reduce their burden.

  18. Multistep carcinogenesis in the formation of basal cell carcinoma of the skin

    SciTech Connect

    Gailani, M.; Leffell, D.; Ziegler, A.

    1994-09-01

    Basal cell carcinoma of the skin (BCC) is the most common cancer in humans, a slow growing tumor whose incidence strongly correlates with exposure to UV light. Although the molecular basis of BCC formation is not well understood, loss of heterozygosity (LOH) for markers on chromosome 9q in 70% of BCCs suggests that inactivation of a tumor suppressor on 9q22 is an important early step. UV induced mutations in the p53 gene have also been found in over 50% of sporadic BCCs. We analyzed 18 sporadic BCCs for allelic loss on chromosome 9 and point mutations in the p53 gene and attempted to correlate genetic alteration with pathological subtype and relative UV light exposure. Eight of eighteen tumors (45%) showed LOH on chromosome 9 as well as point mutation of the p53 gene, three of eighteen tumors (17%) showed mutation of the p53 gene without LOH on chromosome 9, five of eighteen tumors (27%) showed LOH for chromosome 9 without evidence of mutation in the p53 gene, and two of eighteen tumors (11%) showed neither LOH on chromosome 9 nor mutation in the p53 gene. Tumor pathology showed no obvious correlation between mutation and tumor aggressiveness. However, one tumor of a unique, aggressive growth subtype had no genetic alteration suggesting a different genetic mechanism in this particular subgroup. 38% of tumors from areas of greatest sun-exposure showed both mutations. The data suggests a strong correlation between inactivation of a tumor suppressor gene on chromosome 9 and mutation in the p53 gene though the sequence of events cannot be determined. Because carcinogenesis is a multistep process and genetic injury from UV light is only one factor, further correlation with degree of tumor differentiation may clarify the genetic process in BCCs.

  19. SU-F-P-58: Squamous Cell and Basal Cell Carcinoma of the Skin Treated with a Freiburg Flap Applicator

    SciTech Connect

    Dou, K; Li, B; Jacobs, M; Laser, B

    2016-06-15

    Purpose: To treat squamous cell and basal cell carcinoma of the skin with the Freiburg flap applicator using a high dose rate modality of an Elekta Flexitron or MicroSelectron for radiation delivery by compensating the dose deviation resulting from the incomplete scatter environment. Methods: Patients were selected to have lesions greater than or equal to 2cm. A mask might be needed depending on special locations. The lesions on the eyelid and face presented in this research were, however, treated without a mask. Cutting the flap into a shape conformal to the target and attaching it to the mask were used in order to make the treatment reproducible. Patients were scanned with a Philips Big Bore Brilliant CT. A 1cm margin was added to the lesion. An Elekta Oncentra Brachy treatment planning system ver. 4.3 was used for treatment planning. 40 Gy in 10 or 8 fractions was prescribed to the 1cm depth. The Freiburg flap was aligned and verified by CT scanning prior to treatment. Results: Three patients with squamous cell and basal cell carcinoma of the skin were treated with the Freiburg flap applicator. Lesion sizes ranged from 2cm to 6 cm in a maximum dimension. With treatment planning, we made a dose correction for compensating the dose deviation resulting from the incomplete scatter environment of the flap applicators exposed to air. The flap was also covered by a 4cm bolus in order to obtain more back scattered radiation during treatment. Six month follow up showed a very good cosmetic result. Conclusion: The Freiburg flap brachytherapy offers a non-invasive skin cancer treatment with a high skin dose delivered to the tumor while a low dose sparing the surrounding health tissue. It is a promising alternative to skin cancer surgery or external beam radiation therapy.

  20. Reflectance confocal microscopy and dermoscopy for in vivo, non-invasive skin imaging of superficial basal cell carcinoma

    PubMed Central

    GHITA, MIHAELA A.; CARUNTU, CONSTANTIN; ROSCA, ADRIAN E.; KALESHI, HARILLAQ; CARUNTU, ANA; MORARU, LILIANA; DOCEA, ANCA OANA; ZURAC, SABINA; BODA, DANIEL; NEAGU, MONICA; SPANDIDOS, DEMETRIOS A.; TSATSAKIS, ARISTIDIS M.

    2016-01-01

    Superficial basal cell carcinoma (sBCC) is the second most frequent histological type of basal cell carcinoma (BCC), usually requiring a skin biopsy to confirm the diagnosis. It usually appears on the upper trunk and shoulders as erythematous and squamous lesions. Although it has a slow growth and seldom metastasizes, early diagnosis and management are of crucial importance in preventing local invasion and subsequent disfigurement. Dermoscopy is nowadays an indispensable tool for the dermatologist when evaluating skin tumors. Reflectance confocal microscopy (RCM) is a novel imaging technique that allows the non-invasive, in vivo quasi-microscopic morphological and dynamic assessment of superficial skin tumors. Moreover, it offers the advantage of performing infinite repeatable determinations to monitor disease progression and non-surgical treatment for sBCC. Herein, we present three lesions of sBCC evaluated using in vivo and non-invasive imaging techniques, emphasizing the usefulness of combining RCM with dermoscopy for increasing the diagnostic accuracy of sBCC. PMID:27123056

  1. Reflectance confocal microscopy and dermoscopy for in vivo, non-invasive skin imaging of superficial basal cell carcinoma.

    PubMed

    Ghita, Mihaela A; Caruntu, Constantin; Rosca, Adrian E; Kaleshi, Harillaq; Caruntu, Ana; Moraru, Liliana; Docea, Anca Oana; Zurac, Sabina; Boda, Daniel; Neagu, Monica; Spandidos, Demetrios A; Tsatsakis, Aristidis M

    2016-05-01

    Superficial basal cell carcinoma (sBCC) is the second most frequent histological type of basal cell carcinoma (BCC), usually requiring a skin biopsy to confirm the diagnosis. It usually appears on the upper trunk and shoulders as erythematous and squamous lesions. Although it has a slow growth and seldom metastasizes, early diagnosis and management are of crucial importance in preventing local invasion and subsequent disfigurement. Dermoscopy is nowadays an indispensable tool for the dermatologist when evaluating skin tumors. Reflectance confocal microscopy (RCM) is a novel imaging technique that allows the non-invasive, in vivo quasi-microscopic morphological and dynamic assessment of superficial skin tumors. Moreover, it offers the advantage of performing infinite repeatable determinations to monitor disease progression and non-surgical treatment for sBCC. Herein, we present three lesions of sBCC evaluated using in vivo and non-invasive imaging techniques, emphasizing the usefulness of combining RCM with dermoscopy for increasing the diagnostic accuracy of sBCC.

  2. Heterozygous mutations in the tumor suppressor gene PATCHED provoke basal cell carcinoma-like features in human organotypic skin cultures.

    PubMed

    Brellier, F; Bergoglio, V; Valin, A; Barnay, S; Chevallier-Lagente, O; Vielh, P; Spatz, A; Gorry, P; Avril, M-F; Magnaldo, T

    2008-11-20

    Basal cell carcinoma of the skin is the most common type of cancer in humans. The majority of these tumors displays aberrant activation of the SONIC HEDGEHOG (SHH)/PATCHED pathway, triggered by mutations in the PATCHED tumor suppressor gene, which encodes a transmembrane receptor of SHH. In this study, we took advantage of the natural genotype (PATCHED(+/-)) of healthy keratinocytes expanded from patients with the nevoid basal cell carcinoma or Gorlin syndrome to mimic heterozygous somatic mutations thought to occur in the PATCHED gene early upon basal cell carcinoma development in the general population. PATCHED(+/-) epidermis developed on a dermal equivalent containing wild-type (WT) PATCHED(+/+) fibroblasts exhibited striking invasiveness and hyperproliferation, as well as marked differentiation impairment. Deciphering the phenotype of PATCHED(+/-) keratinocytes revealed slight increases of the transcriptional activators GLI1 and GLI2-the latter known to provoke basal cell carcinoma-like tumors when overexpressed in transgenic mice. PATCHED(+/-) keratinocytes also showed a substantial increase of the cell cycle regulator cyclin D1. These data show for the first time the physiological impact of constitutive heterozygous PATCHED mutations in primary human keratinocytes and strongly argue for a yet elusive mechanism of haploinsufficiency leading to cancer proneness.

  3. PTCH1+/− Dermal Fibroblasts Isolated from Healthy Skin of Gorlin Syndrome Patients Exhibit Features of Carcinoma Associated Fibroblasts

    PubMed Central

    Robert, Thomas; Ripoche, Hugues; Brellier, Florence; Chevallier-Lagente, Odile; Avril, Marie-Françoise; Magnaldo, Thierry

    2009-01-01

    Gorlin's or nevoid basal cell carcinoma syndrome (NBCCS) causes predisposition to basal cell carcinoma (BCC), the commonest cancer in adult human. Mutations in the tumor suppressor gene PTCH1 are responsible for this autosomal dominant syndrome. In NBCCS patients, as in the general population, ultraviolet exposure is a major risk factor for BCC development. However these patients also develop BCCs in sun-protected areas of the skin, suggesting the existence of other mechanisms for BCC predisposition in NBCCS patients. As increasing evidence supports the idea that the stroma influences carcinoma development, we hypothesized that NBCCS fibroblasts could facilitate BCC occurence of the patients. WT (n = 3) and NBCCS fibroblasts bearing either nonsense (n = 3) or missense (n = 3) PTCH1 mutations were cultured in dermal equivalents made of a collagen matrix and their transcriptomes were compared by whole genome microarray analyses. Strikingly, NBCCS fibroblasts over-expressed mRNAs encoding pro-tumoral factors such as Matrix Metalloproteinases 1 and 3 and tenascin C. They also over-expressed mRNA of pro-proliferative diffusible factors such as fibroblast growth factor 7 and the stromal cell-derived factor 1 alpha, known for its expression in carcinoma associated fibroblasts. These data indicate that the PTCH1+/− genotype of healthy NBCCS fibroblasts results in phenotypic traits highly reminiscent of those of BCC associated fibroblasts, a clue to the yet mysterious proneness to non photo-exposed BCCs in NBCCS patients. PMID:19287498

  4. Disappearance of an adnexal mass with Saam acupuncture: a case report.

    PubMed

    Seo, Jung Chul; Kwon, Oh-Chang; Kwon, Hyo-Jung; Chung, Dae-Kyoo; Cho, Yoon-Jeong; Lee, Geon Ho

    2014-02-01

    We report the case of a 30-year-old woman with a right adnexal mass resembling an ovarian cyst who declined diagnostic laparoscopy and requested treatment with acupuncture. The patient was treated with Saam acupuncture for 14 weeks. After treatment, transvaginal sonography revealed disappearance of the right adnexal mass. No adverse effects of the Saam acupuncture treatment were reported.

  5. Early Skin Toxicity as a Predictive Factor for Tumor Control in Hepatocellular Carcinoma Patients Treated with Sorafenib

    PubMed Central

    Vincenzi, Bruno; Santini, Daniele; Addeo, Raffaele; Giuliani, Francesco; Montella, Liliana; Rizzo, Sergio; Venditti, Olga; Frezza, Anna Maria; Caraglia, Michele; Colucci, Giuseppe; Del Prete, Salvatore; Tonini, Giuseppe

    2010-01-01

    Introduction. Sorafenib is an oral multikinase inhibitor that targets Raf kinase and receptor tyrosine kinases and has led to a longer median overall survival (OS) time and time to progression (TTP) in patients with advanced hepatocellular carcinoma (HCC). This study was conducted to assess the link between the antitumor efficacy of sorafenib and its early cutaneous side effects in advanced HCC patients. Materials and Methods. All patients received 800 mg daily of sorafenib until progression or unacceptable toxicities. We retrospectively analyzed the incidence of rash and hand–foot skin reactions (HFSR) during the first month of treatment, comparing tumor control (partial response plus stable disease) and TTP. Results. Sixty-five HCC patients treated with sorafenib were included in this analysis: 47 (73.3%) received sorafenib after failure of some local treatment, whereas 18 (27.7%) received it as first-line treatment. Twenty-nine patients developed at least grade 1 skin toxicity (rash, 13; HFSR, 16). In patients who developed skin toxicity, the tumor control rate was 48.3%, versus 19.4% in patients without cutaneous side effects. The median TTP was 8.1 months in the group of patients with skin toxicity versus 4.0 months in those without skin toxicity. This difference was also statistically significant on multivariate analysis. A borderline statistically significant difference was also observed in terms of OS in patients with early skin toxicity. Conclusions. Skin toxicity should be closely monitored in HCC patients treated with sorafenib in relation to its potential role as a surrogate marker of efficacy. PMID:20051477

  6. Overexpression of the human homologue of Drosophila patched (PTCH) in skin tumours: specificity for basal cell carcinoma.

    PubMed

    Nagano, T; Bito, T; Kallassy, M; Nakazawa, H; Ichihashi, M; Ueda, M

    1999-02-01

    The human homologue of the Drosophila segment polarity gene patched (PTCH) has been identified as the gene for the naevoid basal cell carcinoma (BCC) syndrome and has also been shown to be mutated in sporadic BCC. In order to elucidate the specificity of the PTCH abnormality in BCC, we examined normal skin and 12 BCC and 24 other types of tumour from Japanese patients for expression of the PTCH transcript by competitive reverse transcription-polymerase chain reaction, as mutational inactivation of PTCH leads to overexpression of the mutant transcript owing to failure of a negative feedback mechanism. We found a high level of PTCH expression in all 12 BCCs, while 23 of the other tumours and four specimens of normal skin showed no or weak expression of the gene, with the exception of one specimen from a patient with Bowen's disease which had high expression. These results indicate that the PTCH abnormality plays a critical role in the pathogenesis of BCC.

  7. Investigation of P120catenin Expression in Human Basal Cell Carcinoma of the Skin.

    PubMed

    Bartoš, Vladimír; Kullová, Milada

    P120(ctn) is a specific membranous adhesion protein, that maintains the stability of intercellular junctions. An altered expression of p120(ctn), either reduced in the cell membrane or increase in the cytoplasm, plays a crucial role in carcinogenesis. No research has analysed the expression of p120(ctn) in basal cell carcinoma (BCC) of the skin so far. Therefore, we immunohistochemically studied p120(ctn) in a set of cutaneous BCCs in order to determine, whether there is difference in the expression pattern related to the histologic subtypes and tumor growth characteristics. The study group consisted of 38 BCCs cathegorized into low-risk (non-infiltrative) subroup (8 superficial and 12 nodular subtypes) and high-risk (infiltrative) subgroup (10 nodular-infiltrative and 8 infiltrative subtypes). Specific monoclonal antibody against p120(ctn) was used for staining. Overall, there were 12 cases (31.6%) with normal preserved and 26 cases (68.4%) with abnormal p120(ctn) expression. In superficial, nodular, nodular-infiltrative and infiltrative subtypes, abnormal p120(ctn) immunoreactivity was found in 37.5% (3/8), 41.7% (5/12), 100% (10/10) and 100% (8/8), respectively. We have confirmed a strong correlation between the expression of p120(ctn) and both given, non-infiltrative and infiltrative BCC growth phenotypes. In the latter subgroup, almost all lesions showed diffusely reduced membranous staining, of which five also manifested an aberrant immunoreactivity in the cytoplasm. This cytoplasmic positivity occurred solely at the invasive front of the infiltrative tumor formations. Our results showed that decreased membranous expression of p120(ctn) was a frequent event in human cutaneous BCC and it was associated with infiltrative growth phenotype. Considering that nearly half of the BCCs with non-infiltrative growth pattern also exhibited reduced membranous expression, aberrant cytoplasmic immunoreactivity of p120(ctn), which was found exclusively in the high-risk BCC

  8. Basal cell carcinoma of the skin with mixed histomorphology: a comparative study.

    PubMed

    Bartoš, Vladimír; Kullová, Milada

    2016-01-01

    Basal cell carcinoma (BCC) of the skin exhibits a very heterogeneous histomorphology, on the basis of which it is classified into several subtypes and variants. In many cases, however, a definite categorization remains difficult, because BCC may consist of more than one histopathological subtype. There are limited data exploring the characteristics of these mixed BCCs, since they have not been specifically analysed. The aim of this study was to estimate the prevalence of BCCs with mixed histomorphology observed in a set of primary BCCs and to compare their clinicopathological features with a single type BCC subgroup. A total of 911 histologically proven primary BCCs from 697 patients were investigated. Prevalence of single and mixed type BCCs was 64.9 % and 35.1 %, respectively. In mixed type BCC subgroup, a very heterogeneous histomorphology was found comprising a mixture of two to four different subtypes in various proportions. The most frequent combinations included nodular-infiltrative, superficial-nodular, nodular-trichoepithelial and nodular-micronodular subtype. Comparative analysis of the two given subgroups showed that mixed type BCCs were significantly more frequently localized on the extrafacial regions of the head (30.0 % vs. 20.0 %, p = 0.02) and less often on the face (37.2 % vs. 45.2 %, p = 0.03). There were not convincing differences in the occurrence of single vs mixed type BCCs in other parts of the body. Histologically, mixed type BCCs exhibited an aggressive-growth pattern more frequently (64.6 % vs. 13.0 %, p < 0.0001). Positive surgical margins were significantly more common in mixed type BCC subgroup (17.8 % vs. 12.6 %, p = 0.02). Cutaneous BCCs with mixed histomorphology represented about one third of the cases. It is a common finding in routine pathological practice, probably suggestive of evolution and phenotypic transformation of the cancer. Since mixed type BCCs are frequently composed of aggressive histological subtypes, regardless the

  9. Cutaneous Human Papillomaviruses and Squamous Cell Carcinoma of the Skin: Nested Case-Control Study.

    PubMed

    Faust, Helena; Andersson, Kristin; Luostarinen, Tapio; Gislefoss, Randi E; Dillner, Joakim

    2016-04-01

    Cutaneous human papillomavirus (HPV) types have been associated with non-melanoma skin cancer (NMSC), including a previous nested case-control study using HPV serology with bacterially derived fusion proteins with the major HPV capsid protein L1 (GST-L1). However, HPV serology using conformationally intact pseudovirions has been shown to correlate better with natural infection. Prospective studies using a more valid marker of infection are therefore warranted. Cancer registry follow-up of large Nordic biobanks identified prediagnostic serum samples from 633 subjects who later developed SCC, 1,990 subjects who developed basal cell carcinoma (BCC). The samples from cases and matched controls were tested for IgG to pseudovirions to 16 different HPV types (3, 5, 6, 11, 15: , 16, 18, 31, 32, 33, 38: , 45, 52, 58, 68, and 76: ) and two polyomaviruses (MCPyV and JCPyV). Baseline seropositivity was not associated with SCC risk, and there were only weak associations with BCC risk [HPV-5 (OR, 1.1; 95% confidence interval [CI], 1.0-1.3), HPV-15 (OR, 1.2; 95% CI, 1.0-1.4), HPV-38 (OR, 1.2; 95% CI, 1.0-1.3), and MCPyV (OR, 1.1; 95% CI, 1.0-1.3)]. Acquisition of HPV-5 seropositivity during follow-up was associated with SCC risk (OR, 3.2; 95% CI, 1.3-7.6). Persistent seropositivity for HPV-15 was weakly associated with BCC (OR, 1.4; 95% CI, 1.0-1.9) and HPV-6 antibody persistence was weakly associated with SCC (OR, 2.2; 95% CI, 1.0-4.8). Considering the large number of viruses tested, the weak associations found do not support any strong links between studied HPV and NMSC, with the possible exception of HPV-5 seroconversion and SCC. Known alpha and beta papillomaviruses do not appear to be risk factors for NMSC. Cancer Epidemiol Biomarkers Prev; 25(4); 721-4. ©2016 AACR. ©2016 American Association for Cancer Research.

  10. Acoustic streaming cannot discriminate reliably between endometriomas and other types of adnexal lesion: a multicenter study of 633 adnexal masses.

    PubMed

    Van Holsbeke, C; Zhang, Jingh; Van Belle, V; Paladini, D; Guerriero, S; Czekierdowski, A; Muggah, H; Ombelet, W; Jurkovic, D; Testa, A C; Valentin, L; Van Huffel, S; Bourne, T; Timmerman, D

    2010-03-01

    To determine the ability of acoustic streaming to discriminate between endometriomas and other adnexal masses. We used data from 1938 patients with an adnexal mass included in Phase 2 of the International Ovarian Tumor Analysis (IOTA) study. All patients had been examined by transvaginal gray-scale and Doppler ultrasound following a standardized research protocol. Assessment of acoustic streaming was voluntary and was carried out only in lesions containing echogenic cyst fluid. Acoustic streaming was defined as movement of particles inside the cyst fluid during gray-scale and/or color Doppler examination provided that the probe had been held still for two seconds to ensure that the movement of the particles was not caused by movement of the probe or the patient. Only centers where acoustic streaming had been evaluated in > 90% of cases were included. Sensitivity, specificity, positive and negative likelihood ratios (LR+, LR-), and positive and negative predictive values (PPV and NPV) of acoustic streaming with regard to endometrioma were calculated. 460 (24%) masses were excluded because they were examined in centers where adnexal lesions, and the presence of acoustic streaming does not exclude an endometrioma. Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd.

  11. Primary sources of pelvic serous cancer in patients with endometrial intraepithelial carcinoma.

    PubMed

    Jia, Lin; Yuan, Zeng; Wang, Yiying; Cragun, Janiel M; Kong, Beihua; Zheng, Wenxin

    2015-01-01

    Serous endometrial intraepithelial carcinoma is often associated with extrauterine disease. It is currently unclear where does the extrauterine disease come from. This study addressed this issue. A total of 135 samples from 21 serous endometrial intraepithelial carcinoma patients were studied. Cellular lineage relationships between intrauterine and extrauterine serous carcinomas were determined by TP53-mutation analysis and correlated to the clinicopathologic features. There were three conditions contributing the extrauterine disease: metastasis from serous endometrial intraepithelial carcinoma (n=10) showed identical TP53 mutation between intrauterine lesions and extrauterine disease, cases of adnexal origin (n=5) had discordant TP53 mutations, and the mixed cellular origin cases (n=6) with both identical and discordant mutation status. Patients with extrauterine disease from serous endometrial intraepithelial carcinoma metastasis typically had small tumor masses (<2 cm) in extrauterine sites and without finding of serous tubal intraepithelial carcinoma, while extrauterine disease with adnexal or tubal origin commonly had larger tumor masses in extrauterine sites including ovary and omentum and serous tubal intraepithelial carcinoma. The majority of extrauterine diseases associated with serous endometrial intraepithelial carcinoma are metastasized from the endometrium. Serous endometrial intraepithelial carcinoma is frequently associated with serous cancers of adnexal or tubal origin, indicating that endometrial and adnexal or tubal serous cancers may share similar etiologies. TP53-mutation analysis provides a strong linkage for cellular lineage analysis. Tumor size in extrauterine disease and presence of serous tubal intraepithelial carcinoma or not are useful clinicopathologic features to determine primary cancer site, which helps in clinical management.

  12. Discrimination of basal cell carcinoma and melanoma from normal skin biopsies in vitro through Raman spectroscopy and principal component analysis.

    PubMed

    Bodanese, Benito; Silveira, Fabrício Luiz; Zângaro, Renato Amaro; Pacheco, Marcos Tadeu T; Pasqualucci, Carlos Augusto; Silveira, Landulfo

    2012-07-01

    Raman spectroscopy has been employed to discriminate between malignant (basal cell carcinoma [BCC] and melanoma [MEL]) and normal (N) skin tissues in vitro, aimed at developing a method for cancer diagnosis. Raman spectroscopy is an analytical tool that could be used to diagnose skin cancer rapidly and noninvasively. Skin biopsy fragments of ≈ 2 mm(2) from excisional surgeries were scanned through a Raman spectrometer (830 nm excitation wavelength, 50 to 200 mW of power, and 20 sec exposure time) coupled to a fiber optic Raman probe. Principal component analysis (PCA) and Euclidean distance were employed to develop a discrimination model to classify samples according to histopathology. In this model, we used a set of 145 spectra from N (30 spectra), BCC (96 spectra), and MEL (19 spectra) skin tissues. We demonstrated that principal components (PCs) 1 to 4 accounted for 95.4% of all spectral variation. These PCs have been spectrally correlated to the biochemicals present in tissues, such as proteins, lipids, and melanin. The scores of PC2 and PC3 revealed statistically significant differences among N, BCC, and MEL (ANOVA, p<0.05) and were used in the discrimination model. A total of 28 out of 30 spectra were correctly diagnosed as N, 93 out of 96 as BCC, and 13 out of 19 as MEL, with an overall accuracy of 92.4%. This discrimination model based on PCA and Euclidean distance could differentiate N from malignant (BCC and MEL) with high sensitivity and specificity.

  13. Discrimination between basal cell carcinoma and hair follicles in skin tissue sections by Raman micro-spectroscopy

    NASA Astrophysics Data System (ADS)

    Larraona-Puy, M.; Ghita, A.; Zoladek, A.; Perkins, W.; Varma, S.; Leach, I. H.; Koloydenko, A. A.; Williams, H.; Notingher, I.

    2011-05-01

    Skin cancer is the most common human malignancy and basal cell carcinoma (BCC) represents approximately 80% of the non-melanoma cases. Current methods of treatment require histopathological evaluation of the tissues by qualified personnel. However, this method is subjective and in some cases BCC can be confused with other structures in healthy skin, including hair follicles. In this preliminary study, we investigated the potential of Raman micro-spectroscopy (RMS) to discriminate between hair follicles and BCC in skin tissue sections excised during Mohs micrographic surgery (MMS). Imaging and diagnosis of skin sections was automatically generated using ' a priori'-built spectral model based on LDA. This model had 90 ± 9% sensitivity and 85 ± 9% specificity for discrimination of BCC from dermis and epidermis. The model used selected Raman bands corresponding to the largest spectral differences between the Raman spectra of BCC and the normal skin regions, associated mainly with nucleic acids and collagen type I. Raman spectra corresponding to the epidermis regions of the hair follicles were found to be closer to those of healthy epidermis rather than BCC. Comparison between Raman spectral images and the gold standard haematoxylin and eosin (H&E) histopathology diagnosis showed good agreement. Some hair follicle regions were misclassified as BCC; regions corresponded mainly to the outermost layer of hair follicle (basal cells) which are expected to have higher nucleic acid concentration. This preliminary study shows the ability of RMS to distinguish between BCC and other tissue structures associated to healthy skin which can be confused with BCC due to their similar morphology.

  14. Clinicopathological Features Analysis of 86 Endometrial Endometrioid Adenocarcinoma Patients with Adnexal Involvement.

    PubMed

    Zuo, Jing; Cheng, Min; Song, Yan; Li, Zhuo; Zhang, Rong; Li, Bin; Wu, Lingying

    2017-06-20

    To investigate the clinicopathological features of endometrial endometrioid adenocarcinoma(EEA)with adnexal involvement.Methods The clinicopathological data of 86 EEA patients who underwent surgical treatment at our center from January 2000 to December 2015 were analyzed retrospectively.The clinicopathological features were compared between patients with occult adnexal involvement and those with gross adnexal involvement.Results A total of 86 EEA patients with adnexal involvement(mean age:58.1 years)were included in this study,accounting for 5.4%(86/1592)of the EEA patients during the same period.Among these 86 patients,there were 13 premenopausal patients(15.1%)including 2 premenopausal patients aged under 40 years.Gross adnexal involvement was found in 47 patients(54.7%),while occult adnexal involvement was found in 39 patients(45.3%)in pathology evaluation.Ovarian metastasis was found in 34 patients(39.5%),followed by both ovarian and tubal metastasis in 19 patients(22.1%)and tubal metastasis in 33 patients(38.4%).The expressionss of estrogen receptor(χ(2)=8.086,P=0.042)and progesterone receptor(PR)(χ(2)=9.149,P=0.026)were significantly different between gross adnexal involvement group and occult adnexal involvement group,whereas no significant difference was found in other clinicopathological features(all P>0.05).The non-conditional Logistic regression analysis showed that,compared with PR no-expression group,the rate of occult microscopic adnexal involvement in PR low-expression group was 6.375 times of that of the gross adnexal involvement(P=0.005,95%CI:1.768-22.976),and the rate of occult microscopic adnexal involvement in the PR high-expression group was 3.719 times of that of gross adnexal involvement(P=0.048,95%CI:1.009-13.702). Conclusion PR expression level is remarkably lower in EEA patients with gross adnexal involvement than those with occult adenxal involvement.

  15. Preoperative prediction of histopathological outcome in basal cell carcinoma: flat surface and multiple small erosions predict superficial basal cell carcinoma in lighter skin types.

    PubMed

    Ahnlide, I; Zalaudek, I; Nilsson, F; Bjellerup, M; Nielsen, K

    2016-10-01

    Prediction of the histopathological subtype of basal cell carcinoma (BCC) is important for tailoring optimal treatment, especially in patients with suspected superficial BCC (sBCC). To assess the accuracy of the preoperative prediction of subtypes of BCC in clinical practice, to evaluate whether dermoscopic examination enhances accuracy and to find dermoscopic criteria for discriminating sBCC from other subtypes. The main presurgical diagnosis was compared with the histopathological, postoperative diagnosis of routinely excised skin tumours in a predominantly fair-skinned patient cohort of northern Europe during a study period of 3 years (2011-13). The study period was split in two: during period 1, dermoscopy was optional (850 cases with a pre- or postoperative diagnosis of BCC), while during period 2 (after an educational dermoscopic update) dermoscopy was mandatory (651 cases). A classification tree based on clinical and dermoscopic features for prediction of sBCC was applied. For a total of 3544 excised skin tumours, the sensitivity for the diagnosis of BCC (any subtype) was 93·3%, specificity 91·8%, and the positive predictive value (PPV) 89·0%. The diagnostic accuracy as well as the PPV and the positive likelihood ratio for sBCC were significantly higher when dermoscopy was mandatory. A flat surface and multiple small erosions predicted sBCC. The study shows a high accuracy for an overall diagnosis of BCC and increased accuracy in prediction of sBCC for the period when dermoscopy was applied in all cases. The most discriminating findings for sBCC, based on clinical and dermoscopic features in this fair-skinned population, were a flat surface and multiple small erosions. © 2016 British Association of Dermatologists.

  16. Sunlight exposure and cutaneous human papillomavirus seroreactivity in basal cell and squamous cell carcinomas of the skin.

    PubMed

    Iannacone, Michelle R; Wang, Wei; Stockwell, Heather G; O'Rourke, Kathleen; Giuliano, Anna R; Sondak, Vernon K; Messina, Jane L; Roetzheim, Richard G; Cherpelis, Basil S; Fenske, Neil A; Michael, Kristina M; Waterboer, Tim; Pawlita, Michael; Rollison, Dana E

    2012-08-01

    Ultraviolet radiation exposure may interact synergistically with cutaneous human papillomavirus (HPV) infection in the development of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin. To investigate differences in the risk of sunlight-associated BCC and SCC by cutaneous genus-specific HPV serostatus, a case-control study was conducted among 204 BCC and 156 SCC cases who were recruited from a university dermatology clinic and 297 controls who had no history of cancer and screened negative for current skin cancer. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between measures of sunlight exposure and BCC/SCC, stratified by genus-specific HPV serostatus, with adjustment for age and sex. Sunburn due to cutaneous sensitivity to sunlight exposure (P = .006) and poor tanning ability (P = .003) were associated with a higher seroprevalence for genus beta HPV types. Poor or no tanning ability was more strongly associated with SCC among individuals who were seropositive for antibodies to cutaneous HPV types in genera alpha (OR, 15.60; 95% CI, 5.40-45.1; P = .01 for interaction) and beta (OR, 6.86; 95% CI, 3.68-12.80; P = .001 for interaction), compared with individuals who were seronegative for these HPV types. Seropositivity for HPV types in genera alpha or beta increased the risk of SCC associated with poor tanning ability.

  17. A role for sunlight in skin cancer: UV-induced p53 mutations in squamous cell carcinoma.

    PubMed Central

    Brash, D E; Rudolph, J A; Simon, J A; Lin, A; McKenna, G J; Baden, H P; Halperin, A J; Pontén, J

    1991-01-01

    Sunlight is a carcinogen to which everyone is exposed. Its UV component is the major epidemiologic risk factor for squamous cell carcinoma of the skin. Of the multiple steps in tumor progression, those that are sunlight-related would be revealed if they contained mutations specific to UV. In a series of New England and Swedish patients, we find that 14/24 (58%) of invasive squamous cell carcinomas of the skin contain mutations in the p53 tumor suppressor gene, each altering the amino acid sequence. Involvement of UV light in these p53 mutations is indicated by the presence in three of the tumors of a CC----TT double-base change, which is only known to be induced by UV. UV is also implicated by a UV-like occurrence of mutations exclusively at dipyrimidine sites, including a high frequency of C----T substitutions. p53 mutations in internal malignancies do not show these UV-specific mutations. The dipyrimidine specificity also implicates dipyrimidine photoproducts containing cytosine as oncogenic photoproducts. We believe these results identify a carcinogen-related step in a gene involved in the subsequent human cancer. Images PMID:1946433

  18. A role for sunlight in skin cancer: UV-induced p53 mutations in squamous cell carcinoma

    SciTech Connect

    Brash, D.E.; Rudolph, J.A.; Simon, J.A.; Lin, A.; McKenna, G.J. ); Baden, H.P. ); Ponten, J. )

    1991-11-15

    Sunlight is a carcinogen to which everyone is exposed. Its UV component is the major epidemiologic risk factor for squamous cell carcinoma of the skin. Of the multiple steps in tumor progression, those that are sunlight-related would be revealed if they contained mutations specific to UV. In a series of New England and Swedish patients, the authors find that 14/24 (58%) of invasive squamous cell carcinomas of the skin contain mutations in the p53 tumor suppressor gene, each altering the amino acid sequence. Involvement of UV light in these p53 mutations is indicated by the presence in three of the tumors of a CC {yields} TT double-base change, which is only known to be induced by UV. UV is also implicated by a UV-like occurrence of mutations exclusively at dipyrimidine sites, including a high frequency of C {yields} T substitutions. p53 mutations in internal malignancies do not show these UV-specific mutations. The dipyrimidine specificity also implicates dipyrimidine photoproducts containing cytosine as oncogenic photoproducts. They believe these results identify a carcinogen-related step in a gene involved in the subsequent human cancer.

  19. Snai1 and Snai2 collaborate on tumor growth and metastasis properties of mouse skin carcinoma cell lines.

    PubMed

    Olmeda, D; Montes, A; Moreno-Bueno, G; Flores, J M; Portillo, F; Cano, A

    2008-08-07

    Snai1 (Snail) and Snai2 (Slug), the two main members of Snail family factors, are important mediators of epithelial-mesenchymal transitions and involved in tumor progression. We recently reported that Snai1 plays a major role in tumor growth, invasion and metastasis, but the contribution of Snai2 to tumorigenesis is not yet well understood. To approach this question we have silenced Snai2 and/or Snai1 by stable RNA interference in two independent mouse skin carcinoma (HaCa4 and CarB) cell lines. We demonstrate that Snai2 knockdown has a milder effect, but collaborates with Snai1 silencing in reduction of tumor growth potential of either carcinoma cell line when injected into nude mice. Importantly, Snai1 or Snai2 silencing dramatically influences the metastatic ability of squamous carcinoma HaCa4 cells, inducing a strong reduction in liver and lung distant metastasis. However, only Snai1 knockdown has an effective action on invasiveness and fully abolishes tumor cell dissemination into the spleen. These results demonstrate that Snai1 and Snai2 collaborate on primary tumor growth and specifically contribute to site-specific metastasis of HaCa4 cells. These data also indicate that Snai1 is the major regulator of local invasion, supporting a hierarchical participation of both factors in the metastatic process.

  20. Prevalence of actinic skin lesions in patients with basal cell carcinoma of the head: a case-control study.

    PubMed

    Chinem, Valquíria Pessoa; Miot, Hélio Amante

    2012-01-01

    To evaluate the prevalence of actinic skin lesions in patients with basal cell carcinoma of the head. A case-control study was carried out. Cases were patients with primary, solid basal cell carcinoma of the head, less than two centimeters in diameter; and as controls, patients with other dermatoses. Constitutional and behavioral variables were analyzed, as well as actinic lesions. One hundred twenty cases and 360 controls were evaluated. Facial milia (OR = 2.3), leukoderma punctata of the upper limbs (OR = 2.9), and cutis rhomboidalis nuchae (OR = 1.8) were associated with neoplasms regardless of other variables, suggesting a risk phenotype. There was also association with light hair and eye color phenotypes, family genetics, and cumulative sun exposure. Sunburn, smoking, and alcoholism were not identified as risk factors. The use of sunscreens showed no evidence of protection; however, the control group consisted of dermatology patients who are often prescribed sunscreens. Actinic lesions were more prevalent in patients with solid basal cell carcinoma of the head than in controls, especially milia, cutis rhomboidalis nuchae, and leukoderma punctata, regardless of other known risk factors.

  1. Concomitant cetuximab and radiation therapy: A possible promising strategy for locally advanced inoperable non-melanoma skin carcinomas

    PubMed Central

    DELLA VITTORIA SCARPATI, GIUSEPPINA; PERRI, FRANCESCO; PISCONTI, SALVATORE; COSTA, GIUSEPPE; RICCIARDIELLO, FILIPPO; DEL PRETE, SALVATORE; NAPOLITANO, ALBERTO; CARRATURO, MARCO; MAZZONE, SALVATORE; ADDEO, RAFFAELE

    2016-01-01

    Non-melanoma skin cancers (NMSCs) include a heterogeneous group of malignancies arising from the epidermis, comprising squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Merkel cell carcinoma and more rare entities, including malignant pilomatrixoma and sebaceous gland tumours. The treatment of early disease depends primarily on surgery. In addition, certain patients present with extensive local invasion or metastasis, which renders these tumours surgically unresectable. Improving the outcome of radiotherapy through the use of concurrent systemic therapy has been demonstrated in several locally advanced cancer-treatment paradigms. Recently, agents targeting the human epidermal growth factor receptor (EGFR) have exhibited a consolidated activity in phase II clinical trials and case series reports. Cetuximab is a monoclonal antibody that binds to and completely inhibits the EGFR, which has been revealed to be up-regulated in a variety of SCCs, including NMSCs. The present review aimed to summarize the role of anti-EGFR agents in the predominant types of NMSC, including SCC and BCC, and focuses on the cetuximab-based studies, highlighting the biological rationale of this therapeutic option. In addition, the importance of the association between cetuximab and radiotherapy for locally advanced NMSC is discussed. PMID:27073643

  2. A Clinicopathological Study of Women with Adnexal Masses Presenting with Acute Symptoms

    PubMed Central

    Al-Shukri, M; Mathew, M; Al-Ghafri, W; Al-Kalbani, M; Al-Kharusi, L; Gowri, V

    2014-01-01

    Background: Abdominal pain is one of the most common presentations of adnexal pathology in gynecology. Early diagnosis and intervention is essential especially in adolescent girls and reproductive age group women to conserve reproductive function. Aim: The purpose of the following study is to assess the clinicopathologic outcome of women with adnexal masses presenting with acute pain. Subjects and Methods: A retrospective study of women with adnexal masses who had surgical intervention for acute symptoms from June 2007 to May 2012 was undertaken. During the study period, a total of 57 women were operated for adnexal masses as emergency. Results: Of the 57 women operated for adnexal masses as emergency, the most common pathology was teratoma 26% (15/57) followed by corpus luteal hemorrhage (16%) and endometriosis (14%). Laparoscopy was the initial surgical approach in just over 50% of patients, but surgery was completed laparoscopically only in about one-third of patients. Conservative surgery in the form of ovarian cystectomy was possible in 70% of patients. Conclusion: Complications of adnexal masses such as torsion and hemorrhage are common causes of acute abdominal pain. Timely diagnosis of the adnexal pathology and surgical intervention will help to preserve the reproductive outcome. Conservative surgery was possible in 70% of our study group. PMID:24761256

  3. Pagetoid variant of actinic keratosis with or without squamous cell carcinoma of sun-exposed skin: a lesion simulating extramammary Paget's disease.

    PubMed

    Mai, K T; Alhalouly, T; Landry, D; Stinson, W A; Perkins, D G; Yazdi, H M

    2002-10-01

    Extramammary Paget's disease usually occurs in anogenital skin. We present five cases of squamous cell carcinoma in situ of sun-exposed skin and non-squamous cell carcinoma in situ actinic keratosis that displayed atypical keratinocytes disposed in intraepithelial cell nests and immunohistochemical staining simulating extramammary Paget's disease. Two pilot cases--one squamous cell carcinoma in situ and one non-squamous cell carcinoma in situ actinic keratosis with formation of intra-epidermal nests of atypical keratinocytes with a pagetoid spread pattern--were encountered at our institution. Fifty-four consecutive cases of squamous cell carcinoma in situ including bowenoid actinic keratosis and 34 cases of non-squamous cell carcinoma in situ actinic keratosis were reviewed to identify pagetoid spread of atypical cells. Representative sections of all cases with pagetoid spread of atypical keratinocytes were submitted for special stains for mucin, and immunostaining for cytokeratin 7 (CK7), cytokeratin 20 (CK20), cytokeratin CAM 5.2 (CAM 5.2), carcinoembryonic antigen (CEA), vimentin and S100 protein. In the group of squamous cell carcinoma in situ, 10 cases displayed pagetoid spread of atypical keratinocytes with cytoplasm ranging from clear to pale and atypical hyperchromatic nuclei. One review squamous cell carcinoma in situ was multicentric with three separate lesions. The atypical keratinocytes tended to form well to poorly defined cell groups extending from the basal cell layer to the corneal layer. No similar cases were identified in the group of non-squamous cell carcinoma in situ actinic keratosis. Two pilot cases and three of 10 review cases with a total of seven separate lesions displayed a moderate to marked immunohistochemical reactivity for CK7 similar to extramammary Paget's disease. CEA immunoreactivity was also detected in two of these cases. In addition, two of 44 squamous cell carcinomas in situ without pagetoid spread of atypical keratinocytes

  4. Diagnosis of malignant melanoma and basal cell carcinoma by in vivo NIR-FT Raman spectroscopy is independent of skin pigmentation.

    PubMed

    Philipsen, P A; Knudsen, L; Gniadecka, M; Ravnbak, M H; Wulf, H C

    2013-05-01

    There is a general need for methods to obtain fast in vivo diagnosis of skin tumours. Raman spectroscopy measures molecular structure and may thus have potential as a tool for skin tumour diagnosis. The purpose of this study was to investigate how skin pigmentation influenced the Raman spectra and skin tumour diagnostics in vivo. We obtained Raman spectra in vivo from the normal skin of 55 healthy persons with different skin pigmentation (Fitzpatrick skin type I-VI) and in vivo from 25 basal cell carcinomas, 41 pigmented nevi and 15 malignant melanomas. Increased skin pigmentation resulted in a higher spectral background caused by fluorescence, which could be removed by background correction. After background correction, we found only a negligible effect of pigmentation on the major spectral bands, and the comparison of the intensity of these bands allowed us to differentiate between normal skin and the different skin lesions independent of skin type. The diagnosis of skin lesions is possible due to significant (p < 0.05) differences found in the water band around 3250 cm(-1), the protein specific band around 1250 cm(-1) (amide-III) and the amide-III ratio that describes the protein/lipid ratio by comparing bands around 1250 cm(-1) with bands around 1300 cm(-1). We have shown that NIR-FT Raman spectroscopy is useable for malignant melanoma and basal cell carcinoma diagnostics in vivo and that pigmentation of the skin or lesion does not influence the diagnosis, but larger data sets are required to establish accurate diagnostic power.

  5. Immunohistochemical analysis of TIMP-3 and MMP-9 in actinic keratosis, squamous cell carcinoma of the skin, and basal cell carcinoma.

    PubMed

    Poswar, Fabiano O; Fraga, Carlos A C; Farias, Lucyana C; Feltenberger, John D; Cruz, Vitória P D; Santos, Sérgio H S; Silveira, Christine M; de Paula, Alfredo M B; Guimarães, André L S

    2013-11-01

    The expression of metalloproteinases and their inhibitors has been related to different invasive and metastatic potentials in cancer. This study aims to investigate the immunohistochemical expression of TIMP-3 and MMP-9 in samples of basal cell carcinoma (BCC), squamous cell carcinoma of the skin (SCC), and actinic keratosis (AK). Immunohistochemistry was performed to evaluate the expression of TIMP-3 and MMP-9 in samples of BCC (n=22), SCC (n=10), and AK (n=15). Ten fields of both tumor parenchyma and tumor stroma were photographed and counted in image software. The ratio of positive cells to total cells was used to quantify the staining. A higher expression of MMP-9 was found in tumor stroma of SCC compared to BCC and AK. No significant differences in TIMP-3 expression were observed among the groups. Considering the well-described differences between these neoplasms, these results provide additional evidence of the role of MMP-9 in tumor invasiveness of keratinocyte-derived tumors.

  6. Protein expression of MMP-2 and MT1-MMP in actinic keratosis, squamous cell carcinoma of the skin, and basal cell carcinoma.

    PubMed

    de Oliveira Poswar, Fabiano; de Carvalho Fraga, Carlos Alberto; Gomes, Emisael Stênio Batista; Farias, Lucyana Conceição; Souza, Linton Wallis Figueiredo; Santos, Sérgio Henrique Souza; Gomez, Ricardo Santiago; de-Paula, Alfredo Maurício Batista; Guimarães, André Luiz Sena

    2015-02-01

    Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are 2 skin neoplasms with distinct potentials to invasion and metastasis. Actinic keratosis (AK) is a precursor lesion of SCC. Immunohistochemistry was performed to evaluate the expression of MMP-2 and MT1-MMP in samples of BCC (n = 29), SCC (n = 12), and AK (n = 13). The ratio of positive cells to total cells was used to quantify the staining. Statistical significance was considered under the level P < .05. We found a higher expression of MMP-2 in tumor stroma and parenchyma of SCC as compared to BCC. The expression of this protein was also similar between SCC and its precursor actinic keratosis, and it was higher in the stroma of high-risk BCC when compared to low-risk BCC. MT1-MMP, which is an activator of MMP-2, was similarly expressed in all groups. Our results suggest that MMP-2 expression may contribute to the distinct invasive patterns seen in SCC and BCC.

  7. A multistep voriconazole-related phototoxic pathway may lead to skin carcinoma: results from a French nationwide study.

    PubMed

    Epaulard, Olivier; Villier, Céline; Ravaud, Philippe; Chosidow, Olivier; Blanche, Stéphane; Mamzer-Bruneel, Marie-France; Thiébaut, Anne; Leccia, Marie-Thérèse; Lortholary, Olivier

    2013-12-01

    Voriconazole long-term therapy is suspected to induce cutaneous squamous cell carcinoma (SCC), as suggested by 18 case reports worldwide and 3 retrospective studies. To better characterize the natural history of these potentially voriconazole-associated tumors, a nationwide call for notification of skin cancers and other skin lesions observed between 2002 and 2012 in patients treated by voriconazole was launched in France. A multidisciplinary committee evaluated voriconazole involvement in each case. Nineteen SCCs were reported. The committee determined the likelihood of voriconazole involvement to be high in 15 cases, intermediate in 2, and low in 2. In the 17 patients with high/intermediate likelihood of voriconazole involvement, the mean time between voriconazole initiation and SCC diagnosis was 39 ± 18 months (range, 28-84 months), and was shorter in transplant recipients (35 vs 45 months, P < .05). Cumulative mean duration of voriconazole therapy at SCC diagnosis was 35 months (range, 7-63 months). A multistep process was noted in 14 of 17 patients: acute phototoxicity during the first year of voriconazole therapy (mean time, 6 months [range, 0-18 months]), actinic keratosis (AK) of the same sun-exposed skin area in the second/third year (mean, 30 months [range, 11-57 months]), followed by SCC during the third year or later. Five cases of AK without SCC and 37 cases of other skin lesions were also reported. Our results suggest that long-term voriconazole prescription may be associated with a multistep phototoxic process involving acute skin lesions followed by AK then by SCC. Discontinuation of voriconazole should be strongly considered in patients experiencing chronic phototoxicity.

  8. Adnexal Torsion during Pregnancy after Oocyte In Vitro Maturation and Intracytoplasmic Sperm Injection Cycle

    PubMed Central

    Giulini, Simone; Dante, Giulia; Xella, Susanna; La Marca, Antonio; Marsella, Tiziana; Volpe, Annibale

    2010-01-01

    We report a case of right adnexal torsion during pregnancy after an oocyte in vitro maturation and intracitoplasmic sperm injection cycle in patient with polycystic ovary syndrome. A 31-year-old woman with a typical clinical disorder of polycystic ovarian syndrome was included in an oocyte in vitro maturation program. Right adnexal torsion occurred two days after embryo transfer, and laparoscopy detorsion was successfully performed with preservation of adnexa. The patient had a full-term pregnancy and delivered a healthy infant at 40 weeks of gestation. To our knowledge this is the first report of adnexal torsion after an oocyte in vitro maturation and intracitoplasmic sperm injection program. PMID:20814540

  9. Application of Recursive Partitioning to Derive and Validate a Claims-Based Algorithm for Identifying Keratinocyte Carcinoma (Nonmelanoma Skin Cancer).

    PubMed

    Chan, An-Wen; Fung, Kinwah; Tran, Jennifer M; Kitchen, Jessica; Austin, Peter C; Weinstock, Martin A; Rochon, Paula A

    2016-10-01

    Keratinocyte carcinoma (nonmelanoma skin cancer) accounts for substantial burden in terms of high incidence and health care costs but is excluded by most cancer registries in North America. Administrative health insurance claims databases offer an opportunity to identify these cancers using diagnosis and procedural codes submitted for reimbursement purposes. To apply recursive partitioning to derive and validate a claims-based algorithm for identifying keratinocyte carcinoma with high sensitivity and specificity. Retrospective study using population-based administrative databases linked to 602 371 pathology episodes from a community laboratory for adults residing in Ontario, Canada, from January 1, 1992, to December 31, 2009. The final analysis was completed in January 2016. We used recursive partitioning (classification trees) to derive an algorithm based on health insurance claims. The performance of the derived algorithm was compared with 5 prespecified algorithms and validated using an independent academic hospital clinic data set of 2082 patients seen in May and June 2011. Sensitivity, specificity, positive predictive value, and negative predictive value using the histopathological diagnosis as the criterion standard. We aimed to achieve maximal specificity, while maintaining greater than 80% sensitivity. Among 602 371 pathology episodes, 131 562 (21.8%) had a diagnosis of keratinocyte carcinoma. Our final derived algorithm outperformed the 5 simple prespecified algorithms and performed well in both community and hospital data sets in terms of sensitivity (82.6% and 84.9%, respectively), specificity (93.0% and 99.0%, respectively), positive predictive value (76.7% and 69.2%, respectively), and negative predictive value (95.0% and 99.6%, respectively). Algorithm performance did not vary substantially during the 18-year period. This algorithm offers a reliable mechanism for ascertaining keratinocyte carcinoma for epidemiological research in the absence of

  10. Divergence between the high rate of p53 mutations in skin carcinomas and the low prevalence of anti-p53 antibodies

    PubMed Central

    Moch, C; Moysan, A; Lubin, R; Salmonière, P de La; Soufir, N; Galisson, F; Vilmer, C; Venutolo, E; Pelletier, F Le; Janin, A; Basset-Séguin, N

    2001-01-01

    Circulating anti-p53 antibodies have been described and used as tumoural markers in patients with various cancers and strongly correlate with the p53 mutated status of the tumours. No study has yet looked at the prevalence of such antibodies in skin carcinoma patients although these tumours have been shown to be frequently p53 mutated. Most skin carcinoma can be diagnosed by examination or biopsy, but aggressive, recurrent and/or non-surgical cases' follow up would be helped by a biological marker of residual disease. We performed a prospective study looking at the prevalence of anti-p53 antibodies using an ELISA technique in a series of 105 skin carcinoma patients in comparison with a sex- and age-matched control skin carcinoma-free group (n = 130). Additionally, p53 accumulation was studied by immunohistochemistry to confirm p53 protein altered expression in a sample of tumours. Anti-p53 antibodies were detected in 2.9% of the cases, with a higher prevalence in patients suffering from the more aggressive squamous cell type (SCC) of skin carcinoma (8%) than for the more common and slowly growing basal cell carcinoma type or BCC (1.5%). p53 protein stabilization could be confirmed in 80% of tumours studied by IHC. This low level of anti-p53 antibody detection contrasts with the high rate of p53 mutations reported in these tumours. This observation shows that the anti-p53 humoral response is a complex and tissue-specific mechanism. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11747330

  11. Surgical Treatment of Squamous Carcinoma in an Antethoracic Skin Tube Used for Esophageal Replacement.

    PubMed

    Fox, Matthew P; Mathisen, Douglas J

    2017-04-01

    Occasionally, enteric conduits are unavailable or impractical for esophageal replacement. Cutaneous tubes are rarely employed alternatives that remain useful in specific circumstances. We present the case of a patient with a long standing skin tube complicated by malignancy that was replaced with a new skin tube.

  12. Recurrence of breast carcinoma as Paget disease of the skin at a prior core needle biopsy site: Case report and review of the literature

    PubMed Central

    Calvillo, Katherina Zabicki; Guo, Lifei; Brostrom, Valerie; Schnitt, Stuart J.; Hong, Xuefei; Raza, Sughra; Lester, Susan C.

    2015-01-01

    Introduction Core needle biopsy has become the preferred method of diagnosing breast carcinomas prior to definitive surgery. The possibility of displacing tumor cells into the needle track is a concern. Presentation of case A 38 year old woman was diagnosed with right breast ductal carcinoma in situ (DCIS) with microinvasion by core needle biopsy. Bilateral skin sparing mastectomies with immediate autologous reconstruction were performed. One and a half years later the patient noted erythema and a scaling crust on the skin of the right breast that progressed over several months. Punch biopsy revealed Paget disease restricted to the epidermis. Subsequent comparison to initial clinical photographs confirmed the cancer was associated with the skin puncture site of the needle biopsy. The patient underwent complete excision with skin grafting and remains free of disease three years later. Discussion Only 13 cases of needle track recurrences have been reported. The majority presented as invasive carcinoma forming a subcutaneous mass. In the current case, detection was delayed due to not initially noting that a skin lesion was at the puncture site of the original needle biopsy. This is the only case of recurrence as tumor limited to the epidermis. Conclusion Although recurrence in a needle track occurs very infrequently, clinicians should be aware of this phenomenon and investigate any changes, particularly when occurring at a needle biopsy site. Recording the skin puncture site can aid in early detection of recurrences. Recognition of a recurrence is important for prompt treatment and optimal prognosis. PMID:26395914

  13. Genus beta human papillomaviruses and incidence of basal cell and squamous cell carcinomas of skin: population based case-control study.

    PubMed

    Karagas, Margaret R; Waterboer, Tim; Li, Zhongze; Nelson, Heather H; Michael, Kristina M; Bavinck, Jan Nico Bouwes; Perry, Ann E; Spencer, Steven K; Daling, Janet; Green, Adele C; Pawlita, Michael

    2010-07-08

    To investigate the association between genus beta human papillomaviruses and the incidence of non-melanocytic skin cancer in the general population. Population based case-control study. New Hampshire, USA. 2366 skin cancer cases and controls from the general population aged 25 to 74 years (663 squamous cell carcinoma, 898 basal cell carcinoma, 805 controls), with plasma samples tested for L1 antibodies to 16 genus beta human papillomaviruses by multiplex serology. Odds ratios for squamous cell carcinoma and basal cell carcinoma associated with seropositivity to beta human papillomaviruses. Squamous cell carcinoma, but not basal cell carcinoma, cases had a higher prevalence of each of the individual beta human papillomaviruses assayed compared with controls. The odds ratios for squamous cell carcinoma increased with the number of beta types positive (odds ratio for one type positive 0.99 (95% confidence interval 0.74 to 1.33); two to three types positive 1.44 (1.03 to 2.01); four to eight types positive 1.51 (1.03 to 2.20); more than eight types positive 1.71 (1.12 to 2.62); P for trend (categorical)<0.001; P for trend (continuous)=0.003). With limited statistical power, the association was stronger among long term users of systemic glucocorticoids (odds ratio 3.21, 1.22 to 8.44) than among non-users (1.23, 0.97 to 1.55). These findings support a relation between genus beta human papillomavirus infection and the incidence of squamous cell carcinoma of the skin in the general population, as well as potential enhancement of risk by immunosuppression.

  14. Hand-foot skin reaction is associated with the clinical outcome in patients with metastatic renal cell carcinoma treated with sorafenib.

    PubMed

    Nakano, Kazuhiko; Komatsu, Kenji; Kubo, Taro; Natsui, Shinsuke; Nukui, Akinori; Kurokawa, Shinsuke; Kobayashi, Minoru; Morita, Tatsuo

    2013-10-01

    To elucidate whether Hand-Foot skin reaction could become a biomarker of clinical outcome in patients with metastatic renal cell carcinoma treated with sorafenib, we retrospectively examined the association between the Hand-Foot skin reaction and the clinical outcome in metastatic renal cell carcinoma patients treated with sorafenib. Thirty-six Japanese metastatic renal cell carcinoma patients treated with sorafenib were enrolled and divided into the groups with or without Hand-Foot skin reaction. Patient characteristics, best tumor response, progression-free survival and adverse events were investigated and compared between these two groups. A sorafenib-induced Hand-Foot skin reaction in metastatic renal cell carcinoma patients was observed at a significantly higher rate in patients in the favorable-risk group in the Memorial Sloan-Kettering Cancer Center risk classification, and with Eastern Cooperative Oncology Group Performance Status of one or less, prior nephrectomy, higher hemoglobin, lower lactate dehydrogenase and lower C-reactive protein. The mean best tumor response was significantly better in the group with Hand-Foot skin reaction (-16.7%) than that in the group without it (17.9%; P < 0.001). The median progression-free survival was significantly longer in the group with Hand-Foot skin reaction (4.6 months) than that in the group without it (1.5 months; P = 0.002). In multivariate analysis, only Hand-Foot skin reaction was shown to be a predictive factor of progression-free survival (hazard ratio 0.312, P = 0.010). A sorafenib-induced Hand-Foot skin reaction in metastatic renal cell carcinoma patients emerged at a significantly higher rate in patients in the favorable-risk group in the Memorial Sloan-Kettering Cancer Center risk classification and was significantly associated with best tumor response and progression-free survival, suggesting that Hand-Foot skin reaction might be an independent predictive factor for clinical outcome in metastatic renal

  15. Dietary immunosuppressants do not enhance UV-induced skin carcinogenesis, and reveal discordance between p53-mutant early clones and carcinomas.

    PubMed

    Voskamp, Pieter; Bodmann, Carolien A; Koehl, Gudrun E; Rebel, Heggert G; Van Olderen, Marjolein G E; Gaumann, Andreas; El Ghalbzouri, Abdoel; Tensen, Cornelis P; Bavinck, Jan N Bouwes; Willemze, Rein; Geissler, Edward K; De Gruijl, Frank R

    2013-02-01

    Immunosuppressive drugs are thought to cause the dramatically increased risk of carcinomas in sun-exposed skin of organ transplant recipients. These drugs differ in local effects on skin. We investigated whether this local impact is predictive of skin cancer risk and may thus provide guidance on minimizing the risk. Immunosuppressants (azathioprine, cyclosporine, tacrolimus, mycophenolate mofetil, and rapamycin) were assessed on altering the UV induction of apoptosis in human skin models and of p53 mutant cell clones (putative tumor precursors) and ensuing skin carcinomas (with mutant p53) in the skin of hairless mice. Rapamycin was found to increase apoptosis (three-fold), whereas cyclosporine decreased apoptosis (three-fold). Correspondingly, a 1.5- to five-fold reduction (P = 0.07) or a two- to three-fold increase (P < 0.001) was found in cell clusters overexpressing mutant p53 in chronically UV-exposed skin of mice that had been fed rapamycin or cyclosporine, respectively. Deep sequencing showed, however, that the allelic frequency (∼5%) of the hotspot mutations in p53 (codons 270 and 275) remained unaffected. The majority of cells with mutated p53 seemed not to overexpress the mutated protein. Unexpectedly, none of the immunosuppressants admixed in high dosages to the diet accelerated tumor development, and cyclosporine even delayed tumor onset by approximately 15% (P < 0.01). Thus, in contrast to earlier findings, the frequency of p53-mutant cells was not predictive of the incidence of skin carcinoma. Moreover, the lack of any accelerative effect on tumor development suggests that immunosuppressive medication is not the sole cause of the dramatic increase in skin cancer risk in organ transplant recipients.

  16. [Immunohistochemical study of the specific features of expression of matrix metalloproteinases 1, 9 in the photoaged skin, the foci of actinic keratosis and basal cell carcinoma].

    PubMed

    Kuznetsova, E V; Snarskaya, E S; Zavalishina, L E; Tkachenko, S B

    Matrix metalloproteinases (MMPs) mediate the degradation of all types of collagens and other extracellular matrix components (elastin, proteoglycans, and laminin), their synthesis and accumulation play a key role in the hydrolysis of basement membrane. MMPs are involved in a wide range of proteolytic processes in the presence of different physiological and pathological changes, including inflammation, wound healing, angiogenesis, and carcinogenesis. to study the specific features of MMP-1 and MMP-9 expression in different stages of skin photoaging, in the foci of actinic keratosis and basal cell carcinoma by immunohistochemical examination. 12 samples of the healthy skin (6 samples of the eyelid skin with Glogau grade II photoaging; 6 ones of eyelid skin with Glogau grades III-IV photoaging) and biopsies from 8 foci of actinic keratosis and from 8 ones of basal cell carcinoma were examined. A positive reaction to MMPs was shown as different brown staining intensity in the cytoplasm of keratinocytes/tumor cells. MMP-1 and MMP-9 expression was recorded in 67% of the histological specimens of the Glogau grade III photoaged skin and in 100% of those of Glogau grade IV. In the foci of actinic keratosis, the expression of MMP-1 was observed in 62.5% of cases and that of MMP-9 was seen in 87.5%. In basal cell carcinoma, the expression of MMP-1 and MMP-9 was detected in all investigated samples. The immunomorphological findings are indicative of the important role of the level of MMP-1 and MMP-9 expression that is associated with the degree of progression of skin photoaging processes. Minimal MMP-1 and MMP-9 expression was recorded even in grades III-IV photoaging and in the foci of actinic keratosis. Intense MMP-1 and MMP-9 expression was detected in malignant skin epithelial neoplasms as different clinicomorphological types of basal cell carcinoma.

  17. Investigation and Management of Adnexal Masses in Pregnancy

    PubMed Central

    Cavaco-Gomes, João; Jorge Moreira, Cátia; Rocha, Anabela; Mota, Raquel; Paiva, Vera; Costa, Antónia

    2016-01-01

    Adnexal masses can be found in 0.19 to 8.8% of all pregnancies. Most masses are functional and asymptomatic and up to 70% resolve spontaneously in the second trimester. The main predictors of persistence are the size (>5 cm) and the imagiological morphocomplexity. Those that persist carry a low risk of malignancy (0 to 10%). Most malignant masses are diagnosed at early stages and more than 50% are borderline epithelial neoplasms. Ultrasound is the preferred method to stratify the risk of complications and malignancy, allowing medical approach planning. Pregnancy and some gestational disorders may modify the levels of tumor markers, whereby their interpretation during pregnancy should be cautious. Large masses are at increased risk of torsion, rupture, and dystocia. When surgery is indicated, laparoscopy is a safe technique and should ideally be carried out in the second trimester of pregnancy. PMID:27119043

  18. [Laparoscopy for diagnosis and treatment of adnexal masses].

    PubMed

    Barreta, Amilcar; Bastos, Joana Fróes Bragança; Sarian, Luis Otávio; de Toledo, Maria Carolina Szymanski; Sallum, Luis Felipe; Derchain, Sophie

    2014-03-01

    To assess clinical factors, histopathologic diagnoses, operative time and differences in complication rates between women undergoing laparoscopy or laparotomy to diagnose and treat an adnexal mass and their association with laparoscopy failure. In this prospective study, 210 women were invited to participate and 133 of them were included. Eighty-eight women underwent laparotomy and 45 underwent laparoscopy. Fourteen of the 45 laparoscopies were converted to laparotomy intraoperatively. We assessed whether age, body mass index (BMI), previous abdominal surgeries, CA-125, Index of Risk of Malignancy (IRM), tumor diameter, histological diagnosis, operative time and surgical complication rates differed between the laparoscopy group and the group converted to laparotomy and whether those factors were associated with conversion of laparoscopy to laparotomy. We also assessed surgical logs to evaluate the reasons, as stated by the surgeons, to convert a laparoscopy to laparotomy. In this research, 30% of the women had malignant tumors. CA-125, IRM, tumor diameter and operative times were higher for the laparotomy group than the laparoscopy group. Complication rates were similar for both groups and also for the successful laparoscopy and unsuccessful laparoscopy groups. The surgical complication rate in women with benign tumors was lower for the laparoscopy group than for the laparotomy group. The factors associated with conversion to laparotomy were tumor diameter and malignancy. During laparoscopy, adhesions a large tumor diameter were the principal causes of conversion. This study suggests that laparoscopy for the diagnosis and treatment of adnexal masses is safe and does not increase complication rates even in patients who need conversion to laparotomy. However, when doubt about the safety of the procedure and about the presence of malignancy persists, consultation with an expert gynecology-oncologist with experience in advanced laparoscopy is recommended. A large tumor

  19. Discrimination of Basal Cell Carcinoma and Melanoma from Normal Skin Biopsies in Vitro Through Raman Spectroscopy and Principal Component Analysis

    PubMed Central

    Bodanese, Benito; Silveira, Fabrício Luiz; Zângaro, Renato Amaro; Pacheco, Marcos Tadeu T.; Pasqualucci, Carlos Augusto

    2012-01-01

    Abstract Objective: Raman spectroscopy has been employed to discriminate between malignant (basal cell carcinoma [BCC] and melanoma [MEL]) and normal (N) skin tissues in vitro, aimed at developing a method for cancer diagnosis. Background data: Raman spectroscopy is an analytical tool that could be used to diagnose skin cancer rapidly and noninvasively. Methods: Skin biopsy fragments of ∼2 mm2 from excisional surgeries were scanned through a Raman spectrometer (830 nm excitation wavelength, 50 to 200 mW of power, and 20 sec exposure time) coupled to a fiber optic Raman probe. Principal component analysis (PCA) and Euclidean distance were employed to develop a discrimination model to classify samples according to histopathology. In this model, we used a set of 145 spectra from N (30 spectra), BCC (96 spectra), and MEL (19 spectra) skin tissues. Results: We demonstrated that principal components (PCs) 1 to 4 accounted for 95.4% of all spectral variation. These PCs have been spectrally correlated to the biochemicals present in tissues, such as proteins, lipids, and melanin. The scores of PC2 and PC3 revealed statistically significant differences among N, BCC, and MEL (ANOVA, p<0.05) and were used in the discrimination model. A total of 28 out of 30 spectra were correctly diagnosed as N, 93 out of 96 as BCC, and 13 out of 19 as MEL, with an overall accuracy of 92.4%. Conclusions: This discrimination model based on PCA and Euclidean distance could differentiate N from malignant (BCC and MEL) with high sensitivity and specificity. PMID:22693951

  20. Stages of Skin Cancer

    MedlinePlus

    ... Skin Cancer Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer ... carcinoma include the following: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  1. Skin Cancer Treatment

    MedlinePlus

    ... Skin Cancer Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer ... carcinoma include the following: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  2. Animal-inflicted ocular and adnexal injuries in children: A systematic review.

    PubMed

    Yardley, Anne-Marie E; Hoskin, Annette K; Hanman, Kate; Wan, Sue L; Mackey, David A

    2015-01-01

    Eye injury remains the leading cause of monocular blindness in children despite 90% of injuries being potentially preventable. Children interact with animals in a variety of situations, and the associated dangers may be underestimated. Animals are capable of causing ocular and adnexal injuries that are cosmetically and visually devastating. We examine the current literature regarding the nature and severity of animal-inflicted ocular and adnexal injuries in children. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Polarimetry based partial least square classification of ex vivo healthy and basal cell carcinoma human skin tissues.

    PubMed

    Ahmad, Iftikhar; Ahmad, Manzoor; Khan, Karim; Ikram, Masroor

    2016-06-01

    Optical polarimetry was employed for assessment of ex vivo healthy and basal cell carcinoma (BCC) tissue samples from human skin. Polarimetric analyses revealed that depolarization and retardance for healthy tissue group were significantly higher (p<0.001) compared to BCC tissue group. Histopathology indicated that these differences partially arise from BCC-related characteristic changes in tissue morphology. Wilks lambda statistics demonstrated the potential of all investigated polarimetric properties for computer assisted classification of the two tissue groups. Based on differences in polarimetric properties, partial least square (PLS) regression classified the samples with 100% accuracy, sensitivity and specificity. These findings indicate that optical polarimetry together with PLS statistics hold promise for automated pathology classification. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Polycystic ovary syndrome with asynchronous bilateral adnexal torsion in a natural cycle.

    PubMed

    Matsuoka, Shozo; Kobayashi, Toru; Kusunoki, Soshi; Ogishima, Daiki

    2017-08-23

    Cases involving polycystic ovaries (PCOs) with adnexal torsion in a natural cycle without ovulation induction are rare, and no reports of such cases have described asynchronous bilateral adnexal torsion. Here, we report a case of PCO syndrome (PCOS) with asynchronous bilateral adnexal torsion in a natural cycle. The patient was a 37-year-old woman with a history of 2 gravidas 1 para. Her primary complaint was left lower abdominal pain. Ultrasonography and MRI identified multiple uterine myomas occupying the pelvis and the left ovary, with oedematous swelling that had moved ventrally to the uterus. She was diagnosed with adnexal torsion and underwent emergency laparoscopic adnexectomy. Nine months after surgery, she experienced right lower abdominal pain. Ultrasonography revealed suspected right adnexal torsion and she underwent emergency surgery. The right ovary was twisted 540° counterclockwise and swollen to 7 cm in size, with partial polycystic changes. She was histopathologically diagnosed with a PCO, and the final diagnosis, which also considered the endocrine test results, was PCOS. In PCOS, adnexal torsion may occur if the swollen ovary moves because of a hysteromyoma or other cause. Accordingly, torsion should be considered during the follow-up of patients with PCOS. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Ultraviolet light induction of skin carcinoma in the mouse; influence of cAMP modifying agents.

    PubMed

    Zajdela, F; Latarjet, R

    1978-01-01

    A short review of pathogenic factors in U.V. light skin carcinogenesis in the mouse is presented. Caffeine and theophylline applied locally during U.V. irradiation caused a 50 percent reduction of skin tumour induction in Swiss mice. These two chemicals are inhibitors of DNA postreplication repair, but they also raise the intracellular level of cyclic AMP by inhibiting cAMP phosphodiesterase with, as a consequence, a possible slowing down of cellular growth. Control experiments using three different chemicals capable of raising the cAMP level in epidermal cells gave negative results. These experimental data are compatible with our original hypothesis according to which production of skin cancers by U.V. radiation is in same way related to DNA repair which helps the cell to survive but allows or favours the occurrence of errors in cellular DNA.

  6. From Normal Skin to Squamous Cell Carcinoma: A Quest for Novel Biomarkers

    PubMed Central

    Ghita, Mihaela; Moraru, Liliana; Voiculescu, Suzana; Greabu, Maria

    2016-01-01

    Squamous cells carcinoma (SCC) is the second most frequent of the keratinocyte-derived malignancies after basal cell carcinoma and is associated with a significant psychosocial and economic burden for both the patient himself and society. Reported risk factors for the malignant transformation of keratinocytes and development of SCC include ultraviolet light exposure, followed by chronic scarring and inflammation, exposure to chemical compounds (arsenic, insecticides, and pesticides), and immune-suppression. Despite various available treatment methods and recent advances in noninvasive or minimal invasive diagnostic techniques, the risk recurrence and metastasis are far from being negligible, even in patients with negative histological margins and lymph nodes. Analyzing normal, dysplastic, and malignant keratinocyte proteome holds special promise for novel biomarker discovery in SCC that could be used in the future for early detection, risk assessment, tumor monitoring, and development of targeted therapeutic strategies. PMID:27642215

  7. Discrimination of Basal Cell Carcinoma from Normal Skin Tissue Using High-Resolution Magic Angle Spinning 1H NMR Spectroscopy.

    PubMed

    Mun, Je-Ho; Lee, Heonho; Yoon, Dahye; Kim, Byung-Soo; Kim, Moon-Bum; Kim, Shukmann

    2016-01-01

    High-resolution magic angle spinning nuclear magnetic resonance (HR-MAS NMR) spectroscopy is a useful tool for investigating the metabolism of various cancers. Basal cell carcinoma (BCC) is the most common skin cancer. However, to our knowledge, data on metabolic profiling of BCC have not been reported in the literature. The objective of the present study was to investigate the metabolic profiling of cutaneous BCC using HR-MAS (1)H NMR spectroscopy. HR-MAS (1)H NMR spectroscopy was used to analyze the metabolite profile and metabolite intensity of histopathologically confirmed BCC tissues and normal skin tissue (NST) samples. The metabolic intensity normalized to the total spectral intensities in BCC and NST was compared, and multivariate analysis was performed with orthogonal partial least-squares discriminant analysis (OPLS-DA). P values < 0.05 were considered statistically significant. Univariate analysis revealed 9 metabolites that showed statistically significant difference between BCC and NST. In multivariate analysis, the OPLS-DA models built with the HR-MAS NMR metabolic profiles revealed a clear separation of BCC from NST. The receiver operating characteristic curve generated from the results revealed an excellent discrimination of BCC from NST with an area under the curve (AUC) value of 0.961. The present study demonstrated that the metabolite profile and metabolite intensity differ between BCC and NST, and that HR-MAS (1)H NMR spectroscopy can be a valuable tool in the diagnosis of BCC.

  8. Discrimination of Basal Cell Carcinoma from Normal Skin Tissue Using High-Resolution Magic Angle Spinning 1H NMR Spectroscopy

    PubMed Central

    Mun, Je-Ho; Lee, Heonho; Yoon, Dahye; Kim, Byung-Soo; Kim, Moon-Bum; Kim, Shukmann

    2016-01-01

    High-resolution magic angle spinning nuclear magnetic resonance (HR-MAS NMR) spectroscopy is a useful tool for investigating the metabolism of various cancers. Basal cell carcinoma (BCC) is the most common skin cancer. However, to our knowledge, data on metabolic profiling of BCC have not been reported in the literature. The objective of the present study was to investigate the metabolic profiling of cutaneous BCC using HR-MAS 1H NMR spectroscopy. HR-MAS 1H NMR spectroscopy was used to analyze the metabolite profile and metabolite intensity of histopathologically confirmed BCC tissues and normal skin tissue (NST) samples. The metabolic intensity normalized to the total spectral intensities in BCC and NST was compared, and multivariate analysis was performed with orthogonal partial least-squares discriminant analysis (OPLS-DA). P values < 0.05 were considered statistically significant. Univariate analysis revealed 9 metabolites that showed statistically significant difference between BCC and NST. In multivariate analysis, the OPLS-DA models built with the HR-MAS NMR metabolic profiles revealed a clear separation of BCC from NST. The receiver operating characteristic curve generated from the results revealed an excellent discrimination of BCC from NST with an area under the curve (AUC) value of 0.961. The present study demonstrated that the metabolite profile and metabolite intensity differ between BCC and NST, and that HR-MAS 1H NMR spectroscopy can be a valuable tool in the diagnosis of BCC. PMID:26934749

  9. Joint effects of citrus peel use and black tea intake on the risk of squamous cell carcinoma of the skin

    PubMed Central

    Hakim, Iman A; Harris, Robin B

    2001-01-01

    Background Differences in tea drinking habits and/or citrus peel use are likely to vary by populations and could contribute to the inconsistencies found between studies comparing their consumption and cancer risk. Methods A population-based case-control study was used to evaluate the relationships between citrus peel use and black tea intake and squamous cell carcinoma (SCC) of the skin. Moreover, we assessed the independent and interactive effects of citrus peel and black tea in the development of SCC. Results Hot and iced teas were consumed by 30.7% and 51.8% of the subjects, respectively. Peel consumption was reported by 34.5% of subjects. Controls were more likely than were cases to report citrus peel use (odds ratio (OR) = 0.67) and hot tea intake (OR = 0.79). After adjustment for hot and iced tea intake, the ORs associated with citrus peel use were 0.55 and 0.69, respectively, whereas the corresponding adjusted ORs for hot and iced tea intake after adjustment for citrus peel use were 0.87 and 1.22 respectively. Compared with those who did not consume hot black tea or citrus peel, the adjusted ORs associated with sole consumption of hot black tea or citrus peel were 0.60 and 0.30, respectively. Subjects who reported consumption of both hot black tea and citrus peel had a significant marked decrease (OR= 0.22; 95% CI = 0.10 – 0.51) risk of skin SCC. Conclusion These results indicate that both citrus peel use and strong (hot) black tea have independent potential protective effects in relation to skin SCC. PMID:11527506

  10. Comparison of EMA,CEA, CD10 and Bcl-2 Biomarkers by Immunohistochemistry in Squamous Cell Carcinoma and Basal Cell Carcinoma of the Skin.

    PubMed

    Ramezani, Mazaher; Mohamadzaheri, Elham; Khazaei, Sedigheh; Najafi, Farid; Vaisi-Raygani, Asad; Rahbar, Mahtab; Sadeghi, Masoud

    2016-01-01

    Basal and squamous cell carcinoma (BCC and SCC) are the most common skin cancers worldwide and distinction between the two may sometimes be very difficult in routine histopathology. The present study was aimed to evaluate a reliable diagnostic method for these cancers based on immunohistochemistry (IHC). IHC was used with antibodies to Bcl-2, CD10, CEA, and EMA biomarkers, which despite non-specificity are easily available for detection of various types of tumors in pathology sections and can be used as a panel for differentiation. In this descriptive and analytic study, paraffin- embedded blocks of 29 SCC patients and 29 BCC patients were collected and sectioned for IHC staining. The results were analyzed by the STATA (version 8) statistical package using the Chi-square test. BCC patients were 100%, 75.8%, 0% and 0% positive for Bcl-2, CD10, CEA and EMA markers, respectively, and for SCC patients were 3.5%, 0%, 34.5% and 82.7% positive, respectively. Using simultaneously Bcl-2 and CD10 as positive markers, detection of BCC with 88% accuracy and 100% specificity was possible, while application of CEA and EMA positivity could detect SCC with 67% accuracy and 100% specificity. SCC and BCC have different immunostaining profiles; therefore, Bcl-2, CD10, CEA and EMA markers can be helpful to distinguish between them.

  11. Lymphoepithelioma-Like Carcinoma of the Skin Treated with Wide Local Excision and Chemoradiation Therapy: A Case Report and Review of the Literature

    PubMed Central

    Gille, Theresa M.; Miles, Edward F.; Mitchell, Allen O.

    2012-01-01

    Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare cutaneous neoplasm microscopically similar to undifferentiated nasopharyngeal carcinoma. It is typically nonaggressive and is treated with wide local excision. However, we present a case of a patient with a regional recurrence and more aggressive LELCS with perineural invasion and positive margins for which he was treated with wide local excision followed by chemoradiation. We discuss the use of chemoradiation for this patient and review the literature, specifically pertaining to treatment of more aggressive cases of LELCS. PMID:23133769

  12. Two-port laparoscopic adnexal surgery with a multichannel port using a wound retractor: is it safe and minimally scarring?

    PubMed

    Yi, Sang-Wook

    2009-12-01

    This study aimed to explore and evaluate the feasibility and safety of laparoscopic adnexal surgery using a two-port technique with a multichannel port, using a wound retractor, as previously reported. A series of patients undergoing two-port laparoscopy for a benign pelvic mass were enrolled in this study. To perform two-port laparoscopic surgery, the ancillary 5-mm trocar was inserted at the left iliac fossa under laparoscopic view after umbilical trocar insertion. The inserted umbilical trocar was removed and the skin incision was extended about 1.5 cm with index-finger-passable width. An Alexis wound retractor XS (Applied Medical, Santa Rancha Margarita, CA) was inserted through the umbilical wound. Two trocars were inserted into two fingers of a no. 6 surgical rubber glove and ligated with rubber bands. The wrist portion of the rubber glove covered the wound retractor, and the edge of the wound retractor was clamped with three Babcock clamps to prevent carbon-dioxide gas leakage. Both a 10-mm laparoscope and atraumatic forceps were inserted through the umbilical multichannel port. Laparoscopic adnexal surgery was performed in the usual manner. A total of 19 patients were enrolled. The operative procedures were adnexectomy (n = 8), myomectomy (n = 1), and ovarian cystectomy and/or salpingectomy (n = 10). There were no operative complications, conversion to laparotomy, or additional trocar insertions. The mean operation time was 81.3 +/- 28.7 min. The pathologic diagnosis were mature cystic teratoma (n = 6), benign cyst (n = 4), endometrial cyst (n = 3), serous cystadenoma (n = 3), mucinous cystadenoma (n = 1), leiomyoma (n = 1), and tubo-ovarian abscess (n = 1). The mean postoperative hospital stay was 4.0 +/- 1.3 days. This two-port method seems to be safe and needs no additional cost from the use of the conventional laparoscopic instruments. It is also cosmetically effective and highly appreciated by patients, leaving minimal abdominal scarring.

  13. Targeting PI3K-AKT-mTOR by LY3023414 inhibits human skin squamous cell carcinoma cell growth in vitro and in vivo.

    PubMed

    Zou, Ying; Ge, Minggai; Wang, Xuemin

    2017-08-19

    Abnormal activation of PI3K-AKT-mTOR signaling is detected in human skin squamous cell carcinoma (SCC). LY3023414 is a novel, potent, and orally bio-available PI3K-AKT-mTOR inhibitor. Its activity against human skin SCC cells was tested. We demonstrated that LY3023414 was cytotoxic when added to established (A431 line) and primary (patient-derived) human skin SCC cells. LY3023414 induced G0/1-S arrest and inhibited proliferation of skin SCC cells. Moreover, LY3023414 induced activation of caspase-3/-9 and apoptosis in skin SCC cells. Intriguingly, LY3023414 was yet non-cytotoxic nor pro-apoptotic to normal human skin cells (melanocytes, keratinocytes and fibroblasts). At the molecular level, LY3023414 blocked PI3K-AKT-mTOR activation in skin SCC cells, as it dephosphorylated PI3K-AKT-mTOR substrates: P85, AKT and S6K1. In vivo studies showed that oral administration of LY3023414 at well-tolerated doses inhibited A431 xenograft tumor growth in severe combined immunodeficiency (SCID) mice. AKT-mTOR activation in LY3023414-treated tumors was also largely inhibited. Together, these results suggest that targeting PI3K-AKT-mTOR by LY3023414 inhibits human skin SCC cell growth in vitro and in vivo, establishing the rationale for further clinical testing. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. A case of squamous cell carcinoma of the skin due to the molecularly confirmed Lynch Syndrome.

    PubMed

    Sorscher, Steven

    2015-01-01

    Patients with Lynch Syndrome are at high risk for developing a variety of cancers including cancers of the colon or rectum, small bowel, stomach, uterus, renal pelvis, ureter, biliary tract, ovaries, brain and pancreas (N Engl J Med 348: 919-32, 2003; Gut 57:1097-101, 2008; NCCN, Inc Guideline. Ft. Washington, PA. Online Version 2.2014). Lack of MLH-1 and MSH-2 expression commonly result from germline mutations in this inherited cancer syndrome. Here, we report the case of a patient with a molecularly confirmed germline mutation in MLH-1 along with a colon cancer showing lack of expression of MLH-1 as well as a squamous cell cancer of the skin from the abdominal wall also demonstrating lack of expression of MLH-1. This case appears to represent the second case report of a squamous cell skin cancer apparently due to the Lynch Syndrome and further supports a proposed relationship between Lynch Syndrome and these tumors.

  15. Identification of human skin from a tissue fragment by detection of squamous cell carcinoma-related antigen using an enzyme immunoassay.

    PubMed

    Kitao, T; Miyaishi, S; Yamamoto, Y; Ishizu, H

    1996-12-02

    A new method of identifying human skin from a tissue fragment by detection of squamous cell carcinoma-related (SCC) antigen, using an enzyme immunoassay, was developed. When an extract was prepared from 0.1 g human skin homogenized with 1 ml of phosphate buffered saline, this method was able to detect SCC antigen in extracts diluted 10(2)-fold. There was no difference in the detection limit between individuals. Species specificity was good, and there was no cross reaction observed with skins from animals. Our method could also discriminate between skin and other organs or tissues, except for esophagus and lung. A practical case to which this method was applied is presented.

  16. Management of high-risk squamous cell carcinoma of the skin.

    PubMed

    Samarasinghe, Venura; Madan, Vishal; Lear, John T

    2011-05-01

    Cutaneous squamous cell cancer (SCC) is the second most common skin cancer, accounting for one-fifth of all cutaneous malignancies. The majority arise on the head and neck skin, and cumulative UV exposure is thought to be the most likely etiological factor. The majority of deaths from SCC occur in a high-risk subgroup of patients. This high-risk subgroup of patients can be identified as those with tumors greater than 2 cm in diameter; tumor thickness over 4 mm; moderately/poorly differentiated or desmoplastic histological SCC subtype; ear, lip, hand, feet or genital tumor site; presence of perineural or lymphovascular invasion; nodal metastasis at presentation; recurrent SCC; SCC arising from scars or chronic skin disease, for example, chronic ulcers; and SCC arising in immunosuppressed patients. It is important to identify and aggressively treat these patients, as high-risk SCC are associated with a greater mortality and morbidity. This article reviews the diagnosis and management of such high-risk SCC.

  17. Consensus for nonmelanoma skin cancer treatment: basal cell carcinoma, including a cost analysis of treatment methods.

    PubMed

    Kauvar, Arielle N B; Cronin, Terrence; Roenigk, Randall; Hruza, George; Bennett, Richard

    2015-05-01

    Basal cell carcinoma (BCC) is the most common cancer in the US population affecting approximately 2.8 million people per year. Basal cell carcinomas are usually slow-growing and rarely metastasize, but they do cause localized tissue destruction, compromised function, and cosmetic disfigurement. To provide clinicians with guidelines for the management of BCC based on evidence from a comprehensive literature review, and consensus among the authors. An extensive review of the medical literature was conducted to evaluate the optimal treatment methods for cutaneous BCC, taking into consideration cure rates, recurrence rates, aesthetic and functional outcomes, and cost-effectiveness of the procedures. Surgical approaches provide the best outcomes for BCCs. Mohs micrographic surgery provides the highest cure rates while maximizing tissue preservation, maintenance of function, and cosmesis. Mohs micrographic surgery is an efficient and cost-effective procedure and remains the treatment of choice for high-risk BCCs and for those in cosmetically sensitive locations. Nonsurgical modalities may be used for low-risk BCCs when surgery is contraindicated or impractical, but the cure rates are lower.

  18. Comparison of Local Recurrence After Simple and Skin-Sparing Mastectomy Performed in Patients with Ductal Carcinoma In Situ.

    PubMed

    Timbrell, Simon; Al-Himdani, Sarah; Shaw, Oliver; Tan, Kian; Morris, Julie; Bundred, Nigel

    2017-04-01

    The incidence of ductal carcinoma in situ (DCIS) is increasing with the use of screening mammography, and approximately 30% of all women diagnosed with DCIS are treated by mastectomy. There is increasing use of a skin-sparing mastectomy (SSM) approach to surgically excise DCIS as this facilitates immediate breast reconstruction. The rates of locoregional recurrence (LRR) after simple mastectomy performed for pure DCIS are historically reported as 1%; however, international data suggest that LRR after SSM may be higher. To determine our rates of LRR and compare the effect of the type of mastectomy performed, we undertook a retrospective review of all patients who underwent a mastectomy for pure DCIS at our institution between 2000 and 2010. In total, 199 patients underwent a mastectomy for pure DCIS (with eight local recurrences), all of which were invasive ductal carcinoma. The recurrences all occurred after SSM, which was associated with a higher 5-year LRR of 5.9% (5/102) compared with 0% in the simple mastectomy group (0/97; p = 0.012), log-rank. Univariate analysis showed the two factors that predicted the risk of recurrence were a young age at mastectomy and close or involved margins. These data highlight the importance of achieving clear margins, especially in young women with estrogen receptor-negative DCIS who have a higher risk of invasive recurrence. Women undergoing a mastectomy for DCIS should be counseled as to the importance of achieving clear margins and the potential increased need for further excision, post-mastectomy radiotherapy and post-reconstruction mammography in order to prevent LRR after SSM.

  19. Recommendations for Solid Organ Transplantation for Transplant Candidates With a Pretransplant Diagnosis of Cutaneous Squamous Cell Carcinoma, Merkel Cell Carcinoma and Melanoma: A Consensus Opinion From the International Transplant Skin Cancer Collaborative (ITSCC).

    PubMed

    Zwald, F; Leitenberger, J; Zeitouni, N; Soon, S; Brewer, J; Arron, S; Bordeaux, J; Chung, C; Abdelmalek, M; Billingsley, E; Vidimos, A; Stasko, T

    2016-02-01

    Advancements in solid organ transplantation successfully extend the lives of thousands of patients annually. The tenet of organ stewardship aims to prevent the futile expenditure of scarce donor organs in patient populations with high mortality risk, to the detriment of potential recipients with greater predicted life expectancy. The development of skin cancer posttransplantation portends tremendous morbidity, adversely affecting quality of life for many transplant recipients. This special article, provided by of members of the International Transplant Skin Cancer Collaborative (ITSCC), will provide the transplant professional with a consensus opinion and recommendations as to an appropriate wait period pretransplantation for transplant candidates with a history of either cutaneous squamous cell carcinoma, malignant melanoma, or Merkel cell carcinoma.

  20. Total nasal prosthesis after resection of a recurrence of skin carcinoma on a forehead flap in a post-rhinectomy site.

    PubMed

    Benech, Arnaldo; Arcuri, Francesco; Nicolotti, Matteo; Crespi, Maria Cristina; Pia, Francesco

    2012-11-01

    The nose is the most common site for facial skin cancer; nonmelanoma skin cancers are the most common tumors of this region. Median and paramedian forehead flaps have been proposed for nasal defects greater than 2.5-3 cm in diameter. The aim of this study was to describe a peculiar case of a recurrence of a squamous cell carcinoma in a forehead flap of a post-rhinectomy site managed by a fabrication of a total nasal prosthesis as salvage procedure. To the best of our knowledge, this is the first reported case in the scientific literature of a recurrence of a squamous cell carcinoma in a forehead flap of a post-rhinectomy site; this peculiar clinical report adds knowledge in the complex field of nasal reconstruction.

  1. Dose evaluation for skin and organ in hepatocellular carcinoma during angiographic procedure

    PubMed Central

    2013-01-01

    Purpose The purpose of this study is to evaluate the radiation dose in patients undergoing liver angiographic procedure and verify the usefulness of different dose measurements to prevent deterministic effects. Gafchromic film, MicroMOSFET data and DIAMENTOR device of the X-ray system were used to characterize the examined interventional radiology (IR) procedure. Materials and methods A liver embolization procedure, the SIRT (Selective Internal Radiation Therapy), was investigated. The exposure parameters from the DIAMENTOR as well as patient and geometrical data were registered. Entrance skin dose map obtained using Gafchromic film (ESDGAF) in a standard phantom as well as in 12 patients were used to calculate the maximum skin dose (MSDGAF). MicroMOSFETs were used to assess ESD in relevant points/areas. Moreover, the maximum value of five MicroMOSFETs array, due to the extension of treated area and to the relative distance of 2–3 cm of two adjacent MicroMOSFETs, was useful to predict the MSD without interfering with the clinical practice. PCXMC vers.1.5 was used to calculate effective dose (E) and equivalent dose (H). Results The mean dose-area product (DAPDIAMENTOR) for SIRT procedures was 166 Gycm2, although a wide range was observed. The mean MSDGAF for SIRT procedures was 1090 mGy, although a wide range was experienced. A correlation was found between the MSDGAF measured on a patient and the DAPDIAMENTOR value for liver embolizations. MOSFET and Gafchromic data were in agreement within 5% in homogeneous area and within 20% in high dose gradient regions. The mean equivalent dose in critical organs was 89.8 mSv for kidneys, 22.9 mSv for pancreas, 20.2 mSv for small intestine and 21.0 mSv for spleen. Whereas the mean E was 3.7 mSv (range: 0.5-13.7). Conclusions Gafchromic films result useful to study patient exposure and determine localization and amplitude of high dose skin areas to better predict the skin injuries. Then, DAPDIAMENTOR or MOSFET data

  2. Skin-to-tumor Distance Predicts Treatment Failure of T1A Renal Cell Carcinoma Following Percutaneous Cryoablation.

    PubMed

    Vernez, Simone L; Okhunov, Zhamshid; Kaler, Kamaljot; Youssef, Ramy F; Dutta, Rahul; Palvanov, Arkadiy; Shah, Paras; Osann, Kathryn; Siegel, David N; Lobko, Igor; Kavoussi, Louis; Clayman, Ralph V; Landman, Jaime

    2017-06-23

    To determine the impact of skin-to-tumor (STT) distance on the risk for treatment failure following percutaneous cryoablation (PCA). We retrospectively reviewed patients who underwent PCA with documented T1a recurrent renal cell carcinoma (RCC) at 2 academic centers between 2005 and 2015. Patient demographics, tumor characteristics, and perioperative and postoperative course variables were collected. Additionally, we measured the STT distance by averaging the distance from the skin to the center of the tumor at 0°, 45°, and 90° on preoperative computed tomography imaging. We identified 86 patients with documented T1a RCC. The mean age at the time of surgery was 69 years (range: 37-91 years), and the mean tumor size was 2.7 cm (range: 1.0-4.0 cm). With a mean follow-up of 24 months (range: 3-63 months), 11 (12.8%) treatment failures occurred. Patients with treatment failure had significantly higher mean STT distance than those without: 11.0 cm (range: 6.3-20.1 cm) compared to 8.4 cm (range: 4.4-15.2 cm), respectively (P = .002). STT distance was an independent predictor of treatment failure (odds ratio: 1.32, 95% confidence interval: 1.04-1.69, P = .029). STT distance greater than 10 cm had a fourfold increased risk of tumor treatment failure (odds ratio: 4.43, 95% confidence interval: 1.19-16.39, P = .018). Tumor size, R.E.N.A.L. Nephrometry score, and number of cryoprobes placed were not associated with treatment failure. STT, an easily measured preoperative variable, may inform the risk of RCC treatment failure following PCA. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Fatty acid composition of red blood cell membranes and risk of squamous cell carcinoma of the skin.

    PubMed

    Harris, Robin B; Foote, Janet A; Hakim, Iman A; Bronson, Dan L; Alberts, David S

    2005-04-01

    Differential effects of fatty acids on carcinogenesis suggest that fatty acid composition is important in tumor development. Arachidonic acid and its metabolites elicit inflammation and promote tumor formation in mouse skin. Inhibitors of the arachidonic cascade inhibit tumor incidence. A population-based case control study in Southeastern Arizona tested the hypothesis that lower levels of arachidonic acid in RBC membranes were associated with decreased risk of skin squamous cell carcinoma (SCC; n = 335 SCC cases and 321 controls). Extracted and esterified RBC fatty acids were analyzed using capillary gas chromatography. Individual peaks for 14 fatty acids were measured as a percentage of total fatty acids. Logistic regression was used to estimate odds ratios (OR), adjusting for SCC risk factors (age, gender, actinic keratosis history, freckling, and tanning ability). Increased levels of arachidonic acid in RBC membranes were associated with increased risk of SCC [odds ratio (OR), 1.08 per mg/100 mL change; 95% confidence interval (95% CI), 1.02-1.15] and this association remained when controls with actinic keratosis precursor lesions were excluded. SCC risk was highest among the upper quartile of arachidonic acid (OR, 2.38; 95% CI, 1.37-4.12). In contrast, increasing proportions of palmitic acid (OR, 0.94; 95% CI, 0.89-1.00) and palmitoleicacid (OR, 0.49; 95% CI, 0.30-0.81) were associated with reduced SCC risk. More studies are needed to elucidate the function of RBC fatty acids so that recommendations can be made to alter the human diet for cancer prevention.

  4. A case report of Muir-Torre syndrome in a woman with breast cancer and MSI-Low skin squamous cell carcinoma.

    PubMed

    Kientz, Caroline; Joly, Marie-Odile; Faivre, Laurence; Clemenson, Alix; Dalac, Sophie; Lepage, Côme; Chapusot, Caroline; Jacquot, Caroline; Schiappa, Renaud; Lebrun, Marine

    2017-01-01

    The tumor spectrum in the Lynch syndrome is well defined, comprising an increased risk of developing colonic and extracolonic malignancies. Muir-Torre syndrome is a variant with a higher risk of skin disease. Patients have been described carrying mutations in the mismatch repair genes and presenting tumors with unusual histology or affected organ not part of the Lynch syndrome spectrum. Hence, the real link between Lynch syndrome, or Muir-Torre syndrome, and these tumors remains difficult to assess. We present the case of a 45-year-old-woman, diagnosed with breast cancer at 39 years of age and skin squamous cell carcinoma (SCC) at 41 years of age, without personal history of colorectal cancer. The microsatellite instability analysis performed on the skin SCC showed a low-level of microsatellite instability (MSI-Low). The immunohistochemical expression analysis of the four DNA mismatch repair proteins MLH1, MSH2, MSH6 and PMS2 showed a partial loss of the expression of MSH2 and MSH6 proteins. Germline deletion was found in MSH2 gene (c.1277-? _1661 + ?del), exon 8 to 10. Then, at 45 years of age, she presented hyperplastic polyps of the colon and a sebaceous adenoma. Squamous cell carcinomas have been described in Lynch syndrome and Muir-Torre syndrome in two studies and two case reports. This new case further supports a possible relationship between Lynch syndrome and squamous cell carcinoma.

  5. Determination of the maximal carcinoma/normal skin ratio after HpD or m-THPC administration in Hairless mice (SKH-1) by fluorescence spectroscopy.

    PubMed

    Bossu, E; Padilla-Ybarra, J J; Notter, D; Vigneron, C; Guillemin, F

    2000-02-01

    The two major steps in our study on the treatment of skin carcinomas by photochemotherapy (PCT) were the development of a skin tumor model in Hairless mice by a chemical carcinogenesis and the use of fluorescence spectroscopy, a semi-quantitative and non-invasive method, in order to determine the time after i.p. injection of photosensitizer when the tumor/normal skin ratio was the highest. A three-step carcinogenesis protocol provided mice bearing carcinomas and these were used to determine the tumor/normal skin ratios of two photosensitizers by fluorescence spectroscopy. Hematoporphyrin derivative (HpD) (5 mg/kg body weight) and m-tetra(hydroxyphenyl) chlorine (m-THPC) (0.3 mg/kg body weight) were injected i.p., and fluorescence was measured at 1, 4, 8, 12, 24, 48, 72 and 96 h after injection. The best carcinoma/normal skin ratio would be 3.2+/-1.4 for HpD and 2.7+/-2.1 for m-THPC, respectively. The delays required to reach these ratios were 72 h for HpD and 24 h for m-THPC. These results have to be considered with caution due to the high SEs and they must be confirmed by organic extraction. Photodynamic therapy with the same doses of HpD and m-THPC used in this pharmacokinetic study has to be carried out in order to compare the toxicities of the two photosensitizers and to determine which one is the best for this type of tumor.

  6. RalA Function in Dermal Fibroblasts is Required for the Progression of Squamous Cell Carcinoma of the Skin

    PubMed Central

    Sowalsky, Adam G.; Alt-Holland, Addy; Shamis, Yulia; Garlick, Jonathan A.; Feig, Larry A.

    2011-01-01

    A large body of evidence has shown that stromal cells play a significant role in determining the fate of neighboring tumor cells through the secretion of various cytokines. How cytokine secretion by stromal cells is regulated in this context is poorly understood. In this study, we used a bioengineered human tissue model of skin squamous cell carcinoma progression to reveal that RalA function in dermal fibroblasts is required for tumor progression of neighboring neoplastic keratinocytes. This conclusion is based on the observations that suppression of RalA expression in dermal fibroblasts blocked tumorigenic keratinocytes from invading into the dermal compartment of engineered tissues, and suppressed more advanced tumor progression after these tissues were transplanted onto the dorsum of mice. RalA executes this tumor-promoting function of dermal fibroblasts, at least in part, by mediating HGF secretion through its effector proteins, the Sec5 and Exo84 subunits of the exocyst complex. These findings reveal a new level of HGF regulation and highlight the RalA signaling cascade in dermal fibroblasts as a potential anti-cancer target. PMID:21159665

  7. Risk factors for sorafenib-induced high-grade skin rash in Japanese patients with advanced renal cell carcinoma.

    PubMed

    Tsuchiya, Norihiko; Narita, Shintaro; Inoue, Takamitsu; Hasunuma, Naoko; Numakura, Kazuyuki; Horikawa, Yohei; Satoh, Shigeru; Notoya, Takeshi; Fujishima, Naohito; Hatakeyama, Shingo; Ohyama, Chikara; Habuchi, Tomonori

    2013-03-01

    The aim of this study was to evaluate the clinical factors, drug-related genetic polymorphisms, and human leukocyte antigen (HLA) types to determine the association with sorafenib-induced high-grade skin rash (HGSR) in Japanese patients with advanced renal cell carcinoma (RCC). A total of 55 patients with advanced RCC treated with sorafenib were analyzed retrospectively. Of these, 33 patients were subjected to HLA typing and polymorphism analyses of CYP3A5, ABCB1, ABCC2, and UGT1A1, which are involved in the metabolism and membrane transport of sorafenib. Grade 3 or higher SR developed in 12 (22%), and a higher incidence was observed in female patients than in male patients (40 vs. 15%, P=0.046). The initial dose, initial dose per body weight, and initial dose per body surface area in patients with HGSR were significantly higher than those in patients without HGSR. Patients with the ABCC2 -24CC genotype were at a significantly higher risk of SR than those with the CT genotype (35 vs. 0%, P=0.032). HLA-A*24 was significantly associated with the occurrence of HGSR (P=0.049). Our finding suggested that women, higher initial dose per body weight or body surface area, the ABCC2 -24CC genotype, and HLA-A*24 are associated with the risk of sorafenib-induced HGSR in Japanese RCC patients.

  8. Cutaneous Human Papillomavirus Infection and Development of Subsequent Squamous Cell Carcinoma of the Skin

    PubMed Central

    Reed, Rhianna A.; Bezalel, Spencer; Cameron, Michael; Cherpelis, Basil; Fenske, Neil; Sondak, Vernon K.; Messina, Jane; Tommasino, Massimo; Gheit, Tarik; Rollison, Dana E.

    2016-01-01

    The role of cutaneous human papillomavirus (HPV) infection in the development of subsequent cutaneous squamous cell carcinoma (SCC) is unknown. Pathologically confirmed cases of SCC (n = 150) enrolled in a previously conducted case-control study were included in a retrospective cohort study to examine the association of cutaneous HPV at the time of SCC diagnosis with the risk of subsequent SCC development. Data on HPV seropositivity, HPV DNA in eyebrow hairs (EB) and SCC tumors were available from the parent study. Incidence of subsequent SCC was estimated using person-years of follow up. Cox Proportional Hazards ratios were estimated to evaluate the associations of both, HPV seropositivity and HPV DNA positivity with subsequent SCC. The five year cumulative incidence of subsequent SCC was 72%. Seropositivity to cutaneous HPV was not associated with the risk of subsequent SCC (HR = 0.83, 95% CI = 0.41–1.67). Any beta HPV infection in EB was associated with reduced risk (HR = 0.30, 95% CI = 0.11–0.78) of subsequent SCC among cases who were positive for beta HPV DNA in tumor tissue. Infection with beta HPV type 2 (HR = 0.32, 95% CI = 0.12–0.86) in EB was associated with reduced risk of subsequent SCC among HPV DNA positive SCCs. In conclusion, beta HPV infection was inversely associated with the risk of subsequent SCC. PMID:27891253

  9. Sports-related eye and adnexal injuries in the Western Australian paediatric population.

    PubMed

    Hoskin, Annette K; Yardley, Anne-Marie E; Hanman, Kate; Lam, Geoffrey; Mackey, David A

    2016-09-01

    To identify the causes of sports-related eye and adnexal injuries in children in Perth, Western Australia, to determine which sporting activities pose the highest risk of eye and adnexal injury to children. We performed a 12-year retrospective review of children admitted to hospital from 2002 to 2013 with sports-related ocular and adnexal eye injuries. The main outcome measures were the cause and type of ocular and adnexal injuries, age and gender risk factors. A total of 93 cases of sports-related ocular and adnexal injury were identified in the 12-year time period. A peak in injuries occurred for 12- to 14-year-olds with a second peak in 6- to 8-year-olds; the median age was 8.82 years (range = 1.59-16.47). Cycling, football (including soccer and Australian Rules Football), tennis, trampolining, fishing and swimming were the sports responsible for the greatest number of injuries, a total of 63%. More than one-third (35%) of injuries resulted from being struck by a blunt object, and more than a quarter (26%) were as a result of contact with a blunt projectile. Serious ocular and adnexal injuries have occurred in children as a result of participating in sports, with cycling and football being the largest contributors in the 12-year period we assessed. As we continue to encourage children to spend more time participating in sports and recreational activities, identifying associated risk factors will help us develop injury prevention strategies to promote eye safety for children. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. Computed tomography adnexal mass score to estimate risk for ovarian cancer.

    PubMed

    Santoso, Joseph T; Robinson, Aimee; Suganda, Sri; Praservit, Sirinya; Wan, Jim Y; Ueland, Fred

    2014-03-01

    We wish to develop a CT scan-based scoring system which estimates the probability of adnexal mass malignancy. Patients (324) undergoing adnexal mass surgery were recruited into the study from June 1, 2002, to January 1, 2009. All study patients had a preoperative CT scan and serum CA-125 test. CT scan abnormalities included any solid tumor components, ascites, and pelvic or abdominal lymphadenopathy and omental caking. There were 225 (70%) benign and 99 (30%) malignant ovarian masses. Using logistic regression with the area under the curve of the receiver operating curve of 82%, the cancer probability was determined by the equation. e(-3.6372+0.0306*(A)+0.001*(C)+1.551*(D)+1.7377*(E)+2.76*(F)) / 1+e(-3.6372+0.0306*(A)+0.001*(B)+0.876*(C)+1.551*(D)+1.7377*(E)+2.76*(F)) where A = age, B = CA-125, C = solid adnexal mass is 1 and cystic is 0, D = ascites is 1, E = omental caking is 1 and absence is 0, F = node size ≥1 cm is 1 and <1 cm is 0 value. The natural logarithm e is a constant [2.718281828]. For example, for a woman of age 60, CA-125 = 50 U/mL, with solid adnexal mass, ascites, omental caking, and lymphadenopathy, the probability is 0.994. Hence, this woman has a 99.4% probability of having cancer. The computed tomography adnexal mass score combines CT scan findings, CA-125, and patient age into an equation to predict the malignant probability of an adnexal mass.

  11. Trends in incidence and survival analysis in non-melanoma skin cancer from 1994 to 2012 in Girona, Spain: A population-based study.

    PubMed

    Rubió-Casadevall, J; Hernandez-Pujol, A M; Ferreira-Santos, M C; Morey-Esteve, G; Vilardell, L; Osca-Gelis, G; Vilar-Coromina, N; Marcos-Gragera, R

    2016-12-01

    We present an epidemiological study focused on Non-melanoma skin cancers (NMSC), including squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Merkel cell carcinoma (MCC), dermatofibrosarcoma protuberans (DFS) and adnexal and skin appendages neoplasm (ASAN), a neoplasm understudied in cancer registries. We analyze trends of incidence and survival of NMSC registered with the Cancer Registry of Girona, Spain. We found 14389 cases of NMSC, accounting 3,474 SCC, 10729 BCC, 33 MCC, 61 DFSP and 71 ASAN. Incidence increased significantly in SCC and BCC with annual percentage of change of 1.6 and 1.5, respectively, but not in MCC, DFS or ASAN. Five-year relative survival for both sexes was 90.1% in SCC, 99.8% in BCC, 44.2% in MCC, 93.7% in DFS and 84% in ASAN. Our study confirms the increasing incidence and good survival of SCC and BCC and enhances knowledge on the epidemiology of the less incidental NMSC. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Initial basal cell carcinomas diagnosed in the National Campaign for Skin Cancer Prevention are smaller than those identified by the conventional medical referral system*

    PubMed Central

    Wakiyama, Thweicyka Pinheiro; França, Maria Laura Marconi; Carvalho, Larissa Pierri; Marques, Mariangela Esther Alencar; Miot, Hélio Amante; Schmitt, Juliano Vilaverde

    2017-01-01

    BACKGROUND Basal cell carcinoma is the malignant tumor most often diagnosed in the National Campaign for Skin Cancer Prevention (NCSCP). Little is known about the profile of these lesions compared to the profile of lesions diagnosed by conventional routes of public dermatological care. OBJECTIVE To identify if basal cell carcinomas identified in prevention campaigns and referred to surgery are smaller than those routinely removed in a same medical institution. METHODS Cross-sectional study including tumors routed from 2011-2014 campaigns and 84 anatomopathological reports of outpatients. RESULTS The campaigns identified 223 individuals with suspicious lesions among 2,531 examinations (9%), with 116 basal cell carcinomas removed. Anatomopathological examinations revealed that the primary lesions identified in the national campaigns were smaller than those referred to surgery by the conventional routes of public health care (28 [13-50] x 38 [20-113] mm2, p <0.01). On the other hand, after a mean follow-up of 15.6 ± 10.3 months, 31% of cases identified in campaigns showed new basal cell carcinoma lesions. STUDY LIMITATIONS Retrospective study and inaccuracies in the measurements of the lesions. CONCLUSIONS The NCSCP promotes an earlier treatment of basal cell carcinomas compared to patients referred to surgery by the conventional routes of public health care, which can result in lower morbidity rates and better prognosis. PMID:28225952

  13. Low-Grade Appendiceal Mucinous Neoplasm Presenting as an Adnexal Mass

    PubMed Central

    Panagopoulos, P.; Domi, V.; Christodoulaki, C.; Sioutis, D.; Papantoniou, N.

    2017-01-01

    Appendiceal tumors are rare, late diagnosed neoplasms that may not be differentiated from adnexal masses even by advanced imaging methods and other diagnostic procedures. They may be asymptomatic and remain undiagnosed until surgery. We report a case of an 80-year-old postmenopausal woman presenting with a pelvic mass and a history of weight loss. The patient underwent laparotomy which revealed an appendiceal mucocele, for which she received a full oncological procedure. The histology report showed a low-grade appendiceal mucinous neoplasm, and the patient underwent six cycles of chemotherapy. Appendiceal tumors should be kept in mind in patients with adnexal mass. PMID:28286683

  14. Management of pediatric and adolescent adnexal masses by gasless laparoendoscopic single-site surgery.

    PubMed

    Takeda, Akihiro; Imoto, Sanae; Nakamura, Hiromi

    2014-10-01

    To evaluate the safety and feasibility of gasless transumbilical laparoendoscopic single-site (LESS) surgery for the management of adnexal masses in pediatric and adolescent girls aged 19 years or younger. Retrospective study of 28 pediatric and adolescent girls each undergoing gasless LESS surgery and gasless multiport laparoscopic surgery for adnexal masses. In each case, laparoscopic surgery was performed by the abdominal-wall lift method under endotracheal general anesthesia. The two groups were compared for their patient demographics and surgical outcome measures. In the LESS surgery group, median age of the patients including three pre-menarcheal girls was 17.5 years. The most common symptom was abdominal pain. Median tumor diameter in the LESS surgery group was 7.4cm. There were no statistical differences in clinical features between LESS surgery and multiport laparoscopic surgery groups. In the LESS surgery group, adnexal masses were managed by unilateral cystectomy (n=20), unilateral salpingo-oophorectomy (n=5), bilateral cystectomy (n=2), and unilateral salpingectomy (n=1). Emergency LESS surgery was performed for seven cases due to adnexal torsion and one case due to cyst rupture. Preservation of affected ovary was not achieved in three emergency cases with adnexal torsion due to severe necrosis, and in one case each of recurrent mucinous cystadenoma and huge mucinous cystadenoma. In 24 adnexal masses from 22 girls who received adnexal cystectomy by LESS surgery, LESS-assisted extracorporeal cystectomy, was possible in 14 masses while intracorporeal cystectomy was required in other 10. In a case of dermoid cyst managed by LESS-assisted extracorporeal cystectomy, additional hemostasis was required by intracorporeal suturing due to laceration of utero-ovarian ligament. Median-excised tissue weight in the LESS surgery group was 111g. Significant differences between LESS surgery and multiport laparoscopic surgery groups were not noted in surgical outcomes

  15. The expression of miR-124 increases in aged skin to cause cell senescence and it decreases in squamous cell carcinoma.

    PubMed

    Harada, Miho; Jinnin, Masatoshi; Wang, Zhongzhi; Hirano, Ayaka; Tomizawa, Yukiko; Kira, Tomomi; Igata, Toshikatsu; Masuguchi, Shinichi; Fukushima, Satoshi; Ihn, Hironobu

    2017-01-16

    Skin senescence is induced by various factors including intrinsic aging and extrinsic aging. The current study compared the expression of microRNAs in young facial skin and senescent facial skin, and this study identified skin aging-related microRNAs. According to the results from a microRNA PCR Array, miR-124 was the microRNA that increased the most in senescent skin compared to young skin. Real-time PCR with a greater number of samples indicated that the increase in miR-124 levels in senescent facial skin was statistically significant. In situ hybridization was performed, and results indicated that the signal for miR-124 was evident in keratinocytes of senescent skin but not in those of young skin. The morphology of cultured normal human epidermal keratinocytes (NHEKs) transfected with a miR-124 mimic changed to an enlarged and irregular shape. In addition, the number of NHEKs positive for senescence-associated β-galactosidase (SA-β-gal) increased significantly as a result of the overexpression of the miR-124 mimic. The expression of miR-124 increased in UVB-irradiated NHEKs compared to controls in a dose-dependent manner. Expression of miR-124 in A431, a human cutaneous squamous cell carcinoma (SCC) cell line, decreased significantly compared to that in NHEKs. Forced overexpression of miR-124 as a result of the transfection of a miR-124 mimic in A431 resulted in the significant suppression of the proportion of cancer cells. The current results indicated that miR-124 increases as a result of cell senescence and that it decreases during tumorigenesis. The effect of supplementation of miR-124 in an SCC cell line suggests that senescence induction therapy with microRNA may be a new therapeutic approach for treatment of SCC.

  16. Classification of basal cell carcinoma in human skin using machine learning and quantitative features captured by polarization sensitive optical coherence tomography

    PubMed Central

    Marvdashti, Tahereh; Duan, Lian; Aasi, Sumaira Z.; Tang, Jean Y.; Ellerbee Bowden, Audrey K.

    2016-01-01

    We report the first fully automated detection of basal cell carcinoma (BCC), the most commonly occurring type of skin cancer, in human skin using polarization-sensitive optical coherence tomography (PS-OCT). Our proposed automated procedure entails building a machine-learning based classifier by extracting image features from the two complementary image contrasts offered by PS-OCT, intensity and phase retardation (PR), and selecting a subset of features that yields a classifier with the highest accuracy. Our classifier achieved 95.4% sensitivity and specificity, validated by leave-one-patient-out cross validation (LOPOCV), in detecting BCC in human skin samples collected from 42 patients. Moreover, we show the superiority of our classifier over the best possible classifier based on features extracted from intensity-only data, which demonstrates the significance of PR data in detecting BCC. PMID:27699133

  17. Classification of basal cell carcinoma in human skin using machine learning and quantitative features captured by polarization sensitive optical coherence tomography.

    PubMed

    Marvdashti, Tahereh; Duan, Lian; Aasi, Sumaira Z; Tang, Jean Y; Ellerbee Bowden, Audrey K

    2016-09-01

    We report the first fully automated detection of basal cell carcinoma (BCC), the most commonly occurring type of skin cancer, in human skin using polarization-sensitive optical coherence tomography (PS-OCT). Our proposed automated procedure entails building a machine-learning based classifier by extracting image features from the two complementary image contrasts offered by PS-OCT, intensity and phase retardation (PR), and selecting a subset of features that yields a classifier with the highest accuracy. Our classifier achieved 95.4% sensitivity and specificity, validated by leave-one-patient-out cross validation (LOPOCV), in detecting BCC in human skin samples collected from 42 patients. Moreover, we show the superiority of our classifier over the best possible classifier based on features extracted from intensity-only data, which demonstrates the significance of PR data in detecting BCC.

  18. Functional Protein Pathway Activation Mapping of the Progression of Normal Skin to Squamous Cell Carcinoma

    PubMed Central

    Einspahr, Janine G.; Calvert, Valerie; Alberts, David S.; Curiel-Lewandrowski, Clara; Warneke, James; Krouse, Robert; Stratton, Steven P; Liotta, Lance; Longo, Caterina; Pellicani, Giovanni; Prasad, Anil; Sagerman, Paul; Bermudez, Yira; Deng, Jianghong; Bowden, G. Timothy; Petricoin, Emanuel F.

    2012-01-01

    Reverse Phase Protein Microarray analysis was used to identify cell-signaling derangements in squamous cell carcinoma (SCC) compared to actinic keratosis (AK) and upper inner arm (UIA). We analyzed 2 independent tissue sets with isolation and enrichment of epithelial cells by Laser Capture Microdissection. Set 1 served as a pilot and a means to identify protein pathway activation alterations that could be further validated in a second independent set. Set 1 was comprised of 4 AK, 13 SCC, and 20 UIA. Set 2 included 15 AK, 9 SCC and 20 UIA. Activation of 51 signaling proteins known to be involved in tumorigenesis were assessed for set 1 and demonstrated the MEK-ERK pathway was activated in SCC compared to AK and UIA, that EGFR and mTOR pathways were aberrantly activated in SCC. Unsupervised two-way hierarchical clustering revealed that AK and UIA shared a common signaling network activation architecture while SCC was dramatically different. Statistical analysis found that pro-survival signaling through phosphorylation of ASK and 4EBP1 as well as increased Bax and Bak expression was higher in AK compared to UIA. We expanded pathway network activation mapping in Set 2 to 101 key signaling proteins, which corroborated activation of MEK-ERK, EGFR, and mTOR pathways through discovery of a number of upstream, and downstream signaling molecules within these pathways to conclude that SCC is indeed a pathway activation-driven disease. Pathway activation mapping of SCC compared to AK revealed several interconnected networks that could be targeted with drug therapy for potential chemoprevention and therapeutic applications. PMID:22389437

  19. Functional protein pathway activation mapping of the progression of normal skin to squamous cell carcinoma.

    PubMed

    Einspahr, Janine G; Calvert, Valerie; Alberts, David S; Curiel-Lewandrowski, Clara; Warneke, James; Krouse, Robert; Stratton, Steven P; Liotta, Lance; Longo, Caterina; Pellacani, Giovanni; Pellicani, Giovanni; Prasad, Anil; Sagerman, Paul; Bermudez, Yira; Deng, Jianghong; Bowden, G Timothy; Petricoin, Emanuel F

    2012-03-01

    Reverse phase protein microarray analysis was used to identify cell signaling derangements in squamous cell carcinoma (SCC) compared with actinic keratosis (AK) and upper inner arm (UIA). We analyzed two independent tissue sets with isolation and enrichment of epithelial cells by laser capture microdissection. Set 1 served as a pilot and a means to identify protein pathway activation alterations that could be further validated in a second independent set. Set 1 was comprised of 4 AK, 13 SCC, and 20 UIA. Set 2 included 15 AK, 9 SCCs, and 20 UIAs. Activation of 51 signaling proteins, known to be involved in tumorigenesis, were assessed for set 1 and showed that the MEK-ERK [mitogen-activated protein (MAP)/extracellular signal-regulated (ERK; MEK)] pathway was activated in SCC compared with AK and UIA, and that epidermal growth factor receptor (EGFR) and mTOR pathways were aberrantly activated in SCC. Unsupervised two-way hierarchical clustering revealed that AK and UIA shared a common signaling network activation architecture while SCC was dramatically different. Statistical analysis found that prosurvival signaling through phosphorylation of ASK and 4EBP1 as well as increased Bax and Bak expression was higher in AK compared with UIA. We expanded pathway network activation mapping in set 2 to 101 key signaling proteins, which corroborated activation of MEK-ERK, EGFR, and mTOR pathways through discovery of a number of upstream and downstream signaling molecules within these pathways to conclude that SCC is indeed a pathway activation-driven disease. Pathway activation mapping of SCC compared with AK revealed several interconnected networks that could be targeted with drug therapy for potential chemoprevention and therapeutic applications.

  20. Intake of high-fat diet stimulates the risk of ultraviolet radiation-induced skin tumors and malignant progression of papillomas to carcinoma in SKH-1 hairless mice

    SciTech Connect

    Vaid, Mudit; Singh, Tripti; Prasad, Ram; Katiyar, Santosh K.

    2014-01-01

    Previously, we showed that administration of a high-fat diet (HF-diet) to C57BL/6 mice exacerbates their response to short-term UVB radiation-induced inflammation in the skin. To explore the effects of an HF-diet on UVB-induced tumorigenesis, we have used the SKH-1 hairless mouse model in which the mice are exposed to UVB radiation (180 mJ/cm{sup 2}) three times a week for 24 weeks. The development of UVB-induced skin tumors was rapid and the tumor multiplicity and tumor size were significantly higher (P < 0.01–0.005) in the mice fed an HF-diet than the mice fed a control-diet (C-diet). Moreover, the malignant progression of UVB-induced papillomas to carcinomas was higher in HF-diet-fed mice. On analysis of tumors and tumor-uninvolved skin samples from the tumor-bearing mice, we found that administration of an HF-diet significantly enhanced the levels of UVB-induced expression of cyclooxygenase-2 (COX-2), prostaglandin E{sub 2} (P < 0.01), and PGE{sub 2} receptors, and activation of NF-κB in the UVB-exposed skin as well as in tumors. In addition the HF-diet enhanced the expression of proinflammatory cytokines, including tumor necrosis factor-α (P < 0.01), interleukin (IL)-1β (P < 0.01) and IL-6 (P < 0.05) in the UVB-exposed skin as well as in tumors. Western blot analysis revealed that HF-diet enhanced the levels of epidermal cell proliferation, phosphatidylinositol 3-kinase and phosphorylation of Akt at Ser{sup 473} in UVB-exposed skin and skin tumors. Collectively, these data demonstrate that the regular consumption of an HF-diet increases the risk of photocarcinogenesis in mice and that this is associated with enhanced expression of inflammatory mediators in the UVB-exposed skin and tumors. - Highlights: • Consumption of high-fat diet increases UVB-induced skin tumor development in mice. • Intake of high-fat diet stimulates progression of UV-induced papilloma to carcinoma. • Intake of high-fat diet enhances inflammation in UV-exposed skin • Regular

  1. Low-dose Methotrexate Enhances Aminolevulinate-based Photodynamic Therapy in Skin Carcinoma Cells In-vitro and In-vivo

    PubMed Central

    Anand, Sanjay; Honari, Golara; Hasan, Tayyaba; Elson, Paul; Maytin, Edward V.

    2009-01-01

    Purpose To improve treatment efficacy and tumor cell selectivity of δ-aminolevulinic acid (ALA)-based photodynamic therapy (PDT), via pretreatment of cells and tumors with methotrexate (MTX) to enhance intracellular photosensitizer levels. Experimental Design Skin carcinoma cells, in-vitro and in-vivo, served as the model system. Cultured human SCC13 and HEK1 cells, normal keratinocytes, and in-vivo skin tumor models (see below) were preconditioned with MTX for 72 h, then incubated with ALA for 4 h. Changes in PpIX levels and in cell survival after light exposure were assessed. Results MTX-preconditioning of monolayer cultures preferentially raised intracellular PpIX levels 2- to 4-fold in carcinoma cells versus normal keratinocytes. Photodynamic killing was synergistically enhanced by the combined therapy, compared to PDT alone. MTX enhancement of PpIX levels was achieved over a broad MTX concentration range (0.0003 – 1.0 mg/L; 0.6 nM – 2 mM). PpIX enhancement correlated with changes in protein expression of key porphyrin pathway enzymes, i.e. ~4-fold increase in coproporphyrinogen oxidase, and stable or slightly decreased expression of ferrochelatase. Differentiation markers (E-cadherin, involucrin, filaggrin) were also selectively induced by MTX in carcinoma cells. In-vivo relevance was established by showing that MTX preconditioning enhances PpIX accumulation in three models: (1) organotypic cultures of immortalized keratinocytes; (2) chemically-induced skin tumors in mice; and (3) human A431 squamous cell tumors implanted subcutaneously in mice. Conclusion Combination therapy using short-term exposure to low-dose MTX followed by ALA-PDT should be further investigated as a new combination modality to enhance efficacy and selectivity of PDT for epithelial carcinomas. PMID:19447864

  2. Surgical treatment of basal cell carcinoma and squamous cell carcinoma.

    PubMed

    Gualdi, G; Monari, P; Apalla, Z; Lallas, A

    2015-08-01

    Non melanoma skin cancers (NMSC) are the most common human neoplasms, encompassing basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), but also cutaneous lymphomas, adnexal tumors, merckel cell carcinoma and other rare tumors. The incidence of BCC and SCC varies significantly among different populations, and the overall incidence of both tumors has increased over the last decades. Although generally associated with a favorable prognosis, recent evidence suggests that the mortality rates of SCC might have been underestimated up-to-date.1 According to Medicare data, NMSC is the fifth most expensive cancer for health care systems. This increased economic burden is not associated with the cost of treating an individual patient, but with the large number of affected patients and the recurrence rates.2 Therefore, the adequate management of the primary tumor with a complete excision becomes a priority not only for the patient but also for the public health systems. Multiple treatment modalities are currently usedin clinicalpractice for the treatment of NMSC. While surgical excision (SE) remains the gold standard of care, non-surgical techniques have gained appreciation due to lower morbidity and better cosmetic results. The optimal management of treatment includes a complete tumor clearance, preservation of the normal tissue function, and the best possible cosmetic outcome.3 Surgery with a predefined excision margin is the treatment of choice for most NMSCs, with Mohs micrographic surgery being recommended for tumors considered to be at a higher recurrence risk or those developing on cosmetically sensitive areas.4, 5 Therefore, the surgical approach of a NMSC consists with three different and equally important steps. First the preoperative clinical assessment of the tumor margins, which can be facilitated by the use of dermoscopy. Second, the definition of the surgical margins depending on the tumor subtype and its biological behavior. Finally, the surgical

  3. Differences in the peritumoural inflammatory skin infiltrate between squamous cell carcinomas in organ transplant recipients and immunocompetent patients.

    PubMed

    Krynitz, Britta; Lundh Rozell, Barbro; Lindelöf, Bernt

    2010-07-01

    Organ transplant recipients (OTR) have a greatly increased risk (up to 100 times) of developing squamous cell carcinomas (SCC) in the skin. This is attributed specifically to chronic immunosuppression, causing dysfunctional viral defence and tumour protection. To investigate the possible link between increasing risk of SCCs and type of inflammation in these tumour-prone patients, we analysed the peritumoural infiltrates with regard to cell types and densities. Seven SCCs from immunosuppressed OTR and 14 SCCs from immunocompetent patients were immun-histochemically stained for CD3, CD4, CD8, CD56, CD20, CD138, CD14, CD68, CD1a. Cell counts were performed with the aid of computer-based image analysis of > 100,000 cells. When comparing the percentage distributions, significant differences were detected (outlined as median values (min-max)): T cells (CD3+): OTR 57% (35-78), controls 68% (48-80), p = 0.036; plasma cells (CD138+): OTR 2% (0.7-7), controls 0.2% (0-1.2), p = 0.001; mono-cytes (CD14+): OTR 3.2% (1.1-5.6), controls 9.3% (2.2-17.2), p = 0.014. Surprisingly, no differences in cell densities, i.e. cells/mm2 tumour section area, were detected between the 2 groups. In conclusion, we found that the peritumoural infiltrates in immunosuppressed compared with immunocompetent patients differ in cellular composition, inferring a more tumour-submissive environment in OTR. However, cellular densities were equal, suggesting deviating cellular functionality in OTR.

  4. 76 FR 82129 - Medical Devices; Ovarian Adnexal Mass Assessment Score Test System; Labeling; Black Box Restrictions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ..., or as a test to determine whether or not to proceed with surgery. DATES: Effective Date: January 30... likelihood that an adnexal pelvic mass in a woman for whom surgery is planned, is malignant. The test is for... identification of patients whose gynecologic surgery requires oncology expertise and resources. B....

  5. Adnexal masses in the pregnant patient: a diagnostic and management challenge.

    PubMed

    Glanc, Phyllis; Salem, Shia; Farine, Dan

    2008-12-01

    Ultrasound is a valuable diagnostic tool, which can be used to stratify pregnant women with adnexal masses into a conservative management protocol versus those that require further diagnostic and management decisions. Familiarity with the natural history and sonographic features of common adnexal lesions, such as simple cysts, hemorrhagic cysts, endometriomas, mature cystic teratomas, and ovarian conditions specific to pregnancy, may permit stratification of patients into management protocols. The goal of ultrasound evaluation in the pregnant patient with an adnexal mass is to identify those patients in whom conservative management is appropriate versus those who require more immediate interventions such as surgery. The risk of surgical interventions needs to be balanced against the potential risks of nonintervention, which may include torsion, rupture, hemorrhage, or the rare spread of a malignant cancer. Atypical features or persistent large lesions should initiate a multidisciplinary team approach to optimize diagnostic and management strategy. Acute symptoms may precipitate emergency intervention at any point in the pregnancy. We will present a diagnostic and management algorithm based on clinical symptoms, timing of detection, natural history, and sonographic features of adnexal masses in pregnancy.

  6. 76 FR 22322 - Medical Devices; Immunology and Microbiology Devices; Classification of Ovarian Adnexal Mass...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 866 Medical Devices; Immunology and Microbiology Devices; Classification of Ovarian Adnexal Mass Assessment Score Test System; Correction AGENCY: Food and...

  7. Single port access laparoscopic surgery for large adnexal tumors: Initial 51 cases of a single institute

    PubMed Central

    Cho, Bo Ra; Han, Jae Won; Kim, Tae Hyun; Han, Ae Ra; Hur, Sung Eun; Lee, Sung Ki

    2017-01-01

    Objective Investigation of initial 51 cases of single port access (SPA) laparoscopic surgery for large adnexal tumors and evaluation of safety and feasibility of the surgical technique. Methods We retrospectively reviewed the medical records of the first 51 patients who received SPA laparoscopic surgery for large adnexal tumors greater than 10 cm, from July 2010 to February 2015. Results SPA adnexal surgeries were successfully completed in 51 patients (100%). The mean age, body mass index of the patients were 43.1 years and 22.83 kg/m2, respectively. The median operative time, median blood loss were 73.5 (range, 20 to 185) minutes, 54 (range, 5 to 500) mL, and the median tumor diameter was 13.6 (range, 10 to 30) cm. The procedures included bilateral salpingo-oophorectomy (n=18, 36.0%), unilateral salpingo-oophorectomy (n=14, 27.45%), and paratubal cystectomy (n=1, 1.96%). There were no cases of malignancy and none were insertion of additional ports or conversion to laparotomy. The cases with intraoperative spillage were 3 (5.88%) and benign cystic tumors. No other intraoperative and postoperative complications were observed during hospital days and 6-weeks follow-up period after discharge. Conclusion Our results suggest that SPA laparoscopic surgery for large adnexal tumors may be a safe and feasible alternative to conventional laparoscopic surgery. PMID:28217669

  8. Aberrant upregulation of MUC4 mucin expression in cutaneous condyloma acuminatum and squamous cell carcinoma suggests a potential role in the diagnosis and therapy of skin diseases

    PubMed Central

    Chakraborty, Subhankar; Swanson, Benjamin J; Bonthu, Neelima; Batra, Surinder K

    2010-01-01

    Aim Mucins comprise a family of high-molecular-weight glycoproteins. MUC4, a large transmembrane mucin, has recently emerged as a novel marker for diagnosis, prognosis and therapy in several malignancies. However, its role in skin pathologies remains unknown. The aim of this study was to analyse the expression of MUC4 in cutaneous pathologies by immunohistochemistry for potential diagnostic, prognostic and therapeutic applications. Methods A total of 330 tissue spots representing the normal skin, and benign and malignant cutaneous diseases, were analysed after staining with the monoclonal antibody to human MUC4 (clone 8G7). Results While the normal epidermis showed a negative to weak-positive expression of MUC4, its expression was significantly upregulated in squamous cell carcinomas (SCCs) where the intensity of staining correlated negatively with tumour grade and positively with age. A moderately strong MUC4 expression was also noted in 2/20 cancer adjacent normal skin and 2/21 chronically inflamed skin tissues, while 10/19 cases of vulval condyloma acuminate, 3/12 of vulval hyperplasia and 2 cases of verruca vulgaris also showed strong MUC4 positivity. Malignant melanoma, basal cell carcinoma and cutaneous cysts were negative. Conclusion The results indicate that MUC4 expression is aberrantly upregulated in cutaneous SCCs, vulval condylomas and verruca vulgaris. Further, it appears that MUC4 expression in the skin may be modulated by chronic inflammation and the presence of an adjacent cutaneous malignancy in certain cases. These observations suggest a novel role for MUC4 mucin in the pathogenesis of cutaneous SCC and a possible application as a diagnostic and/or prognostic marker in cutaneous pathologies. PMID:20591909

  9. [Basal cell carcinoma of the skin--biological behaviour of the tumor and a review of the most important molecular predictors of disease progression in pathological practice].

    PubMed

    Bartos, V; Adamicová, K; Kullová, M; Péc, M

    2011-01-01

    Basal cell carcinoma of the skin is currently the most frequent malignancy in human population. Basal cell carcinoma represents a heterogeneous group of tumors with a variable clinical and morphological picture. Based on its biological behaviour, we generally differentiate between indolent (superficial and nodular) and aggressive type (infiltrative, micronodular, and metatypical) of basal cell carcinoma. Because of the different biological characteristics of these tumors, it is questionable whether they are a part of a continuous spectrum of carcinogenesis, starting with indolent and ending with aggressive forms, or they represent separate developmental lines. In the current clinical practice, there is an increasing demand for identification of tumors that are prognostically more adverse and their impact on the overall health status of patients is more serious. Recent advances in pathology and molecular medicine allow identification of various biomarkers from tumor tissue that are significantly involved in the mechanisms of malignant cell transformation. Detection of these biomarkers is of great importance in predicting further clinical behaviour of the cancer. The authors of the paper present basic information about biological behaviour of cutaneous basal cell carcinoma and provide an overview of the most important biomarkers that influence the clinical outcome and disease progression and are detectable through a routine biopsy tissue examination. It is now necessary to search for novel histological and molecular parameters that, in the future, could have a prognostic value in diagnostic and therapeutic process of this disorder.

  10. Strict Criteria for Selection of Laparoscopy for Women with Adnexal Mass

    PubMed Central

    Sallum, Luis Felipe; Sarian, Luis Otávio; Bastos, Joana Fróes Bragança; Derchain, Sophie

    2014-01-01

    Objectives: We compared the indication of laparoscopy for treatment of adnexal masses based on the risk scores and tumor diameters with the indication based on gynecology-oncologists' experience. Methods: This was a prospective study of 174 women who underwent surgery for adnexal tumors (116 laparotomies, 58 laparoscopies). The surgeries begun and completed by laparoscopy, with benign pathologic diagnosis, were considered successful. Laparoscopic surgeries that required conversion to laparotomy, led to a malignant diagnosis, or facilitated cyst rupture were considered failures. Two groups were defined for laparoscopy indication: (1) absence of American College of Obstetrics and Gynecology (ACOG) guideline for referral of high-risk adnexal masses criteria (ACOG negative) associated with 3 different tumor sizes (10, 12, and 14 cm); and (2) Index of Risk of Malignancy (IRM) with cutoffs at 100, 200, and 300, associated with the same 3 tumor sizes. Both groups were compared with the indication based on the surgeon's experience to verify whether the selection based on strict rules would improve the rate of successful laparoscopy. Results: ACOG-negative and tumors ≤10 cm and IRM with a cutoff at 300 points and tumors ≤10cm resulted in the same best performance (78% success = 38/49 laparoscopies). However, compared with the results of the gynecology-oncologists' experience, those were not statistically significant. Discussion: The selection of patients with adnexal mass to laparoscopy by the use of the ACOG guideline or IRM associated with tumor diameter had similar performance as the experience of gynecology-oncologists. Both methods are reproducible and easy to apply to all women with adnexal masses and could be used by general gynecologists to select women for laparoscopic surgery; however, referral to a gynecology-oncologist is advisable when there is any doubt. PMID:25392617

  11. Quantitative dynamic contrast-enhanced MR imaging analysis of complex adnexal masses: a preliminary study.

    PubMed

    Thomassin-Naggara, Isabelle; Balvay, Daniel; Aubert, Emilie; Daraï, Emile; Rouzier, Roman; Cuenod, Charles A; Bazot, Marc

    2012-04-01

    To evaluate the ability of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to differentiate malignant from benign adnexal tumours. Fifty-six women with 38 malignant and 18 benign tumours underwent MR imaging before surgery for complex adnexal masses. Microvascular parameters were extracted from high temporal resolution DCE-MRI series, using a pharmacokinetic model in the solid tissue of adnexal tumours. These parameters were tissue blood flow (F(T)), blood volume fraction (Vb), permeability-surface area product (PS), interstitial volume fraction (Ve), lag time (Dt) and area under the enhancing curve (rAUC). Area under the receiver operating curve (AUROC) was calculated as a descriptive tool to assess the overall discrimination of parameters. Malignant tumours displayed higher F(T), Vb, rAUC and lower Ve than benign tumours (P < 0.0001, P = 0.0006, P = 0.04 and P = 0.0002, respectively). F(T) was the most relevant factor for discriminating malignant from benign tumours (AUROC = 0.86). Primary ovarian invasive tumours displayed higher F(T) and shorter Dt than borderline tumours. Malignant adnexal tumours with associated peritoneal carcinomatosis at surgery displayed a shorter Dt than those without peritoneal carcinomatosis at surgery (P = 0.01). Quantitative DCE-MRI is a feasible and accurate technique to differentiate malignant from benign adnexal tumours and could potentially help oncologists with management decisions. Quantitative DCE MR imaging allows accurate differentiation between malignant and benign tumours. Quantitative DCE MRI may help predict peritoneal carcinomatosis associated with ovarian tumors. Quantitative DCE MRI helps distinguish between invasive and borderline primary ovarian tumours.

  12. Effect of Cuscuta chinensis water extract on 7,12-dimethylbenz[a]anthracene-induced skin papillomas and carcinomas in mice.

    PubMed

    Nisa, M; Akbar, S; Tariq, M; Hussain, Z

    1986-10-01

    Cuscuta chinensis, known as Aftimun, is reputed to have antitumour activity in the Unani system of medicine in India. The effect of a hot water extract of C. chinensis on 7,12-dimethylbenz[a]anthracene (DMBA)-induced skin papillomas and carcinomas in Swiss albino mice was studied. Oral administration of the extract (1 g/kg body wt) thrice a week in 22 mice, started on the tenth day after the first application of DMBA to the 252nd day, markedly delayed the appearance and retarded the growth of papillomas and the incidence of carcinoma, relative to a control group with 28 mice, in a two-stage system of tumorigenesis. Its prophylactic effect was found to be statistically significant.

  13. Giant extraocular sebaceous carcinoma: case report and a brief review of a literature.

    PubMed

    Torres, José Saulo; Amorim, Ana Cristina; Hercules, Flavio Marcondes; Kac, Bernard Kawa

    2012-11-15

    Extraocular sebaceous carcinoma (ESC) is a rare, aggressive malignant tumor that originates from the adnexal epithelium of the sebaceous gland. We present herein one of the largest cases reported in the literature until now. We also review briefly the relevant aspects including clinical presentation, differential diagnosis, histopathological features, inmunohistochemical profile, and therapeutic options.

  14. Validation of a diagnostic algorithm for the discrimination of actinic keratosis from normal skin and squamous cell carcinoma by means of high-definition optical coherence tomography.

    PubMed

    Marneffe, Alice; Suppa, Mariano; Miyamoto, Makiko; Del Marmol, Véronique; Boone, Marc

    2016-09-01

    Actinic keratoses (AKs) commonly arise on sun-damaged skin. Visible lesions are often associated with subclinical lesions on surrounding skin, giving rise to field cancerization. To avoid multiple biopsies to diagnose subclinical/early invasive lesions, there is an increasing interest in non-invasive diagnostic tools, such as high-definition optical coherence tomography (HD-OCT). We previously developed a HD-OCT-based diagnostic algorithm for the discrimination of AK from squamous cell carcinoma (SCC) and normal skin. The aim of this study was to test the applicability of HD-OCT for non-invasive discrimination of AK from SCC and normal skin using this algorithm. Three-dimensional (3D) HD-OCT images of histopathologically proven AKs and SCCs and images of normal skin were collected. All images were shown in a random sequence to three independent observers with different experience in HD-OCT, blinded to the clinical and histopathological data and with different experience with HD-OCT. Observers classified each image as AK, SCC or normal skin based on the diagnostic algorithm. A total of 106 (38 AKs, 16 SCCs and 52 normal skin sites) HD-OCT images from 71 patients were included. Sensitivity and specificity for the most experienced observer were 81.6% and 92.6% for AK diagnosis and 93.8% and 98.9% for SCC diagnosis. A moderate interobserver agreement was demonstrated. HD-OCT represents a promising technology for the non-invasive diagnosis of AKs. Thanks to its high potential in discriminating SCC from AK, HD-OCT could be used as a relevant tool for second-level examination, increasing diagnostic confidence and sparing patients unnecessary excisions.

  15. Principle component analysis and linear discriminant analysis of multi-spectral autofluorescence imaging data for differentiating basal cell carcinoma and healthy skin

    NASA Astrophysics Data System (ADS)

    Chernomyrdin, Nikita V.; Zaytsev, Kirill I.; Lesnichaya, Anastasiya D.; Kudrin, Konstantin G.; Cherkasova, Olga P.; Kurlov, Vladimir N.; Shikunova, Irina A.; Perchik, Alexei V.; Yurchenko, Stanislav O.; Reshetov, Igor V.

    2016-09-01

    In present paper, an ability to differentiate basal cell carcinoma (BCC) and healthy skin by combining multi-spectral autofluorescence imaging, principle component analysis (PCA), and linear discriminant analysis (LDA) has been demonstrated. For this purpose, the experimental setup, which includes excitation and detection branches, has been assembled. The excitation branch utilizes a mercury arc lamp equipped with a 365-nm narrow-linewidth excitation filter, a beam homogenizer, and a mechanical chopper. The detection branch employs a set of bandpass filters with the central wavelength of spectral transparency of λ = 400, 450, 500, and 550 nm, and a digital camera. The setup has been used to study three samples of freshly excised BCC. PCA and LDA have been implemented to analyze the data of multi-spectral fluorescence imaging. Observed results of this pilot study highlight the advantages of proposed imaging technique for skin cancer diagnosis.

  16. [Relationship between sorafenib-associated hand-food skin reaction and efficacy in treatment of advanced hepatocellular carcinoma].

    PubMed

    Luo, Xiao-ning; Lu, Li-gong; Shao, Pei-jian; Hu, Bao-shan; Li, Yong; Yu, Xian-yi; He, Xu

    2012-04-03

    To investigate the link between the antitumor efficacy of sorafenib and its cutaneous side effects in advanced hepatocellular carcinoma (HCC). We retrospectively analyzed the incidence of hand-foot skin reactions (HFRS) of 51 patients with advanced HCC who treated by sorafenib combined with transcatheter arterial chemoembolization (TACE), comparing tumor disease control rate (DCR), median progression free survival (mPFS) and median overall survival (mOS) in the different severity HFRS groups. The Cox proportional hazard model was applied to the multivariate survival analysis for the PFS. Fifty-one HCC patients treated with sorafenib combined with TACE were included in this study. 13/51 without HFRS (grade 0), 38/51 developed at all grade 1-3, 27 developed at grade 1-2, 11 developed at grade 3. The DCR were 38.5%, 70.4% and 90.9% in the three groups (P < 0.05). Group grade 0 vs grade 1-3, P = 0.031, the difference had statistical significance. Group grade 1-2 vs grade 3, P = 0.352, the difference had no statistical significance. The mPFS were 2.8 months (95%CI 1.6 - 4.0), 4.5 (95%CI 1.3 - 7.7) months and 12.8 (95%CI 3.7 - 21.9) months (P < 0.05), group grade 0 vs grade 1-2, P = 0.019, HR (hazard ratio): 2.8 (95%CI 1.3 - 6.3), P = 0.010, group grade 0 vs grade 3, P < 0.01, HR 6.6 (95%CI 2.3 - 19.0), P < 0.01, group grade 1-2 vs grade 3, P = 0.054; the three groups' mOS were 8.5 months (95%CI 5.9 - 11.1), 13.0 (95%CI 10.1 - 15.9) months and 25.4 months, P < 0.05, there were statistically significant differences between the any two groups. HFRS should be closely monitored in HCC patients treated with sorafenib in relation to its potential role as a surrogate marker of efficacy, but it has yet to be demonstrated whether the efficacy increasing with the severity of HFRS or not.

  17. Photodamage in feline skin: clinical and histomorphometric analysis.

    PubMed

    Almeida, E M P; Caraça, R A; Adam, R L; Souza, E M; Metze, K; Cintra, M L

    2008-05-01

    The purpose of this study was to investigate clinical and histomorphometric features of cat skin under long-term solar exposure. Ear skin of 34 Domestic Shorthair cats that were chronically exposed to sun was classified as follows: group 0, normal (n = 13); group 1, initial stage of photodamage (PD) (n = 10); group 2, advanced stage of PD (n = 11). Histologic sections were examined independently by 2 pathologists, and epidermal thickness, adnexal unit area, and dermal cellularity were assessed by morphometry. A positive correlation was obtained between age, degree of edema and sclerosis in the upper dermis, telangiectases, squamatization of basal keratinocytes, and epidermis thickness and the degree of PD. The area occupied by adnexal structures in the dermis diminished with increased PD. Dermal sclerosis and edema best separated the 3 groups. The results indicated a high level of skin hypersensitivity to sun rays in cats. The findings may be useful for clinical testing and in general veterinary pathology and dermatology.

  18. The prognosis of tumors with only microscopic skin involvement without clinical T4b signs is significantly better than T4b tumors in breast carcinoma.

    PubMed

    Duraker, Nüvit; Batı, Bakır; Caynak, Zeynep Civelek; Demir, Davut; Kurtuluş, Idris

    2011-01-01

    The number of studies forming a base for tumor (T)-node (N)-metastasis (M) classification by comparing T4b tumors with only histological skin involvement in breast carcinoma is limited and results are contradictory. In this study, the survival of patients with T4b tumor and patients whose tumor had only microscopic skin involvement without clinical T4b signs were compared. The file records of 101 patients with T4b tumor (group A) and 79 patients whose tumor had only microscopic skin involvement (group B) were reviewed. The endpoint was disease recurrence. For the whole series, disease-free survival (DFS) of group B patients was significantly better compared with group A patients treated with either adjuvant (p<0.001) or neoadjuvant (p<0.001) therapies. When patients were subgrouped according to tumor size, DFS of group B patients was significantly better than group A patients receiving either adjuvant or neoadjuvant therapy for all tumor size subgroups of ≤3, >3, ≤5, and >5cm. Presence of T4b clinical signs had independent prognostic value in multivariate Cox analysis. In conclusion, tumors with only histological skin involvement without clinical T4b signs should be classified as T1-T3 according to their size instead of T4 as stated in the TNM classification. © 2010 Wiley Periodicals, Inc.

  19. Clinical evaluation of safety and efficacy of Boswellia-based cream for prevention of adjuvant radiotherapy skin damage in mammary carcinoma: a randomized placebo controlled trial.

    PubMed

    Togni, S; Maramaldi, G; Bonetta, A; Giacomelli, L; Di Pierro, F

    2015-04-01

    Acute radiation erythema and other skin reactions are common adverse effects experienced by breast carcinoma patients undergoing radiotherapy treatment. Boswellic acids are pentacyclic triterpenes extracted from the resins of the tropical tree Boswellia serrata with strong anti-inflammatory properties. This study was designed to evaluate the safety and the efficacy of the application of a base cream containing boswellic acids in a proprietary formulation (Bosexil(R)) for the prevention and relief of radiation-induced adverse effects in breast cancer patients. The acute skin reactions were clinically evaluated by visual intensity and computer-assisted skin color analysis, and toxicity was assessed by the Radiation Therapy Oncology Group (RTOG) rating scale. These findings indicate that the use of a boswellia-based cream is effective in reducing the use of topical corticosteroids and is able to reduce the grade of erythema and the skin superficial symptoms, being well tolerated by the patients. Further studies comparing boswellia cream with other topical agents will be appropriate to confirm the effectiveness of this treatment for breast cancer patients under radiation therapy.

  20. The prognostic value of the expression of collagenase IV, cathepsin D and metallothionein in squamous cell carcinomas of the skin determined by immunohistochemistry.

    PubMed

    Goldmann, T; Moorkamp, A; Wiedorn, K H; Suter, L; Otto, F

    2001-03-01

    We analyzed 53 specimens from primary squamous cell carcinomas of the skin for the expression of collagenase IV, cathepsin D and metallothionein by means of immunohistochemistry along with histological data. We compared tumors that metastasized (30) with tumors that did not (23) during a follow-up period of at least 5 years. The expression of the two proteolytic enzymes cathepsin D and collagenase IV was also assessed at the invading front of the tumors. Statistical analyses revealed significant differences for the overall expression of cathepsin D (P < 0.05), expression of cathepsin at the invading front (P < 0.05) and the tumor thickness (P < 0.01). The results showed that cathepsin D may be a prognostic factor for squamous cell carcinomas of the skin. We then combined the results of parameters with statistically significant differences by multiplication. The prognostic value of such a combined risk-factor score showed higher confidence than any of the single parameters alone: a sensitivity of 63.3%, a specificity of 87.0% and an efficiency of 73.6%. This kind of combined risk-factor score might be used to more accurately detect patients at high risk of metastasis.

  1. Comparison of risk patterns in carcinoma and melanoma of the skin in men: a multi-centre case–case–control study

    PubMed Central

    Zanetti, R; Rosso, S; Martinez, C; Nieto, A; Miranda, A; Mercier, M; Loria, D I; Østerlind, A; Greinert, R; Navarro, C; Fabbrocini, G; Barbera, C; Sancho-Garnier, H; Gafà, L; Chiarugi, A; Mossotti, R

    2006-01-01

    We directly compared risk factors between 214 histologically confirmed melanomas (CMM), 215 basal-cell carcinomas (BCC) and 139 squamous-cell carcinomas (SCC) in a multiple case–case–control study with 349 controls from patients without dermatological disease admitted to the same hospitals. Subjects with fair hair had a significant risk increase for all types of tumours at a comparable level (ORadj for blonde hair: CMM 2.3; SCC 2.4; BCC 2.3). The effect of pale eyes was significant and similar for CMM and BCC (ORadj 2.6). Intermittent sun exposure measured in hours spent at beach during holidays was significant for both CMM (ORadj 2.6 for more than 7000 lifelong hours) and BCC (ORadj 2.1 for more than 7000 lifelong hours), while SCC exhibited a significant risk increase for chronic exposure to sunlight measured in hours of outdoor work (ORadj 2.2 for more than 6000 lifelong hours). In the case–case comparison using a multinomial logistic regression model, we found a statistically significant risk difference for pale eyes, and number of naevi in the CMM group, compared to other skin cancers. For intermittent sun exposure, there was a significant risk difference of BCC when compared to the risk of SCC. Factors influencing risk of SCC are different, with chronic exposure to sun playing a major role in causing this type of carcinoma. PMID:16495934

  2. Radiation therapy of carcinomas of the skin of nose and nasal vestibule: a report of 1676 cases by the Groupe Europeen de Curiethérapie.

    PubMed

    Mazeron, J J; Chassagne, D; Crook, J; Bachelot, F; Brochet, F; Brune, D; Brunin, F; Bunescu, U; Daly, N; Danczak, S

    1988-11-01

    A retrospective multicentric analysis of the results of irradiation of 1676 carcinomas of the skin of the nose and nasal vestibule was performed by the Groupe Européen de Curiethérapie (Tunis, May 1986). Overall local control was 93% with a minimum follow-up of 2 years. Local control is dependent on the tumor size (diameter less than 2 cm: 96%, 2-3.9 cm: 88%, greater than or equal to 4 cm: 81%), and tumor site (external surface of the nose: 94%, vestibule: 75%). Local control was independent of histology for smaller tumors, but for those larger than 4 cm, basal cell carcinomas were more frequently controlled than squamous cell carcinomas. Recurrent tumors are less frequently controlled than those being treated for the first time (88 vs. 95%). There were few complications and cosmetic results were generally satisfactory. The results of implantation, orthovoltage and megavoltage irradiation are compared with respect to local control, complication rate and cosmesis. Implantation is usually the treatment of choice for vestibular tumors but for those of the external surface the choice depends on the tumor diameter. Implantation and orthovoltage irradiation are equivalent for tumors less than 2 cm. For those from 2 to 3.9 cm, the results of orthovoltage irradiation may be satisfactory in a selected population but implantation is usually more suitable for tumors with rapidly changing contour.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. The occurrence of non-melanoma malignant skin lesions and non-cutaneous squamous-cell carcinoma among metastatic melanoma patients: an observational cohort study in Denmark.

    PubMed

    Li, Haojie; Pedersen, Lars; Nørgaard, Mette; Ulrichsen, Sinna P; Thygesen, Sandra K; Nelson, Jeanenne J

    2016-05-03

    Inhibitors of mutant BRAF are emerging as standard of care in patients with metastatic melanoma who carry relevant oncogenic mutations. However, BRAF inhibitors are found to induce cutaneous squamous cell carcinoma (cuSCC). Population-based background rates of cuSCC and non-cutaneous squamous cell carcinoma (non-cuSCC) in the metastatic melanoma population may contextualize safety signals from randomized clinical trials or the clinics. However, these background rates are lacking. We conducted a historical cohort study to evaluate the background rates of new-onset non-melanoma skin lesions and non-cuSCC among 2,814 metastatic malignant melanoma patients diagnosed in 1997-2010, identified through the Danish Cancer Registry and the National Pathology Registry. Patients were excluded if they had a history of cancer before the metastatic melanoma diagnosis, other than skin cancers. We determined the incidence of non-melanoma malignant skin lesions and non-cuSCC that occurred post metastatic melanoma diagnosis, censoring patients at death, emigration, or December 31, 2011 (end of study period), whichever came first. The median age at metastatic melanoma diagnosis was 64 years. Over 40% of patients died within one year of metastatic diagnosis and ~70% died within 5 years. The percentages of patients with prior history or prevalent disease at metastatic melanoma diagnosis included: 8.6% with cuSCC or basal cell carcinoma (BCC), 3.9% with actinic keratosis (AK), and 0.7% with Bowen's disease. No patients had past or current non-cuSCC per study exclusion criterion. The incidence of non-melanoma skin lesions during the 6 months post-metastatic melanoma diagnosis was as follows: BCC, 1.8% (42.5 per 1000 person-years [PY]); AK, 0.8% (18.6 per 1000 PY); cuSCC, 0.1% (1.7 per 1000 PY); Bowen's disease, 0.04% (0.8 per 1000 PY); and keratoacanthoma (KA), 0%. Non-cuSCC was observed in 3 patients (0.1%; 2.5 per 1000 PY) at 3 sites: bronchi, heart and lung. CuSCC and non-cuSCC were

  4. [Laparoscopic intraoperative differential diagnosis of adnexal tumors. A pilot study of 20 premenopausal patients].

    PubMed

    Grab, D; Kühn, T; Flock, F; Terinde, R

    2000-12-01

    The purpose of the study was to determine the feasibility and potential clinical value of laparoscopic intraoperative sonography in the female genital tract. Intraoperative ultrasound was performed in 20 consecutive premenopausal patients with adnexal masses during laparoscopy using a 7.5 MHz semiflexible transducer. Laparoscopic ultrasound of the female genital tract improves image resolution. Furthermore, this new method allows accurate localisation of early tubal pregnancy and may be helpful if laparoscopic evaluation of the inner genital tract is impaired by severe adhesions. In 7 out of 20 patients, the therapeutical procedure was clearly influenced by the laparoscopic ultrasound findings, resulting in a benefit for the patients in all seven cases. Intraoperative laparoscopic ultrasound may improve minimal invasive management of adnexal masses.

  5. Hyperreactio luteinalis presenting with marked hyperglycemia and bilateral multicystic adnexal masses at 21 weeks gestation.

    PubMed

    Sherer, David M; Dalloul, Mudar; Khoury-Collado, Fady; Hellman, Mira; Osho, Joseph A; Gupta, Roopa S P; Abulafia, Ovadia

    2006-02-01

    We present an unusual case in which a 23-year-old nulliparous patient was noted to have bilateral multicystic adnexal masses at 21 weeks gestation. Subsequent severe nausea, vomiting, and hyperglycemia with a serum glucose level of 450 mg/dL led to the diagnosis of gestational diabetes. Gradual development of marked maternal virilization ensued and was associated with a serum testosterone level of 4030 ng/mL (free testosterone level of 224 pg/mL), with normal serum dehydroepiandrostendione, estriol, and cortisol levels, leading to the diagnosis of hyperreactio luteinalis. Following vaginal delivery at 38 weeks gestation, gradual and complete spontaneous resolution of signs, symptoms, adnexal masses, diabetes, and testosterone levels were documented.

  6. [Clinical significance of arteriovenous shunt malformations in the uterine and adnexal region (author's transl)].

    PubMed

    Szalay, S; Bardach, G; Janisch, H; Leodolter, S

    1979-01-01

    This case report describes and discusses the entity of arteriovenous shunt malformations in the uterine and adnexal region. The diagnostic measurements and clinical importance of this disease is also outlined. The condition is rare, but should be considered in cases of severe hemorrhage when routine investigations have been normal. For the first time bloodgas-analytic measurements showing the extent of the shunting have been performed with such a disease.

  7. [Diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours].

    PubMed

    Treviño-Báez, Joaquín Darío; Cantú-Cruz, Javier Alejandro; Medina-Mercado, Javier; Abundis, Alberto

    2016-01-01

    The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  8. Color Doppler energy prediction of malignancy in adnexal masses using logistic regression models.

    PubMed

    Marret, H; Ecochard, R; Giraudeau, B; Golfier, F; Raudrant, D; Lansac, J

    2002-12-01

    The aim of this study was to assess the usefulness of color Doppler energy in the preoperative diagnosis of ovarian malignancy using multivariate logistic regression analysis. One hundred and thirty adnexal masses were studied with transvaginal B-mode, color energy, and pulsed Doppler ultrasonography before surgery in order to develop a model that could be used to determine malignancy. Each ultrasonographic variable (tumor size, wall thickness, septal structure, echogenicity, papillary projection, density (solid or not)) was included individually or combined together as part of the Sassone ultrasound score. Intratumoral blood flow velocity waveforms were obtained to determine pulsatility index and resistance index and a more subjective parameter, location of tumor vascularity, was also assessed. Menopausal status and serum CA 125 levels were also entered as categorical variables. Sonographic parameters were entered alone, then associated with menopausal status and CA 125 serum levels, and finally with Doppler energy measurements. Our model was then validated in a group of 68 adnexal masses and compared to the model of Alcazar. Eighteen adnexal masses (13.8%) were malignant or of low malignant potential. Multivariate analysis showed that papillary projection of the tumor wall, cyst with solid parts, resistance index with a cut-off value of 0.53, CA 125, and central blood flow location, were the only factors to be independent predictors of malignancy. Menopausal status was not an independent factor. For the final model including the Doppler energy parameter the best sensitivity and specificity were 83% and 93%, respectively, at a cut-off value of 10% probability of malignancy compared to 83% and 87% for the morphological variables alone. Validation of the model showed its diagnostic performance to be as good as that reported in the original population and better than the model of Alcazar. Sonographic analysis of adnexal masses including color Doppler energy shows the

  9. Accuracy of Pelvic Mass Score in Pre-operative Determination of Malignancy in Adnexal Masses

    PubMed Central

    Rao, Arun; Ullal, Sonali; Krishna, Gowtham

    2016-01-01

    Introduction Suspicious adnexal masses are common clinical problems in gynaecological practice. A reliable diagnostic tool for the early detection of the ovarian malignancy is essential. Aim To validate a new scoring system –Pelvic Mass Score (PMS) in predicting the nature of the adnexal mass pre-operatively. Materials and Methods A prospective observational study was carried out in 100 consenting women with an undiagnosed adnexal mass requiring operative intervention. Among them 62 patients had mass with a feeding vessel in which the Doppler velocimetry study values were available. The PMS was determined in these 62 patients. A score of 29 or more was taken as suggestive of malignancy. The results were compared with the histopathological diagnosis to confirm malignancy. The chi-square test was applied to test the significance. Results Among the 62 patients with vascular mass, 31 had histopathological diagnosis of malignancy. The statistical analysis of the data with PMS with 29 as cut-off revealed 100% sensitivity and 100% Negative Predictive Value (NPV) as there was no false negative case detected. But the specificity and Positive Predictive Value (PPV) was poor; 45.2% and 64.6% respectively. Based on the Receiver Operating Characteristic (ROC) curve, if we redefine cut-off as 69, specificity increases to 80.6% with a sensitivity of 90.3%, the PPV and NPV being 82.35 and 89.29 respectively. Conclusion The present study concludes that, in suspicious vascular adnexal masses PMS can be used as a reliable diagnostic score to predict malignancy if we redefine the existing cut-off of 29 to 69. PMID:28050448

  10. Papillomaviral DNA and increased p16CDKN2A protein are frequently present within feline cutaneous squamous cell carcinomas in ultraviolet-protected skin.

    PubMed

    Munday, John S; Gibson, Isobel; French, Adrienne F

    2011-08-01

    Squamous cell carcinomas (SCCs) are common feline skin tumours. While exposure to ultraviolet (UV) light causes some SCCs, a subset develop in UV-protected skin. In cats, papillomaviruses (PVs) cause viral plaques and Bowenoid in situ carcinomas (BISCs). As both may progress to SCC, it was hypothesized that SCCs in UV-protected skin may represent neoplastic transformation of a PV-induced lesion. To investigate this hypothesis, PCR was used to amplify PV DNA from 25 UV-protected and 45 UV-exposed SCCs. Oncogenic human PVs cause neoplasia by mechanisms that also increase p16(CDKN2A) protein (p16). As increased p16 is present in feline viral plaques and BISCs, immunohistochemistry was used to detect p16 within the SCCs. Papillomaviral DNA was amplified from 76% of UV-protected SCCs, but only 42% of UV-exposed SCCs. Increased p16 was present in 84% of UV-protected SCCs, but only 40% of UV-exposed SCCs. The more frequent detection of PV DNA and increased p16 within UV-protected SCCs supports the hypothesis that some develop from a PV-induced plaque or BISC. Felis domesticus PV-2 is thought to cause viral plaques and BISCs. This PV was detected most frequently within the UV-protected SCCs, supporting development from a PV-induced lesion. Increased p16 and PV DNA were less frequent within UV-exposed SCCs, presumably because these developed from actinic keratosis rather than a PV-induced lesion. The results support the hypothesis that some feline cutaneous SCCs are caused by PV infection and suggest that PVs may cause neoplasia by mechanisms that also increase p16.

  11. A meta-analysis of pigmentary characteristics, sun sensitivity, freckling and melanocytic nevi and risk of basal cell carcinoma of the skin.

    PubMed

    Khalesi, Mohammad; Whiteman, David C; Tran, Bich; Kimlin, Michael G; Olsen, Catherine M; Neale, Rachel E

    2013-10-01

    To calculate pooled risk estimates of the association between pigmentary characteristics and basal cell carcinoma (BCC) of the skin. We searched three electronic databases and reviewed the reference lists of the retrieved articles until July 2012 to identify eligible epidemiologic studies. Eligible studies were those published in between 1965 and July 2012 that permitted quantitative assessment of the association between histologically-confirmed BCC and any of the following characteristics: hair colour, eye colour, skin colour, skin phototype, tanning and burning ability, and presence of freckling or melanocytic nevi. We included 29 studies from 2236 initially identified. We calculated summary odds ratios (ORs) using weighted averages of the log OR, using random effects models. We found strongest associations with red hair (OR 2.02; 95% CI: 1.68, 2.44), fair skin colour (OR 2.11; 95% CI: 1.56, 2.86), and having skin that burns and never tans (OR 2.03; 95% CI: 1.73, 2.38). All other factors had weaker but positive associations with BCC, with the exception of freckling of the face in adulthood which showed no association. Although most studies report risk estimates that are in the same direction, there is significant heterogeneity in the size of the estimates. The associations were quite modest and remarkably similar, with ORs between about 1.5 and 2.5 for the highest risk level for each factor. Given the public health impact of BCC, this meta-analysis will make a valuable contribution to our understanding of BCC. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Recurrence rates of basal cell carcinoma of the periocular skin: what to do with patients who have positive margins after resection.

    PubMed

    Jebodhsingh, Kim N; Calafati, Jennifer; Farrokhyar, Forough; Harvey, John T

    2012-04-01

    To determine the recurrence rates of basal cell carcinoma of the periocular skin in patients who were in the following 3 groups after pathologic analysis: Mohs frozen sections (negative margins); permanent sections with positive tumor margins; and permanent sections with negative tumor margins at the time of primary surgical removal. The study is a retrospective chart review. We identified 385 patients who underwent surgery for basal cell carcinoma. The surgery was performed by a single surgeon between January 1, 1995 and January 1, 2005. The patients were divided into 3 groups: (i) Mohs frozen sections with margins negative for tumor; (ii) permanent sections with margins negative for tumor; (iii) permanent sections with margins positive for tumor. The recurrence rates of basal cell carcinoma were compared. The recurrence-free rate was 92% for the group that had had Mohs frozen-section, 87% for the group that had had permanent sections with negative margins, and 80% for the group that had had permanent sections with positive margins at 170 months follow-up time. We found that the only predictor of recurrence rate was younger age (hazards ratio (HR) = 0.97 95%; CI 0.94, 0.99; p = 0.021). The results showed a statistically significant difference in the recurrence-free rate in the 3 groups. A minimum of a 3-year follow-up is recommended in patients who have had basal cell carcinomas removed; the average time to recurrence was approximately 3 years. Copyright © 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  13. [Experience with laparoscopic surgery for adnexal masses at the Regional Hospital of Temuco, Chile].

    PubMed

    Celis, R; Sierralta, P; Valdés, P; Leiva, A; Soto, E

    1999-06-01

    Laparoscopic surgery has clear advantages over open surgical procedures. In gynecology, laparoscopic surgery for adnexal masses in pre or post menopausal women has been used for several years. To report the experience with gynecologic laparoscopic surgery at the Temuco Regional Hospital. Between 1996 and 1998, laparoscopic surgery was done in 96 patients aged 16 to 56 years and open surgery in 56 patients aged 15 to 74 years, with a clinical or ultrasound diagnosis of adnexal masses or ovarian dermoid cysts. The most frequent tumors excised were epithelial and germinal cell. Laparoscopic surgery required a mean operative time of 69.9 min and it had a 3.1% of complications. Women subjected to this type of surgery had a mean hospital stay of 3.1 days and the mean postoperative stay was 2 days. Open surgery required an operative time of 69 min and it had no postoperative complications. The mean hospital stay for women subjected to this type of procedure was 9.5 days. Women subjected to laparoscopic surgical procedures for adnexal masses had a shorter hospital stay than women subjected to open surgical procedures.

  14. Adnexal masses requiring reoperation in women with previous hysterectomy with or without adnexectomy.

    PubMed

    Shiber, Linda-Dalal J; Gregory, Emily J; Gaskins, Jeremy T; Biscette, Shan M

    2016-05-01

    To characterize the etiologies of adnexal masses requiring reoperation in women with prior hysterectomy and to compare incidence and pathology of these masses based upon whether total, partial or no adnexectomy was performed at time of hysterectomy. In addition, the average time interval between hysterectomy and reoperation for a pelvic mass is ascertained. A single-institution, retrospective review spanning 10 years. Using pertinent ICD-9 and CPT codes, women with a history of hysterectomy who underwent a subsequent surgery for an adnexal or pelvic mass were identified. Over ten years, 250 women returned for gynecologic surgery due to a pelvic mass after prior hysterectomy. Most had undergone hysterectomy only (76%). 64.8% of these women had masses of ovarian origin, 12.4% were tubal in origin, 20% of masses involved both the ovary and tube and a small proportion arose from non-gynecologic processes. 18% of these women had a malignancy; 80% were ovarian and 6.7% originated from the fallopian tube. Patients having had a prior hysterectomy and bilateral salpingectomy returned soonest (p<0.0001) and patients with malignant masses returned after the longest time intervals (HR 0.41, p<0.0001). The majority of adnexal masses requiring reoperation after hysterectomy are gynecologic in origin, benign, and arise from the ovary. Women returning with malignant masses after hysterectomy present after longer time intervals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Role of Fine Needle Aspiration Cytology as a Diagnostic Tool in Orbital and Adnexal Lesions

    PubMed Central

    Khan, Lubna; Malukani, Kamal; Malaiya, Siddharth; Yeshwante, Prashant; Ishrat, Saba; Nandedkar, Shirish S.

    2016-01-01

    Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored. PMID:27621787

  16. Laparoscopic surgery for treating adnexal masses during the first trimester of pregnancy

    PubMed Central

    Minig, Lucas; Otaño, Lucas; Cruz, Pilar; Patrono, María Guadalupe; Botazzi, Cecilia; Zapardiel, Ignacio

    2016-01-01

    OBJECTIVE: To evaluate the feasibility and safety of laparoscopic surgery for treating adnexal masses during the first trimester of pregnancy. STUDY DESIGN: An observational study of a prospective collection of data of all pregnant women who underwent laparoscopic surgery for adnexal masses during the first trimester of pregnancy between January 1999 and November 2012 at the Obstetrics and Gynecology Department of the Italian Hospital of Buenos Aires, Buenos Aires, Argentina was performed. RESULTS: A total of 13 women were included. The median (range) gestational age at the moment of surgical procedure was 7 weeks (range: 5-12 weeks). The main indication of surgery was cyst torsion in four cases (30.7%) and rupture of ovarian cysts in four cases (30.7%). Other indications included persistent ovarian cyst in three patients (23%) and heterotopic pregnancy in two cases (15.3%). Neither surgical complications nor spontaneous abortions occurred in any of the cases and the post-operative period was uneventful in all the cases. No cases of intrauterine growth retardation, preterm delivery, congenital defects, or neonatal complications were registered. CONCLUSION: The treatment of complicated adnexal masses by laparoscopic surgery during the first trimester of pregnancy appears to be a safe procedure both for the mother and for the foetus. Additional research on a larger number of cases is still needed to support these conclusions. PMID:26917915

  17. Performance of the Risk of Malignancy Index for Discriminating Malignant Tumors in Women With Adnexal Masses.

    PubMed

    Campos, Camila; Sarian, Luis Otávio; Jales, Rodrigo Menezes; Hartman, Caio; Araújo, Karla Galvão; Pitta, Denise; Yoshida, Adriana; Andrade, Liliana; Derchain, Sophie

    2016-01-01

    We examined the performance of 4 risk of malignancy index (RMI) variants in a medium-resource gynecologic cancer center. A total of 158 women referred for adnexal masses were evaluated before surgery by the 4 RMI variants. Physicians with varied experience in ultrasound assessment of adnexal masses performed ultrasound examinations. We compared the performance of the 4 RMI variants using receiver operating characteristic curve analyses followed by calculation of sensitivity, specificity, and positive and negative likelihood ratios using the pathologic diagnosis of the masses as the reference standard. Among the 158 women with adnexal masses included in this study, 51 (32%) had malignant tumors; 26 (51%) of them were stage I. All RMI variants performed similarly (accuracy range, 74%-83%), regardless of menopausal status. Considering all women included, the positive likelihood ratios of the 4 RMI variants ranged from 3.52 to 4.41. In subset analyses, all RMI variants had decreased sensitivity for stage I malignant tumors and for those of nonepithelial histologic types. The 4 RMI variants performed acceptably in a medium-resource setting where ultrasound examiners were physicians with varied experience. This finding indicates a good tradeoff between performance and feasibility, since ultrasound RMI protocols are of low complexity.

  18. Usefulness of T2*-weighted MRI in the detection of adnexal torsion

    PubMed Central

    Kawai, Nobuyuki; Kanematsu, Masayuki; Kawaguchi, Shimpei; Kojima, Toshihisa; Furui, Tatsuro; Morishige, Ken-ichirou; Matsuo, Masayuki

    2016-01-01

    Background The usefulness of T2*-weighted (T2*W) imaging for the detection of adnexal torsion has yet to be determined. Purpose To assess the usefulness of T2*W imaging for detecting and differentiating adnexal torsion. Material and Methods Eight patients with eight ovaries with torsion and 44 patients with 72 ovaries without torsion were included in this study. All patients underwent 1.5-T magnetic resonance imaging (MRI) including T2*W images. The frequency and distribution of hypointensity on T2*W images were compared between ovaries with torsion and ovaries without torsion. Results Hypointensity on T2*W images was significantly more frequent in ovaries with torsion than in ovaries without torsion (75% vs. 36%; P < 0.05). Among patients with hypointensity on T2*W images, the frequency of diffuse hypointensity was significantly higher in ovaries with torsion than in ovaries without torsion (83% vs. 0%; P < 0.01); whereas the frequency of focal hypointensity was significantly lower in ovaries with torsion than in ovaries without torsion (17% vs. 100%; P < 0.01). Conclusion The presence and distribution of hypointensity on T2*W images may play a supplementary role in the detection of adnexal torsion. PMID:27478621

  19. Indeterminate adnexal masses at ultrasound: effect of MRI imaging findings on diagnostic thinking and therapeutic decisions.

    PubMed

    Chilla, Bianka; Hauser, Nik; Singer, Gad; Trippel, Mafalda; Froehlich, Johannes M; Kubik-Huch, Rahel A

    2011-06-01

    To determine the impact of MRI including DWI on therapeutic decision-making and costs in the work-up of patients with a indeterminate adnexal mass on ultrasound. Thirty-eight patients with indeterminate ovarian lesions scheduled for surgery were included in this prospective study. In a questionnaire, the surgeon characterised the lesions based on a morphological score and determined the surgical procedure. The assessment was re-evaluated knowing MR findings and correlated with the final diagnosis. A cost-benefit analysis of MRI was performed. The impact of including DWI in the MR protocol was assessed. MRI provided major diagnostic information in 11/38 cases (28.9%) resulting in abstention from surgery in 5 cases; moderate additional information was recorded in 10/38 (26.3%) patients. Overall a net cost saving (3'676 EUR) was achieved. DWI did not show a significant difference between benign and malignant lesions. Teratomas yielded significantly lower mean ADC values (0.597 × 10(-3) mm(2)/s) compared with all other adnexal lesions (1.812 × 10(-3) mm(2)/s); the mean ADC values in endometrioma (1.387 × 10(-3) mm(2)/s) were significantly lower than in other cystic lesions (2.372 × 10(-3) mm(2)/s). Inclusion of MRI in the diagnostic algorithm of the indeterminate adnexal mass allows better differentiation of ovarian lesions resulting in a change of therapeutic decision-making with net cost savings.

  20. Tretinoin and the prevention of keratinocyte carcinoma (Basal and squamous cell carcinoma of the skin): a veterans affairs randomized chemoprevention trial.

    PubMed

    Weinstock, Martin A; Bingham, Stephen F; Digiovanna, John J; Rizzo, Amilcar E; Marcolivio, Kim; Hall, Russell; Eilers, David; Naylor, Mark; Kirsner, Robert; Kalivas, James; Cole, Gary; Vertrees, Julia E

    2012-06-01

    Keratinocyte carcinoma (KC) is the most common cancer in the United States, with no proven means for prevention other than systemic retinoids, which have significant toxicity, and sunscreen. Topical tretinoin has been used for KC chemoprevention, although this use is unproven. Hence, we conducted the randomized Veterans Affairs Topical Tretinoin Chemoprevention Trial of high-dose topical tretinoin for KC prevention. We randomized 1,131 patients to topical 0.1% tretinoin or a matching vehicle control for 1.5-5.5 years. The primary outcomes were time to development of new basal cell carcinoma (BCC) and new invasive squamous cell carcinoma (SCC) on the face or ears. The effects were not significant (P=0.3 for BCC and P=0.4 for SCC). The proportions of the tretinoin and control groups who developed a BCC at 5 years were 53 and 54% and an invasive SCC at 5 years were 28 and 31%. These differences (95% confidence intervals) were: for BCC, 1.0% (-6.5, 8.6%); for SCC, 3.6% (-3.1, 10.3%). No differences were observed in any cancer-related end points or in actinic keratosis counts. The only quality of life difference was worse symptoms in the tretinoin group at 12 months after randomization. This trial in high-risk patients demonstrates that high-dose topical tretinoin is ineffective at reducing risk of KCs.

  1. A case of allergic contact dermatitis from propylene glycol in an ultrasonic gel, sensitized at a leakage skin injury due to transcatheter arterial chemoembolization for hepatocellular carcinoma.

    PubMed

    Horiguchi, Yuji; Honda, Tetsuya; Fujii, Shinobu; Matsushima, Satoko; Osaki, Yukio

    2005-08-01

    A 63-year-old man with hepatocellular carcinoma consequent to chronic viral hepatitis C presented with severe dermatitis on the lower right side of the back after transcatheter arterial chemoembolization (TACE) via the 10th intercostal artery, because his hepatic artery had already collapsed due to repeated usage for TACE. The regional skin showed redness and hardness with pustules. Histologically, there was epidermal and appendage necrosis, as well as exocytosis of red blood cells. With a diagnosis of skin injury due to leakage of lipiodol ultrafluid, mitomycin, and epirubicin, administered via the 10th intercostal artery, onto the skin tissue, topical application of 0.06% fluocinonide-containing cream was prescribed. After several weeks of conservative local treatment, the leakage skin injury improved significantly, leaving pigmentation, hardness, and a small necrotic mass, as reported elsewhere (Honda T, Matsushima S, Fujii S, et al. A case of skin injury following transcatheter arterial chemotherapy through intercostal artery for hepatocellular carcinoma. Skin Res 2003; 2: 18-22). Subsequently, the patient again consulted the Dermatology Department with further dermatitis in an almost identical skin region on the right side of the abdomen (irregularly spreading erythematous and edematous eruptions with itching; Fig. 1). As he had undergone an ultrasonic examination 2 days earlier, allergic contact dermatitis from the ultrasonic gel was suspected. The contact dermatitis was treated with a topical corticosteroid hormone-containing ointment. Patch testing was performed with Ultra Phonic Conductivity Gel (Pharmaceutical Innovations Inc., Newark, NJ, USA), with which the patient had undergone a series of ultrasonic examinations, and Sono Jelly (Toshiba Medical Supply Co., Ltd., Tokyo, Japan) as a reference, as well as white petroleum as a negative control. A positive result was obtained for Ultra Phonic Conductivity Gel, whereas Sono Jelly was negative (Fig. 2a

  2. Noninvasive Optical Imaging of UV-Induced Squamous Cell Carcinoma in Murine Skin: Studies of Early Tumor Development and Vitamin D Enhancement of Protoporphyrin IX Production.

    PubMed

    Rollakanti, Kishore R; Anand, Sanjay; Davis, Scott C; Pogue, Brian W; Maytin, Edward V

    2015-11-01

    Better noninvasive techniques are needed to monitor protoporphyrin IX (PpIX) levels before and during photodynamic therapy (PDT) of squamous cell carcinoma (SCC) of the skin. Our aim was to evaluate (1) multispectral fluorescent imaging of ultraviolet light (UV)-induced cancer and precancer in a mouse model of SCC and (2) multispectral imaging and probe-based fluorescence detection as a tool to study vitamin D (VD) effects on aminolevulinic acid (ALA)-induced PpIX synthesis. Dorsal skin of hairless mice was imaged weekly during a 24-week UV carcinogenesis protocol. Hot spots of PpIX fluorescence were detectable by multispectral imaging beginning at 14 weeks of UV exposure. Many hot spots disappeared after cessation of UV at week 20, but others persisted or became visible after week 20, and corresponded to tumors that eventually became visible by eye. In SCC-bearing mice pretreated with topical VD before ALA application, our optical techniques confirmed that VD preconditioning induces a tumor-selective increase in PpIX levels. Fluorescence-based optical imaging of PpIX is a promising tool for detecting early SCC lesions of the skin. Pretreatment with VD can increase the ability to detect early tumors, providing a potential new way to improve efficacy of ALA-PDT. © 2015 The American Society of Photobiology.

  3. Noninvasive Optical Imaging of UV-Induced Squamous Cell Carcinoma in Murine Skin: Studies of Early Tumor Development and Vitamin D Enhancement of Protoporphyrin IX Production

    PubMed Central

    Rollakanti, Kishore R.; Anand, Sanjay; Davis, Scott C.; Pogue, Brian W.; Maytin, Edward V.

    2015-01-01

    Better noninvasive techniques are needed to monitor protoporphyrin IX (PpIX) levels before and during photodynamic therapy (PDT) of squamous cell carcinoma (SCC) of the skin. Our aim was to evaluate: (1) multispectral fluorescent imaging of ultraviolet light (UV)-induced cancer and precancer in a mouse model of SCC; (2) multispectral imaging and probe-based fluorescence detection as a tool to study Vitamin D (VD) effects on aminolevulinic acid (ALA)-induced PpIX synthesis. Dorsal skin of hairless mice was imaged weekly during a 24-week UV carcinogenesis protocol. Hot spots of PpIX fluorescence were detectable by multispectral imaging beginning at 14 weeks of UV exposure. Many hot spots disappeared after cessation of UV at week 20, but others persisted or became visible after week 20, and corresponded to tumors that eventually became visible by eye. In SCC-bearing mice pretreated with topical VD before ALA application, our optical techniques confirmed that VD preconditioning induces a tumor-selective increase in PpIX levels. Fluorescence-based optical imaging of PpIX is a promising tool for detecting early SCC lesions of the skin. Pretreatment with VD can increase the ability to detect early tumors, providing a potential new way to improve efficacy of ALA-PDT. PMID:26223149

  4. Water-based correction fluid is a useful skin marker for determination of the tumor margin of basal cell carcinoma under high-frequency ultrasound.

    PubMed

    Hayashi, Koichi; Okuyama, Ryuhei; Uhara, Hisashi

    2016-07-01

    We propose a new method to determine the appropriate preoperative surgical margin of basal cell carcinoma (BCC) by using water-based correction fluid as a skin marker showing the tumor position on the skin under high-frequency ultrasound (HFUS). After a provisional evaluation by dermoscopy, an approximately 2-mm dot of water-based correction fluid is applied to the tumor margin. The ultrasound waves are blocked by the dot of correction fluid, and a low-signal column is observed under the dot of correction fluid. The dots of correction fluid are moved and located as near as possible to the tumor margin, which is shown as a solid hypoechoic area by the HFUS. After confirming that the dots of correction fluid are applied to the circumferential margin, we draw a line in the gaps between the dots. Before the operation, the dots of correction fluid are removed by forceps, and a line for the tumor margin is drawn where the dots were. The surgical margin is set just outside of this line with the use of a measuring device. Water-based correction fluid is thus a useful skin marker under HFUS to determine the circumferential surgical margin of BCC. © 2016 Japanese Dermatological Association.

  5. Pilomatrix carcinoma of the clitoris.

    PubMed

    Gazic, Barbara; Sramek-Zatler, Simona; Repse-Fokter, Alenka; Pizem, Joze

    2011-12-01

    Pilomatrix carcinoma, a malignant counterpart of pilomatrixoma, is a rare skin neoplasm composed of basaloid and shadow cells that characterize differentiation toward the hair matrix. The authors present a case of pilomatrix carcinoma of the clitoris, a very unusual location not previously reported. Diagnostic criteria and differential diagnoses are discussed. Pilomatrix carcinoma should be differentiated from benign pilomatrixoma and other carcinomas with shadow cells, including basal cell carcinoma with matrical differentiation and metastases of visceral carcinomas with shadow cells.

  6. Primary cutaneous adenoid cystic carcinoma of the scalp with p16 expression: a case report and review of the literature.

    PubMed

    Morrison, Annie O; Gardner, Jerad M; Goldsmith, Stuart M; Parker, Douglas C

    2014-09-01

    Adenoid cystic carcinoma (ACC) is a rare carcinoma that typically arises in salivary glands but can also occur in other sites including skin. Primary salivary ACC is a locally aggressive tumor characterized by local recurrence and late metastasis. Primary cutaneous ACC is found predominately on the scalp and is more indolent than salivary ACC; and, despite a high incidence of local recurrence, metastases are exceedingly rare. A 62-year-old white male presented with a 6-mm mobile, blue-tinted nodule on the left mid scalp unchanged for several years. The histopathological findings of an excisional biopsy were diagnostic for a primary cutaneous ACC. Immunohistochemistry demonstrated focal positivity for p16. Primary cutaneous ACC is a rare malignancy that should be considered in the differential diagnosis of adnexal neoplasms and, when occurring on the head and neck, must be distinguished from cutaneous involvement by salivary ACC. The majority of reported salivary ACC with p16 protein expression were not positive for high-risk human papilloma virus by in situ hybridization. Immunostaining for p16 has previously been reported in salivary gland ACC. This is the first report in the English literature of p16 immunoexpression in primary cutaneous ACC.

  7. Radiation Therapy for Skin Cancer

    MedlinePlus

    ... than in African-Americans. TYPES OF SKIN CANCER Basal cell carcinoma: This is the most common form of skin ... epidermis ). Radiation therapy is very effective for treating basal cell cancers that have not spread elsewhere. Other common treatments ...

  8. Pelvic MRI as the "gold standard" in the subsequent evaluation of ultrasound-indeterminate adnexal lesions: a systematic review.

    PubMed

    Anthoulakis, C; Nikoloudis, N

    2014-03-01

    Incidentally discovered adnexal masses are common, posing a challenging diagnostic problem because imaging features of benign and malignant overlap. Thus, once an adnexal lesion has been detected, the primary goal of further imaging is accurate tissue characterization resulting in surgery only for lesions that are indeterminate or frankly malignant. This study aims to conduct a systematic review, following the PRISMA guidelines, and critically appraise pelvic MR Imaging as the preferred advanced second imaging test, as regards detection of ovarian cancer and assessment of indeterminate adnexal masses, with respect to pre-operatively improving the assignment of these patients to the appropriate level of care. A comprehensive computerized systematic literature search of English language studies was performed (from 2002 to 2012) of PubMed, EMBASE, Scopus, Evidence Based Medicine Reviews (Cochrane Database and Cochrane Central Register of Controlled Trials), and Google Scholar. Relevant article reference lists were hand searched. Computerized database search revealed 37 citations of relevance, 10 of which fulfilled the inclusion/exclusion criteria. From the aforementioned, 8 articles were acquired (2 authors were contacted but did not respond) as well as assessed with AHRQ, QUADAS, and STARD evaluation tools. Finally, 6 papers (5 prospective and 1 retrospective) were included in the systematic review. MRI with intravenous (IV) contrast administration provides the highest post-test probability of ovarian cancer detection. However, the preponderant contribution of MRI in adnexal mass evaluation is its specificity because it provides confident diagnosis of many benign adnexal lesions. © 2013.

  9. Treatment Options for Nonmelanoma Skin Cancer

    MedlinePlus

    ... Skin Cancer Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer ... carcinoma include the following: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  10. Mammalian target of rapamycin activator RHEB is frequently overexpressed in human carcinomas and is critical and sufficient for skin epithelial carcinogenesis.

    PubMed

    Lu, Zhi Hong; Shvartsman, Mark B; Lee, Andrew Y; Shao, Jenny M; Murray, Mollianne M; Kladney, Raleigh D; Fan, Dong; Krajewski, Stan; Chiang, Gary G; Mills, Gordon B; Arbeit, Jeffrey M

    2010-04-15

    Small GTPase Ras homologue enriched in brain (RHEB) binds and activates the key metabolic regulator mTORC1, which has an important role in cancer cells, but the role of RHEB in cancer pathogenesis has not been shown. By performing a meta-analysis of published cancer cytogenetic and transcriptome databases, we defined a gain of chromosome 7q36.1-q36.3 containing the RHEB locus, an overexpression of RHEB mRNA in several different carcinoma histotypes, and an association between RHEB upregulation and poor prognosis in breast and head and neck cancers. To model gain of function in epithelial malignancy, we targeted Rheb expression to murine basal keratinocytes of transgenic mice at levels similar to those that occur in human squamous cancer cell lines. Juvenile transgenic epidermis displayed constitutive mTORC1 pathway activation, elevated cyclin D1 protein, and diffuse skin hyperplasia. Skin tumors subsequently developed with concomitant stromal angio-inflammatory foci, evidencing induction of an epidermal hypoxia-inducible factor-1 transcriptional program, and paracrine feed-forward activation of the interleukin-6-signal transducer and activator of transcription 3 pathway. Rheb-induced tumor persistence and neoplastic molecular alterations were mTORC1 dependent. Rheb markedly sensitized transgenic epidermis to squamous carcinoma induction following a single dose of Ras-activating carcinogen 7,12-dimethylbenz(a)anthracene. Our findings offer direct evidence that RHEB facilitates multistage carcinogenesis through induction of multiple oncogenic mechanisms, perhaps contributing to the poor prognosis of patients with cancers overexpressing RHEB.

  11. Association Between Mohs Surgery Wait Times and Surgical Defect Size in Patients With Squamous Cell or Basal Cell Carcinoma of the Skin.

    PubMed

    Diehl, Joseph; Choi, Young M; Liang, Li-Jung; Chiu, Melvin

    2015-07-01

    Consequences of delays in treatment of nonmelanoma skin cancers (NMSCA) are largely unstudied. To determine the relationship between Mohs micrographic surgery (MMS) delay time and final MMS defect size. A retrospective chart review was performed to identify patients who underwent MMS for biopsy-proven basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) between 2004 and 2006. Time delay between date of biopsy and date of surgery and lesion diameter increase between biopsy and surgical defect were calculated. Two hundred eighty-three lesions qualified for inclusion in the study. No significant difference in mean change of major diameter between primary and recurrent tumors (1.0 vs 1.1 cm, p = .67), between BCCs and SCCs (both were 1.0 cm, p = .99), and between tumor size at presentation <1.0 versus ≥1.0 cm (1.1 vs 0.8 cm, p = .11) were found. However, the mean number of MMS layers taken was significantly different between BCCs and SCCs (1.9 vs 1.5, respectively; p = .0022). Linear regression analysis of major diameter change versus time delay to MMS showed no significant increasing trend over time. No evidence was found that time delays of up to 1 year from biopsy to MMS impact the growth of NMSCA.

  12. Ultraviolet Light and Skin Cancer in Athletes

    PubMed Central

    Harrison, Shannon C.; Bergfeld, Wilma F.

    2009-01-01

    The incidence of melanoma and nonmelanoma skin cancers is increasing worldwide. Ultraviolet light exposure is the most important risk factor for cutaneous melanoma and nonmelanoma skin cancers. Nonmelanoma skin cancer includes basal cell carcinoma and squamous cell carcinoma. Constitutive skin color and genetic factors, as well as immunological factors, play a role in the development of skin cancer. Ultraviolet light also causes sunburn and photoaging damage to the skin. PMID:23015891

  13. Topical (+)-catechin emulsified gel prevents DMBA/TPA-induced squamous cell carcinoma of the skin by modulating antioxidants and inflammatory biomarkers in BALB/c mice.

    PubMed

    Monga, Jitender; Aggarwal, Vaibhav; Suthar, Sharad Kumar; Monika; Nongalleima, Khumukcham; Sharma, Manu

    2014-12-01

    An emulsified gel of (+)-catechin was developed and evaluated topically against 7,12-dimethylbenz(a)anthracene-induced and 12-O-tetradecanoylphorbol-13-acetate-promoted (DMBA-induced and TPA-promoted) squamous cell carcinoma of the skin in BALB/c mice. The biological evaluation outcome indicated that the (+)-catechin emulsified gel increased the activity of oxidative stress biomarkers glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione S-transferase (GST), glutathione reductase (GR), and glutathione peroxidase (GPx), whereas it decreased the level of malondialdehyde (MDA). The mechanistic study showed that genes implicated in the inflammation and cancer, such as cyclooxygenase-2 (COX-2), nuclear factor-kappa B (NF-κB), and inducible nitric-oxide synthase (iNOS), were down-regulated by (+)-catechin emulsified gel while inhibiting an inflammatory mediator prostaglandin E2 (PGE2). The (+)-catechin emulsified gel further suppressed the activity of pro-inflammatory cytokines, viz. tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6). The in vitro permeation study revealed that release of (+)-catechin from an emulsified gel base reached a steady state after 6 h, while pH of the entire emulsified gel was found to be between 6.2 and 6.5 that falls well within the normal pH range of the skin.

  14. Proteomic analysis of PTCH1+/- fibroblast lysate and conditioned culture media isolated from the skin of healthy subjects and nevoid basal cell carcinoma syndrome patients.

    PubMed

    Ponti, Giovanni; Bertazzoni, Giorgia; Pastorino, Lorenza; Monari, Emanuela; Cuoghi, Aurora; Bergamini, Stefania; Bellei, Elisa; Benassi, Luisa; Azzoni, Paola; Petrachi, Tiziana; Magnoni, Cristina; Pellacani, Giovanni; Loschi, Pietro; Pollio, Annamaria; Witkowski, Alexander Michael; Tomasi, Aldo

    2013-01-01

    The pathogenesis underlying the increased predisposition to the development of basal cell carcinomas (BCCs) in the context of Gorlin-Goltz syndrome is linked to molecular mechanisms that differ from sporadic BCCs. Patients with Gorlin syndrome tend to develop multiple BCCs at an early age and present with tumors of non-sun-exposed skin. The aim of this study was to compare the proteomic profile of cultured fibroblast and fibroblast conditioned culture media of PTCH1+ and nonmutated fibroblasts. Proteomic analysis was performed using Surface-Enhanced Laser Desorption/Ionization Time-of-Flight mass spectrometry in PTCH1+ fibroblast conditioned media isolated from not affected sun-protected skin areas of Gorlin patients and from healthy subjects. 12 protein cluster peaks, >5 kDa, had significant differences in their peak intensities between PTCH1+ and PTCH1- subject groups. We detected a strongly MMP1 overexpression in PTCH1+ fibroblasts obtained from NBCCS patients with respect to healthy donors. Protein profiles in the fibroblast conditioned media revealed statistically significant differences between two different types (missense versus nonsense) of PTCH1 mutations. These differences could be useful as signatures to identify PTCH1 gene carriers at high risk for the development of NBCCS-associated malignancies and to develop novel experimental molecular tailored therapies based on these druggable targets.

  15. Expression profile of skin papillomas with high cancer risk displays a unique genetic signature that clusters with squamous cell carcinomas and predicts risk for malignant conversion.

    PubMed

    Darwiche, N; Ryscavage, A; Perez-Lorenzo, R; Wright, L; Bae, D-S; Hennings, H; Yuspa, S H; Glick, A B

    2007-10-18

    Chemical induction of squamous tumors in the mouse skin induces multiple benign papillomas: high-frequency terminally benign low-risk papillomas and low-frequency high-risk papillomas, the putative precursor lesions to squamous cell carcinoma (SCC). We have compared the gene expression profile of twenty different early low- and high-risk papillomas with normal skin and SCC. Unsupervised clustering of 514 differentially expressed genes (P<0.001) showed that 9/10 high-risk papillomas clustered with SCC, while 1/10 clustered with low-risk papillomas, and this correlated with keratin markers of tumor progression. Prediction analysis for microarrays (PAM) identified 87 genes that distinguished the two papilloma classes, and a majority of these had a similar expression pattern in both high-risk papillomas and SCC. Additional classifier algorithms generated a gene list that correctly classified unknown benign tumors as low- or high-risk concordant with promotion protocol and keratin profiling. Reduced expression of immune function genes characterized the high-risk papillomas and SCC. Immunohistochemistry confirmed reduced T-cell number in high-risk papillomas, suggesting that reduced adaptive immunity defines papillomas that progress to SCC. These results demonstrate that murine premalignant lesions can be segregated into subgroups by gene expression patterns that correlate with risk for malignant conversion, and suggest a paradigm for generating diagnostic biomarkers for human premalignant lesions with unknown individual risk for malignant conversion.

  16. Impact of various color LED flashlights and different lighting source to skin distances on the manual and the computer-aided detection of basal cell carcinoma borders.

    PubMed

    Bakht, Mohamadreza K; Pouladian, Majid; Mofrad, Farshid B; Honarpisheh, Hamid

    2014-02-01

    Quantitative analysis based on digital skin image has been proven to be helpful in dermatology. Moreover, the borders of the basal cell carcinoma (BCC) lesions have been challenging borders for the automatic detection methods. In this work, a computer-aided dermatoscopy system was proposed to enhance the clinical detection of BCC lesion borders. Fifty cases of BCC were selected and 2000 pictures were taken. The lesion images data were obtained with eight colors of flashlights and in five different lighting source to skin distances (SSDs). Then, the image-processing techniques were used for automatic detection of lesion borders. Further, the dermatologists marked the lesions on the obtained photos. Considerable differences between the obtained values referring to the photographs that were taken at super blue and aqua green color lighting were observed for most of the BCC borders. It was observed that by changing the SSD, an optimum distance could be found where that the accuracy of the detection reaches to a maximum value. This study clearly indicates that by changing SSD and lighting color, manual and automatic detection of BCC lesions borders can be enhanced. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Consensus for Nonmelanoma Skin Cancer Treatment, Part II: Squamous Cell Carcinoma, Including a Cost Analysis of Treatment Methods.

    PubMed

    Kauvar, Arielle N B; Arpey, Christopher J; Hruza, George; Olbricht, Suzanne M; Bennett, Richard; Mahmoud, Bassel H

    2015-11-01

    Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer in the United States. Cutaneous squamous cell carcinoma has an estimated incidence of more than 700,000 new cases per year and a 5% risk of metastasis. To provide clinicians with guidelines for the management of cSCC based on evidence from a comprehensive literature review and consensus among the authors. The authors conducted an extensive review of the medical literature on treatment methods for cSCC, taking into consideration cure rates, recurrence and metastatic rates, aesthetic and functional outcomes, and cost effectiveness of the procedures. Surgical treatments provide the best outcomes for cSCC. Mohs micrographic surgery is a cost-effective procedure that affords the highest cure rate, maximal tissue preservation, and superior cosmetic outcomes. Nonsurgical methods may be used as a primary treatment for low-risk squamous cell carcinomas, but the cure rates are lower. The cure rate remains the most important consideration in choosing the treatment method, but additional factors, such as the patient's general medical condition, psychosocial circumstances, the location of the tumor and cost effectiveness of the therapy should be considered. Mohs micrographic surgery remains the preferred treatment for high-risk tumors and tumors located in cosmetically sensitive areas.

  18. Potential harms outweigh benefits of indefinite monitoring of stable adnexal masses.

    PubMed

    Suh-Burgmann, Elizabeth; Kinney, Walter

    2015-12-01

    The management of women with asymptomatic adnexal masses should aim to balance potential benefit with potential harm. While masses with highly worrisome features or other signs of malignancy should be referred for surgery, the vast majority of masses have an indeterminate or benign appearance and are candidates for observation. Evidence supports the use of initial short-term serial ultrasound in distinguishing between benign and malignant masses. However, benefit from prolonged, potentially life-long monitoring of stable masses has not been demonstrated. Since the goal of monitoring an adnexal mass is to observe for worrisome growth or increasing complexity as an indicator of malignancy, if the mass remains stable, the likelihood of malignancy and therefore, the potential benefit of observation wanes with time. The recognition that Type 2 high grade serous cancers, which are responsible for the majority of deaths from ovarian cancer, arise from fallopian tube rather than ovarian precursors, further diminishes the likelihood that monitoring a stable ovarian mass will lead to early diagnosis of high grade disease. While some Type 1 cancers may develop from ovarian precursors, the available data suggest that any measurable benefit of monitoring known lesions for detection of these cancers is realized within the first year of observation. The argument in favor of indefinite, potentially life-long monitoring of stable masses also fails to adequately account for the risks of perpetual imaging, which include the risk of incidental findings, an increased likelihood of unnecessary surgery, patient anxiety and cost. It is not always better to order a test than not order a test. Given the absence of evidence of benefit, observation of stable small adnexal masses should be limited in duration in order to minimize potential harms. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Anti-angiogenic and anti-cancer evaluation of betulin nanoemulsion in chicken chorioallantoic membrane and skin carcinoma in Balb/c mice.

    PubMed

    Dehelean, Cristina A; Feflea, Stefana; Gheorgheosu, Dorina; Ganta, Srinivas; Cimpean, Anca M; Muntean, Danina; Amiji, Mansoor M

    2013-04-01

    Betulin (Bet), the main component of birch tree bark, has been recently reported to exert anticancer activity in several cell lines; however the underlying mechanisms are only partially elucidated. The aims of the present work were to assess the in vivo effects of betulin administered as nanoemulsion (NE) in two experimental models: (i) the chicken embryo chorioallantoic membrane (CAM) assay for the study of anti-angiogenic effects and (ii) the two-stage model of skin carcinoma induced in mice for the study of anti-tumor and anti-inflammatory effects, respectively. On the CAM of the chicken betulin in nanoemulsion (BetNE) shows a good penetrability at extra-embryonic tissue level, affecting both the chorioallantoic membrane as well as the yolk sac by reducing the capillary density. In the animal model, the potential impact of local application of betulin on the respiratory function of isolated liver mitochondria was further assessed. Topical application of betulin nanoemulsion for 12 weeks together with DMBA (7,12-dimethylbenz[a]anthracene) and TPA (12-O-tetradecanoylphorbol 13-acetate), as tumor initiator and promoter, enhanced the active respiration of isolated liver mitochondria. Betulin also inhibit skin tumor apparition and promotion, proved by histological results and VEGF (vascular endothelial growth factor) expression correlated to non-invasive measurements. Betulin is active in nanoemulsion formulation as a potential inhibitory on the angiogenic process in CAM assay. BetNE can develop a potent anti-inflammatory and anti-carcinogenic activity with a low toxicity at skin level. It can also influence the penetration of carcinogens and reduce damage in main organs (e.g., liver).

  20. Patterns and timing of sunlight exposure and risk of basal cell and squamous cell carcinomas of the skin--a case-control study.

    PubMed

    Iannacone, Michelle R; Wang, Wei; Stockwell, Heather G; O'Rourke, Kathleen; Giuliano, Anna R; Sondak, Vernon K; Messina, Jane L; Roetzheim, Richard G; Cherpelis, Basil S; Fenske, Neil A; Rollison, Dana E

    2012-09-20

    Non-melanoma skin cancer (NMSC), comprised of basal (BCC) and squamous (SCC) cell carcinomas, is the most common cancer in Caucasians. Ultraviolet radiation (UVR) exposure is the most important environmental risk factor for NMSC. However, the precise relationship between UVR and the risk of NMSC is complex, and the relationship may differ by skin cancer type. A case-control study was conducted among Florida residents to investigate measures of patterns (intermittent vs. continuous) and timing (childhood vs. adulthood) of sunlight exposure in BCC and SCC. Participants included 218 BCC and 169 SCC cases recruited from a university dermatology clinic and 316 controls with no history of skin or other cancers. A history of blistering sunburn (a measure of intermittent sunlight exposure) was associated with both BCC (OR = 1.96, 95% CI = 1.27-3.03) and SCC (OR = 2.02, 95% CI = 1.22-3.33). Additionally, having a job in the sun for ≥ 3 months for 10 years or longer (a measure of continuous sunlight exposure) was also associated with both BCC and SCC in our study population. With the exception of younger age at first blistering sunburn, measures of younger age at sunlight exposure tended to be associated with SCC, but not BCC risk. Results from the current study suggest that sunlight exposure is associated with both BCC and SCC risk regardless of the pattern in which the exposure was received (i.e. intermittent vs. continuous). The data also suggest that sunlight exposure at a younger age may be more important for SCC but not BCC, however additional studies are needed to further characterize sunlight exposure-response relationships in different types of NMSC.

  1. Patterns and timing of sunlight exposure and risk of basal cell and squamous cell carcinomas of the skin – a case–control study

    PubMed Central

    2012-01-01

    Background Non-melanoma skin cancer (NMSC), comprised of basal (BCC) and squamous (SCC) cell carcinomas, is the most common cancer in Caucasians. Ultraviolet radiation (UVR) exposure is the most important environmental risk factor for NMSC. However, the precise relationship between UVR and the risk of NMSC is complex, and the relationship may differ by skin cancer type. Methods A case–control study was conducted among Florida residents to investigate measures of patterns (intermittent vs. continuous) and timing (childhood vs. adulthood) of sunlight exposure in BCC and SCC. Participants included 218 BCC and 169 SCC cases recruited from a university dermatology clinic and 316 controls with no history of skin or other cancers. Results A history of blistering sunburn (a measure of intermittent sunlight exposure) was associated with both BCC (OR = 1.96, 95% CI = 1.27-3.03) and SCC (OR = 2.02, 95% CI = 1.22-3.33). Additionally, having a job in the sun for ≥3 months for 10 years or longer (a measure of continuous sunlight exposure) was also associated with both BCC and SCC in our study population. With the exception of younger age at first blistering sunburn, measures of younger age at sunlight exposure tended to be associated with SCC, but not BCC risk. Conclusions Results from the current study suggest that sunlight exposure is associated with both BCC and SCC risk regardless of the pattern in which the exposure was received (i.e. intermittent vs. continuous). The data also suggest that sunlight exposure at a younger age may be more important for SCC but not BCC, however additional studies are needed to further characterize sunlight exposure-response relationships in different types of NMSC. PMID:22994655

  2. Cystic acantholytic dyskeratosis of the vulva: An unusual presentation of a follicular adnexal neoplasm

    PubMed Central

    Torres, Kara Melissa Tiangco; Junkins-Hopkins, Jacqueline M.

    2016-01-01

    Acantholytic dyskeratosis (AD) is a histologic pattern seen in Darier's disease or dyskeratosis follicularis, warty dyskeratoma, and transient AD. This pattern is characterized by suprabasilar clefting, acantholysis, and formation of corps ronds and grains. We present a case of AD that is unique based on its genital location and cystic architecture. A 53-year-old woman presented with an otherwise asymptomatic cyst on her left vulva of uncertain duration. On microscopic examination, there were fragments of cystic epithelium with areas of hypergranulosis, acantholysis, corps ronds, and corps grains formation. These features are felt by the authors to be a unique presentation of a follicular adnexal neoplasm. PMID:27559500

  3. Comparative Effectiveness of Robotically Assisted Compared With Laparoscopic Adnexal Surgery for Benign Gynecologic Disease

    PubMed Central

    Wright, Jason D.; Kostolias, Alessandra; Ananth, Cande V.; Burke, William M.; Tergas, Ana I.; Prendergast, Eri; Ramsey, Scott D.; Neugut, Alfred I.; Hershman, Dawn L.

    2014-01-01

    Objective To perform a population-based analysis to compare the complications and cost of laparoscopic and robotically assisted adnexal surgery. Methods A nationwide database was utilized to analyze the use and outcomes of robotically assisted adnexal surgery from 2009–2012. Multivariable mixed effects regression models were developed to examine predictors of use of robotic surgery. After propensity score matching, complications and cost were compared between robotically assisted and laparoscopic surgery. Results 87,514 women were identified. From 2009 to 2012, performance of robotic-assisted oophorectomy increased from 3.5% (95% CI, 3.2–3.8%) to 15.0% (95% CI, 14.4–15.6%), while robotically assisted cystectomy rose from 2.4% (95% CI, 2.0–2.7%) to 12.9% (95% CI, 12.2–13.5%). The overall complication rate was 7.1% (95% CI, 4.0–10.2%) for robotically assisted vs. 6.0% (95% CI, 2.9–9.1%) for laparoscopic oophorectomy (OR=1.20; 95% CI, 1.00–1.45) (P=0.052). Robotic-assisted oophorectomy was associated with a higher rate of intraoperative complications (3.4% vs. 2.1%, OR=1.60; 95% CI, 1.21–2.13). The overall complication rate was 3.7% (95% CI −0.8–8.2%) after robotically assisted versus 2.7% (95% CI, −1.8–7.2%) for laparoscopic cystectomy (OR=1.38; 95% CI, 0.95–1.99). The intraoperative complication rate was higher for robotically assisted cystectomy (2.0% vs. 0.9%, OR=2.40; 95% CI, 1.31–4.38). Compared to laparoscopy, robotically assisted oophorectomy was associated with $2504 (95% CI, $2356–$2652) increased total costs and robotically assisted cystectomy $3310 (95% CI, $3082–$3581) higher costs. Conclusion Use of robotically assisted adnexal surgery increased rapidly. Compared to laparoscopic surgery, robotically assisted adnexal surgery is associated with substantially greater costs and a small, but statistically significant, increase in intraoperative complications. PMID:25437715

  4. Characteristics and management of adnexal masses in a canadian pediatric and adolescent population.

    PubMed

    Kirkham, Yolanda A; Lacy, Judith A; Kives, Sari; Allen, Lisa

    2011-09-01

    To determine whether there were differences in presentation, imaging, and tumour markers between pediatric and adolescent gynaecology patients with adnexal masses managed expectantly and those managed surgically. We conducted a retrospective review of patients who presented to the pediatric and adolescent gynaecology service with adnexal masses between January 2003 and January 2006 at Toronto's Hospital for Sick Children. We used t tests, chi-square, and Pearson correlation tests for analysis. We identified 114 patients with an adnexal mass. Fifty-nine percent had surgery (laparotomy 41.8%, laparoscopy 58.2%) and 41% were managed conservatively. The mean age of patients was 12.7 years (range 7 days to 18 years) and there was no difference in age between management groups (P = 0.59). The most common presenting symptom was abdominal pain (72.8%). Increased abdominal girth was found only in the surgical group (P < 0.01). Size of the mass was the only feature on imaging that differed between groups (11.1 cm surgical vs. 5.3 cm observed, P < 0.001). CT scans were performed in 35 patients, 94.3% of whom had surgery (P < 0.001). Tumour markers were drawn in 41.2% of patients, more often in surgical patients (P < 0.001), and 27% were abnormal, all in the surgical group. Surgical approaches included cystectomy, oophorectomy, or detorsion. Twelve percent of surgeries were for malignancies, representing 7.0% of all adnexal masses, and malignant masses were larger than benign masses (16.1 cm vs. 10.5 cm, P < 0.05). In cases that required only expectant management with serial ultrasound, both simple and complex masses resolved, with or without hormonal suppression. Larger masses and masses associated with increased abdominal girth or abnormal tumour markers were more likely to be managed by surgical intervention. Surgically managed patients had more investigations. Forty-one percent of masses in patients referred to pediatric and adolescent gynaecology specialists resolved with

  5. Fine Needle Aspiration Cytology of Papulonodular Lesions of Skin: A Study of 50 Cases

    PubMed Central

    Mahadevappa, Asha; Manjunath, Gubbanna Vimalambike

    2016-01-01

    Introduction Skin is one of the frequent site of disease in human body. Fine Needle Aspiration Cytology (FNAC) is a safe diagnostic method in these cases. FNAC has some limitation, particularly related to representativity of samples, exact typing of skin adnexal tumours and classifying the nature of metastatic cutaneous nodules. Thus, FNAC alone may not give a confirmative diagnosis regarding few skin lesions. Hence, histopathological study has been the standard technique for the diagnosis of skin lesions. Aim To study the FNAC findings in various papulonodular lesions and to correlate them with histopathological findings wherever possible. Materials and Methods In the present study, 50 cases of clinically diagnosed papulonodular lesions were evaluated by FNAC and correlated with histopathology wherever possible. Results There was 100% correlation in cases of epidermal cyst, leprosy, tuberculosis, actinomycosis, acute and chronic inflammatory lesions and 67% accuracy was seen in adnexal tumours. Aspiration cytology along with radiological studies proved very useful in classifying the nature of metastatic cutaneous nodules and suggesting the possible site of unknown primary. Sensitivity of FNAC for epidermal cyst and inflammatory lesions was 100%. In case of adnexal tumours, sensitivity and specificity was 67% and 50% respectively. Conclusion FNAC is a rapid, efficient, cost effective, relatively painless procedure and produces a speedy result with high diagnostic accuracy. It has high rates of sensitivity and specificity in diagnosing papulonodular lesions of skin and hence, is a valuable tool in the diagnosis and management of patients with papulonodular skin lesions. PMID:28208863

  6. Large mucocele of the appendix at laparoscopy presenting as an adnexal mass in a postmenopausal woman: a case report.

    PubMed

    Paladino, Elvira; Bellantone, Maria; Conway, Francesca; Sesti, Francesco; Piccione, Emilio; Pietropolli, Adalgisa

    2014-01-01

    A 79-year-old female was referred to our Gynecologic Department presenting with a pelvic magnetic resonance imaging (MRI), showing an adnexal mass, later confirmed at the pelvic examination. The patient's routine laboratory tests were normal. A sonographic examination was performed with inconclusive results. Although the ultrasonography excluded the presence of vascularization and malignant degeneration, the adnexal localization appeared to be dubious. The laparoscopy and the subsequent histologic examination revealed the presence of a mucocele of the appendix. The following case report focuses the attention on a misdiagnosis of appendiceal mucocele. The misdiagnosis caused no negative impact on the treatment that in this case was adequate and successful.

  7. Common Skin Cancers

    PubMed Central

    Ho, Vincent C.

    1992-01-01

    Melanoma, basal cell carcinoma, and squamous cell carcinoma are the three most common forms of skin cancer. The incidence of skin cancer is increasing at an alarming rate. Early detection is the key to successful management. In this article, the salient clinical features and diagnostic clues for these tumors and their precursor lesions are presented. Current management guidelines are also discussed. ImagesFigure 1Figures 2-3Figures 4-6Figures 7-9 PMID:21221380

  8. Sleeping Beauty transposon system harboring HRAS, c-Myc and shp53 induces sarcomatoid carcinomas in mouse skin.

    PubMed

    Jung, Sunyoung; Ro, Simon Weonsang; Jung, Geunyoung; Ju, Hye-Lim; Yu, Eun-Sil; Son, Woo-Chan

    2013-04-01

    The Sleeping Beauty transposon system is used as a tool for insertional mutagenesis and oncogenesis. However, little is known about the exact histological phenotype of the tumors induced. Thus, we used immunohistochemical markers to enable histological identification of the type of tumor induced by subcutaneous injection of the HRAS, c-Myc and shp53 oncogenes in female C57BL/6 mice. The tumor was removed when it reached 100 mm3 in volume. Subsequently, we used 13 immunohistochemical markers to histologically identify the tumor type. The results suggested that the morphology of the tumor was similar to that of sarcomatoid carcinoma.

  9. Skin Cancer Treatment (PDQ®)—Patient Version

    Cancer.gov

    Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common types of skin cancer. Find out about risk factors, symptoms, tests to diagnose, prognosis, staging, and treatment for skin cancer.

  10. Laparoscopy versus laparotomy in the management of benign unilateral adnexal masses.

    PubMed

    Carley, Michael E; Klingele, Christopher J; Gebhart, John B; Webb, Maurice J; Wilson, Timothy O

    2002-08-01

    To compare operative characteristics and charges of laparoscopy and laparotomy for women with a benign unilateral adnexal mass 7 cm or less in greatest diameter. Historical cohort study (Canadian Task Force classification II-2). Clinic department of obstetrics and gynecology. One hundred six women. Unilateral oophorectomy or unilateral salpingo-oophorectomy performed by laparoscopy or laparotomy. When patients were compared on an intent to treat basis, no differences in greatest mass diameter (4.2 vs 4.5 cm), patient age (49.2 vs 46.4 yrs), or body mass index (26.0 vs 27.0 kg/m(2)) were found between 62 laparoscopies and 44 laparotomies. Laparoscopy was associated with longer operating times (94 vs 63 min, p <0.001), shorter hospital stay (1.6 vs 2.5 days, p <0.001), higher sterile supply charges ($1031 vs $40, p <0.001), and lower hospital room charges ($672 vs $1351, p <0.0001). No significant differences in total hospital charges, febrile morbidity, or transfusion rates were identified. Patient charges and early operative morbidity are similar for laparoscopy and laparotomy. Therefore, patient and surgeon preference should be a primary consideration when deciding on operative approach in carefully selected women with a unilateral adnexal mass.

  11. The Value of Ultrasound Monitoring of Adnexal Masses for Early Detection of Ovarian Cancer

    PubMed Central

    Suh-Burgmann, Elizabeth; Kinney, Walter

    2016-01-01

    Although ultrasound has so far been found to be ineffective as a screening tool for ovarian cancer, it is commonly used as a means of evaluating or following ovarian or adnexal masses once they are detected. We review the use of serial ultrasound for the management of adnexal masses and propose an approach to monitoring based on an understanding of the overall risk of cancer among the population in question and an assessment of how the potential benefit of monitoring compares with potential risk. In our approach, masses that are symptomatic, large (>10 cm), associated with an elevated CA 125 level or overt signs of malignancy, or that are determined to have a worrisome appearance by stringent ultrasound criteria should be evaluated surgically. Women with masses that have none of these characteristics should be offered monitoring. Short-term initial ultrasound monitoring carries significant potential benefit in terms of aiding detection of early malignancy and avoidance of unnecessary surgery. However, if a mass remains stable but persistent, the potential benefit of ongoing monitoring wanes with time, whereas the potential harms, in terms of patient anxiety, cost, and the risk of incidental findings and unnecessary surgery increase. Therefore, monitoring of stable lesions should be limited in duration in order to limit potential harms from overtreatment and overdiagnosis. PMID:26904503

  12. Ultrasound Image Discrimination between Benign and Malignant Adnexal Masses Based on a Neural Network Approach.

    PubMed

    Aramendía-Vidaurreta, Verónica; Cabeza, Rafael; Villanueva, Arantxa; Navallas, Javier; Alcázar, Juan Luis

    2016-03-01

    The discrimination between benign and malignant adnexal masses in ultrasound images represents one of the most challenging problems in gynecologic practice. In the study described here, a new method for automatic discrimination of adnexal masses based on a neural networks approach was tested. The proposed method first calculates seven different types of characteristics (local binary pattern, fractal dimension, entropy, invariant moments, gray level co-occurrence matrix, law texture energy and Gabor wavelet) from ultrasound images of the ovary, from which several features are extracted and collected together with the clinical patient age. The proposed technique was validated using 106 benign and 39 malignant images obtained from 145 patients, corresponding to its probability of appearance in general population. On evaluation of the classifier, an accuracy of 98.78%, sensitivity of 98.50%, specificity of 98.90% and area under the curve of 0.997 were calculated. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  13. Prognostic factors for tumour response and skin damage to combined radiotherapy and hyperthermia in superficial recurrent breast carcinomas.

    PubMed

    Lindholm, C E; Kjellén, E; Nilsson, P; Weber, L; Hill, S

    1995-01-01

    Prognostic factors for complete tumour response and acute skin damage to combined hyperthermia and radiotherapy were analysed in material of patients with breast cancer, recurrent in previously irradiated areas. Radiotherapy was given daily to a total absorbed dose of 30.0 Gy in 2 weeks or 34.5 Gy in 3 weeks. The first radiotherapy schedule was combined with heat twice weekly, a total of four heat treatments (schedule A). The second radiotherapy schedule was combined with heat either once or twice a week resulting in a total of three (schedule B) or six (schedule C) heat treatments. Heat was induced with microwaves (2450, 915 or 434 MHz) via external applicators and always given after the radiotherapy fraction. The complete response (CR) rate in evaluable patients was 71% (49/69). There was no significant difference in CR rate between the three different hyperthermia schedules. The CR rates were 74% (14/19), 65% (15/23) and 74% (20/27) for schedules A, B and C respectively. The only factor predicting CR, evaluated both uni- and multivariately, was the CRE-value for the present radiotherapy dose (p = 0.02). If only tumours treated with 915 MHz were taken into account, however, then the highest minimum temperature at a given heat session predicted complete response (p = 0.03). This was true also in a multivariate analysis of this subgroup of tumours. A Kaplan-Meier analysis (log rank test) showed no significant difference in duration of CR between the different treatment schedules. Cox's proportional hazards method revealed three significant factors: tumour size (negatively correlated, p = 0.007), the time interval between the diagnosis of the primary tumour and the present treatment (p = 0.02) and the average temperature (0.03). Maximum acute skin reactions in the treatment field were scored according to an ordinal scale of 0-8, modified after WHO 1979. Twenty-six treatment areas (32%) expressed more severe skin damage (score > or = 5) in terms of desquamation with

  14. Quantitative phosphoproteomic analysis reveals system-wide signaling pathways regulated by site-specific phosphorylation on Keratin-8 in skin squamous cell carcinoma derived cell- line.

    PubMed

    Tiwari, Richa; Sahu, Indrajit; Soni, Bihari Lal; Sathe, Gajanan J; Datta, Keshava K; Thapa, Pankaj; Sinha, Shruti; Vadivel, Chella Krishna; Dhaka, Bharti; Gowda, Harsha; Vaidya, Milind M

    2017-02-07

    Keratin 8/18, a simple epithelia specific keratin pair, is often aberrantly expressed in squamous cell carcinomas (SCC) where its expression is correlated with increased invasion and poor prognosis. Majority of Keratin 8 (K8) functions are governed by its phosphorylation at Serine(73) (head-domain) and Serine(431) (tail-domain) residues. Although, deregulation of K8 phosphorylation is associated with progression of different carcinomas, its role in skin-SCC and the underlying mechanism is obscure. In this direction, we performed TMT-based quantitative phosphoproteomics by expressing K8 wild type, phosphodead and phosphomimetic mutants in K8-deficient A431 cells. Further analysis of our phosphoproteomics data showed a significant proportion of total phosphoproteome associated with migratory, proliferative and invasive potential of these cells to be differentially phosphorylated. Differential phosphorylation of CDK1(T14,Y15) , EIF4EBP1(T46,T50) , EIF4B(S422) , AKT1S1T246,S247, CTTN1(T401,S405,) Y421 & CAP1(S307/309) in K8-S73A/D mutant and CTTN1(T401,S405,Y421) , BUB1B(S1043) & CARHSP1(S30,S32) in K8-S431A/D mutants as well as some anonymous phosphosites including MYC(S176) , ZYX(S344) and PNN(S692) could be potential candidates associated with K8 phosphorylation mediated tumorigenicity. Biochemical validation followed by phenotypic analysis further confirmed our quantitative phosphoproteomics data. In conclusion, our study provides the first global picture of K8 site- specific phosphorylation function in neoplastic progression of A431 cells and suggests various potential starting points for further mechanistic studies. This article is protected by copyright. All rights reserved.

  15. The Mechanism Causing High-signal Intensity on Diffusion-weighted Imaging in Adnexal Torsion: Two Case Reports.

    PubMed

    Fujii, Shinya; Mukuda, Naoko; Nosaka, Kanae; Fukunaga, Takeru; Inoue, Chie; Ogawa, Toshihide

    2017-07-10

    We report two cases with adnexal torsion to assess the mechanism of very strong signal intensity in ovarian lesions on DW imaging using MR imaging such as T2*-weighted imaging. MR imaging findings of the cases suggest that the very strong signal intensity on DW imaging is contributed to cytotoxic edema with or without vasogenic edema, as well as oxyhemoglobin or extracellular methemoglobin.

  16. Meta-analysis comparing the safety of laparoscopic and open surgical approaches for suspected adnexal mass during the second trimester.

    PubMed

    Liu, Yi-Xuan; Zhang, Yang; Huang, Jin-Feng; Wang, Li

    2017-03-01

    The safety of laparoscopic surgery during the second trimester of pregnancy remains a controversial subject. To compare the safety of laparoscopic surgery and laparotomy for suspected adnexal mass during the second trimester. Articles published in any language prior to April 31, 2016, were retrieved from PubMed, Scopus, EMBSCO, and the Cochrane Library using keywords including pregnant, adnexal mass, laparoscopy, laparotomy, pregnancy outcomes, and surgical outcomes. Randomized and non-randomized controlled trials reporting at least one obstetric or surgical outcome were included if they compared laparoscopic surgery and laparotomy for adnexal masses during the second trimester. Data were independently extracted by two reviewers. Homogeneous data were pooled using a fixed effects model and heterogeneous data were qualitatively analyzed. Four comparative effectiveness studies including a total of 240 patients were identified. Laparoscopic surgery was associated with a reduced risk of post-operative adverse events (relative risk 0.20, 95% confidence interval 0.06-0.72); no difference was recorded in the risk of post-operative spontaneous abortion (P=0.26) or threatened spontaneous abortion (P=0.13). Laparoscopic surgery could be preferable to laparotomy for suspected adnexal mass during the second trimester of pregnancy. © 2016 International Federation of Gynecology and Obstetrics.

  17. History of allergy and atopic dermatitis in relation to squamous cell and Basal cell carcinoma of the skin.

    PubMed

    Cheng, Judy; Zens, M Scot; Duell, Eric; Perry, Ann E; Chapman, M Shane; Karagas, Margaret R

    2015-04-01

    Little is known about whether history of allergies and atopy is related to the occurrence of keratinocyte cancers. Thus, we evaluated the association between history of allergies and atopy and the incidence of squamous cell carcinoma (SCC) and early onset basal cell carcinoma (BCC). As part of a population-based case-control study, interviews were conducted with 1,050 residents of New Hampshire (375 early onset BCC cases and 251 controls, 254 SCC cases and 432 controls). ORs of SCC and early onset BCC and history of allergy and atopic dermatitis were computed using logistic regression, while controlling for potential confounding factors. An overall inverse association was observed between a history of allergy and early onset BCC [OR, 0.61; 95% confidence interval (CI), 0.38-0.97] but not SCC (OR, 1.18; 95% CI, 0.78-1.79). Among women, we found reduced ORs of both early onset BCC and of SCC in relation to allergy history (early onset BCC OR, 0.53; 95% CI, 0.31-0.92 and SCC OR, 0.59; 95% CI, 0.29-1.19). Among men, we observed no clear association with early onset BCC (OR, 0.87; 95% CI, 0.39-1.99) and an increased risk of SCC (OR, 1.58; 95% CI, 0.93-2.69). Our findings suggest that allergies and atopy may influence risk of early onset BCC and SCC, and that effects may be gender specific. A deeper understanding of the immune mechanisms underlying allergies and atopy may provide new routes of preventing keratinocyte cancers. ©2015 American Association for Cancer Research.

  18. Automated Detection and Segmentation of Vascular Structures of Skin Lesions Seen in Dermoscopy, with an application to Basal Cell Carcinoma Classification.

    PubMed

    Kharazmi, Pegah; AlJasser, Mohammed I; Lui, Harvey; Wang, Z Jane; Lee, Tim K

    2016-12-08

    Blood vessels are important biomarkers in skin lesions both diagnostically and clinically. Detection and quantification of cutaneous blood vessels provide critical information towards lesion diagnosis and assessment. In this paper, a novel framework for detection and segmentation of cutaneous vasculature from dermoscopy images is presented and the further extracted vascular features are explored for skin cancer classification. Given a dermoscopy image, we segment vascular structures of the lesion by first decomposing the image using independent component analysis into melanin and hemoglobin components. This eliminates the effect of pigmentation on the visibility of blood vessels. Using k-means clustering, the hemoglobin component is then clustered into normal, pigmented and erythema regions. Shape filters are then applied to the erythema cluster at different scales. A vessel mask is generated as a result of global thresholding. The segmentation sensitivity and specificity of 90% and 86% were achieved on a set of 500000 manually segmented pixels provided by an expert. To further demonstrate the superiority of the proposed method, based on the segmentation results, we defined and extracted vascular features towards lesion diagnosis in Basal cell carcinoma (BCC). Among a data set of 659 lesions (299 BCC and 360 non-BCC), a set of 12 vascular features are extracted from the final vessel images of the lesions and fed into a random forest classifier. When compared with a few other state-of-art methods, the proposed method achieves the best performance of 96.5% in terms of AUC in differentiating BCC from benign lesions using only the extracted vascular features.

  19. Enhancement of tumor responsiveness to aminolevulinate-photodynamic therapy (ALA-PDT) using differentiation-promoting agents in mouse models of skin carcinoma

    NASA Astrophysics Data System (ADS)

    Anand, Sanjay; Honari, Golara; Paliwal, Akshat; Hasan, Tayyaba; Maytin, Edward V.

    2009-06-01

    Aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is an emerging treatment for cancers. ALA, given as a prodrug, selectively accumulates and is metabolized in cancer cells to form protoporphyrin IX (PpIX). Targeted local irradiation with light induces cell death. Since the efficacy of ALA-PDT for large or deep tumors is currently limited, we are developing a new approach that combines differentiation-inducing agents with ALA-PDT to improve the clinical response. Here, we tested this new combination paradigm in the following two models of skin carcinoma in mice: 1) tumors generated by topical application of chemical carcinogens (DMBA-TPA); 2) human SCC cells (A431) implanted subcutaneously. To achieve a differentiated state of the tumors, pretreatment with a low concentration of methotrexate (MTX) or Vitamin D (Vit D) was administered for 72 h prior to exposure to ALA. Confocal images of histological sections were captured and digitally analyzed to determine relative PpIX levels. PpIX in the tumors was also monitored by real-time in vivo fluorescence dosimetry. In both models, a significant increase in levels of PpIX was observed following pretreatment with MTX or Vit D, as compared to no-pretreatment controls. This enhancing effect was observed at very low, non-cytotoxic concentrations, and was highly specific to cancer cells as compared to normal cells. These results suggest that use of differentiating agents such as MTX or Vit D, as a short-term combination therapy given prior to ALA-PDT, can increase the production of PpIX photosensitizer and enhance the therapeutic response of skin cancers.

  20. Skin toxicity and efficacy of sunitinib and sorafenib in metastatic renal cell carcinoma: a national registry-based study.

    PubMed

    Poprach, A; Pavlik, T; Melichar, B; Puzanov, I; Dusek, L; Bortlicek, Z; Vyzula, R; Abrahamova, J; Buchler, T

    2012-12-01

    A retrospective, registry-based analysis to assess the outcomes of metastatic renal cell cancer (mRCC) patients treated with sunitinib and sorafenib who developed dermatologic adverse events was performed. Data on mRCC patients treated with sunitinib or sorafenib were obtained from the Czech Clinical Registry of Renal Cell Cancer Patients. Outcomes of patients who developed hand-foot syndrome (HFS) of any grade and/or grade 3/4 rash during the treatment were compared with patients without HFS and no, mild, or moderate rash. The cohort included 705 patients treated with sunitinib and 365 patients treated with sorafenib. For sunitinib, the median overall survival (OS) was 43.0 months versus 31.0 months (P = 0.027) and median progression-free survival (PFS) 20.8 months versus 11.1 months (P = 0.007) for patients with versus without dermatologic toxicity, respectively. For sorafenib, the median OS and PFS were 27.9 and 24.6 months (P = 0.244), and 12.2 and 8.8 months (P = 0.050), respectively. In multivariable Cox regression, the skin toxicity was significantly associated with longer OS in the sunitinib cohort. The presence of skin toxicity is associated with improved OS and PFS in patients with mRCC treated with sunitinib.

  1. Isolation and evaluation of anticancer efficacy of stigmasterol in a mouse model of DMBA-induced skin carcinoma

    PubMed Central

    Ali, Huma; Dixit, Savita; Ali, Daoud; Alqahtani, Saeed M; Alkahtani, Saad; Alarifi, Saud

    2015-01-01

    Stigmasterol (99.9% pure) was isolated from Azadirachta indica and its chemopreventive effect on 7,12-dimethylbenz[a]anthracene (DMBA)-induced skin cancer was investigated in Swiss albino mice. Skin tumors were induced by topical application of DMBA and promoted by croton oil. To assess the chemopreventive potential of stigmasterol, it was orally administered at a concentration of 200 mg/kg and 400 mg/kg three times weekly for 16 weeks. Reduction in tumor size and cumulative number of papillomas were seen as a result of treatment with stigmasterol. The average latency period was significantly increased as compared with the carcinogen-treated control. Stigmasterol induced a significant decrease in the activity of serum enzymes, such as aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and bilirubin as compared with the control. Stigmasterol significantly increased glutathione, superoxide dismutase, and catalase as compared with the control. Elevated levels of lipid peroxide and DNA damage in the control group were significantly inhibited by administration of stigmasterol. From the present study, it can be inferred that stigmasterol has chemopreventive activity in an experimental model of cancer. This chemopreventive activity may be linked to the oxidative stress of stigmasterol. The antigenotoxic properties of stigmasterol are also likely to contribute to its chemopreventive action. PMID:26060396

  2. Correlation of distribution of sulphonated aluminium phthalocyanines with their photodynamic effect in tumour and skin of mice bearing CaD2 mammary carcinoma.

    PubMed Central

    Peng, Q.; Moan, J.

    1995-01-01

    A chemical extraction assay and fluorescence microscopy incorporating a light-sensitive thermoelectrically cooled charge-coupled device (CCD) camera was used to study the kinetics of uptake, retention and localisation of disulphonated aluminium phthalocyanine (A1PcS2) and tetrasulphonated aluminium phthalocyanine (A1PcS4) at different time intervals after an i.p. injection at a dose of 10 mg kg-1 body weight (b.w.) in tumour and surrounding normal skin and muscle of female C3D2/F1 mice bearing CaD2 mammary carcinoma. Moreover, the photodynamic effect on the tumour and normal skin using sulphonated aluminium phthalocyanines (A1PcS1, A1PcS2, A1pcS4) and Photofrin was compared with respect to dye, dye dose and time interval between dye administration and light exposure. The maximal concentrations of A1PcS2 in the tumour tissue were reached 2-24 h after injection of the dye, while the amounts of A1PcS4 peaked 1-2 h after the dye administration. A1PcS2 was simultaneously localised in the interstitium and in the neoplastic cells of the tumour, whereas A1PcS4 appeared to localise only in the stroma of the tumour. The photodynamic efficiency (light was applied 24 h after dye injection at a dose of 10 mg kg-1 b.w.) of the tumours was found to decrease in the following order: A1PcS2 > A1PcS4 > Photofrin > A1PcS1. Furthermore, photodynamic efficacy was strongly dependent upon dye doses and time intervals between dye administration and light exposure: the higher the dose, the higher the photodynamic efficiency. The most efficient photodynamic therapy (PDT) of the tumour was reached (day 20 tumour-free) when light exposure took place 2 h after injection of A1PcS2 (10 mg kg-1). A dual intratumoral localisation pattern of the dye, as found for A1PcS2, seems desirable to obtain a high photodynamic efficiency. The kinetic patterns of uptake, retention and localisation of A1PcS2 and A1PcS4 are roughly correlated with their photodynamic effect on the tumour and normal skin. Images

  3. [Inclusion of symptoms in the discrimination between benign and malignant adnexal masses].

    PubMed

    Hartman, Caio Augusto; Juliato, Cássia Raquel; Sarian, Luis Otávio; Barreta, Amilcar; de Toledo, Maria Carolina Szymanski; Pitta, Denise da Rocha; Derchain, Sophie

    2012-11-01

    To assess the association between clinical symptoms and the diagnosis of malignancy in women with adnexal tumors who underwent surgery. Cross-sectional study, in which 105 women with adnexal tumors and indication for laparotomy/laparoscopy were included. All women were treated at a teaching hospital in the state of São Paulo between November 2009 and March 2011. All patients underwent a structured interview about the occurrence of 18 symptoms associated with ovarian cancer. The interview included the severity, frequency, and duration of these symptoms in the 12 months prior to the first medical consultation. The CA125 levels and the ultrasound classification of the tumors were also evaluated. We calculated for each symptom the prevalence ratio with 95% confidence intervals. The golden-standard was the result of the pathological examination of the surgical specimens. Of the 105 women included, 75 (71.4%) had benign tumors and 30 (28.6%) had malignant ones. In women with malignant tumors, the most frequent symptoms were: abdominal bloating (70%), increased abdominal size (67%), pelvic pain (60%), menstrual irregularity (60%), swelling (53%), abdominal pain (50%), backache (50%), and early repletion (50%). Women with benign tumors showed essentially pelvic pain (61%), menstrual irregularities (61%), and abdominal swelling (47%). Symptoms significantly associated with malignancy were: bloating (PR=2.0; 95%CI 1.01 - 3.94), increased abdominal size (PR=2.16; 95%CI 1.12 - 4.16), backache (RP=1.97; 95%CI 1.09 - 3.55), swelling (PR=2.25; 95%CI 1.25 - 4.07), early repletion (RP=2.06; 95%CI 1.14 - 3.70), abdominal mass (PR=1.83; 95%CI 1.01 - 3.30), eating difficulties (PR=1.98; 95%CI 1.10 - 3.56), and postmenopausal bleeding (PR=2.91; 95%CI 1.55 - 5.44). The presence of pelvic pain, constipation, dyspareunia, fatigue, abdominal pain, nausea or vomiting, menstrual irregularity, weight loss, diarrhea, and bleeding after intercourse was similar in both groups. In women with

  4. Markers of cutaneous human papillomavirus infection in individuals with tumor-free skin, actinic keratoses, and squamous cell carcinoma.

    PubMed

    Struijk, Linda; Hall, Lisa; van der Meijden, Els; Wanningen, Patrick; Bavinck, Jan Nico Bouwes; Neale, Rachel; Green, Adèle C; Ter Schegget, Jan; Feltkamp, Mariet C W

    2006-03-01

    Separately, actinic keratosis (AK) and cutaneous squamous cell carcinoma (SCC) have been associated with cutaneous human papillomavirus (HPV) infections. To further explore the association between HPV infection and SCC development, we determined markers of cutaneous HPV infection within a single population in persons with precursor lesions (AK), cancerous lesions (SCC), and without. Serum and plucked eyebrow hairs were collected from 57 tumor-free controls, 126 AK, and 64 SCC cases. Presence of HPV L1 and E6 seroreactivity and viral DNA were determined for HPV types 5, 8, 15, 16, 20, 24, and 38. Significant positive associations with increasing severity of the lesions (controls, AK, and SCC, respectively) were observed for overall HPV L1 seropositivity (13%, 26%, and 37%) and for HPV8 (4%, 17%, and 30%). In parallel, the proportion of L1 seropositive individuals against multiple HPV types increased from 14% to 39% and 45%. The overall E6 seroreactivity, however, tended to decline with AK and SCC, especially for HPV8 (21%, 11%, and 2%). HPV DNA positivity was most prevalent in the AK cases (54%) compared with the SCC cases (44%) and the tumor-free controls (40%). Among all participants, there was a positive trend between overall HPV DNA positivity and L1 seropositivity, but not E6 seropositivity. Taken together, our data suggest that cutaneous HPV infections accompanied by detectable HPV DNA in eyebrow hairs and HPV L1 seropositivity, but not E6 seropositivity, are associated with an increased risk of AK and SCC.

  5. Patched (ptch)-associated preferential expression of smoothened (smoh) in human basal cell carcinoma of the skin.

    PubMed

    Kallassy, M; Toftgård, R; Ueda, M; Nakazawa, K; Vorechovský, I; Yamasaki, H; Nakazawa, H

    1997-11-01

    The discovery of specific overexpression of a gatekeeper gene, ptch, in basal cell carcinoma (BCC) led to a hypothesis that the human homologue of patched (PTCH) normally functions as a negative regulator of the signaling pathway that is initiated by hedgehogs (HHs) and activated by the human homologue of smoothened (SMOH); however, no evidence for the involvement of smoh and hhs has been provided. Here, we show novel evidence that smoh is also preferentially overexpressed in BCC, together with ptch (P < 0.002), and that Sonic hh was expressed in only some BCCs. Our data, therefore, indicate that such overexpression of smoh may be associated with overexpression or mutation of PTCH and that this overexpression subsequently stimulates the PTCH/SMOH signaling pathway. In an investigation of a possible regulation of ptch and smoh, we demonstrated that expression of exogenous p21WAF1 in immortalized keratinocytes down-regulates both ptch and smoh and that the down-regulation is accompanied by growth arrest, which suggests the involvement of p21WAF1 in regulation of the PTCH/SMOH signaling pathway.

  6. Adnexal Torsion

    MedlinePlus

    ... Dictionary Also of Interest (Quiz) Overview of the Female Reproductive System (Video) Cervical Dysplasia (News) Antiperspirant Use Seems Safe ... version Also of Interest Test your knowledge The female reproductive system consists of the external and internal genital organs. ...

  7. One-Step Laparoscopic Management of a Female Adnexal Tumor of Wolffian Origin

    PubMed Central

    Seracchioli, R.; Mabrouk, M.; Solfrini, S.; Savelli, S.; Caprara, G.; Facchini, C.; Geraci, E.; Del Forno, S.; Venturoli, S.

    2010-01-01

    We report a case of female adnexal tumor of Wolffian origin (FATWO), a rare neoplasm arising from the mesonephric ducts. A 48-year-old woman came first to our center for a recent discovery of a pelvic mass. Transvaginal ultrasonographic findings suggested a solid right para-ovarian mass suspected to be malignant. After thorough counseling, the patient underwent operative laparoscopy for excision of the para-ovarian mass with frozen section (FS) examination resulting in the diagnosis of a poorly differentiated adenocarcinoma. In this case, FS results allowed performing a comprehensive oncological staging, through a totally laparoscopic extrafascial hysterectomy, bilateral adnexectomy, total omentectomy, pelvic wall peritonectomy, and pelvic, parasacral and para-aortic lymphadenectomy. Final pathological and immunohistochemical results confirmed the diagnosis of FATWO. To our knowledge, this is the first case of FATWO managed entirely by a minimally invasive laparoscopic approach in a single surgical session. PMID:21151637

  8. Wilkie's Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma.

    PubMed

    Devadass, Clement Wilfred; Okaly, Geetha V Patil; Hm, Sudha; Pai, Sreekar Agumbe; Sridher, H

    2014-08-01

    Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3(rd) portion of duodenum with reduced aortomesentric angle consistent with Wilkie's syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia. The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses.

  9. Tumefactive intramural gossypiboma of the urinary bladder mimicking an invasive adnexal malignancy

    PubMed Central

    Jain, Shivi; Verma, Ashish; Jain, Madhu; Trivedi, Sameer; Shukla, Ram C; Srivastava, Arvind

    2015-01-01

    A surgical swab retained in the body after surgery is known as ‘Gossypiboma’. The purpose of this report is to highlight an intramural vesical gossypiboma mimicking an invasive adnexal malignancy. A 28-year-old multiparous, with open-tubal ligation three years ago, presented with painless hematuria and a nontender mass on vaginal examination. USG suggested ‘pelvic endometriosis’ infiltrating into the bladder and cystoscopy showed no intraluminal extension of the mass. Contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) misdiagnosed it as invasive malignancy of the fallopian tube. Exploratory laparotomy found it to be an intramural vesical gossypiboma. A pelvic gossypiboma infiltrating into the wall of the urinary bladder may easily be misinterpreted as an invasive pelvic malignancy on imaging and may make one consider unwarranted radical surgery. PMID:25969644

  10. Adnexal Incarceration in a Posterior Pelvic Peritoneal Defect Mimics Ovarian Torsion.

    PubMed

    Jackson, Amanda M; Hope, Erica R; Phippen, Neil T

    2015-01-01

    Surgery for suspected ovarian torsion sometimes reveals unexpected sources of pelvic pain, such as internal hernias, adhesions, or anatomic defects. A 23-year-old nulligravida with Alagille syndrome was taken to the operating room with suspected ovarian torsion. Intraoperatively, the right adnexa bulged out of a right-sided, posterior peritoneal cleft that incarcerated most of the enlarged ovary. No ovarian torsion was identified. The left adnexa appeared to be normal; however, it dwelled within a left-sided posterior peritoneal cleft. The bilateral posterior peritoneal defects that housed the adnexa were likely of congenital etiology. Although adnexal incarceration is a rare finding at surgery for suspected ovarian torsion, it should be part of the differential diagnosis when evaluating acute pelvic pain.

  11. Ophthalmic diagnostic tests, orbital anatomy, and adnexal histology of the broad-snouted caiman (Caiman latirostris).

    PubMed

    Oriá, Arianne P; Oliveira, Alberto Vinícius D; Pinna, Melissa H; Martins Filho, Emanoel F; Estrela-Lima, Alessandra; Peixoto, Tiago C; Silva, Renata Maria M da; Santana, Fernanda O; Meneses, Íris Daniela S; Requião, Kátia G; Ofri, Ron

    2015-01-01

    The aim of this study was to establish normal ophthalmic parameters for selected diagnostic tests, and to describe the orbital anatomy and adnexal histology of the broad-snouted caiman. A total of 35 Caiman latirostris that were free of obvious ocular diseases were used to measure the parameters in this investigation. Ages ranged from 5 to 15 years. Ophthalmic diagnostic tests were conducted, including evaluation of tear production with Schirmer Tear test-1 (STT1), culture of the conjunctival bacterial flora, applanation tonometry, conjunctival cytology, nictiating membrane incursion frequency test (NMIFT), endodontic absorbent paper point tear test (EAPPTT), palpebral fissure length measurement (PFL) and B-mode ultrasonography. Adnexal histology and skull samples were studied. Mean (±SD) STT1 was 3.4 ± 3.6 mm/min (95% confidence interval of 2.01-4.78 mm/min), intraocular pressure (IOP) was 12.9 ± 6.2 mmHg, NMIFT was 6.0 ± 3.5, EAPPTT was 17.1 ± 2.5 mm/min, PFL was 28.9 ± 3.0 mm, anterior chamber depth was 3.1 ± 0.3 mm, lens axial length was 8.4 ± 0.6 mm, vitreous chamber depth was 7.9 ± 0.7 mm and axial globe length was 19.9 ± 1.3 mm. For all animals evaluated, Bacillus sp., Diphteroids and Staphylococcus sp. were predominant. © 2013 American College of Veterinary Ophthalmologists.

  12. Can a T2 hyperintense rim sign differentiate uterine leiomyomas from other solid adnexal masses?

    PubMed

    Reiter, Michael J; Schwope, Ryan B; Lisanti, Christopher J; Banks, Nancy B

    2015-10-01

    To investigate the incidence of high T2 signal rims surrounding leiomyomas, evaluate if a particular T2-weighted sequence is more effective in depicting this rim, and determine if this sign is useful in differentiating pedunculated leiomyomas from other solid adnexal masses. In this retrospective study, two radiologists evaluated 233 T2 dark pelvic masses (223 uterine leiomyomas and 10 ovarian fibromas) in 60 women (mean age 47) on Magnetic resonance imaging for the presence of a high signal rim. Three different T2-weighted sequences were reviewed independently for uterine leiomyomas: half-Fourier acquisition single-shot turbo spin echo (HASTE), SPACE, and T2 with fat saturation (T2 FS). Only T2 FS images were available for 10 fibromas. A consensus review was conducted for discrepant cases. Statistical analyses were performed using Fisher's exact test, kappa test, and ANOVA RESULTS: For 223 uterine leiomyomas, 23% (95% CI 17.8-28.9%) demonstrated a high T2 signal rim sign on T2 FS compared with 4.9% (95% CI 2.6-8.9%) for HASTE and 6.7% (95% CI 3.9-11.1%) for SPACE. The difference between the number of positive rims on T2 FS relative-HASTE and SPACE was statistically significant (p < 0.001). For ovarian fibromas, 40% (95% CI 16.9-68.8%) were classified positive for a rim sign. A high T2 signal rim sign was present for up to 23% of uterine leiomyomas and the T2 FS sequence detected this rim sign most frequently. Up to 40% of ovarian fibromas can also have a T2 rim sign and, therefore, a solid adnexal mass with a T2 rim sign cannot be assumed to represent a pedunculated leiomyoma.

  13. Assessment of factors that affect the quality of performance and interpretation of sonography of adnexal masses.

    PubMed

    Levine, Deborah; Asch, Elizabeth; Mehta, Tejas S; Broder, Jennifer; O'Donnell, Carl; Hecht, Jonathan L

    2008-05-01

    The purpose of this study was to assess factors that affect the quality of performance and interpretation of sonography of adnexal masses. Two gynecologic sonographers performed blinded reviews of up to 3 sonograms within 5 years before surgery in 325 consecutive women who underwent oophorectomy (610 sonograms). Three 5-point quality scores were assigned (with 5 being the best score) on the basis of the technical quality of the images, accurate description of findings, and summary impression in the report. The location of the examination (on-site, remote, or emergency department), type of fellowship, practice experience (<5, 5-10, or >10 years), and specialty (women's imaging, abdominal imaging, or other) of the radiologists were recorded. Analysis of variance was used to assess the impact of these multiple factors on quality. No significant differences were found among 31 radiologists on the basis of the type of training, years in practice, or number of examinations read. Average scores among radiologists for technical quality, findings, and impressions were 4.96, 4.88, and 4.83, respectively. Radiologists who specialized in women's imaging performed best in the quality of their impressions (4.86 versus 4.79; P = .029). There were no significant differences in scores with respect to the examination location. Within this sample of radiologists, the technical quality of the examinations was not affected by the type of training or subspecialty practice. Reports of adnexal mass findings were accurately described by all radiologists, although specialization in women's imaging improved the ability to provide an accurate impression.

  14. Ocular adnexal marginal zone B cell lymphoma: a clinical and pathologic study of 23 cases.

    PubMed

    Charlotte, Frédéric; Doghmi, Kamal; Cassoux, Nathalie; Ye, Hongtao; Du, Ming-Qing; Kujas, Michèle; Lesot, Annette; Mansour, George; Lehoang, Phuc; Vignot, Nicole; Capron, Frédérique; Leblond, Véronique

    2006-04-01

    To better characterize ocular adnexal marginal zone lymphoma of mucosa-associated lymphoid tissue (MZL-MALT), we analyzed the clinical and pathologic features of 23 patients (11 men, 12 women, median age 66 years). The tumor was confined to one ocular structure in 18 cases (conjunctiva, n=8; orbit, n=8; or lacrimal gland, n=2). Concurrent extraorbital disease was detected by the staging procedure in five patients, and preferentially involved other MALT sites. Histogenetic B cell marker studies, available in 13 cases, showed an early post-germinal center (GC) phenotype (BCL-6(-)/IRF4(+)/CD138(-)) (n=5) or a late post-GC phenotype (BCL-6(-)/IRF4(+)/CD138(+)) (n=8), which could be helpful for discrimination from other types of small-B cell lymphoma. BCL10 was positive in 12 of 13 patients tested, with nuclear (n=4) or cytoplasmic (n=8) immunoreactivity. These staining patterns ruled out t(1;14)(p22;q32) translocation. T(11;18)(q21;q21), another MZL-MALT-specific translocation, was detected by reverse transcriptase polymerase chain reaction in four of 15 patients tested. Clinical outcome was excellent but the overall relapse rate was 26.1% with a median follow-up of 39 months (range 6-132 months). Regardless of the disease stage at diagnosis, combined chemotherapy and radiotherapy seemed to be more effective than chemotherapy alone in ocular adnexal MZL-MALT, as persistent complete remission was achieved in nine patients receiving combination therapy, while six of 14 patients treated with chemotherapy alone relapsed.

  15. Lysyl oxidase-like 2 represses Notch1 expression in the skin to promote squamous cell carcinoma progression

    PubMed Central

    Martin, Alberto; Salvador, Fernando; Moreno-Bueno, Gema; Floristán, Alfredo; Ruiz-Herguido, Cristina; Cuevas, Eva P; Morales, Saleta; Santos, Vanesa; Csiszar, Katalin; Dubus, Pierre; Haigh, Jody J; Bigas, Anna; Portillo, Francisco; Cano, Amparo

    2015-01-01

    Lysyl oxidase-like 2 (LOXL2) is involved in a wide range of physiological and pathological processes, including fibrosis and tumor progression, implicating intracellular and extracellular functions. To explore the specific in vivo role of LOXL2 in physiological and tumor contexts, we generated conditional gain- and loss-of-function mouse models. Germ-line deletion of Loxl2 promotes lethality in half of newborn mice mainly associated to congenital heart defects, while Loxl2 overexpression triggers male sterility due to epididymal dysfunction caused by epithelial disorganization, fibrosis and acute inflammation. Remarkably, when challenged to chemical skin carcinogenesis, Loxl2-overexpressing mice increased tumor burden and malignant progression, while Loxl2-deficient mice exhibit the opposite phenotypes. Loxl2 levels in premalignant tumors negatively correlate with expression of epidermal differentiation markers and components of the Notch1 pathway. We show that LOXL2 is a direct repressor of NOTCH1. Additionally, we identify an exclusive expression pattern between LOXL2 and members of the canonical NOTCH1 pathway in human HNSCC. Our data identify for the first time novel LOXL2 roles in tissue homeostasis and support it as a target for SCC therapy. PMID:25759215

  16. [Early diagnosis of skin cancer].

    PubMed

    Kolm, Isabell; Hofbauer, Günther; Braun, Ralph P

    2010-09-01

    The skin is the most affected organ by cancer. The incidence rates of skin cancer are steadily increasing, both for melanoma and non-melanoma skin cancers (squamous cell carcinoma, basal cell carcinoma). Over 90 % of the death cases from skin cancers attribute to melanoma. Survival from melanoma is strongly related to tumour thickness. Therefore early detection is the most important step to improve prognosis. In the last years a number of new non invasive techniques for the early diagnosis of melanoma have been developed which are superior to the naked eye examination. In this overview article we present some non-invasive diagnostic techniques like total body photography, digital dermoscopy and confocal microscopy which in addition to dermoscopy assist the dermatologist in differentiating nevi from early melanomas.Non-melanoma skin cancer can be prevented by accurate sun protection. Early squamous cell carcinomas and basal cell carcinomas can be treated either invasively or non-invasively with excellent prognosis.

  17. A new algorithm for the discrimination of actinic keratosis from normal skin and squamous cell carcinoma based on in vivo analysis of optical properties by high-definition optical coherence tomography.

    PubMed

    Boone, M A L M; Suppa, M; Marneffe, A; Miyamoto, M; Jemec, G B E; Del Marmol, V

    2016-10-01

    High-definition optical coherence tomography (HD-OCT) features of actinic keratosis (AK) may aid in its diagnosis and therapeutic strategy. A diagnostic algorithm permitting discrimination of AK from squamous cell carcinoma (SCC) and normal skin has been proposed. However, diagnostic accuracy strongly depends on the experience of physicians. In two recent studies, it was demonstrated that HD-OCT permits to quantify in vivo optical properties such as light attenuation in intrinsic ageing skin, in melanocytic lesions and in basal cell carcinoma. This approach seems to permit a semiautomated classification of lesions easier to handle by non-experts. The aim of this paper was to quantify in vivo optical properties of facial located AK/SCC lesions, such as light attenuation, by HD-OCT. Additional objectives were to determine the best critical value of these optical properties for discrimination of AK from SCC and from normal sun exposed skin and to subdifferentiate AKs. The technique of semi-log plot has been implemented on HD-OCT signals. This permitted the in vivo measurement of OCT signals coming from the skin entrance up to the superficial reticular dermis. Moreover, relative attenuation factor (μraf ) at different skin layers (1-3) could be determined. Optical properties with high diagnostic accuracy (DA) and high negative predictive values (NPV) could be defined permitting the differentiation between normal skin, non-Bowenoid AK without follicular involvement, non-Bowenoid AK with follicular involvement, Bowenoid AK, hypertrophic and lichenoid form of AK and squamous cell carcinoma. HD-OCT seems to enable the combination of in vivo morphological analysis of cellular and 3D microarchitectural structures with in vivo analysis of optical properties of tissue scatterers in AK/SCC lesions and normal sun-exposed skin. In vivoHD-OCT analysis of optical properties permits AK discrimination from SCC and AK subdifferentiation with higher accuracy than in vivo

  18. Tomotherapy concomitant with cetuximab, followed by cetuximab as single-agent therapy for unresectable squamous cell carcinoma of the skin: a case report

    PubMed Central

    2014-01-01

    Background Cutaneous squamous cell carcinoma (SCC) is the second most frequency of all skin tumors. Incidence of SCC has risen significantly due to an increased sun exposure and the number of immunodeficient patients. Cutaneous SCC is characterized by high Epidermal growth factor receptor (EGFR) expression with low frequency of RAS mutations. Generally, locoregional surgery is curative and systemic therapy is not indicated. We evaluated the activity and toxicity profile of tomotherapy concomitant with Cetuximab, followed by Cetuximab as single agent therapy in a patient affected by unresectable, locally advanced cutaneous SCC. Case presentation At our institution, on March 2012 we treated a 45 years-old patient affected by locally advanced, unresectable G1 SCC of the lumbar region. At our first observation, the patient was asthenic, with severe pain and functional limitations. There was also a superinfection due to Pseudomonas Aeruginosa resistant to antibiotics, and a G3 anemia secondary to the bleeding lesion. ECOG Performance Status was 2. Tomotherapy has been performed concomitant with the Cetuximab (400 mg/m2, followed by weekly doses of 250 mg/m2) at the total dose of 60 Gy (2 Gy/fx), followed by Cetuximab monotherapy. The lesion reduced progressively until disappear even after the suspension of the treatment and the patient achieved complete response. Toxicity resulted in G1 cutaneous rash and G2 toxicity to the nails, appeared after 5 months of treatment, typical toxicity profile of the anti-EGFR therapies. After one month of therapy the Pseudomonas Aeruginosa superinfection totally disappeared. Quality of life resulted significantly improved with reduction until discontinuation of the anti-pain drugs, and progressive increase of the hemoglobin levels. At follow up of 15 months there was no evidence of active disease and the ECOG Performance Status was 0 (zero). Conclusion The treatment was effective and feasible. Considering these excellent results

  19. Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline.

    PubMed

    Stratigos, Alexander; Garbe, Claus; Lebbe, Celeste; Malvehy, Josep; del Marmol, Veronique; Pehamberger, Hubert; Peris, Ketty; Becker, Jürgen C; Zalaudek, Iris; Saiag, Philippe; Middleton, Mark R; Bastholt, Lars; Testori, Alessandro; Grob, Jean-Jacques

    2015-09-01

    Cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in Caucasian populations, accounting for 20% of all cutaneous malignancies. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on cSCC diagnosis and management, based on a critical review of the literature, existing guidelines and the expert's experience. The diagnosis of cSCC is primarily based on clinical features. A biopsy or excision and histologic confirmation should be performed in all clinically suspicious lesions in order to facilitate the prognostic classification and correct management of cSCC. The first line treatment of cutaneous SCC is complete surgical excision with histopathological control of excision margins. The EDF-EADO-EORTC consensus group recommends a standardised minimal margin of 5 mm even for low-risk tumours. For tumours, with histological thickness of >6 mm or in tumours with high risk pathological features, e.g. high histological grade, subcutaneous invasion, perineural invasion, recurrent tumours and/or tumours at high risk locations an extended margin of 10 mm is recommended. As lymph node involvement by cSCC increases the risk of recurrence and mortality, a lymph node ultrasound is highly recommended, particularly in tumours with high-risk characteristics. In the case of clinical suspicion or positive findings upon imaging, a histologic confirmation should be sought either by fine needle aspiration or by open lymph node biopsy. In large infiltrating tumours with signs of involvement of underlying structures, additional imaging tests, such as CT or MRI imaging may be required to accurately assess the extent of the tumour and the presence of metastatic spread. Current staging systems for cSCC are not optimal, as they have been developed for head and neck

  20. Differential responses of skin cancer-chemopreventive agents silibinin, quercetin, and epigallocatechin 3-gallate on mitogenic signaling and cell cycle regulators in human epidermoid carcinoma A431 cells.

    PubMed

    Bhatia, N; Agarwal, C; Agarwal, R

    2001-01-01

    Silibinin, quercetin, and epigallocatechin 3-gallate (EGCG) have been shown to be skin cancer-preventive agents, albeit by several different mechanisms. Here, we assessed whether these agents show their cancer-preventive potential by a differential effect on mitogenic signaling molecules and cell cycle regulators. Treatment of human epidermoid carcinoma A431 cells with these agents inhibited the activation of the epidermal growth factor receptor and the downstream adapter protein Shc, but only silibinin showed a marked inhibition of mitogen-activated protein kinase-extracellular signal-regulated kinase-1 and -2 activation. In terms of cell cycle regulators, silibinin treatment showed an induction of Cip1/p21 and Kip1/p27 together with a significant decrease in cyclin-dependent kinase (CDK)-4, CDK2, and cyclin D1. Quercetin treatment, however, resulted in a moderate increase in Cip1/p21 with no change in Kip1/p27 and a decrease in CDK4 and cyclin D1. EGCG treatment also led to an induction of Cip1/p21 but no change in Kip1/27, CDK2, and cyclin D1 and a decrease in CDK4 only at low doses. Treatment of cells with these agents resulted in a strong dose- and time-dependent cell growth inhibition. A high dose of silibinin and low and high doses of quercetin and EGCG also led to cell death by apoptosis, suggesting that a lack of their inhibitory effect on mitogen-activated protein kinase-extracellular signal-regulated kinase-1 and -2 activation possibly "turns on" an apoptotic cell death response associated with their cancer-preventive and anticarcinogenic effects. Together, these results suggest that silibinin, quercetin, and EGCG exert their cancer-preventive effects by differential responses on mitogenic signaling and cell cycle regulators.

  1. Suppression of the metastatic phenotype of a mouse skin carcinoma cell line independent of E-cadherin expression and correlated with reduced Ha-ras oncogene products.

    PubMed

    Caulín, C; López-Barcons, L; Gonzáles-Garrigues, M; Navarro, P; Lozano, E; Rodrigo, I; Gamallo, C; Cano, A; Fabra, A; Quintanilla, M

    1996-02-01

    The HaCa4 cell line, derived from a mouse skin carcinoma induced by Harvey murine sarcoma virus, is highly tumorigenic when injected into nude mice and produces multiple metastases in the lungs. HaCa4 cells express high levels of viral Ha-ras oncogene products, anomalously synthesize the embryonic/simple epithelial keratin K8, and have lost the expression of the cell-cell adhesion receptor E-cadherin (E-CD). E-CD(+) cell clones (E62 and E24), obtained by transfection of an exogenous E-CD cDNA into HaCa4 cells, had a decreased ability to migrate through type IV collagen matrices. However, the E-CD (+) E62 clone remained as metastatic as the parental cell line, whereas the E24 clone, which does not take up the exogenous cDNA but spontaneously switches on the endogenous E-CD gene, suppressed the metastatic phenotype although it maintained its tumorigenicity. E24 cells had fivefold to sixfold lower levels of viral Ha-ras mRNA and p21 protein than the other cell lines. In addition, they did not synthesize K8 but rather switched on keratin K19. The comparison of E-CD proteins synthesized by E62 and E24 cell lines revealed no structural or functional differences because both localized at cell-cell contacts and associated with alpha-catenin, beta-catenin, and plakoglobin. Furthermore, E-CD was still expressed in metastatic lung nodules produced by E62 cells. These results suggest that suppression of the metastatic phenotype in E24 cells occurs independently of E-CD expression and correlates with decreased levels of the oncogenic ras p21 protein.

  2. Differentiating normal and basal cell carcinoma human skin tissues in vitro using dispersive Raman spectroscopy: a comparison between principal components analysis and simplified biochemical models.

    PubMed

    Bodanese, Benito; Silveira, Landulfo; Albertini, Regiane; Zângaro, Renato Amaro; Pacheco, Marcos Tadeu Tavares

    2010-08-01

    Raman spectroscopy has been used to detect spectral differences between normal and basocellular cell carcinoma (BCC) skin tissues that are related to biochemical alterations between tissues. Raman spectroscopy is an analytic tool that could detect biochemical alterations in tissues, and its use would lead to real-time and less-invasive cancer diagnosis. Raman spectra from human tissue fragments (normal and BCC) were obtained in a dispersive, near-infrared Raman spectrometer (laser parameters: 830 nm, 80 mW) with a CCD detector. Spectral changes between normal and BCC were analyzed with a principal components analysis (PCA) algorithm and a simplified biochemical model based on the relative amount of collagen and cell fat extracted from tissue Raman spectra. Main spectral differences between these samples were in the region of 800 to 1,000 per centimeter and 1,200 to 1,300 per centimeter, corresponding to vibrational bands from lipids and proteins (C-C bonds and amide III, respectively). The diagnostic algorithm based on PCA and Mahalanobis distance applied to the scores of principal components vectors PC1 and PC2 could identify tissue with sensitivity and specificity of 89% and 93%, respectively, for the training group and 96% and 92% for the prospective group. The simplified biochemical model for collagen amount had sensitivity and specificity of 95% and 83% for the training group and 87% and 92% for the prospective group. Raman spectroscopy could differentiate between normal and BCC tissues in both the PCA and biochemical models, showing higher sensitivity and specificity for the PCA model, although the simplified biochemical model is easier to implement.

  3. Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group

    PubMed Central

    Ameye, Lieveke; Fischerova, Daniela; Epstein, Elisabeth; Melis, Gian Benedetto; Guerriero, Stefano; Van Holsbeke, Caroline; Savelli, Luca; Fruscio, Robert; Lissoni, Andrea Alberto; Testa, Antonia Carla; Veldman, Joan; Vergote, Ignace; Van Huffel, Sabine; Bourne, Tom; Valentin, Lil

    2010-01-01

    Objectives To prospectively assess the diagnostic performance of simple ultrasound rules to predict benignity/malignancy in an adnexal mass and to test the performance of the risk of malignancy index, two logistic regression models, and subjective assessment of ultrasonic findings by an experienced ultrasound examiner in adnexal masses for which the simple rules yield an inconclusive result. Design Prospective temporal and external validation of simple ultrasound rules to distinguish benign from malignant adnexal masses. The rules comprised five ultrasonic features (including shape, size, solidity, and results of colour Doppler examination) to predict a malignant tumour (M features) and five to predict a benign tumour (B features). If one or more M features were present in the absence of a B feature, the mass was classified as malignant. If one or more B features were present in the absence of an M feature, it was classified as benign. If both M features and B features were present, or if none of the features was present, the simple rules were inconclusive. Setting 19 ultrasound centres in eight countries. Participants 1938 women with an adnexal mass examined with ultrasound by the principal investigator at each centre with a standardised research protocol. Reference standard Histological classification of the excised adnexal mass as benign or malignant. Main outcome measures Diagnostic sensitivity and specificity. Results Of the 1938 patients with an adnexal mass, 1396 (72%) had benign tumours, 373 (19.2%) had primary invasive tumours, 111 (5.7%) had borderline malignant tumours, and 58 (3%) had metastatic tumours in the ovary. The simple rules yielded a conclusive result in 1501 (77%) masses, for which they resulted in a sensitivity of 92% (95% confidence interval 89% to 94%) and a specificity of 96% (94% to 97%). The corresponding sensitivity and specificity of subjective assessment were 91% (88% to 94%) and 96% (94% to 97%). In the 357 masses for which the

  4. Single Port Transumbilical Laparoscopic Surgery versus Conventional Laparoscopic Surgery for Benign Adnexal Masses: A Retrospective Study of Feasibility and Safety

    PubMed Central

    Wang, Si-Yun; Yin, Ling; Guan, Xiao-Ming; Xiao, Bing-Bing; Zhang, Yan; Delgado, Amanda

    2016-01-01

    Background: Single port laparoscopic surgery (SPLS) is an innovative approach that is rapidly gaining recognition worldwide. The aim of this study was to determine the feasibility and safety of SPLS compared to conventional laparoscopic surgery for the treatment of benign adnexal masses. Methods: In total, 99 patients who underwent SPLS for benign adnexal masses between December 2013 and March 2015 were compared to a nonrandomized control group comprising 104 conventional laparoscopic adnexal surgeries that were performed during the same period. We retrospectively analyzed multiple clinical characteristics and operative outcomes of all the patients, including age, body mass index, size and pathological type of ovarian mass, operative time, estimated blood loss (EBL), duration of postoperative hospital stay, etc. Results: No significant difference was observed between the two groups regarding preoperative baseline characteristics. However, the pathological results between the two groups were found to be slightly different. The most common pathological type in the SPLS group was mature cystic teratoma, whereas endometrioma was more commonly seen in the control group. Otherwise, the two groups had comparable surgical outcomes, including the median operation time (51 min vs. 52 min, P = 0.909), the median decreased level of hemoglobin from preoperation to postoperation day 3 (10 g/L vs. 10 g/L, P = 0.795), and the median duration of postoperative hospital stay (3 days vs. 3 days, P = 0.168). In SPLS groups, the median EBL and the anal exsufflation time were significantly less than those of the conventional group (5 ml vs. 10 ml, P < 0.001; 10 h vs. 22 h, P < 0.001). Conclusions: SPLS is a feasible and safe approach for the treatment of benign adnexal masses. Further study is required to better determine whether SPLS has significant benefits compared to conventional techniques. PMID:27231167

  5. Vismodegib in basal cell carcinoma.

    PubMed

    Amaria, R N; Bowles, D W; Lewis, K D; Jimeno, A

    2012-07-01

    Vismodegib is a novel, small-molecule inhibitor of smoothened, a key component of the hedgehog signaling pathway. Increased hedgehog pathway signaling is critical in the development of hereditary and spontaneous basal cell carcinomas of the skin, and has been implicated in the development of a number of other tumors. In preclinical models, vismodegib demonstrated potent antitumor activity in hedgehog-dependent tumors, particularly basal cell carcinomas. Clinically, phase I and II studies showed dramatic anticancer activity in patients with advanced basal cell carcinomas. In January 2012, vismodegib was approved by the FDA for the treatment of unresectable or metastatic basal cell carcinomas of the skin.

  6. Randomized controlled trial of the prophylactic effect of urea-based cream on sorafenib-associated hand-foot skin reactions in patients with advanced hepatocellular carcinoma.

    PubMed

    Ren, ZhengGang; Zhu, KangShun; Kang, HaiYan; Lu, MinQiang; Qu, ZengQiang; Lu, LiGong; Song, TianQiang; Zhou, WeiPing; Wang, Hui; Yang, WeiZhu; Wang, Xuan; Yang, YongPing; Shi, LeHua; Bai, YuXian; Guo, XiaoFeng; Ye, Sheng-Long

    2015-03-10

    To assess whether urea-based cream (UBC) has prophylactic benefits on sorafenib-induced hand-foot skin reaction (HFSR) in patients with advanced hepatocellular carcinoma (HCC). In this randomized, open-label trial, 871 patients with advanced HCC throughout China were treated with 10% UBC three times per day plus best supportive care (BSC; n = 439) or BSC alone excluding all creams (n = 432), starting on day 1 of sorafenib treatment, for up to 12 weeks. HFSR was assessed every 2 weeks and at 14 weeks for patients completing the study. Once HFSR occurred, patients were allowed any cream, including a UBC. The 12-week incidence of any grade HFSR was significantly lower in the UBC group versus the BSC-alone group (56.0% v 73.6%, respectively; odds ratio [OR], 0.457; 95% CI, 0.344 to 0.608; P < .001), as was the incidence of grade ≥ 2 HFSR (20.7% v 29.2%, respectively; OR, 0.635; 95% CI, 0.466 to 0.866; P = .004). Median time to first occurrence of HFSR was significantly longer in the UBC group than the BSC-alone group (84 v 34 days, respectively; hazard ratio, 0.658; 95% CI, 0.541 to 0.799; P < .001). Elevated AST was associated with increased risk of HFSR but did not alter the treatment effect of UBC. UBC plus BSC, compared with BSC alone, did not affect the sorafenib dose reduction or interruption rate (9.1% v 11.8%, respectively; P = .1937), response rate (11.1% v 10.1%, respectively; P = .6674), or disease control rate (98.8% v 98.2%, respectively; P = .5350) at week 12. UBC prophylaxis in patients with advanced HCC starting sorafenib reduced HFSR rates, extended the time to first occurrence of HFSR, and improved patient quality of life compared with BSC. Blinded, randomized, placebo-controlled trials to determine the role of UBC on the incidence and severity of HFSR are warranted. © 2015 by American Society of Clinical Oncology.

  7. [Case with hairy cell leukemia-Japanese variant following radiotherapy for orbital adnexal MALT lymphoma].

    PubMed

    Nakamura, Yuichi; Kayano, Hidekazu; Kakegawa, Emi; Uchida, Yumiko; Shimada, Tsuneyuki; Wakimoto, Naoki; Ito, Yoshihiro; Bessho, Masami

    2010-11-01

    We report a patient with hairy cell leukemia Japanese variant (HCL-Jv) that developed after radiotherapy for orbital adnexal MALT lymphoma. A 78-year-old man was diagnosed as having MALT lymphoma in the left conjunctiva in December 2003. The patient was treated by local radiotherapy and the tumor disappeared. Thereafter, he gradually developed leukocytosis and mild splenomegaly. In May 2009, the leukocyte count was 34,300 with 80% lymphoid cells. A diagnosis of HCL-Jv was made since the lymphoid cells showed a hairy morphology with round nuclei and indistinct nucleoli. These cells expressed CD11c, CD19, CD20, CD103 and showed weak reaction for tartrate-resistant acid phosphatase (TRAP). Bone marrow was infiltrated by atypical cells with an intrasinusoidal pattern. No treatment was needed as the patient was asymptomatic without anemia, thrombocytopenia or lymphadenopathy. Results of the immunoglobulin light chain expression and the heavy chain rearrangement in the tumor cells indicated that the two mature B-lymphoid neoplasms, MALT lymphoma and HCL-Jv, in this patient were derived from independent clones. This appears to be the first reported case of HCL-Jv associated with other lymphoid tumor. Further analysis is needed to clarify the risk of secondary malignancy in HCL-Jv.

  8. Uncommon Implantation Sites of Ectopic Pregnancy: Thinking beyond the Complex Adnexal Mass.

    PubMed

    Chukus, Anjeza; Tirada, Nikki; Restrepo, Ricardo; Reddy, Neelima I

    2015-01-01

    Ectopic pregnancy occurs when implantation of the blastocyst takes place in a site other than the endometrium of the uterine cavity. Uncommon implantation sites of ectopic pregnancy include the cervix, interstitial segment of the fallopian tube, scar from a prior cesarean delivery, uterine myometrium, ovary, and peritoneal cavity. Heterotopic and twin ectopic pregnancies are other rare manifestations. Ultrasonography (US) plays a central role in diagnosis of uncommon ectopic pregnancies. US features of an interstitial ectopic pregnancy include an echogenic interstitial line and abnormal bulging of the myometrial contour. A gestational sac that is located below the internal os of the cervix and that contains an embryo with a fetal heartbeat is indicative of a cervical ectopic pregnancy. In a cesarean scar ectopic pregnancy, the gestational sac is implanted in the anterior lower uterine segment at the site of the cesarean scar, with thinning of the myometrium seen anterior to the gestational sac. An intramural gestational sac implants in the uterine myometrium, separate from the uterine cavity and fallopian tubes. In an ovarian ectopic pregnancy, a gestational sac with a thick hyperechoic circumferential rim is located in or on the ovarian parenchyma. An intraperitoneal gestational sac is present in an abdominal ectopic pregnancy. Intra- and extrauterine gestational sacs are seen in a heterotopic pregnancy. Two adnexal heartbeats suggest a live twin ectopic pregnancy. Recognition of the specific US features will help radiologists diagnose these uncommon types of ectopic pregnancy.

  9. Adnexal masses associated with peritoneal involvement: diagnosis with CT and MRI.

    PubMed

    Ognong-Boulemo, Audrey; Dohan, Anthony; Hoeffel, Christine; Stanek, Agatha; Golfier, François; Glehen, Olivier; Valette, Pierre-Jean; Rousset, Pascal

    2017-03-18

    Given the unique intra-peritoneal anatomic location of the adnexa, tubo-ovarian diseases can commonly spread into the peritoneal cavity. Peritoneal seeding may occur in a spectrum of adnexal conditions including infectious diseases, endometriosis, and benign or malignant primary or secondary ovarian tumors. CT is usually the imaging modality on which the concomitant involvement of the peritoneum and the ovary is depicted. The first diagnosis to be considered by the radiologist is generally peritoneal carcinomatosis from ovarian cancer but other conditions cited above have also to be borne in mind and may be suggested on the basis of careful assessment of CT findings or on further MR findings. MRI may indeed help characterize the lesions in some cases. The purpose of this review is to describe the clinical and imaging patterns of peritoneal involvement that may be found in association with different ovarian lesions. Familiarity with these patterns and diagnoses will help the radiologist narrow the differential diagnosis and make an accurate diagnosis, thus facilitating patient management and avoiding unnecessary invasive treatment.

  10. [Skin cancer incidence in Zacatecas].

    PubMed

    Pinedo-Vega, José Luis; Castañeda-López, Rosalba; Dávila-Rangel, J Ignacio; Mireles-García, Fernando; Ríos-Martínez, Carlos; López-Saucedo, Adrián

    2014-01-01

    Skin cancer is the most frequent cancer related to ultraviolet radiation. The aim was to estimate the incidence of skin cancer type, melanoma and non-melanoma in Zacatecas, Mexico. An epidemiological study was carried out during the period from 2008 to 2012. The data were obtained from the Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Secretaría de Salud de Zacatecas (SSZ) and a private source, the Centro Médico Alameda. The incidence and the global prevalence were estimated. We studied 958 skin cancer cases, histopathologically confirmed. The cases were distributed as: 63.6 % basal cell carcinomas, 25.8 % squamous cell carcinomas, and 10.6 % melanoma. Significantly higher proportions were observed in women in the basal cell carcinomas (60.4 %) and squamous cell carcinomas (53.4 %). However, in the case of melanoma, the major proportion was observed in men (55.9 %). The more frequent skin cancer location was the face and for basal cell carcinoma was the nose (53 %); for squamous cell carcinomas were the lips (36 %), and for melanoma it was also the nose (40 %). The skin cancer incidence was estimated in 20 cases for each 100 000 inhabitants. Linear regression analysis showed that the skin cancer is increasing at an annual rate of 10.5 %. The anatomical location indicates that solar UV radiation is a risk factor, since the face is the zone with major exposure to solar radiation.

  11. A case report of peritoneal tuberculosis with multiple miliary peritoneal deposits mimicking advanced ovarian carcinoma

    PubMed Central

    Yazdani, Shahla; Sadeghi, Mahmod; Alijanpour, Abolhasan; Naeimi-rad, Mojgan

    2016-01-01

    Background: Peritoneal tuberculosis accounts 1-2% of all forms of tuberculosis. Peritoneal tuberculosis is an important differential diagnosis for ovarian cancer in women with ascites, adnexal mass and elevated cancer antigen 125 (CA125) levels. We report a case of a 32- year -old woman with multiple miliary peritoneal deposits mimicking advanced ovarian carcinoma. Case Presentation: A 32-year-old drug addicted woman presented with menometrorrhagia, fever and shivering, ascites and pelvis mass. Ultrasonography revealed a 53×65 mm cyst in left ovary and ascites. Multiple miliary peritoneal deposits were observed during laparatomy without any mass, histologic examination confirmed tuberculosis of uterus, tubes, omentum, liver and external surfaces of small intestine. Finally, the patient recovered with anti-tuberculosis treatment. Conclusion: These findings highlight considering tuberculosis in the differential diagnosis of any patients with adnexal mass, ascitis and elevated serum CA125 even with negative cytology and bacteriology test results. PMID:26958336

  12. Diagnostic accuracy and cost-effectiveness of different strategies to triage women with adnexal masses: a prospective study.

    PubMed

    Piovano, E; Cavallero, C; Fuso, L; Viora, E; Ferrero, A; Gregori, G; Grillo, C; Macchi, C; Mengozzi, G; Mitidieri, M; Pagano, E; Zola, P

    2017-09-01

    Transvaginal sonography (TVS) and serum biomarkers are used widely in clinical practice to triage women with adnexal masses, but the effectiveness of current biomarkers is weak. The aim of this study was to determine the best method of diagnosing patients with adnexal masses, in terms of diagnostic accuracy and economic costs, among four triage strategies: (1) the International Ovarian Tumor Analysis group's simple rules (SR) for interpretation of TVS with subjective assessment (SA) by an experienced ultrasound operator when TVS results are inconclusive (referred to hereafter as SR ± SA), (2) SR ± SA and cancer antigen 125 (CA 125), (3) SR ± SA and human epididymis protein 4 (HE4) and (4) SR ± SA and the risk of malignancy algorithm (ROMA). Our main hypothesis was that the addition of the biomarkers to SR ± SA could improve triaging of these patients in terms of diagnostic accuracy (i.e. malignant vs benign). As secondary analyses, we estimated the cost effectiveness of the four strategies and the diagnostic accuracy of SR ± SA at the study hospitals. Between February 2013 and January 2015, 447 consecutive patients who were scheduled for surgery for an adnexal mass at the S. Anna and Mauriziano Hospitals in Turin were enrolled in this multicenter prospective cohort study. Preoperative TVS was performed and preoperative CA 125 and HE4 levels were measured. Pathology reports were used to assess the diagnostic accuracy of the four triage strategies and the cost of each strategy was calculated. A total of 391 patients were included in the analysis: 57% (n = 221) were premenopausal and 43% (n = 170) were postmenopausal. The overall prevalence of malignancy was 21%. SR were conclusive in 89% of patients and thus did not require SA; the overall performance of SR ± SA showed a sensitivity of 82%, specificity of 92% and positive and negative predictive values and positive and negative likelihood ratios of 74%, 95%, 10.5 and 0.19, respectively. In premenopausal women

  13. Skin cancer after pancreas transplantation.

    PubMed

    Spanogle, Joshua P; Kudva, Yogish C; Dierkhising, Ross A; Kremers, Walter K; Roenigk, Randall K; Brewer, Jerry D; Prieto, Mikel; Otley, Clark C

    2012-10-01

    Skin cancer in patients who have undergone pancreas transplantation (PT) has not been extensively characterized. We sought to describe the incidence, tumor burden, and risk factors for skin cancer in PT recipients at Mayo Clinic from 1998 through 2006. A retrospective study was performed by analyzing outcomes among a cohort of pancreas allograft recipients at Mayo Clinic between 1998 and 2006. Among 216 allogeneic PT recipients at 2, 5, and 10 years posttransplantation, the cumulative incidence of any skin cancer was 4.7%, 12.7%, and 19.6%; the cumulative incidence of squamous cell carcinoma was 2.8%, 10.3%, and 16.7%; and the cumulative incidence of basal cell carcinoma was 2.4%, 7.8%, and 17.4%, respectively. The cumulative incidence of a second squamous cell carcinoma developing was 56% at 2 years; the cumulative incidence of a second basal cell carcinoma developing was 36% at 2 years. Of the risk factors examined, only age and having a skin cancer before transplantation were predictive of skin cancer development. This was a retrospective study. Results from a large tertiary center may not be generalizable. Nonmelanoma skin cancers commonly occur in recipients of PT, and those patients who have a history of nonmelanoma skin cancer have a very high likelihood of further skin cancer development. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. [Preservation of the fertility and the ovaries in women with benign adnexal tumors].

    PubMed

    Souza, Elen; Yoshida, Adriana; Peres, Heloisa; Andrade, Liliana de Angelo; Sarian, Luis Otávio; Derchain, Sophie

    2015-01-01

    To evaluate the sparing of fertility and ovaries in women submitted to surgical treatment for benign adnexal tumors. Between February 2010 and January 2014, 206 patients were included in this observational study as they were submitted to surgical treatment for benign ovarian tumors at CAISM, a tertiary hospital. Fertility sparing surgery was defined as tumorectomy or unilateral salpingoophorectomy without hysterectomy in premenopausal women. Preservation of the ovary occurred when at least one ovary or part of it was mantained. Of the 206 women with benign tumors, 120 (58%) were premenopausal and 86 (42%) were postmenopausal. There were 36 (30%) ovarian germ cell tumors, 31 (26%) epithelial neoplasms and 11 (9%) sex-cord stromal tumors among premenopausal women. In the group of postmenopausal women, 35 (41%) epithelial neoplasms, 27 (31%) sex-cord stromal tumors and 8 (9%) ovarian germ cell tumors were identified. Among 36 women with non-neoplastic ovarian tumors, 21 (58%) had endometriomas and 8 (22%) functional cysts. Among 22 women with extra-ovarian tumors, uterine leiomyomatosis was the most frequent finding (50%). In the group of women who were ≤ 35 years old, 26 (57%) were treated by tumorectomy and 18 (39%) were submitted to unilateral salpingoophorectomy with sparing of the uterus and the contralateral ovary. Women who were ≤ 35 years old were more frequently operated by laparoscopy which was associated with a higher number of fertility sparing procedures when compared to laparotomy (p<0.01). Twenty-six (28%) women submitted to hysterectomy with bilateral salpingoophorectomy were premenopausal. Although there is a trend to perform only tumorectomy in women who are ≤ 35 years old, a significant number of young women is still treated by salpingoophorectomy. Among 36- to 45-year-old women, only 70% had their fertility spared, while 20% had both ovaries removed. However, whenever possible, we must try to preserve the ovaries, mainly in premenopausal

  15. Three-dimensional volume off-line analysis as compared to real-time ultrasound for assessing adnexal masses.

    PubMed

    Alcázar, Juan Luis; Iturra, Alberto; Sedda, Federica; Aubá, María; Ajossa, Silvia; Guerriero, Stefano; Jurado, Matías

    2012-03-01

    To assess the agreement between three-dimensional volume off-line analysis as compared to real-time ultrasound for assessing adnexal masses. Ninety-nine non-consecutive women diagnosed as having an adnexal mass were assessed by transvaginal power Doppler ultrasound. One single examiner performed all ultrasound examinations. Based on the examiner's subjective evaluation using gray scale and Doppler ultrasound findings a presumptive diagnosis (benign or malignant) was provided after real-time ultrasound was performed. Once real-time was done a 3D volume of the adnexal mass was acquired and stored by this examiner. Two examiners, unaware of the real-time ultrasound results, evaluated the 3D volumes using multiplanar display and virtual navigation and also had to provide a presumptive diagnosis (benign or malignant). These two examiners, like the first one, had information about patient's age, menopausal status and complaints. All women underwent surgery or were followed-up until cyst resolution. Histologic diagnosis was used as gold standard. Cysts that resolved spontaneously were considered as benign for analytical purposes. The Kappa index was used to assess the agreement between real time ultrasound and 3D volume analysis. Sensitivity and specificity of both methods were calculated and compared using McNemar test. Forty-one masses were malignant and 58 were benign. Agreement between real-time ultrasound and 3D volume analysis was good for both off-line examiners (Kappa index: 0.82, 95% CI: 0.70-0.93 and 0.78, 95% CI: 0.65-0.90). Sensitivities for real-time ultrasound and 3D volume analyses were 100%, 93% and 90%, respectively (p>0.05). Specificities for real-time ultrasound and 3D volume analyses were 91%, 84% and 86%, respectively (p>0.05). Off-line 3D volume analysis may be a useful method for assessing adnexal masses, showing a good agreement with real-time ultrasound and having a similar diagnostic performance. Copyright © 2011 Elsevier Ireland Ltd. All

  16. A cross-sectional survey of the association between bilateral topical prostaglandin analogue use and ocular adnexal features.

    PubMed

    Shah, Mamta; Lee, Grace; Lefebvre, Daniel R; Kronberg, Benjamin; Loomis, Stephanie; Brauner, Stacey C; Turalba, Angela; Rhee, Douglas J; Freitag, Suzanne K; Pasquale, Louis R

    2013-01-01

    We studied the relation between prostaglandin analogue use and ocular adnexal features. We used a prospective, cross-sectional study involving 157 current, 15 past, and 171 never users of prostaglandin analogues. Patients 50 years of age or older and without conditions affecting ocular adnexal anatomy underwent glaucoma medication use history, external digital photography and systematic external adnexal exam. Two masked readers assessed the digital photos for upper lid dermatochalasis and lower lid steatoblepharon using a validated grading scheme. Another masked clinical examiner also assessed upper lid ptosis, levator muscle function, and inferior scleral show. We performed ordinal logistic regression analysis accounting for multiple covariates to assess the relation between prostaglandin analogue use and adnexal features. Multivariable analyses indicated there was a 230-fold increased risk of incremental involution of dermatochalasis (odds ratio (OR) = 2.30; 95% confidence interval (CI) 1.43-3.69; p = 5.44E-04) and a 249-fold increased risk of incremental loss of lower lid steatoblepharon (OR = 2.49; 95% CI, 1.54-4.03; p= 1.98E-04) associated with current prostaglandin analogue use (bimatoprost 0.03%, travoprost 0.005%, or latanoprost 0.004%) versus prostaglandin analogue never or past users. Upper lid ptosis (OR = 4.04; 95% CI, 2.43-6.72; p = 7.37E-08), levator dysfunction (OR = 7.51; 95% CI, 3.39-16.65; p = 6.74E-07) and lower lid retraction (OR = 2.60; 95% CI, 1.58-4.28; p = 1.72E-04) were highly associated with current prostaglandin analogue use versus prostaglandin analogue never or past users. The associations between prostaglandin analogue use and deepening of the upper lid sulci and between prostaglandin analogue use and loss of inferior periorbital fat are confirmed in this multivariable analysis. The associations between prostaglandin analogue use and levator muscle dysfunction and between prostaglandin analogue use and upper lid ptosis represent

  17. Signet-ring Cells in the Skin: A Case of Late-onset Cutaneous Metastasis of Gastric Carcinoma and a Brief Review of Histological Approach

    PubMed Central

    Gündüz, Özgür; Emeksiz, Mehmet Can; Atasoy, Pinar; Kidir, Mehtap; Yalçin, Selim; Demirkan, Serkan

    2017-01-01

    Up to 10% of patients with visceral malignancies develop skin metastases during their clinical course and these metastases constitute about 2% of all skin cancers. Skin metastasis may be the first sign of a clinically silent visceral cancer or represent recurrence of an internal malignancy. In both situations, they are associated with poor prognosis, which can partly be attributed to underdiagnosis. In this paper, a case of relapsing gastric adenocarcinoma, which manifested itself as asymptomatic cutaneous papules and nodules on a patient’s head and neck, is reported and histopathological approach to the cutaneous lesions containing signet-ring cell is briefly reviewed. PMID:28326183

  18. Signet-ring Cells in the Skin: A Case of Late-onset Cutaneous Metastasis of Gastric Carcinoma and a Brief Review of Histological Approach.

    PubMed

    Gündüz, Özgür; Emeksiz, Mehmet Can; Atasoy, Pinar; Kidir, Mehtap; Yalçin, Selim; Demirkan, Serkan

    2016-06-15

    Up to 10% of patients with visceral malignancies develop skin metastases during their clinical course and these metastases constitute about 2% of all skin cancers. Skin metastasis may be the first sign of a clinically silent visceral cancer or represent recurrence of an internal malignancy. In both situations, they are associated with poor prognosis, which can partly be attributed to underdiagnosis. In this paper, a case of relapsing gastric adenocarcinoma, which manifested itself as asymptomatic cutaneous papules and nodules on a patient's head and neck, is reported and histopathological approach to the cutaneous lesions containing signet-ring cell is briefly reviewed.

  19. Eosinophilic Skin Diseases: A Comprehensive Review.

    PubMed

    Long, Hai; Zhang, Guiying; Wang, Ling; Lu, Qianjin

    2016-04-01

    Eosinophilic skin diseases, commonly termed as eosinophilic dermatoses, refer to a broad spectrum of skin diseases characterized by eosinophil infiltration and/or degranulation in skin lesions, with or without blood eosinophilia. The majority of eosinophilic dermatoses lie in the allergy-related group, including allergic drug eruption, urticaria, allergic contact dermatitis, atopic dermatitis, and eczema. Parasitic infestations, arthropod bites, and autoimmune blistering skin diseases such as bullous pemphigoid, are also common. Besides these, there are several rare types of eosinophilic dermatoses with unknown origin, in which eosinophil infiltration is a central component and affects specific tissue layers or adnexal structures of the skin, such as the dermis, subcutaneous fat, fascia, follicles, and cutaneous vessels. Some typical examples are eosinophilic cellulitis, granuloma faciale, eosinophilic pustular folliculitis, recurrent cutaneous eosinophilic vasculitis, and eosinophilic fasciitis. Although tissue eosinophilia is a common feature shared by these disorders, their clinical and pathological properties differ dramatically. Among these rare entities, eosinophilic pustular folliculitis may be associated with human immunodeficiency virus (HIV) infection or malignancies, and some other diseases, like eosinophilic fasciitis and eosinophilic cellulitis, may be associated with an underlying hematological disorder, while others are considered idiopathic. However, for most of these rare eosinophilic dermatoses, the causes and the pathogenic mechanisms remain largely unknown, and systemic, high-quality clinical investigations are needed for advances in better strategies for clinical diagnosis and treatment. Here, we present a comprehensive review on the etiology, pathogenesis, clinical features, and management of these rare entities, with an emphasis on recent advances and current consensus.

  20. Steroidogenesis in the skin: implications for local immune functions.

    PubMed

    Slominski, Andrzej; Zbytek, Blazej; Nikolakis, Georgios; Manna, Pulak R; Skobowiat, Cezary; Zmijewski, Michal; Li, Wei; Janjetovic, Zorica; Postlethwaite, Arnold; Zouboulis, Christos C; Tuckey, Robert C

    2013-09-01

    The skin has developed a hierarchy of systems that encompasses the skin immune and local steroidogenic activities in order to protect the body against the external environment and biological factors and to maintain local homeostasis. Most recently it has been established that skin cells contain the entire biochemical apparatus necessary for production of glucocorticoids, androgens and estrogens either from precursors of systemic origin or, alternatively, through the conversion of cholesterol to pregnenolone and its subsequent transformation to biologically active steroids. Examples of these products are corticosterone, cortisol, testosterone, dihydrotesterone and estradiol. Their local production can be regulated by locally produced corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH) or cytokines. Furthermore the production of glucocorticoids is affected by ultraviolet B radiation. The level of production and nature of the final steroid products are dependent on the cell type or cutaneous compartment, e.g., epidermis, dermis, adnexal structures or adipose tissue. Locally produced glucocorticoids, androgens and estrogens affect functions of the epidermis and adnexal structures as well as local immune activity. Malfunction of these steroidogenic activities can lead to inflammatory disorders or autoimmune diseases. The cutaneous steroidogenic system can also have systemic effects, which are emphasized by significant skin contribution to circulating androgens and/or estrogens. Furthermore, local activity of CYP11A1 can produce novel 7Δ-steroids and secosteroids that are biologically active. Therefore, modulation of local steroidogenic activity may serve as a new therapeutic approach for treatment of inflammatory disorders, autoimmune processes or other skin disorders. In conclusion, the skin can be defined as an independent steroidogenic organ, whose activity can affect its functions and the development of local or systemic inflammatory or

  1. Steroidogenesis in the skin: implications for local immune functions

    PubMed Central

    Slominski, Andrzej; Zbytek, Bazej; Nikolakis, Georgios; Manna, Pulak R.; Skobowiat, Cezary; Zmijewski, Michal; Li, Wei; Janjetovic, Zorica; Postlethwaite, Arnold; Zouboulis, Christos C.; Tuckey, Robert C.

    2013-01-01

    The skin has developed a hierarchy of systems that encompasses the skin immune and local steroidogenic activities in order to protect the body against the external environment and biological factors and to maintain local homeostasis. Most recently it has been established that skin cells contain the entire biochemical apparatus necessary for production of glucocorticoids, androgens and estrogens either from precursors of systemic origin or, alternatively, through the conversion of cholesterol to pregnenolone and its subsequent transformation to biologically active steroids. Examples of these products are corticosterone, cortisol, testosterone, dihydrotesterone and estradiol. Their local production can be regulated by locally produced corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH) or cytokines. Furthermore the production of glucocorticoids is affected by ultraviolet B radiation. The level of production and nature of the final steroid products are dependent on the cell type or cutaneous compartment, e.g., epidermis, dermis, adnexal structures or adipose tissue. Locally produced glucocorticoids, androgens and estrogens affect functions of the epidermis and adnexal structures as well as local immune activity. Malfunction of these steroidogenic activities can lead to inflammatory disorders or autoimmune diseases. The cutaneous steroidogenic system can also have systemic effects, which are emphasized by significant skin contribution to circulating androgens and/or estrogens. Furthermore, local activity of CYP11A1 can produce novel 7 -steroids and secosteroids that are biologically active. Therefore, modulation of local steroidogenic activity may serve as a new therapeutic approach for treatment of inflammatory disorders, autoimmune processes or other skin disorders. In conclusion, the skin can be defined as an independent steroidogenic organ, whose activity can affect its functions and the development of local or systemic inflammatory or

  2. Laparoendoscopic single-site surgery (LESS) versus conventional laparoscopic surgery for adnexal preservation: a randomized controlled study

    PubMed Central

    Cho, Yeon Jean; Kim, Mi-La; Lee, Soo Yoon; Lee, Hee Suk; Kim, Joo Myoung; Joo, Kwan Young

    2012-01-01

    Objective To compare the operative outcomes, postoperative pain, and subsequent convalescence after laparoendoscopic single-site surgery (LESS) or conventional laparoscopic surgery for adnexal preservation. Study design From December 2009 to September 2010, 63 patients underwent LESS (n = 33) or a conventional laparoscopic surgery (n = 30) for cyst enucleation. The overall operative outcomes including postoperative pain measurement using the visual analog scale (VAS) were evaluated (time points 6, 24, and 24 hours). The convalescence data included data obtained from questionnaires on the need for analgesics and on patient-reported time to recovery end points. Results The preoperative characteristics did not significantly differ between the two groups. The postoperative hemoglobin drop was higher in the LESS group than in the conventional laparoscopic surgery group (P = 0.048). Postoperative pain at each VAS time point, oral analgesic requirement, intramuscular analgesic requirement, and the number of days until return to work were similar in both groups. Conclusion In adnexa-preserving surgery performed in reproductive-age women, the operative outcomes, including satisfaction of the patients and convalescence after surgery, are comparable for LESS and conventional laparoscopy. LESS may be a feasible and a promising alternative method for scarless abdominal surgery in the treatment of young women with adnexal cysts PMID:22448110

  3. Unexpected ovarian malignancy found after laparoscopic surgery in patients with adnexal masses--a single institutional experience.

    PubMed

    Saito, Shigeko; Kajiyama, Hiroaki; Miwa, Yoko; Mizuno, Mika; Kikkawa, Fumitaka; Tanaka, Shiho; Okamoto, Tomomitsu

    2014-02-01

    Laparoscopy has become the standard surgery for the treatment of benign ovarian tumors. The aim of this study was to evaluate the appropriateness of laparoscopy for ovarian tumors, including those with malignant potential. A total of 487 patients with adnexal masses underwent laparoscopic surgery in Social Insurance Chukyo Hospital from January 2000 to December 2012. We reviewed 471 cases that fulfilled the criteria set for this study, and examined 10 cases with unexpected ovarian malignancy to analyze their preoperative diagnosis, second surgery, postoperative chemotherapy, and prognosis. The ages of the 471 patients ranged from 13 to 50 years, with a median of 31. Nulliparous patients numbered 321(68.1%). Of all, 436 patients mostly consisted of those with endometrioma, benign ovarian neoplasm or functional cyst. In all, we histologically identified 10 women with malignancy: 6 with borderline ovarian tumors (BOT), 2 with ovarian cancer, and 2 with histologically rare tumors (immature teratoma and granulosa cell tumor). All patients with BOT were diagnosed with a mucinous histology. Two patients underwent both second radical surgery (hysterectomy and contra- or bilateral salpingo-oophorectomy) and chemotherapies that consisted of CBDCA and PTX or DTX. Thus, 2 patients underwent staging procedures, but the remaining 8 cases did not. None of them had evidence of recurrences. With accurate staging and careful postoperative follow-up, laparoscopic surgery could be a feasible initial operation for patients with adnexal masses including early-stage ovarian malignancy.

  4. Diagnosis of adnexal malignancies by using color Doppler energy imaging as a secondary test in persistent masses.

    PubMed

    Guerriero, S; Ajossa, S; Risalvato, A; Lai, M P; Mais, V; Angiolucci, M; Melis, G B

    1998-04-01

    The purpose of this prospective study was to compare the accuracy of B-mode transvaginal ultrasonography alone and in combination with color Doppler energy (or power Doppler) imaging in differentiating benign from malignant adnexal masses. A total of 192 consecutive persistent adnexal masses (159 benign, 33 malignant) were studied before surgery by B-mode transvaginal ultrasonography with and without color Doppler energy. In addition, CA-125 plasma levels were determined and spectral Doppler analysis was performed. By color Doppler energy imaging, a mass was considered malignant when arterial flow was visualized in an echogenic portion of a mass defined as malignant by B-mode. Intratumoral arterial blood flow could be readily detected by color Doppler energy imaging in all malignant tumors and in 94% of the benign tumors. The combined use of transvaginal B-mode ultrasonography and color Doppler energy imaging has greater accuracy in the diagnosis of ovarian malignancies than transvaginal ultrasonography alone (value of kappa: 0.81 and 0.63, respectively), reducing the number of false-positive results. The use of spectral Doppler analysis was of limited diagnostic value, with a kappa value of 0.17 for the pulsatility index (< 1) and of 0.41 for the resistance index (< 0.4). Also, the association with CA-125 increased the number of false-negative results. In conclusion, the use of color Doppler energy imaging seems to be a useful secondary test when a mass is suspected to be malignant by B-mode ultrasonography.

  5. A Distinct and Replicable Squamous Cell Carcinoma Gene INPPA5 Variant Modifies Susceptibility of Arsenic-Associated Skin Lesions in Bangladesh

    PubMed Central

    Seow, Wei Jie; Pan, Wen-Chi; Kile, Molly L.; Lin, Tong; Baccarelli, Andrea; Quamruzzaman, Quazi; Rahman, Mahmuder; Mostofa, Golam; Rakibuz-Zaman, Muhammad; Kibriya, Muhammad; Ahsan, Habibul; Lin, Xihong; Christiani, David C.

    2015-01-01

    Background Single nucleotide polymorphisms (SNPs) in inflammation, one-carbon metabolism and skin cancer genes might influence susceptibility to arsenic-induced skin lesions. Methods A case-control study was conducted in Pabna, Bangladesh (2001-2003) and drinking water arsenic concentration was measured for each participant. A panel of twenty-five candidate SNPs was analyzed in 540 cases and 400 controls. Logistic regression was used to estimate the association between each SNP and the potential for gene-environment interactions in skin lesion risk adjusting for relevant covariates. Replication testing was conducted in an independent Bangladesh population with 488 cases and 2,794 controls. Results In the discovery population, genetic variants in the one-carbon metabolism genes PEMT (rs2278952, P for interaction = 0.004; rs897453, P for interaction = 0.05) and DHFR (rs1650697, P for interaction = 0.02), inflammation gene IL10 (rs3024496, P for interaction = 0.04), and skin cancer genes INPP5A (rs1133400, P for interaction = 0.03) and XPC (rs2228000, P for interaction = 0.01) significantly modified the association between arsenic and skin lesions after adjusting for multiple comparisons. The significant gene-environment interaction between a SNP in INPP5A gene (rs1133400) and water arsenic on skin lesion risk was successfully replicated in an independent population (P for interaction = 0.03). Conclusion Minor allele carriers of skin cancer gene INPP5A modified odds of arsenic-induced skin lesions in both main and replicative populations. Genetic variation in INPP5A appears to have a role in susceptibility to arsenic toxicity. PMID:25759212

  6. Bacteria-eradicating therapy with doxycycline in ocular adnexal MALT lymphoma: a multicenter prospective trial.

    PubMed

    Ferreri, Andrés J M; Ponzoni, Maurilio; Guidoboni, Massimo; Resti, Antonio Giordano; Politi, Letterio S; Cortelazzo, Sergio; Demeter, Judit; Zallio, Francesco; Palmas, Angelo; Muti, Giuliana; Dognini, Giuseppina P; Pasini, Elisa; Lettini, Antonia Anna; Sacchetti, Federico; De Conciliis, Carlo; Doglioni, Claudio; Dolcetti, Riccardo

    2006-10-04

    An association between ocular adnexal MALT lymphoma (OAL) and Chlamydia psittaci (Cp) infection has been proposed, and recent reports suggest that doxycycline treatment causes tumor regression in patients with Cp-related OAL. The effectiveness of doxycycline treatment in Cp-negative OAL has not been tested. In a prospective trial, 27 OAL patients (15 newly diagnosed and 12 having experienced relapse) were given a 3-week course of doxycycline therapy. Objective lymphoma response was assessed by computerized tomography scans or magnetic resonance imaging at 1, 3, and 6 months after the conclusion of therapy and every 6 months during follow-up. Cp infection in patients was determined by touchdown enzyme time-release polymerase chain reaction (TETR-PCR). Statistical tests were two-sided. Eleven patients were Cp DNA-positive and 16 were Cp DNA negative. Doxycycline was well tolerated. At a median follow-up of 14 months, lymphoma regression was complete in six patients, and a partial response (> or = 50% reduction of all measurable lesions) was observed in seven patients (overall response rate [complete and partial responses] = 48%). Lymphoma regression was observed in both Cp DNA-positive patients (seven of 11 experienced regression) and Cp DNA-negative patients (six of 16 experienced regression) (64% versus 38%; P = .25, Fisher's exact test). The three patients with regional lymphadenopathies and three of the five patients with bilateral disease achieved objective response. In relapsed patients, response was observed both in previously irradiated and nonirradiated patients. The 2-year failure-free survival rate among the doxycycline-treated patients was 66% (95% confidence interval = 54 to 78), and 20 of the 27 patients were progression free. Doxycycline is a fast, safe, and active therapy for Cp DNA-positive OAL that was effective even in patients with multiple failures involving previously irradiated areas or regional lymphadenopathies. The responses observed in PCR

  7. Radiation-induced bladder carcinoma

    SciTech Connect

    Uyama, T.; Nakamura, S.; Moriwaki, S.

    1981-01-01

    Two cases are presented of radiation-induced bladder carcinoma which followed prior irradiation for cervical carcinoma of the uterus. One was a sixty-eight-year-old woman with bladder carcinoma fourteen years after irradiation (total dose of 4,500 rad) for cervical carcinoma of the uterus. The other was a sixty-four-year-old woman with bladder carcinoma twenty-five years after irradiation with 150-K volt apparatus for cervical carcinoma of the uterus. From the late radiation change of the skin, it was estimated that the total dose of prior radiation might be 4,000 rad or more. Both had high-grade, high-stage transitional cell bladder carcinoma, and the former was with marked mucus-forming adenomatous metaplasia.

  8. Phase I/II Study of Postoperative Adjuvant Chemoradiation for Advanced-Stage Cutaneous Squamous Cell Carcinoma of the Head and Neck (cSCCHN)

    ClinicalTrials.gov

    2014-11-17

    Recurrent Skin Cancer; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Squamous Cell Carcinoma of the Skin; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity

  9. Basal cell carcinoma, squamous cell carcinoma and melanoma of the head and face.

    PubMed

    Feller, L; Khammissa, R A G; Kramer, B; Altini, M; Lemmer, J

    2016-02-05

    Ultraviolet light (UV) is an important risk factor for cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma and cutaneous melanoma of the skin. These cancers most commonly affect persons with fair skin and blue eyes who sunburn rather than suntan. However, each of these cancers appears to be associated with a different pattern of UV exposure and to be mediated by different intracellular molecular pathways.Some melanocortin 1 receptor (MC1R) gene variants play a direct role in the pathogenesis of cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma and cutaneous melanoma apart from their role in determining a cancer-prone pigmentory phenotype (fair skin, red hair, blue eyes) through their interactions with other genes regulating immuno-inflammatory responses, DNA repair or apoptosis.In this short review we focus on the aetiological role of UV in cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma and cutaneous melanoma of the skin, and on some associated biopathological events.

  10. Skin graft

    MedlinePlus

    ... that need skin grafts to heal Venous ulcers, pressure ulcers , or diabetic ulcers that do not heal Very ... graft; Full thickness skin graft Patient Instructions Preventing pressure ulcers Surgical wound care - open Images Skin graft Skin ...

  11. Skin Cancer

    MedlinePlus

    ... version of this page please turn Javascript on. Skin Cancer What is Skin Cancer? Skin cancer is the most common type ... of approximately 9,480 Americans in 2013. Can Skin Cancer Be Treated? Most basal cell and squamous ...

  12. Skin Diseases: Skin Health and Skin Diseases

    MedlinePlus

    ... and dryness. Sunlight is a major cause of skin aging. ( See "Skin and Sun—Not a Good Mix") . ... person has smoked. Many products claim to revitalize aging skin or reduce wrinkles, but the Food and Drug ...

  13. Prolonged Survival (>48 months) in a Squamous Cell Carcinoma of the Cervix After Late Skin Metastasis (>5 year) to Incision Site: A Case Report.

    PubMed

    Ozmen, Batuhan; Sükür, Yavuz Emre; Atabekoğlu, Cem; Güngör, Mete

    2009-01-01

    Metastasis to the incision site of squamous cervical cancer (SCC) is an extremely rare entity which is strictly related with extremely poor prognosis. The vast majority of the reported cases died in a year due to distant recurrences, whereby skin metastases were predominantly observed close to the primary tumor site. A SCC with skin metastasis which was diagnosed 5 years after the radical surgery and postoperative radiotherapy which involved the midline incision site was reported. Large surgical excision of the metastasis with remaining surgical free margins (>2 cm) and combined chemo-radiotherapy with single agent (cisplatinum) was performed. The patient did not show any recurrences for 4 years follow-up. Apparently, palliative combined chemo-radiotherapy along with large excision seems favorable for controlling symptoms and progression of skin metastasis of squamous cervical cancer.

  14. Intake of Omega-3 and Omega-6 Fatty Acids and Risk of Basal and Squamous Cell Carcinomas of the Skin: A Longitudinal Community-Based Study in Australian Adults

    PubMed Central

    Wallingford, Sarah C.; van As, Josephina A.; Hughes, Maria Celia; Ibiebele, Torukiri I.; Green, Adèle C.; van der Pols, Jolieke C.

    2012-01-01

    Intake of omega-3 and omega-6 fatty acids may modify the risk of basal and squamous cell carcinoma of the skin (BCC and SCC), but population-based evidence is limited and inconsistent. We examined prospectively associations between intake of omega-3 and omega-6 fatty acids estimated from food frequency questionnaires and BCC and SCC incidence among 1322 randomly selected adults in Nambour, Australia. Relative risks (RR) and 95% confidence intervals (CI) were estimated based on histologically confirmed tumors diagnosed between 1997 and 2007. Incidence of BCC was lowest in the middle third of both total omega-6 intake (RRmv.adj = 0.74, 95% CI = 0.56–0.97) and linoleic acid intake (RRmv.adj = 0.75, 95% CI = 0.57–0.99) compared with the lowest third of intake. Evidence for associations with SCC was weak, though persons with arachidonic acid intake in the middle third had a marginally increased risk of SCC (RRmv.adj = 1.42, 95% CI = 1.00–2.02). Consumption of omega-3 fatty acids was not associated with subsequent skin cancer risk. Suggestion that intake of arachidonic acid may be associated with increased SCC incidence and total omega-6 with reduced BCC from our study is still highly uncertain and may be due to chance. These data do not support an association between these fatty acids and risk of BCC or SCC. PMID:22974045

  15. Asian expert recommendation on management of skin and mucosal effects of radiation, with or without the addition of cetuximab or chemotherapy, in treatment of head and neck squamous cell carcinoma.

    PubMed

    Zhu, Guopei; Lin, Jin-Ching; Kim, Sung-Bae; Bernier, Jacques; Agarwal, Jai Prakash; Vermorken, Jan B; Thinh, Dang Huy Quoc; Cheng, Hoi-Ching; Yun, Hwan Jung; Chitapanarux, Imjai; Lertsanguansinchai, Prasert; Reddy, Vijay Anand; He, Xia

    2016-01-27

    With increasing numbers of patients with unresectable locoregionally advanced (LA) head and neck squamous cell carcinoma (HNSCC) receiving cetuximab/radiotherapy (RT), several guidelines on the early detection and management of skin-related toxicities have been developed. Considering the existing management guidelines for these treatment-induced conditions, clinical applicability and standardization of grading methods has remained a cause of concern globally, particularly in Asian countries. In this study, we attempted to collate the literature and clinical experience across Asian countries to compile a practical and implementable set of recommendations for Asian oncologists to manage skin- and mucosa-related toxicities arising from different types of radiation, with or without the addition of cetuximab or chemotherapy. In December 2013, an international panel of experts in the field of head and neck cancer management assembled for an Asia-Pacific head and neck cancer expert panel meeting in China. The compilation of discussion outcomes of this meeting and literature data ultimately led to the development of a set of recommendations for physicians with regards to the approach and management of dermatological conditions arising from RT, chemotherapy/RT and cetuximab/RT, and similarly for the approach and management of mucositis resulting from RT, with or without the addition of chemotherapy or cetuximab. These recommendations helped to adapt guidelines published in the literature or text books into bedside practice, and may also serve as a starting point for developing individual institutional side-effect management protocols with adequate training and education.

  16. Occupational skin diseases.

    PubMed

    Diepgen, Thomas L

    2012-05-01

    Occupational skin diseases are the most commonly reported notifiable occupational diseases. In Germany, 23 596 out of a total of 71 263 reported occupational diseases in 2010 were classified as occupational skin diseases (BK No. 5101: "severe or recurrent skin diseases which have forced the person to discontinue all occupational activities that caused or could cause the development, worsening, or recurrence of the disease"). Contact dermatitis (allergic, irritant) of the hands is the most common skin disease and atopic skin diathesis is often an important co-factor. The number of work-related skin diseases is many times higher than the number of notified occupational dermatoses. This CME article explains the legal framework of occupational diseases, the tasks and obligations of the legal statutory work insurance. Typical allergens and irritants of high risk professions are also presented as are the important steps from diagnosis to compensation. Early prevention of occupational skin diseases is very important to avoid severe chronic hand eczema. Therefore the "dermatologist's report" is crucial. Other occupational dermatoses (outside of BK 5101) are briefly mentioned. In recent years the number of notifications of occupational skin cancer due to occupational UV-irradiation has increased. According to recent epidemiological findings, there is a significant and consistent positive association between occupational UV-irradiation and squamous cell carcinoma. Therefore, an important criterion for a new occupational disease is fulfilled. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

  17. Ultrasound methods to distinguish between malignant and benign adnexal masses in the hands of examiners with different levels of experience.

    PubMed

    Van Holsbeke, C; Daemen, A; Yazbek, J; Holland, T K; Bourne, T; Mesens, T; Lannoo, L; De Moor, B; De Jonge, E; Testa, A C; Valentin, L; Jurkovic, D; Timmerman, D

    2009-10-01

    To determine the effect of an ultrasound training course on the performance of pattern recognition when used by less experienced examiners and to compare the performance of pattern recognition, a logistic regression model and a scoring system to estimate the risk of malignancy between examiners with different levels of experience. Using ultrasound images of selected adnexal masses, two trainees classified the masses as benign or malignant by using pattern recognition both before and after they had attended a theoretical gynecological ultrasound course. They also classified the masses by using a logistic regression model and a scoring system, but only after they had attended the course. The performance of these three methods when they were used by the trainees was then compared with that when they were used by experts. One hundred and sixty-five adnexal masses were included, of which 42% were malignant (21% invasive tumors and 21% borderline tumors). The area under the receiver-operating characteristics curve of pattern recognition when used by the trainees was similar before and after they had attended the course. Training decreased sensitivity (84% vs. 70% for Trainee 1, P = 0.004; 70% vs. 61% for Trainee 2, P = 0.058) and increased specificity (77% vs. 92% for Trainee 1, P = 0.001; 89% vs. 95% for Trainee 2, P = 0.058). The performance of pattern recognition was poorer in the hands of the trainees than in the hands of the experts. The sensitivities of the logistic regression model were 70% and 54% for the trainees vs. 83% for an expert (P = 0.020 and < 0.001, respectively) and the specificities were 84% and 94% vs. 89% (P = 0.25 and 0.59, respectively). The sensitivities of the scoring system were 59% and 54% for the trainees vs. 75% for the expert (P = 0.002 and < 0.001, respectively), and the specificities were 90% and 93% vs. 85% (P = 0.103 and 0.008, respectively). Theoretical ultrasound teaching did not seem to improve the performance of pattern recognition

  18. Fabrication, in-vitro characterization, and enhanced in-vivo evaluation of carbopol-based nanoemulsion gel of apigenin for UV-induced skin carcinoma.

    PubMed

    Jangdey, Manmohan S; Gupta, Anshita; Saraf, Swarnlata

    2017-11-01

    The aim of this study was to develop a potential novel formulation of carbopol-based nanoemulsion gel containing apigenin using tamarind gum emulsifier which was having the smallest droplet size, the highest drug content, and a good physical stability for Skin delivery. Apigenin loaded nanoemulsion was prepared by high speed homogenization method and they were characterized with respect to morphology, zeta potential, differential scanning calorimeter study, and penetration studies. In-vitro release studies and skin permeation of apigenin loaded nanoemulsion by goat abdominal skin was determined using Franz diffusion cell and confocal laser scanning microscope (CLSM). The cytotoxicity of the reported formulation was evaluated in HaCaT Cells (A) and A431 cells (B) by MTT assay. The nanoemulsion formulation showed droplet size, polydispersity index, and zeta potential of 183.31 nm, 0.532, and 31.9 mV, respectively. The nanoemulsions were characterized by TEM demonstrated spherical droplets and FTIR to ensure the compatibility among its ingredients. CLSM showed uniform fluorescence intensity across the entire depth of skin in nanocarriers treatment, indicating high penetrability of nanoemulsion gel through goatskin. The nanoemulsion gel showed toxicity on melanoma (A341) in a concentration range of 0.4-2.0 mg/ml, but less toxicity toward HaCaT cells. The carbopol-based nanoemulsion gel formulation of apigenin possesses better penetrability across goatskin as compared to marketed formulation. Hence, the study postulates that the novel nanoemulsion gel of apigenin can be proved fruitful for the treatment of skin cancer in near future.

  19. Performance of three-dimensional power Doppler angiography as third-step assessment in differential diagnosis of adnexal masses.

    PubMed

    Utrilla-Layna, J; Alcázar, J L; Aubá, M; Laparte, C; Olartecoechea, B; Errasti, T; Juez, L; Mínguez, J Á; Guerriero, S; Jurado, M

    2015-05-01

    To evaluate the contribution of three-dimensional (3D) power Doppler angiography (3D-PDA) to the differential diagnosis of adnexal masses. This was a prospective study in women diagnosed with a persistent adnexal mass and subsequently scheduled for surgery in a tertiary university hospital. All women were evaluated by transvaginal/transrectal ultrasound according to a predetermined three-step protocol, with transabdominal ultrasound being performed in some cases. First, morphological evaluation of the mass was performed using gray-scale 'pattern recognition' (first step). Lesions diagnosed as having a benign pattern were considered as being at low risk of malignancy whereas tumors with solid components, ascites and/or signs of carcinomatosis were considered as being at high risk of malignancy. In both cases no further test was performed and a decision regarding clinical management, either for follow-up or surgery, was taken. Tumors with solid components but without signs of ascites or carcinomatosis were considered as being at intermediate risk of malignancy. These lesions were assessed by two-dimensional (2D) PDA to evaluate tumor vascularity (color score) (second step). Solid tumors with a color score of 1 or 2 were considered as benign and no further test was performed, while tumors with a color score of 2, 3 or 4 within solid components or a color score of 3 or 4 in the case of a solid tumor were considered as malignant. The latter group underwent 3D-PDA assessment (third step). Vascularization index (VI) was calculated in a 1-mL sphere of the most vascularized area of the tumor. When a VI ≥ 24.015% was found, the tumor was considered as malignant. All masses were removed surgically and definitive histological diagnosis was used as the gold standard. Sensitivity and specificity for each strategy were calculated and compared. In the case of bilateral tumors, only the more suspicious one was used for analysis. A total of 367 adnexal masses diagnosed in 367

  20. Expression of heparanase in basal cell carcinoma and squamous cell carcinoma*

    PubMed Central

    Pinhal, Maria Aparecida Silva; Almeida, Maria Carolina Leal; Costa, Alessandra Scorse; Theodoro, Thérèse Rachell; Serrano, Rodrigo Lorenzetti; Machado Filho, Carlos D'Apparecida Santos

    2016-01-01

    Background Heparanase is an enzyme that cleaves heparan sulfate chains. Oligosaccharides generated by heparanase induce tumor progression. Basal cell carcinoma and squamous cell carcinoma comprise types of nonmelanoma skin cancer. Objectives Evaluate the glycosaminoglycans profile and expression of heparanase in two human cell lines established in culture, immortalized skin keratinocyte (HaCaT) and squamous cell carcinoma (A431) and also investigate the expression of heparanase in basal cell carcinoma, squamous cell carcinoma and eyelid skin of individuals not affected by the disease (control). Methods Glycosaminoglycans were quantified by electrophoresis and indirect ELISA method. The heparanase expression was analyzed by quantitative RT-PCR (qRTPCR). Results The A431 strain showed significant increase in the sulfated glycosaminoglycans, increased heparanase expression and decreased hyaluronic acid, comparing to the HaCaT lineage. The mRNA expression of heparanase was significantly higher in Basal cell carcinoma and squamous cell carcinoma compared with control skin samples. It was also observed increased heparanase expression in squamous cell carcinoma compared to the Basal cell carcinoma. Conclusion The glycosaminoglycans profile, as well as heparanase expression are different between HaCaT and A431 cell lines. The increased expression of heparanase in Basal cell carcinoma and squamous cell carcinoma suggests that this enzyme could be a marker for the diagnosis of such types of non-melanoma cancers, and may be useful as a target molecule for future alternative treatment. PMID:27828631

  1. Expression of heparanase in basal cell carcinoma and squamous cell carcinoma.

    PubMed

    Pinhal, Maria Aparecida Silva; Almeida, Maria Carolina Leal; Costa, Alessandra Scorse; Theodoro, Thérèse Rachell; Serrano, Rodrigo Lorenzetti; Machado, Carlos D'Apparecida Santos

    2016-01-01

    Heparanase is an enzyme that cleaves heparan sulfate chains. Oligosaccharides generated by heparanase induce tumor progression. Basal cell carcinoma and squamous cell carcinoma comprise types of nonmelanoma skin cancer. Evaluate the glycosaminoglycans profile and expression of heparanase in two human cell lines established in culture, immortalized skin keratinocyte (HaCaT) and squamous cell carcinoma (A431) and also investigate the expression of heparanase in basal cell carcinoma, squamous cell carcinoma and eyelid skin of individuals not affected by the disease (control). Glycosaminoglycans were quantified by electrophoresis and indirect ELISA method. The heparanase expression was analyzed by quantitative RT-PCR (qRTPCR). The A431 strain showed significant increase in the sulfated glycosaminoglycans, increased heparanase expression and decreased hyaluronic acid, comparing to the HaCaT lineage. The mRNA expression of heparanase was significantly higher in Basal cell carcinoma and squamous cell carcinoma compared with control skin samples. It was also observed increased heparanase expression in squamous cell carcinoma compared to the Basal cell carcinoma. The glycosaminoglycans profile, as well as heparanase expression are different between HaCaT and A431 cell lines. The increased expression of heparanase in Basal cell carcinoma and squamous cell carcinoma suggests that this enzyme could be a marker for the diagnosis of such types of non-melanoma cancers, and may be useful as a target molecule for future alternative treatment.

  2. Skin cancer in the elderly

    SciTech Connect

    Pollack, S.V.

    1987-11-01

    Skin cancer is a major concern in geriatric populations. Cumulative exposure to carcinogens and age-related factors both contribute to the high prevalence of cutaneous malignancy in the elderly. Although mortality rates from skin cancer are relatively low, morbidity can be significant, particularly if lesions are neglected. Physicians can have a major impact on the course of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma by nurturing a high index of suspicion for malignancy when unexplained cutaneous lesions are encountered. 56 references.

  3. Inherited mouse mutations as models of human adnexal, cornification, and papulosquamous dermatoses.

    PubMed

    Sundberg, J P; Beamer, W G; Shultz, L D; Dunstan, R W

    1990-11-01

    Nearly 100 mouse mutations have been described as causing some type of abnormality of the skin or hair. As only a few of these mutations have been studied in detail, they remain an untapped resource for furthering knowledge of basic cutaneous physiology and understanding the pathophysiology of analogous diseases in humans. Several diverse murine mutations are discussed. These include "asebia," a mildly hyperkeratotic disorder with sebaceous gland hypoplasia; "ichthyosis," an example of abnormal hair growth associated with hyperkeratosis; "rhino" and "hairless," two related examples of congenital follicular malformations; and "flaky skin", a potential animal model of eruptive psoriasis.

  4. Towards an evidence-based approach for diagnosis and management of adnexal masses: findings of the International Ovarian Tumour Analysis (IOTA) studies.

    PubMed

    Kaijser, J

    2015-01-01

    Whilst the outcomes for patients with ovarian cancer clearly benefit from centralised, comprehensive care in dedicated cancer centres, unfortunately the majority of patients still do not receive appropriate specialist treatment. Any improvement in the accuracy of current triaging and referral pathways whether using new imaging tests or biomarkers would therefore be of value in order to optimise the appropriate selection of patients for such care. An analysis of current evidence shows that such tests are now available, but still await recognition, acceptance and widespread adoption. It is therefore to be hoped that present guidance relating to the classification of ovarian masses will soon become more "evidence-based". These promising tests include the International Ovarian Tumour Analysis (IOTA) LR2 model and ultrasound-based Simple Rules (SR). Based on a comprehensive recent meta-analysis both currently offer the optimal "evidence-based" approach to discriminating between cancer and benign conditions in women with adnexal tumours needing surgery. LR2 and SR are reliable tests having been shown to maintain a high sensitivity for cancer after independent external and temporal validation by the IOTA group in the hands of examiners with various levels of ultrasound expertise. They also offer more accurate triage compared to the existing Risk of Malignancy Index (RMI). The development of the IOTA ADNEX model represents an important step forward towards more individualised patient care in this area. ADNEX is a novel test that enables the more specific subtyping of adnexal cancers (i.e. borderline, stage 1 invasive, stage II-IV invasive, and secondary metastatic malignant tumours) and shares similar levels of accuracy to IOTA LR2 and SR for basic discrimination between cancer and benign disease. The IOTA study has made significant progress in relation to the classification of adnexal masses, however what is now needed is to see if these or new diagnostic tools can assist

  5. Towards an evidence-based approach for diagnosis and management of adnexal masses: findings of the International Ovarian Tumour Analysis (IOTA) studies

    PubMed Central

    Kaijser, J.

    2015-01-01

    Whilst the outcomes for patients with ovarian cancer clearly benefit from centralised, comprehensive care in dedicated cancer centres, unfortunately the majority of patients still do not receive appropriate specialist treatment. Any improvement in the accuracy of current triaging and referral pathways whether using new imaging tests or biomarkers would therefore be of value in order to optimise the appropriate selection of patients for such care. An analysis of current evidence shows that such tests are now available, but still await recognition, acceptance and widespread adoption. It is therefore to be hoped that present guidance relating to the classification of ovarian masses will soon become more “evidence-based”. These promising tests include the International Ovarian Tumour Analysis (IOTA) LR2 model and ultrasound-based Simple Rules (SR). Based on a comprehensive recent meta-analysis both currently offer the optimal “evidence-based” approach to discriminating between cancer and benign conditions in women with adnexal tumours needing surgery. LR2 and SR are reliable tests having been shown to maintain a high sensitivity for cancer after independent external and temporal validation by the IOTA group in the hands of examiners with various levels of ultrasound expertise. They also offer more accurate triage compared to the existing Risk of Malignancy Index (RMI). The development of the IOTA ADNEX model represents an important step forward towards more individualised patient care in this area. ADNEX is a novel test that enables the more specific subtyping of adnexal cancers (i.e. borderline, stage 1 invasive, stage II-IV invasive, and secondary metastatic malignant tumours) and shares similar levels of accuracy to IOTA LR2 and SR for basic discrimination between cancer and benign disease. The IOTA study has made significant progress in relation to the classification of adnexal masses, however what is now needed is to see if these or new diagnostic tools

  6. Genetics of Skin Cancer (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the genetics of skin cancer — basal cell carcinoma, squamous cell carcinoma, and melanoma — including information about specific gene mutations and related cancer syndromes. The summary also contains information about interventions that may influence the risk of developing skin cancer in individuals who may be genetically susceptible to these syndromes.

  7. Immunohistochemical and morphologic evaluation of primary cutaneous apocrine carcinomas and cutaneous metastases from ductal breast carcinoma.

    PubMed

    Fernandez-Flores, A

    2012-01-01

    The differential diagnosis between a primary cutaneous apocrine carcinoma (CAC) and a cutaneous metastasis from a breast carcinoma can be a very difficult task if it is only made on morphologic bases. Concerning adnexal tumors (in general), there have been many attempts to define an immunohistochemical panel, and while a definition is useful in certain respects, the series presented often times does not include examples of CAC. Other times, CAC seems to behave in an odd way in an immunohistochemical context; they behave differently than other adnexal tumors, and this in turn adds a grade of confusion to the differential diagnosis of a cutaneous metastasis. In the current study, we include seven cases of primary cutaneous apocrine tumors, including one carcinoma in situ, five infiltrating carcinomas, and one adenoma. Additionally, we examine the expression of estrogen receptors (ER), progesterone receptors (PR), and c-erbB-2. We also study myoepithelial markers, such as p63, D2-40, and SMA in them, as well as the pattern of expression of the following cytokeratins: CK7, CK8, CK18, CK19, CK5/6 and 34betaE12. On the other hand, we examine the expression of six immunohistochemical markers (ER, PR, p63, mammaglobin, CK5÷6 and D2-40) in 30 cases of cutaneous metastases from breast carcinoma, ductal type. None of our infiltrating primary CAC expressed ER or PR, while the cutaneous metastasis expressed the markers in 90% of the cases. D2-40 was expressed in 60% of the infiltrating CACs, while the metastases were either negative (93.33% of the cases) or positive with luminal reinforcement. Mammaglobin was a very useful marker, expressed by 66.66% of the metastases, and by only one CAC (and in less than 10% of the cells). None of the metastases were positive for p63, while 60% of the CAC expressed the marker. CK 5/6 was also expressed by a high percentage of our CACs (80%), while it was seen in only 6.66% of the metastases. We found SMA as a very useful tool in diagnosing

  8. Stimulation of the follicular bulge LGR5+ and LGR6+ stem cells with the gut-derived human alpha defensin 5 results in decreased bacterial presence, enhanced wound healing, and hair growth from tissues devoid of adnexal structures.

    PubMed

    Lough, Denver; Dai, Hui; Yang, Mei; Reichensperger, Joel; Cox, Lisa; Harrison, Carrie; Neumeister, Michael W

    2013-11-01

    Discovery of leucine-rich repeat-containing G-protein-coupled receptors 5 and 6 (LGR5 and LGR6) as markers of adult epithelial stem cells of the skin and intestine permits researchers to draw on the intrinsic cellular fundamentals of wound healing and proliferation dynamics of epithelial surfaces. In this study, the authors use the intestine-derived human alpha defensin 5 to stimulate epithelial proliferation, bacterial reduction, and hair production in burn wound beds to provide the field with initial insight on augmenting wound healing in tissues devoid of adnexal stem cells. Murine third-degree burn wound beds were treated with (1) intestine-derived human alpha defensin 5, (2) skin-derived human beta defensin 1, and (3) sulfadiazine to determine their roles in wound healing, bacterial reduction, and hair growth. The human alpha defensin 5 peptide significantly enhanced wound healing and reduced basal bacterial load compared with human beta defensin 1 and sulfadiazine. Human alpha defensin 5 was the only therapy to induce LGR stem cell migration into the wound bed. In addition, gene heat mapping showed significant mRNA up-regulation of key wound healing and Wnt pathway transcripts such as Wnt1 and Wisp1. Ex vivo studies showed enhanced cell migration in human alpha defensin 5-treated wounds compared with controls. Application of human alpha defensin 5 increases LGR stem cell migration into wound beds, leading to enhanced healing, bacterial reduction, and hair production through the augmentation of key Wnt and wound healing transcripts. These findings can be used to derive gut protein-based therapeutics in wound healing.

  9. Aging Skin

    MedlinePlus

    ... email address Submit Home > Healthy Aging > Wellness Healthy Aging Aging skin More information on aging skin When it ... treated early. Return to top More information on Aging skin Read more from womenshealth.gov Varicose Veins ...

  10. Skin Conditions

    MedlinePlus

    Your skin is your body's largest organ. It covers and protects your body. Your skin Holds body fluids in, preventing dehydration Keeps harmful ... it Anything that irritates, clogs, or inflames your skin can cause symptoms such as redness, swelling, burning, ...

  11. Ganoderma lucidum total triterpenes induce apoptosis in MCF-7 cells and attenuate DMBA induced mammary and skin carcinomas in experimental animals.

    PubMed

    Smina, T P; Nitha, B; Devasagayam, T P A; Janardhanan, K K

    2017-01-01

    Ganoderma lucidum total triterpenes were evaluated for its apoptosis-inducing and anti-cancer activities. Cytotoxicity and pro-apoptotic effect of total triterpenes were evaluated in human breast adenocarcinoma (MCF-7) cell line using MTT assay and DNA fragmentation analysis. Total triterpenes induced apoptosis in MCF-7 cells by down-regulating the levels of cyclin D1, Bcl-2, Bcl-xL and also by up-regulating the levels of Bax and caspase-9. Anti-carcinogenicity of total triterpenes was analysed using dimethyl benz [a] anthracene (DMBA) induced skin papilloma and mammary adenocarcinoma in Swiss albino mice and Wistar rats respectively. Topical application of 5mg, 10mg and 20mg total triterpenes reduced the incidence of skin papilloma by 62.5, 37.5 and 12.5% respectively. Incidence of the mammary tumour was also reduced significantly by 33.33, 66.67 and 16.67% in 10, 50 and 100mg/kg b.wt. total triterpenes treated animals respectively. Total triterpenes were also found to reduce the average number of tumours per animal and extended the tumour latency period in both the models. The results indicate the potential cytotoxicity and anti-cancerous activity of total triterpenes, there by opens up a path to the development of a safe and successive chemo preventive agent of natural origin. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Smoking and skin disease.

    PubMed

    Thomsen, S F; Sørensen, L T

    2010-06-01

    Tobacco smoking is a serious and preventable health hazard that can cause or exacerbate a number of diseases and shorten life expectancy, but the role of smoking as an etiologic factor in the development of skin disease is largely unknown. Although epidemiological evidence is sparse, findings suggest that tobacco smoking is a contributing factor in systemic lupus erythematosus, psoriasis, palmoplantar pustulosis, cutaneous squamous cell carcinoma, hidradenitis suppurativa, and genital warts. In contrast, smoking may confer some protective effects and mitigate other skin diseases, notably pemphigus vulgaris, pyoderma gangrenosum, aphthous ulcers, and Behçet's disease. Various degenerative dermatologic conditions are also impacted by smoking, such as skin wrinkling and dysregulated wound healing, which can result in post-surgical complications and delayed or even arrested healing of chronic wounds. Most likely, alteration of inflammatory cell function and extracellular matrix turnover caused by smoking-induced oxidative stress are involved in the pathophysiologic mechanisms.

  13. Accuracy of intraoperative frozen section in the evaluation of patients with adnexal mass: retrospective analysis of 748 cases with multivariate regression analysis.

    PubMed

    Basaran, Derman; Salman, M Coskun; Boyraz, Gokhan; Selcuk, Ilker; Usubutun, Alp; Ozgul, Nejat; Yuce, Kunter

    2015-01-01

    To evaluate the accuracy of intraoperative frozen section in the evaluation of patients with adnexal mass and to define the clinicopathological factors associated with misdiagnosis during frozen section evaluation. The clinicopathological data of patients who underwent exploratory laparotomy for adnexal mass were reviewed. Results of the intraoperative frozen section and permanent histology reports were compared. Univariate and multivariate analyses were performed to reveal factors associated with misdiagnosis. The study group consisted of 748 patients. Of these patients, 509 (68.0%) had benign, 43 (5.7%) had borderline, 196 (26.2%) had malignant histological diagnosis at permanent section. The overall agreement between intraoperative frozen section and permanent pathology was 96.8%. Twenty four out of 745 cases (3.8%) were misdiagnosed by frozen section. Univariate analysis showed that borderline histology (p < 0.0001) and tumor size larger than 10 cm (p = 0.012) were associated with misdiagnosis. According to multivariate analysis, borderline histology (OR: 22.6, p < 0.0001) was the only independent predictor for misdiagnosis during frozen examination. The frozen section evaluation of the adnexal mass is highly accurate. However, tumor size greater than 10 cm and borderline histology are the factors that adversely influence the accuracy of intraoperative frozen section. Clinicians must be aware of these pitfalls during intraoperative decision making following frozen section report.

  14. A comparison of clinical and surgical outcomes between laparo-endoscopic single-site surgery and traditional multiport laparoscopic surgery for adnexal tumors

    PubMed Central

    Lee, In Ok; Yoon, Jung Won; Chung, Dawn; Yim, Ga Won; Nam, Eun Ji; Kim, Sunghoon; Kim, Sang Wun

    2014-01-01

    Objective The purpose of this study was to compare clinical and surgical outcomes between laparo-endoscopic single-site (LESS) surgery and traditional multiport laparoscopic (TML) surgery for treatment of adnexal tumors. Methods Medical records were reviewed for patients undergoing surgery for benign adnexal tumors between January 2008 and April 2012 at our institution. All procedures were performed by the same surgeon. Clinical and surgical outcomes for patients undergoing LESS surgery using Glove port were compared with those patients undergoing TML surgery. Results A review of 129 patient cases undergoing LESS surgery using Glove port and 100 patient cases undergoing TML surgery revealed no significant differences in the baseline characteristics of the two groups. The median operative time was shorter in the LESS group using Glove port at 44 minutes (range, 19-126 minutes) than the TML group at 49 minutes (range, 20-196 minutes) (P=0.0007). There were no significant differences between in the duration of postoperative hospital stay, change in hemoglobin levels, pain score or the rate of complications between the LESS and TML groups. Conclusion LESS surgery showed comparable clinical and surgical outcomes to TML surgery, and required less operative time. Future prospective trials are warranted to further define the benefits of LESS surgery for adnexal tumor treatment. PMID:25264529

  15. A new scoring model for characterization of adnexal masses based on two-dimensional gray-scale and colour Doppler sonographic features

    PubMed Central

    Abbas, A.M.; Zahran, K.M.; Nasr, A.; Kamel, H.S.

    2014-01-01

    Objective: To determine the most discriminating two-dimensional gray-scale and colour Doppler sonographic features that allow differentiation between malignant and benign adnexal masses, and to develop a scoring model that would enable more accurate diagnosis with those features. Methods: A cross sectional prospective study was conducted on patients scheduled for surgery due to presence of adnexal masses at Woman’s Health Center, Assiut University, Egypt between October 2012 and October 2013. All patients were evaluated by 2D ultrasound for morphological features of the masses combined with colour Doppler examination of their vessels. The final diagnosis, based on histopathological analysis, was used as a gold standard. Results: One hundred forty-six patients were recruited, 104 with benign masses, 42 with malignant masses. Features that allowed statistically significant discrimination of benignity from malignancy were; volume of mass, type of mass, presence and thickness of septae, presence and length of papillary projections, location of vessels at colour Doppler and colour score. A scoring model was formulated combining these features together; Assiut Scoring Model (ASM). The cut-off level with the highest accuracy in detection of malignancy, was ≥6, had a sensitivity of 93.5% and specificity of 92.2%. Conclusion: Our Scoring Model; a multiparameter scoring using four gray-scale ultrasound and two colour Doppler features, had shown a high sensitivity and specificity for prediction of malignancy in adnexal masses compared with previous scoring systems. PMID:25009729

  16. Presurgical diagnosis of adnexal tumours using mathematical models and scoring systems: a systematic review and meta-analysis.

    PubMed

    Kaijser, Jeroen; Sayasneh, Ahmad; Van Hoorde, Kirsten; Ghaem-Maghami, Sadaf; Bourne, Tom; Timmerman, Dirk; Van Calster, Ben

    2014-01-01

    BACKGROUND Characterizing ovarian pathology is fundamental to optimizing management in both pre- and post-menopausal women. Inappropriate referral to oncology services can lead to unnecessary surgery or overly radical interventions compromising fertility in young women, whilst the consequences of failing to recognize cancer significantly impact on prognosis. By reflecting on recent developments of new diagnostic tests for preoperative identification of malignant disease in women with adnexal masses, we aimed to update a previous systematic review and meta-analysis. METHODS An extended search was performed in MEDLINE (PubMed) and EMBASE (OvidSp) from March 2008 to October 2013. Eligible studies provided information on diagnostic test performance of models, designed to predict ovarian cancer in a preoperative setting, that contained at least two variables. Study selection and extraction of study characteristics, types of bias, and test performance was performed independently by two reviewers. Quality was assessed using a modified version of the QUADAS assessment tool. A bivariate hierarchical random effects model was used to produce summary estimates of sensitivity and specificity with 95% confidence intervals or plot summary ROC curves for all models considered. RESULTS Our extended search identified a total of 1542 new primary articles. In total, 195 studies were eligible for qualitative data synthesis, and 96 validation studies reporting on 19 different prediction models met the predefined criteria for quantitative data synthesis. These models were tested on 26 438 adnexal masses, including 7199 (27%) malignant and 19 239 (73%) benign masses. The Risk of Malignancy Index (RMI) was the most frequently validated model. The logistic regression model LR2 with a risk cut-off of 10% and Simple Rules (SR), both developed by the International Ovarian Tumor Analysis (IOTA) study, performed better than all other included models with a pooled sensitivity and specificity

  17. A randomized multicenter phase II trial on the efficacy of a hydrocolloid dressing containing ceramide with a low-friction external surface for hand-foot skin reaction caused by sorafenib in patients with renal cell carcinoma.

    PubMed

    Shinohara, N; Nonomura, N; Eto, M; Kimura, G; Minami, H; Tokunaga, S; Naito, S

    2014-02-01

    The purpose of this study was to investigate the usefulness of a hydrocolloid dressing containing ceramide for hand-foot skin reaction (HFSR) on the soles of the feet in metastatic renal cell carcinoma (RCC) patients treated with sorafenib. Patients with grade 1 HFSR on the soles of the feet were randomly assigned in to two groups. One group received a hydrocolloid dressing containing ceramide (arm A) and the other received 10% urea cream (arm B). Patients in both groups applied treatment to the affected sites on the soles of the feet, but not to the hands. The primary end point was the incidence of grade 2 or 3 HFSR on the soles of the feet in the first 4 weeks. Thirty-three patients were assessed (17 in arm A and 16 in arm B), and there were no significant differences in baseline characteristics between the two groups. During the observation period of this study, grade 2 or 3 HFSR on the soles of the feet was found in 29% of patients in arm A and was significantly less than the 69% in arm B (P=0.03). The incidence of HFSR on the hands, however, was similar in both arms. The median time to grade 2 or 3 HFSR on the soles of the feet was also significantly longer in arm A than in arm B (P=0.03). These results indicate that a hydrocolloid dressing containing ceramide prevented the worsening of HFSR caused by sorafenib in metastatic RCC patients. UMIN000002016.

  18. Tumor Progression of Skin Carcinoma Cells in Vivo Promoted by Clonal Selection, Mutagenesis, and Autocrine Growth Regulation by Granulocyte Colony-Stimulating Factor and Granulocyte-Macrophage Colony-Stimulating Factor

    PubMed Central

    Mueller, Margareta M.; Peter, Wolfgang; Mappes, Marion; Huelsen, Andrea; Steinbauer, Heinrich; Boukamp, Petra; Vaccariello, Michael; Garlick, Jonathan; Fusenig, Norbert E.

    2001-01-01

    Tumor microenvironment is crucial for cancer growth and progression as evidenced by reports on the significance of tumor angiogenesis and stromal cells. Using the HaCaT/HaCaT-ras human skin carcinogenesis model, we studied tumor progression from benign tumors to highly malignant squamous cell carcinomas. Progression of tumorigenic HaCaT-ras clones to more aggressive and eventually metastatic phenotypes was reproducibly achieved by their in vivo growth as subcutaneous tumors in nude mice. Their enhanced malignant phenotype was stably maintained in recultured tumor cells that represented, identified by chromosomal analysis, a distinct subpopulation of the parental line. Additional mutagenic effects were apparent in genetic alterations involving chromosomes 11 and 2, and in amplification and overexpression of the H-ras oncogene. Importantly, in vitro clonal selection of benign and malignant cell lines never resulted in late-stage malignant clones, indicating the importance of the in vivo environment in promoting an enhanced malignant phenotype. Independently of their H-ras status, all in vivo-progressed tumor cell lines (five of five) exhibited a constitutive and stable expression of the hematopoietic growth factors granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor, which may function as autocrine/paracrine mediators of tumor progression in vivo. Thus, malignant progression favored by the in vivo microenvironment requires both clonal selection of subpopulations adapted to in vivo growth and mutational events leading to stable functional alterations. PMID:11583982

  19. In-vivo fluorescence detection and imaging of porphyrin-producing bacteria in the human skin and in the oral cavity for diagnosis of acne vulgaris, caries, and squamous cell carcinoma

    NASA Astrophysics Data System (ADS)

    Koenig, Karsten; Schneckenburger, Herbert; Hemmer, Joerg; Tromberg, Bruce J.; Steiner, Rudolf W.

    1994-05-01

    Certain bacteria are able to synthesize metal-free fluorescent porphyrins and can therefore be detected by sensitive autofluorescence measurements in the red spectral region. The porphyrin-producing bacterium Propionibacterium acnes, which is involved in the pathogenesis of acne vulgaris, was localized in human skin. Spectrally resolved fluorescence images of bacteria distribution in the face were obtained by a slow-scan CCD camera combined with a tunable liquid crystal filter. The structured autofluorescence of dental caries and dental plaque in the red is caused by oral bacteria, like Bacteroides or Actinomyces odontolyticus. `Caries images' were created by time-gated imaging in the ns-region after ultrashort laser excitation. Time-gated measurements allow the suppression of backscattered light and non-porphyrin autofluorescence. Biopsies of oral squamous cell carcinoma exhibited red autofluorescence in necrotic regions and high concentrations of the porphyrin-producing bacterium Pseudomonas aerigunosa. These studies suggest that the temporal and spectral characteristics of bacterial autofluorescence can be used in the diagnosis and treatment of a variety of diseases.

  20. [Skin cancer as occupational disease].

    PubMed

    Bauer, A

    2016-11-01

    The incidence of epithelial skin neoplasms, such as squamous cell carcinoma and basal cell carcinoma is significantly increasing worldwide. Leisure time solar UV exposure is causative in the overwhelming majority of cases in the general population; however, occupational exposure is responsible for a certain percentage of cases. Employees with a relevant exposure to polycyclic aromatic hydrocarbons in soot, raw paraffin, coal tar, anthracene, pitch or similar substances, to sunlight in outdoor occupations as well as to arsenic and ionizing radiation have a significantly increased risk to develop occupational skin cancer compared to the general population. In the official occupational disease list in the appendix of the German by-law on occupational diseases, the following occupational diseases concerning skin cancer are listed: BK 5102 "skin cancer and carcinoma in situ caused by soot, raw paraffin, coal tar, anthracene, pitch or similar substances" (e.g. various solid paraffins, asphalt and mazut as well as mineral oils, grease, cylinder and drilling oils), BK 5103 "squamous cell carcinoma or multiple actinic keratosis caused by natural UV radiation", BK 1108 "diseases caused by arsenic and its compounds" and BK 2402 "diseases caused by ionizing radiation". For further occupational exposure to carcinogenic substances and potential occupationally acquired skin tumors, no official lists are currently available. These cancers might be considered under a special opt out paragraph in the German Social Law (§ 9 para 2 SGB VII). Tumors in scars after occupational skin trauma or occupational burns are compensated as consequences of work accidents. The current official list of occupational skin cancers and new developments for expert opinions are described in this article.

  1. Genomic Reprogramming and Skin-Like Maturation of Engineered Human Skin Substitutes

    PubMed Central

    Supp, Dorothy M.

    2012-01-01

    Background Cultured skin substitutes (CSS) have been evaluated in clinical trials as an adjunctive treatment for large full-thickness burn wounds. Prepared with autologous fibroblasts, keratinocytes, and biopolymers, CSS can provide permanent wound closure upon engraftment to excised burns. The Problem CSS containing only two cell types are limited in anatomy and physiology compared with normal uninjured skin. Identifying deficiencies in CSS can instruct further tissue engineering advances. Basic/Clinical Science Advances Expression profiling of CSS during in vitro maturation and after transplantation in vivo with Affymetrix GeneChip® Arrays was used to characterize pathways that are abnormal or deficient in CSS compared with normal human skin. Examination of the large data set generated from microarray expression analysis revealed similarities between healed CSS and normal skin, particularly in expression of genes involved in epidermal differentiation and barrier function. However, deficiencies in several pathways were also noted, such as the genetic pathways regulating development of adnexal structures, including hair follicles. Clinical Care Relevance A deeper understanding of the cellular and molecular events guiding morphogenesis of engineered skin can lead to improvements that will increase clinical efficacy. Conclusion The results of GeneChip analysis highlighted the processes that act to regulate tissue development in vitro and adaptation to the wound environment and healing in vivo. This knowledge can be used to inform modifications to the model that will facilitate incorporation of additional cell types for increased homology with native human skin and improved functional outcome for burn patients treated with engineered skin grafts. PMID:24527282

  2. Vitamin D for combination photodynamic therapy of skin cancer in individuals with vitamin D deficiency: Insights from a preclinical study in a mouse model of squamous cell carcinoma

    NASA Astrophysics Data System (ADS)

    Anand, Sanjay; Thomas, Erik; Hasan, Tayyaba; Maytin, Edward V.

    2016-03-01

    Combination photodynamic therapy (cPDT) in which vitamin D (VD) is given prior to aminolevulinate, a precursor (pro-drug) for protoporphyrin IX (PpIX), is an approach developed in our laboratory. We previously showed that 1α,25- dihydroxyvitamin D3 (calcitriol), given prior to PDT, enhances accumulation of PpIX and improves cell death post-PDT in a mouse skin cancer model. However, since calcitriol poses a risk for hypercalcemia, we replaced systemic calcitriol with oral cholecalciferol (D3), administered as a high (tenfold, "10K") diet over a ten-day period. Here, we ask whether VD deficiency might alter the response to cPDT. Nude mice were fed a VD-deficient diet for at least 4 weeks ("deficient"); controls were fed a normal 1,000 IU/kg diet ("1K"). Human A431 cells were implanted subcutaneously and mice were switched to the 10K diet or continued on their baseline diets (controls). In other experiments, mice received a human equivalent dose of 50,000 IU D3 by oral gavage, to simulate administration of a single, high-dose VD pill. At various times, tumors were harvested and serum was collected to measure levels of VD metabolic intermediates. A significant increase in PpIX levels and in the expression of differentiation and proliferation markers in tumor tissue was observed after VD supplementation of both the deficient and 1K mice. Further results describing mechanistic details of PpIX enhancement through alteration of heme- and VD-metabolic enzyme levels will be presented. Based on these results, a clinical study using oral vitamin D prior to PDT for human skin cancer should be performed.

  3. Potential O-acyl-substituted (-)-Epicatechin gallate prodrugs as inhibitors of DMBA/TPA-induced squamous cell carcinoma of skin in Swiss albino mice.

    PubMed

    Vyas, Sandeep; Manon, Benu; Vir Singh, Tej; Dev Sharma, Pritam; Sharma, Manu

    2011-04-01

    (-)-Epicatechin-3-gallate (1) is one of the principal catechins of green tea and exhibits cancer-preventive activities in various animal models. However, this compound is unstable in neutral or alkaline medium and, therefore, has a poor bioavailability. To improve its stability, O-acyl derivatives of 1 were prepared by isolating the partially purified tea catechin fraction from green tea extract and treating it with a variety of acylating agents. The resulting derivatives, compounds 2-6, were screened for their antitumor potential against 7,12-dimethylbenz[a]anthracene (DMBA)/12-O-tetradecanoylphorbol-13-acetate (TPA)-induced squamous cell carcinogenesis of skin in mice. The results showed that the antitumor activity decreased with the increase in size of the chain length of the acyl groups, i.e., from compound 2, derivative with an Ac group, to compound 6, possessing a valeryl group. Moreover, the C(4) derivative with a branched acyl chain, 5, had a lower activity than the linear C(4) derivative 4. This reduction in the inhibitory activity may be due to the steric hindrance by the two Me groups. Moreover, significant increases in the protein levels analyzed by ELISA of c-Jun, p65, and p53 were observed in the skin of DMBA/TPA treated mice, whereas mice treated with 2 and DMBA/TPA had a similar expression of these transcription factors than the control mice. The prodrug potential of the O-acyl derivatives 2-6 showed that they were adequately stable to be absorbed intact from the intestine, more stable at gastric pH, and suitable for oral administration.

  4. Skin Biomes.

    PubMed

    Fyhrquist, N; Salava, A; Auvinen, P; Lauerma, A

    2016-05-01

    The cutaneous microbiome has been investigated broadly in recent years and some traditional perspectives are beginning to change. A diverse microbiome exists on human skin and has a potential to influence pathogenic microbes and modulate the course of skin disorders, e.g. atopic dermatitis. In addition to the known dysfunctions in barrier function of the skin and immunologic disturbances, evidence is rising that frequent skin disorders, e.g. atopic dermatitis, might be connected to a dysbiosis of the microbial community and changes in the skin microbiome. As a future perspective, examining the skin microbiome could be seen as a potential new diagnostic and therapeutic target in inflammatory skin disorders.

  5. Mucoepidermoid carcinoma of the conjunctiva.

    PubMed

    Gamel, J W; Eiferman, R A; Guibor, P

    1984-05-01

    A 73-year-old man had a limbal nodule that, on histopathologic examination, proved to be mucoepidermoid carcinoma of the conjunctiva. Despite radiation therapy and extensive corneoscleral lamellar resection, widespread invasion of the lids and orbit ultimately led to exenteration. Although mucoepidermoid carcinoma of the conjunctiva resembles squamous cell carcinoma clinically and histopathologically, it pursues a more rapid and destructive clinical course. Intraepithelial invasion often leads to tumor involvement of conjunctiva and skin that seem normal on clinical examination. Special stains and a high level of suspicion are required for diagnosis of mucoepidermoid carcinoma of the conjunctiva, and proper initial management demands more aggressive surgical resection than is usually indicated for squamous cell carcinoma.

  6. Combination effect of photodynamic and sonodynamic therapy on experimental skin squamous cell carcinoma in C3H/HeN mice.

    PubMed

    Jin, Z H; Miyoshi, N; Ishiguro, K; Umemura, S; Kawabata, K; Yumita, N; Sakata, I; Takaoka, K; Udagawa, T; Nakajima, S; Tajiri, H; Ueda, K; Fukuda, M; Kumakiri, M

    2000-05-01

    We studied a combination of photodynamic therapy (PDT) and sonodynamic therapy (SDT) for improving tumoricidal effects in a transplantable mouse squamous cell carcinoma (SCC) model. Two sensitizers were utilized: the pheophorbide-a derivative PH-1126, which is a newly developed photosensitizer, and the gallium porphyrin analogue ATX-70, a commonly used sonosensitizer. Mice were injected with either PH-1126 or ATX-70 i.p. at doses of 5 or 10 mg/kg.bw. At 24 (ATX-70) or 36 hr (PH-1126) (time of optimum drug concentration in the tumor) after injection, SCCs underwent laser light irradiation (88 J/cm2 of 575 nm for ATX-70; 44J/cm2 of 650 nm for PH-1126) (PDT), ultrasound irradiation (0.51 W/cm2 at 1.0 MHz for 10 minutes) (SDT), or a combination of the two treatments. The combination of PDT and SDT using either PH-1126 or ATX-70 as a sensitizer resulted in significantly improved inhibition of tumor growth (92-98%) (additive effect) as compared to either single treatment (27-77%). The combination using PH-1126 resulted in 25% of the treated mice being tumor free at 20 days after treatment. Moreover, the median survival period (from irradiation to death) of PDT + SDT-treated mice (> 120 days) was significantly greater than that in single treatment groups (77-95 days). Histological changes revealed that combination therapy could induce tumor necrosis 2-3 times as deep as in either of the single modalities. The combination of PDT and SDT could be very useful for treatment of non-superficial or nodular tumors.

  7. Cutaneous metastatic pigmented breast carcinoma.

    PubMed

    Gaitan-Gaona, Francisco; Said, Mirra C; Valdes-Rodriguez, Rodrigo

    2016-03-16

    A 66-year-old woman presented with a 3 cm black, ulcerated nodule located on the skin of the upper abdomen, just below the breast. The lesion was painful to the touch, but the patient reported no other associated symptoms and was otherwise healthy. A 4-mm punch biopsy of the affected skin was obtained and the histological diagnosis was cutaneous metastatic pigmented breast carcinoma.

  8. [Radiotherapy of skin cancers].

    PubMed

    Hennequin, C; Rio, E; Mahé, M-A

    2016-09-01

    The indications of radiotherapy for skin cancers are not clearly defined because of the lack of randomised trials or prospective studies. For basal cell carcinomas, radiotherapy frequently offers a good local control, but a randomized trial showed that surgery is more efficient and less toxic. Indications of radiotherapy are contra-indications of surgery for patients older than 60, non-sclerodermiform histology and occurring in non-sensitive areas. Adjuvant radiotherapy could be proposed to squamous cell carcinomas, in case of poor prognostic factors. Dose of 60 to 70Gy are usually required, and must be modulated to the size of the lesions. Adjuvant radiotherapy seems beneficial for desmoplastic melanomas but not for the other histological types. Prophylactic nodal irradiation (45 to 50Gy), for locally advanced tumours (massive nodal involvement), decreases the locoregional failure rate but do not increase survival. Adjuvant radiotherapy (50 to 56Gy) for Merckel cell carcinomas increases also the local control rate, as demonstrated by meta-analysis and a large epidemiological study. Nodal areas must be included, if there is no surgical exploration (sentinel lymph node dissection). Kaposi sarcomas are radiosensitive and could be treated with relatively low doses (24 to 30Gy). Also, cutaneous lymphomas are good indications for radiotherapy: B lymphomas are electively treated with limited fields. The role of total skin electron therapy for T-lymphomas is still discussed; but palliative radiotherapy is very efficient in case of cutaneous nodules.

  9. Evaluation of the Diagnostic Accuracy of Serum D-Dimer Levels in Pregnant Women with Adnexal Torsion.

    PubMed

    Topçu, Hasan Onur; İskender, Can Tekin; Ceran, Ufuk; Kaymak, Oktay; Timur, Hakan; Uygur, Dilek; Danışman, Nuri

    2015-01-05

    We aimed to evaluate the diagnostic accuracy of serum D-dimer levels in pregnant women with adnexal torsion (AT). The pregnant women with ovarian cysts who suffered from pelvic pain were divided into two groups; the first group consisted of the cases with surgically proven as AT (n = 17) and the second group consisted of the cases whose pain were resolved in the course of follow-up period without required surgery (n = 34). The clinical characteristics and serum D-dimer levels were compared between the groups. Patients with AT had a higher rate of elevated serum white blood cell (WBC) count (57% vs. 16%, p = 0.04) and serum D-dimer levels (77% vs. 21%, p < 0.01) on admission in the study group than in the control group. Elevated D-dimer and cyst diameter larger than 5 cm yielded highest sensitivity (82% for each); whereas the presence of nausea and vomiting and elevated CRP had the highest specificity (85% and 88%, respectively). This is the first study that evaluates the serum D-dimer levels in humans in the diagnosis of AT, and our findings supported the use of D-dimer for the early diagnosis of AT in pregnant women.

  10. Basal Cell Carcinoma Arising in a Tattooed Eyebrow

    PubMed Central

    Lee, Jong-Sun; Park, Jin; Kim, Seong-Min; Kim, Han-Uk

    2009-01-01

    Malignant skin tumors, including squamous cell carcinoma and malignant melanoma, have occurred in tattoos. Seven documented cases of basal cell carcinoma associated with tattoos have also been reported in the medical literature. We encountered a patient with basal cell carcinoma in a tattooed eyebrow. We report on this case as the eighth reported case of a patient with basal cell carcinoma arising in a tattooed area. PMID:20523804

  11. Burn scar carcinoma.

    PubMed

    Huang, Chun-Yuan; Feng, Chung-Ho; Hsiao, Yen-Chang; Chuang, Shiow Shuh; Yang, Jui-Yung

    2010-11-01

    Since Jean-Nicolas Marjolin reported carcinoma arising in post-traumatic scars in 1828, the term 'Marjolin ulcer' has been applied to malignant changes in burn scars. Although many papers have been published already in this field, there are few reports from Oriental people. From 1989 to 2008, there were 11 cases noted as burn scar carcinoma in Chang Gung Memorial Hospital. Ten were reported as squamous cell carcinoma (SCC) and the one was verrucous carcinoma. Most of the cases occurred in the extremities (10/11). Ten cases underwent an operation initially with wide excision and skin graft or local flap for coverage. Forefoot amputation was performed in one patient. One patient received above-knee amputation and adjuvant therapy because recurrent verrucous carcinoma occurred 2 years later. One patient suffered from a new lesion 8 years later and another case had inguinal lymph node metastasis 8 months later. Five patients were lost to follow-up and six cases were tumor-free during the follow-up period. Most scar malignancies are SCC while other cell types are rarer. The casual association between burn injuries and a later risk of basal cell carcinoma is questionable. Owing to poor prognosis in advanced scar cancer, the best treatment for scar carcinoma is to prevent the scar from developing repeated ulceration by performing aggressive initial burn wound care: early grafting by surgeons and daily scar care with regular follow-up for patients. This may be why a lower incidence has been noted in recent years.

  12. Skin Infections

    MedlinePlus

    ... to the touch may have yellow drainage Of cellulitis: a red, inflamed area on the skin that is tender to the touch may occur in an area of a scratch or cut redness often spreads rapidly over the skin's surface ...

  13. Skin Aging

    MedlinePlus

    ... heal, too. Sunlight is a major cause of skin aging. You can protect yourself by staying out of ... person has smoked. Many products claim to revitalize aging skin or reduce wrinkles, but the Food and Drug ...

  14. Skin Complications

    MedlinePlus

    ... drugs that can help clear up this condition. Day-to-Day Skin Care See our tips for daily skin ... Better Breakfast Ensure a healthy start to your day with this guide. » « Connect With Us Register for ...

  15. Adrenocortical carcinoma

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001663.htm Adrenocortical carcinoma To use the sharing features on this page, please enable JavaScript. Adrenocortical carcinoma (ACC) is a cancer of the adrenal glands . ...

  16. UV Radiation and the Skin

    PubMed Central

    D’Orazio, John; Jarrett, Stuart; Amaro-Ortiz, Alexandra; Scott, Timothy

    2013-01-01

    UV radiation (UV) is classified as a “complete carcinogen” because it is both a mutagen and a non-specific damaging agent and has properties of both a tumor initiator and a tumor promoter. In environmental abundance, UV is the most important modifiable risk factor for skin cancer and many other environmentally-influenced skin disorders. However, UV also benefits human health by mediating natural synthesis of vitamin D and endorphins in the skin, therefore UV has complex and mixed effects on human health. Nonetheless, excessive exposure to UV carries profound health risks, including atrophy, pigmentary changes, wrinkling and malignancy. UV is epidemiologically and molecularly linked to the three most common types of skin cancer, basal cell carcinoma, squamous cell carcinoma and malignant melanoma, which together affect more than a million Americans annually. Genetic factors also influence risk of UV-mediated skin disease. Polymorphisms of the melanocortin 1 receptor (MC1R) gene, in particular, correlate with fairness of skin, UV sensitivity, and enhanced cancer risk. We are interested in developing UV-protective approaches based on a detailed understanding of molecular events that occur after UV exposure, focusing particularly on epidermal melanization and the role of the MC1R in genome maintenance. PMID:23749111

  17. Laminin C1 expression by uterine carcinoma cells is associated with tumor progression.

    PubMed

    Kashima, Hiroyasu; Wu, Ren-Chin; Wang, Yihong; Sinno, Abdulrahman K; Miyamoto, Tsutomu; Shiozawa, Tanri; Wang, Tian-Li; Fader, Amanda N; Shih, Ie-Ming

    2015-11-01

    Molecular markers associated with tumor progression in uterine carcinoma are poorly defined. In this study, we determine whether upregulation of LAMC1, a gene encoding extracellular matrix protein, laminin γ1, is associated with various uterine carcinoma subtypes and stages of tumor progression. An analysis of the immunostaining patterns of laminin γ1 in normal endometrium, atypical hyperplasia, and a total of 150 uterine carcinomas, including low-grade and high-grade endometrioid carcinomas, uterine serous and clear cell carcinoma, was performed. Clinicopathological correlation was performed to determine biological significance. The Cancer Genome Atlas (TCGA) data set was used to validate our results. As compared to normal proliferative and secretory endometrium, for which laminin γ1 immunoreactivity was almost undetectable, increasing laminin C1 staining intensity was observed in epithelial cells from atypical hyperplasia to low-grade endometrioid to high-grade endometrioid carcinoma, respectively. Laminin γ1 expression was significantly associated with FIGO stage, myometrial invasion, cervical/adnexal involvement, angiolymphatic invasion and lymph node metastasis. Similarly, analysis of the endometrial carcinoma data set from TCGA revealed that LAMC1 transcript levels were higher in high-grade than those in low-grade endometrioid carcinoma. Silencing LAMC1 expression by siRNAs in a high-grade endometrioid carcinoma cell line did not affect its proliferative activity but significantly suppressed cell motility and invasion in vitro. These data suggest that laminin γ1 may contribute to the development and progression of uterine carcinoma, likely through enhancing tumor cell motility and invasion. Laminin γ1 warrants further investigation regarding its role as a biomarker and therapeutic target in uterine carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Surgery and electrochemotherapy treatment of incompletely excised mammary carcinoma in two male pet rats (Rattus norvegicus)

    PubMed Central

    LANZA, Andrea; PETTORALI, Michela; BALDI, Alfonso; SPUGNINI, Enrico P.

    2017-01-01

    Two male rats (Rattus norvegicus; 18 and 24 months old), were referred for treatment of large masses located in the axillary area. Following total body radiography and hematological and serum biochemical analysis, the rats were anesthetized, and the masses were surgically removed. Both lesions were diagnosed as mammary carcinoma based on histopathological diagnosis. The tumor beds were treated with two sessions of electrochemotherapy (ECT), two weeks apart. ECT involved cisplatin administration in the tumor bed, followed by a series of eight biphasic electric pulses. The treatment was well tolerated, and the rats were disease-free after 10 and 14 months. Therefore, adjuvant ECT resulted in good local control of mammary carcinoma and can potentially be used for adjuvant treatment of pet rats with cutaneous and adnexal tumors. PMID:28216544

  19. Pulsed laser radiation therapy of skin tumors

    SciTech Connect

    Kozlov, A.P.; Moskalik, K.G.

    1980-11-15

    Radiation from a neodymium laser was used to treat 846 patients with 687 precancerous lesions or benign tumors of the skin, 516 cutaneous carcinomas, 33 recurrences of cancer, 51 melanomas, and 508 metastatic melanomas in the skin. The patients have been followed for three months to 6.5 years. No relapses have been observed during this period. Metastases to regional lymph nodes were found in five patients with skin melanoma. Pulsed laser radiation may be successfully used in the treatment of precancerous lesions and benign tumors as well as for skin carcinoma and its recurrences, and for skin melanoma. Laser radiation is more effective in the treatment of tumors inaccessible to radiation therapy and better in those cases in which surgery may have a bad cosmetic or even mutilating effect. Laser beams can be employed in conjunction with chemo- or immunotherapy.

  20. Incidence and risk factors for skin cancer following lung transplantation.

    PubMed

    Rashtak, Shadi; Dierkhising, Ross A; Kremers, Walter K; Peters, Steve G; Cassivi, Stephen D; Otley, Clark C

    2015-01-01

    Relative to other solid-organ transplantations, limited studies characterize skin cancer among lung-transplant recipients. We sought to assess the cumulative incidence, tumor burden, and risk factors for skin cancer among patients with lung transplantation. Medical records of patients at Mayo Clinic who had undergone lung transplantation between 1990 and 2011 were reviewed (N = 166). At 5 and 10 years posttransplantation the cumulative incidence was 31% and 47% for any skin cancer, 28% and 42% for squamous cell carcinoma, 12% and 21% for basal cell carcinoma, and 53% and 86% for death, respectively. Four patients died of metastatic squamous cell carcinoma. The cumulative incidence for a subsequent skin cancer of the same type 4 years after an initial skin cancer was 85% and 43% for squamous and basal cell carcinoma, respectively. Increasing age, male gender, skin cancer history, and more recent year of transplantation were associated with increased risk of skin cancer posttransplantation. Sirolimus was not associated with decreased risk, nor did voriconazole show an increased risk for skin cancer. Retrospective and tertiary single-center design of the study is a limitation. Skin cancers frequently occur in lung-transplant recipients. The risk of subsequent skin cancer is increased substantially in patients who develop a skin cancer after their transplantation. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Sensitive skin.

    PubMed

    Misery, L; Loser, K; Ständer, S

    2016-02-01

    Sensitive skin is a clinical condition defined by the self-reported facial presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus. Sensitive skin may occur in individuals with normal skin, with skin barrier disturbance, or as a part of the symptoms associated with facial dermatoses such as rosacea, atopic dermatitis and psoriasis. Although experimental studies are still pending, the symptoms of sensitive skin suggest the involvement of cutaneous nerve fibres and neuronal, as well as epidermal, thermochannels. Many individuals with sensitive skin report worsening symptoms due to environmental factors. It is thought that this might be attributed to the thermochannel TRPV1, as it typically responds to exogenous, endogenous, physical and chemical stimuli. Barrier disruptions and immune mechanisms may also be involved. This review summarizes current knowledge on the epidemiology, potential mechanisms, clinics and therapy of sensitive skin.

  2. Orbital and ocular adnexal Mucosa-Associated Lymphoid Tissue (MALT) lymphomas: a single-center 10-year experience.

    PubMed

    Smiljanic, M; Milosevic, R; Antic, D; Andjelic, B; Djurasinovic, V; Todorovic, M; Bila, J; Bogdanovic, A; Mihaljevic, B

    2013-12-01

    Orbital and ocular andexal Mucosa-Associated Lymphoid Tissue Lymphoma (MALT) or ocular adnexal MALT lymphoma (OAML) is the most common of all eye non-Hodgkin lymphomas. Autoimmune inflammatory disorders and chronic infections are important etiological factors and CD5 and CD43 (sialophorin) tumor markers are significant negative prognostic factors. Disease signs and symptoms can occur a long time before diagnosis. Varieties of treatment options are available. The aim of this retrospective analysis was to compare the efficiency of different treatment options and to investigate disease outcome. Twenty OAML patients, diagnosed in the Clinic of Hematology, Clinical Centre of Serbia, between 2003 and 2013, were enrolled. In most cases, OAML developed in the eighth decade with greater incidence in the male population. Median age was 67.5 years. The median period between the appearance of local signs and symptoms and diagnosis was 7 months. The dominant sign at presentation was swelling of involved tissue (40%). The most common was orbital involvement (55%). All patients had localized disease. Observed laboratory parameters on presentation showed low disease activity. Sialophorin prognostic significance was not registered. Our patients were initially treated differently but there was no significant difference in progression-free survival (PFS) due to initial treatment option (p = 0.2957). Median PFS was 22 months (3-89), and 5-year PFS was 60%. Median overall survival (OS) was 43 months (1-105) and 5-year OS 95%. Eight patients (40%) relapsed and one patient died due to non-hematological complications. In our experience, most modern induction treatment options appear to result in the same, favorable outcome.

  3. Preoperative measurement of serum C-reactive protein: is it useful in the differential diagnosis of adnexal masses?

    PubMed

    Yoshida, Adriana; Derchain, Sophie F; Pitta, Denise R; Crozatti, Nathália; Andrade, Liliana A L A; da Silva, Rodrigo F; Sarian, Luis O

    2017-03-02

    Serum biomarkers may help to discriminate malignant from benign adnexal masses with equivocal features on imaging. Adequate discrimination of such tumors is crucial for referring patients to either a specialized cancer center or a nonspecialized gynecology service. We aimed to investigate whether the preoperative level of serum C-reactive protein (CRP), alone or combined with CA125 and menopausal status in the Ovarian Score (OVS), is useful in the prediction of malignancy in women with ovarian tumors. This cross-sectional study included 293 patients who underwent surgery in a tertiary cancer center. Receiver operating characteristic (ROC) areas under the curves (AUC) for CRP, CA125 and OVS were calculated in different scenarios, as well as their sensitivity and specificity, using standard cutoff points (for CRP, 10 mg/L; for CA125, 35 U/mL). CA125 and the OVS performed significantly better than CRP alone in the differentiation of benign disease from epithelial ovarian cancer (EOC) (AUC = 0.86 for CA125, 0.79 for OVS, and 0.73 for CRP). OVS and CRP alone were superior to CA125 only in the differentiation of borderline ovarian tumors from advanced stages of EOC and non-EOC. Sensitivity and specificity were 52.5% and 83%, respectively, for CRP, 77.9% and 66.7% for CA125, and 71.3% and 67.8% for OVS. OVS is as good as CA125 in the differentiation of benign tumors from ovarian cancer. The addition of CA125 and menopausal status to CRP enhanced the relatively low discriminatory power of isolated CRP.

  4. Subjective ultrasound assessment, the ADNEX model and ultrasound-guided tru-cut biopsy to differentiate disseminated primary ovarian cancer from metastatic non-ovarian cancer.

    PubMed

    Epstein, E; Van Calster, B; Timmerman, D; Nikman, S

    2016-01-01

    To compare subjective ultrasound assessment and the ADNEX model with ultrasound-guided tru-cut biopsy to differentiate disseminated primary ovarian cancer from metastatic non-ovarian cancer. This was a prospective study including 143 consecutive women with disseminated malignancy of unknown primary origin, with a pelvic tumor/carcinosis. Women underwent either transvaginal or transrectal ultrasound as well as transabdominal ultrasound examination followed by tru-cut biopsy. The ultrasound examiner assessed tumor morphology, spread in the pelvis and abdomen, and predicted tumor origin as primary ovarian or metastatic using both subjective assessment and the ADNEX model. Histology from tru-cut biopsy served as the gold standard for assessment of diagnostic accuracy. Biopsy adequacy and the complication rate were assessed. Tru-cut biopsy was performed transvaginally in 131/143 (92%) women. Two women needed inpatient care (one had abdominal wall hematoma, and one infection). Biopsy resulted in a conclusive diagnosis in 126/143 (88%) women, amongst whom cytoreductive surgery was performed in 30/126 confirming the diagnosis in all cases. Non-ovarian metastatic cancer was found in 37/126 (29%) women and primary ovarian cancer in 89/126 (71%) women. Subjective ultrasound evaluation had a sensitivity of 82% (73/89) and a specificity of 70% (26/37) in predicting primary ovarian cancer. The ADNEX model had an area under the receiver-operating characteristics curve of 0.891 (95% CI, 0.794-0.946) (in women with an ovarian lesion, n = 104). Tumor origin was associated with age, CA 125, previous neoplasia, presence of omental cake and tumor mobility. Subjective ultrasound assessment and the ADNEX model can both be used to predict whether a pelvic tumor is metastatic and of non-ovarian origin, indicating the need for tru-cut biopsy, which is associated with very few complications and will provide a conclusive diagnosis in nine out of 10 women. Copyright © 2015 ISUOG

  5. Skin features in myotonic dystrophy type 1: an observational study.

    PubMed

    Campanati, A; Giannoni, M; Buratti, L; Cagnetti, C; Giuliodori, K; Ganzetti, G; Silvestrini, M; Provinciali, L; Offidani, A

    2015-05-01

    Poor data regarding skin involvement in Myotonic Dystrophy, also named Dystrophia Myotonica type 1, have been reported. This study aimed to investigate the prevalence and types of skin disorders in adult patients with Myotonic Dystrophy type 1. Fifty-five patients and one hundred age- and sex-matched healthy subjects were referred to a trained dermatologist for a complete skin examination to check for potential cutaneous hallmarks of disease. No difference in prevalence of preneoplastic, neoplastic, and cutaneous lesions was detected between the two groups. Among morphofunctional, proliferative and inflammatory lesions, focal hyperhidrosis (p < 0.0001), follicular hyperkeratosis (p = 0.0003), early androgenic alopecia (p = 0.01), nail pitting (p = 0.003), pedunculus fibromas (p = 0. 01), twisted hair (p = 0.01), seborrheic dermatitis (p = 0.02), macules of hyperpigmentation (p = 0.03) were significantly more frequent in patients compared with controls. In patients with Myotonic Dystrophy type 1 significant differences according to sex were found for: early androgenic alopecia, twisted hair and seborrheic dermatitis, whose prevalence was higher in males (p < 0.0001). Our preliminary results seem to rule out an increased prevalence of pre-neoplastic, and neoplastic skin lesions in Myotonic Dystrophy type 1. On the other hand, an increased prevalence of morphofunctional, inflammatory, and proliferative diseases involving adnexal structures seems to characterize adult patients with Myotonic Dystrophy type 1.

  6. Analysis of recurrence and survival rates in grade 3 endometrioid endometrial carcinoma

    PubMed Central

    Wang, Jieyu; Jia, Nan; Li, Qing; Wang, Chao; Tao, Xiang; Hua, Keqin; Feng, Weiwei

    2016-01-01

    The aim of the present study was to determine risk factors associated with recurrence and survival in patients with grade 3 endometrioid endometrial carcinoma (G3EEC). A retrospective analysis of 117 patients with G3EEC, who were admitted to the Obstetrics and Gynecology Hospital of Fudan University between January 2000 and December 2011, was performed. The χ2 test or Fisher's exact test were used for the comparison of categorical variables. Kaplan-Meier method was used for estimating recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) rates. Univariate and multivariate Cox proportional hazards model were used to assess the prognostic significance of various patient characteristics. In 117 patients, 16 patients (13.7%) had tumor recurrence, of which 6 (37.5%) developed local-regional recurrence and 10 (62.5%) developed distant recurrence. Out of the 16 patients with tumor recurrence, 14 (87.5%) had a recurrence within 3 years of surgery. Statistically significant characteristics affecting RFS, DSS and OS rates were outer half myometrial invasion (MI ≥50%), advanced International Federation of Gynecology and Obstetrics stage, positive lymph node metastasis (PLNM), lymph vascular space invasion, adnexal involvement and characterization as a high-risk group, according to the Gynecologic Oncology Group 99 stratification algorithm. RFS was associated with the depth of cervical mucosa (stromal) involvement. Furthermore, in the multivariate Cox proportional hazards model, significant independent adverse factors for RFS and DSS included MI ≥50% and adnexal involvement. For OS, there were no statistically significant prognostic factors. In conclusion, MI ≥50% and adnexal involvement are independent prognostic factors for RFS and DSS in G3EEC patients. PMID:27698871

  7. Chemoprevention of Skin Cancer Program Project | Division of Cancer Prevention

    Cancer.gov

    DESCRIPTION (provided by applicant): Skin cancer is the most common malignancy in the world. One out of three new cancers is a skin cancer. More than 1 million cases of non-melanoma skin cancer (NMSC) (basal cell carcinoma [BCC] and squamous cell cancers [SCC]) occur annually. While the incidence rates for non-melanoma skin cancers continue to rise, there continues to be a substantial impact on morbidity, health and health care costs. |

  8. Metastatic giant basal cell carcinoma: a case report

    PubMed Central

    Bellahammou, Khadija; Lakhdissi, Asmaa; Akkar, Othman; Rais, Fadoua; Naoual, Benhmidou; Elghissassi, Ibrahim; M’rabti, Hind; Errihani, Hassan

    2016-01-01

    Basal cell carcinoma is the most common skin cancer, characterised by a slow growing behavior, metastasis are extremely rare, and it occurs in less than 0, 1% of all cases. Giant basal cell carcinoma is a rare form of basal cell carcinoma, more aggressive and defined as a tumor measuring more than 5 cm at its largest diameter. Only 1% of all basal cell carcinoma develops to a giant basal cell carcinoma, resulting of patient's negligence. Giant basal cell carcinoma is associated with higher potential of metastasis and even death, compared to ordinary basal cell carcinoma. We report a case of giant basal cell carcinoma metastaticin lung occurring in a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy. Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent metastasis occurrence and improve the prognosis of this malignancy. PMID:27795755

  9. Metastatic giant basal cell carcinoma: a case report.

    PubMed

    Bellahammou, Khadija; Lakhdissi, Asmaa; Akkar, Othman; Rais, Fadoua; Naoual, Benhmidou; Elghissassi, Ibrahim; M'rabti, Hind; Errihani, Hassan

    2016-01-01

    Basal cell carcinoma is the most common skin cancer, characterised by a slow growing behavior, metastasis are extremely rare, and it occurs in less than 0, 1% of all cases. Giant basal cell carcinoma is a rare form of basal cell carcinoma, more aggressive and defined as a tumor measuring more than 5 cm at its largest diameter. Only 1% of all basal cell carcinoma develops to a giant basal cell carcinoma, resulting of patient's negligence. Giant basal cell carcinoma is associated with higher potential of metastasis and even death, compared to ordinary basal cell carcinoma. We report a case of giant basal cell carcinoma metastaticin lung occurring in a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy. Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent metastasis occurrence and improve the prognosis of this malignancy.

  10. Skin aging and dry skin.

    PubMed

    Hashizume, Hideo

    2004-08-01

    Skin aging appears to be the result of both scheduled and continuous "wear and tear" processes that damage cellular DNA and proteins. Two types of aging, chronological skin aging and photoaging, have distinct clinical and histological features. Chronological skin aging is a universal and inevitable process characterized primarily by physiologic alterations in skin function. In this case, keratinocytes are unable to properly terminally differentiate to form a functional stratum corneum, and the rate of formation of neutral lipids that contribute to the barrier function slows, causing dry, pale skin with fine wrinkles. In contrast, photoaging results from the UVR of sunlight and the damage thus becomes apparent in sun-exposed skin. Characteristics of this aging type are dry and sallow skin displaying fine wrinkles as well as deep furrows, resulting from the disorganization of epidermal and dermal components associated with elastosis and heliodermatitis. Understanding of the functions of the skin and the basic principles of moisturizer use and application is important for the prevention of skin aging. Successful treatment of dry skin with appropriate skin care products gives the impression of eternal youth.

  11. Photodynamic therapy for skin cancer

    NASA Astrophysics Data System (ADS)

    Panjehpour, Masoud; Julius, Clark E.; Hartman, Donald L.

    1996-04-01

    Photodynamic therapy was used to treat 111 lesions in 27 cases with squamous and basal cell carcinoma. There were 82 squamous cell carcinomas and 29 basal cell carcinomas. Photofrin was administered intravenously at either 1.0 mg/kg or 0.75 mg/kg. An argon/dye laser was used to deliver 630 nm light to the lesion superficially at either 215 J/cm2 or 240 J/cm2. In some cases the laser light was delivered both superficially and interstitially. The laser light was delivered two to four days after the Photofrin injection. There were 105 complete responses and 5 partial responses. One patient was lost to follow-up. Among partial responses were basal cell carcinoma on the tip of the nose and morphea basal cell carcinoma of the left cheek. Another partial response occurred in a basal cell carcinoma patient where insufficient margins were treated due to the proximity to the eye. When 0.75 mg/kg drug dose was used, the selectivity of tumor necrosis was improved. Decreased period of skin photosensitivity was documented in some cases.

  12. Characteristics of the Aging Skin

    PubMed Central

    Farage, Miranda A.; Miller, Kenneth W.; Elsner, Peter; Maibach, Howard I.

    2013-01-01

    Significance Although most researches into the changes in skin with age focus on the unwelcome aesthetic aspects of the aging skin, skin deterioration with age is more than a merely cosmetic problem. Although mortality from skin disease is primarily restricted to melanoma, dermatological disorders are ubiquitous in older people with a significant impact on quality of life. The structural and functional deterioration of the skin that occurs with age has numerous clinical presentations, ranging from benign but potentially excruciating disorders like pruritus to the more threatening carcinomas and melanomas. Recent Advances The degenerative changes that occur in the aging skin are increasingly understood at both the molecular and cellular level, facilitating a deeper understanding of the structural and functional deterioration that these changes produce. Critical Issues A loss of both function and structural stability in skin proceeds unavoidably as individuals age, which is the result of both intrinsic and extrinsic processes, which contribute simultaneously to a progressive loss of skin integrity. Intrinsic aging proceeds at a genetically determined pace, primarily caused by the buildup of damaging products of cellular metabolism as well as an increasing biological aging of the cells. Estrogen levels strongly influence skin integrity in women as well; falling levels in midlife, therefore, produce premature aging as compared with similarly aged men. Extrinsic insults from the environment add to the dermatological signs of aging. Future Directions A deeper understanding of the physiological basis of skin aging will facilitate progress in the treatment of the unwelcome sequelae of aging skin, both cosmetic and pathogenic. PMID:24527317

  13. Skin optics

    SciTech Connect

    van Gemert, M.J.; Jacques, S.L.; Sterenborg, H.J.; Star, W.M.

    1989-12-01

    Quantitative dosimetry in the treatment of skin disorders with (laser) light requires information on propagation of light in the skin related to the optical properties of the individual skin layers. This involves the solution of the integro-differential equation of radiative transfer in a model representing skin geometry, as well as experimental methods to determine the optical properties of each skin layer. These activities are unified under the name skin optics. This paper first reviews the current status of tissue optics, distinguishing between the cases of: dominant absorption, dominant scattering, and scattering about equal to absorption. Then, previously published data as well as some current unpublished data on (human) stratum corneum, epidermis and dermis, have been collected and/or (re)analyzed in terms of absorption coefficient, scattering coefficient, and anisotropy factor of scattering. The results are that the individual skin layers show strongly forward scattering (anisotropy factors between 0.7 and 0.9). The absorption and scattering data show that for all wavelengths considered scattering is much more important than absorption. Under such circumstances, solutions to the transport equation for a multilayer skin model and finite beam laser irradiation are currently not yet available. Hence, any quantitative dosimetry for skin treated with (laser) light is currently lacking.

  14. Targets for molecular therapy of skin cancer.

    PubMed

    Green, Cheryl L; Khavari, Paul A

    2004-02-01

    Cancers of the skin encompass the first and second most common neoplasms in the United States, epidermal basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), respectively, as well as the melanocytic malignancy, malignant melanoma (MM). Recently identified alterations in the function of specific genes in these cancers provide new potential therapeutic targets. These alterations affect conserved regulators of cellular proliferation and viability, including the Sonic Hedgehog, Ras/Raf, ARF/p53, p16(INK4A)/CDK4/Rb and NF-kappaB pathways. New modalities designed to target these specific proteins may represent promising approaches to therapy of human skin cancers.

  15. Epidemiology of basal cell carcinoma.

    PubMed

    Chinem, Valquiria Pessoa; Miot, Hélio Amante

    2011-01-01

    Basal cell carcinoma is the most common malignant neoplasm in humans and its incidence has increased over the last decades. Its high frequency significantly burdens the health system, making the disease a public health issue. Despite the low mortality rates and the rare occurrence of metastases, the tumor may be locally invasive and relapse after treatment, causing significant morbidity. Exposure to ultraviolet radiation is the main environmental risk factor associated with its cause. However, other elements of risk are described, such as light skin phototypes, advanced age, family history of skin carcinoma, light eyes and blond hair, freckles in childhood and immunosuppression. Behavioral aspects such as occupational sun exposure, rural labor and sunburns at a young age also play a role. Between 30% and 75% of the sporadic cases are associated with patched hedgehog gene mutation, but other genetic changes are also described. The tumor is commonly found in concomitance with skin lesions related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. The prevention of basal cell carcinoma is based on the knowledge of risk factors, early diagnosis and treatment, as well as on the adoption of specific measures, particularly in susceptible populations. The authors present a review of the epidemiology of basal cell carcinoma.

  16. IgG4-related skin manifestations in patients with IgG4-related disease.

    PubMed

    Ikeda, Tetsuya; Oka, Masahiro; Shimizu, Hideki; Hatakeyama, Mayumi; Kanki, Haruhisa; Kunisada, Makoto; Tsuji, Goh; Morinobu, Akio; Kumagai, Shunichi; Azumi, Atsushi; Negi, Akira; Nishigori, Chikako

    2013-04-01

    We describe two cases of IgG4-related disease associated with skin manifestations with IgG4-positive plasma cells. The first patient was a 52-year-old woman with a 3-year history of IgG4-related sialadenitis who presented with pruritic, indurated erythematous lesions on the auricle, postauricular and submandibular regions and neck. A skin biopsy showed infiltration of IgG4-positive plasma cells in the subcutaneous tissue. The second patient was a 53-year-old woman with IgG4-related lesions in the ocular adnexal tissues and nasal cavity who presented with pruritic, indurated erythema on the cheek and submandibular region. Histopathological examination of a skin biopsy revealed a dense, patchy infiltrate comprised of lymphocytes, IgG4-positive plasma cells and eosinophils around blood vessels and sweat glands in the entire dermis and subcutis. The skin lesions in these cases were considered to be skin manifestations of IgG4-related disease. The findings of these two cases together with the three reported cases of IgG4-related disease with skin manifestations in the literature suggest that IgG4-related skin lesions may appear on the scalp, face, neck, auricle and postauricular regions during the course of IgG4-related disease.

  17. A multispectral imaging approach for diagnostics of skin pathologies

    NASA Astrophysics Data System (ADS)

    Lihacova, Ilze; Derjabo, Aleksandrs; Spigulis, Janis

    2013-06-01

    Noninvasive multispectral imaging method was applied for different skin pathology such as nevus, basal cell carcinoma, and melanoma diagnostics. Developed melanoma diagnostic parameter, using three spectral bands (540 nm, 650 nm and 950 nm), was calculated for nevus, melanoma and basal cell carcinoma. Simple multispectral diagnostic device was established and applied for skin assessment. Development and application of multispectral diagnostics method described further in this article.

  18. Skin findings in newborns

    MedlinePlus

    Newborn skin characteristics; Infant skin characteristics; Neonatal care - skin ... the first few weeks of the baby's life. Newborn skin will vary, depending on the length of the pregnancy. Premature infants have thin, transparent skin. The skin of a ...

  19. Skin Infections

    MedlinePlus

    ... it can get infected by them. Some common types of skin infections are Bacterial: Cellulitis and impetigo. Staphylococcal infections can also affect the skin. Viral: Shingles, warts, and herpes simplex Fungal: Athlete's foot and yeast infections Parasitic: Body lice, head lice, and scabies ...

  20. Skin Substitutes

    PubMed Central

    Howe, Nicole; Cohen, George

    2014-01-01

    In a relatively short timespan, a wealth of new skin substitutes made of synthetic and biologically derived materials have arisen for the purpose of wound healing of various etiologies. This review article focuses on providing an overview of skin substitutes including their indications, contraindications, benefits, and limitations. The result of this overview was an appreciation of the vast array of options available for clinicians, many of which did not exist a short time ago. Yet, despite the rapid expansion this field has undergone, no ideal skin substitute is currently available. More research in the field of skin substitutes and wound healing is required not only for the development of new products made of increasingly complex biomolecular material, but also to compare the existing skin substitutes. PMID:25371771

  1. Hepatocellular carcinoma.

    PubMed

    Macdonald, G A

    1999-05-01

    Hepatitis C infection is associated with the development of hepatocellular carcinoma, and progress has been made in a number of areas. Transgenic mice lines expressing the hepatitis C core protein develop hepatic steatosis, adenomas, and hepatocellular carcinomas, with no significant hepatitis or fibrosis. This implies that hepatitis C can lead directly to malignant transformation. A new lesion, irregular regeneration, has been described in chronic hepatitis C infection and is associated with a 15-fold increase in the relative risk of developing hepatocellular carcinoma. A minority of patients with hepatitis C-related hepatocellular carcinoma have intense lymphocytic infiltration of the cancer, a feature associated with a better prognosis. Several studies have confirmed the association between large cell dysplasia and hepatocellular carcinoma. However, large cell dysplasia may not be a premalignant lesion and instead may be a marker for premalignant alterations elsewhere in the liver. Oral contraceptives previously have been linked to an increased risk of hepatocellular carcinoma. A large multicenter European case-control study has shown minimal increased risk of hepatocellular carcinoma with use of steroidal contraception. Tamoxifen had shown promise in the management of advanced hepatocellular carcinoma. However, a randomized placebo-controlled study of 477 patients with hepatocellular carcinoma found no benefit from tamoxifen. In a preliminary study, however, octreotide has shown improved survival and quality of life in patients with advanced hepatocellular carcinoma. Finally, interferon treatment continues to be linked to a reduced risk of hepatocellular carcinoma in patients with hepatitis C. These studies generally are not randomized, and a randomized prospective study is required to address this issue.

  2. Magnetic Resonance Imaging Characteristics of Ovarian Clear Cell Carcinoma

    PubMed Central

    Wang, Wei; Ding, Jianhui; Zhu, Xiaoli; Li, Yuan; Gu, Yajia; Peng, Weijun

    2015-01-01

    Purpose To probe the magnetic resonance imaging (MRI) features of ovarian clear cell carcinoma (OCCC). Methods This study retrospectively collected MRI data for 21 pathology-confirmed OCCCs from 19 female patients. The MRI findings were analyzed to determine the tumor size, shape/edge, shape and number of protrusions within the cyst, cystic or necrotic components, signal intensity (SI) and enhancement features. Results The age of the 19 patients ranged from 28 to 63 years (mean age: 53 years). Unilateral tumors were found in 17 patients (17/19, 89%); the average size of all tumors was 10.8 cm. The tumors on MRI were classified into two categories: (a) “cystic adnexal mass with solid protrusions” in 12 (57%) and (b) “solid adnexal mass with cystic areas or necrosis” in 9 (43%). For group a, high to very high SI was observed for most tumors (10/12, 83%) on T1-weighted images (T1WIs), and very high SI was observed on T2-weighted images (T2WIs) for all 12 tumors. Most solid protrusions were irregular and few in number and exhibited heterogeneous intermediate SI on T1WIs and T2WIs and prolonged enhanced SI in the contrast study. All 9 OCCCs in group b were predominantly solid masses with unequally sized necrotic or cystic areas in which some cysts were located at the periphery of the tumor (4/9, 44%). The solid components in all 9 tumors showed iso- or slightly high SI on T1WIs, heterogeneous iso-high SI on T2WIs and heterogeneous prolonged enhancement. According to FIGO classification, 14 tumors (14/19, 74%) were stages I-II, and 5 (5/19, 26%) were stages III-IV. Conclusions On MRI, OCCCs present as large unilateral multilocular or unilocular cystic masses with irregular intermediate SI solid protrusions or predominantly solid masses with cysts or necrosis at an early FIGO stage. PMID:26161555

  3. A case of Meigs syndrome mimicking metastatic breast carcinoma

    PubMed Central

    Lanitis, Sophocles; Sivakumar, Sivahamy; Behranwala, Kasim; Zacharakis, Emmanouil; Al Mufti, Ragheed; Hadjiminas, Dimitri J

    2009-01-01

    Background Adnexal masses are not uncommon in patients with breast cancer. Breast cancer and ovarian malignancies are known to be associated. In patients with breast cancer and co-existing pleural effusions, ascites and adnexal masses, the probability of disseminated disease is high. Nevertheless, benign ovarian masses can mimic this clinical picture when they are associated with Meigs' syndrome making the work-up and management of these patients challenging. To our knowledge, there are no similar reports in the literature and therefore we present this case to highlight this entity. Case presentation A 56-year old woman presented with a 4 cm, grade 2, invasive ductal carcinoma of her left breast. Pre-treatment staging investigations showed a 13.5 cm mass in her left ovary, a small amount of ascites and a large right pleural effusion. Serum tumour markers showed a raised CA125 supporting the malignant nature of the ovarian mass. The cytology from the pleural effusion was indeterminate but thoracoscopic biopsy failed to show malignancy. The patient was strongly against mastectomy and she was commenced on neo-adjuvant Letrozole 2.5 mg daily with a view to perform breast conserving surgery. After a good response to the hormone manipulation, the patient had breast conserving surgery, axillary sampling and laparoscopic excision of the ovarian mass which was eventually found to be a benign ovarian fibroma. Conclusion Despite the high probability of disseminated malignancy when an ovarian mass associated with ascites if found in a patient with a breast cancer and pleural effusion, clinicians should be aware about rare benign syndromes, like Meigs', which may mimic a similar picture and mislead the diagnosis and management plan. PMID:19161612

  4. Massive zosteriform cutaneous metastasis from rectal carcinoma.

    PubMed

    Damin, D C; Lazzaron, A R; Tarta, C; Cartel, A; Rosito, M A

    2003-07-01

    A 44-year-old man presented with a large and rapidly growing skin lesion approximately six months after resection of a rectal carcinoma. The lesion measured 40 cm in size, extended from the suprapubic area to the proximal half of the left groin, and showed a particular zosteriform aspect. Biopsy confirmed a metastatic skin adenocarcinoma. Cutaneous metastases from rectal cancer are very uncommon. Their gross appearance is not distinctive, although the skin tumors are usually solid, small (less than 5 cm) and painless nodules or papules. Early biopsies for suspicious skin lesions are needed in patients with a history of colorectal cancer.

  5. Multifocal aggressive squamous cell carcinomas induced by prolonged voriconazole therapy: a case report.

    PubMed

    Morice, C; Acher, A; Soufir, N; Michel, M; Comoz, F; Leroy, D; Verneuil, L

    2010-01-01

    Voriconazole is a treatment for severe fungal infections. Prolonged voriconazole therapy may induce skin reactions, with 1% of severe photosensitivity accidents. Recently the imputability of voriconazole in skin carcinogenesis has been suggested. This report concerns a 55-year-old man suffering from pulmonary aspergillosis who presented a phototoxic reaction a few months after introduction of voriconazole, followed by multiple squamous cell carcinomas of sun-exposed skin areas. After voriconazole discontinuation, no new carcinoma was observed. The detection of EBV and HPV in skin lesions was negative. Exploration of gene mutations involved in skin carcinogenesis showed two variants of the MICR gene. The occurrence of multiple, recurrent, aggressive squamous cell carcinomas is rare with voriconazole, but its imputability is strongly suggested. A plausible hypothesis is that several factors including voriconazole uptake, immunosuppression, and genetic background could explain the phenotype of fast-developing skin carcinomas. Voriconazole therapy should be accompanied by stringent photoprotection and skin monitoring.

  6. Childhood Carcinoma.

    PubMed

    Vargas, Sara O

    2010-09-01

    Carcinoma in children differs from that occurring in adults. It is far rarer and represents only a small fraction of all pediatric cancer diagnoses. Pediatric sarcomas were among the first tumors in which recurrent chromosomal aberrations were discovered. Once defined, these recurrent aberrations, many of them translocations, became incorporated into the pathologist's diagnostic armamentarium. In the past several years, defining chromosomal rearrangements have been identified in pediatric carcinomas as well, and this has become a new frontier in pathologic diagnosis. This article provides an overview of pediatric carcinoma as well as a detailed review of selected types of carcinoma that in particular can present diagnostic difficulty to the practicing pathologist and illustrate new and emerging concepts in pediatric carcinoma.

  7. A 10-year review of outpatient skin biopsy results and skin cancer subtypes.

    PubMed

    DeMarco, Sebastian S; Vos, Paul; Green, Harris; Defazio, Jennifer; Davis, Natalie; Fiz, Lindsey; Phillips, Charles

    2016-01-15

    The results of skin biopsies over a 10 year period were reviewed from the outpatient dermatology clinic at the Brody School of Medicine in Greenville, North Carolina. This research was conducted because there are very few studies that characterize this information over a long-term horizon. The biopsy rate per patient encounter, the clinical reason for the biopsy, the biopsy outcomes, the distribution of cutaneous malignancies per encounter, and the distribution of the subtypes of basal cell carcinoma, squamous cell carcinoma, and melanoma were analyzed. Biopsy logs from January 1, 2001 to December 31, 2010 were reviewed. Our investigation found that 20% of patient encounters resulted in a biopsy. Of these biopsies, 87.9% were performed to rule out malignancy and 12.1% were completed on patients suspected of having inflammatory skin conditions. The basal cell carcinomas diagnosed in Greenville, NC have more aggressive histologic subtypes compared to other studies, whereas the squamous cell carcinomas and melanomas were less aggressive.

  8. Comprehensive Genomic Profiling of Orbital and Ocular Adnexal Lymphomas Identifies Frequent Alterations in MYD88 and Chromatin Modifiers: New Routes to Targeted Therapies

    PubMed Central

    Cani, Andi K.; Soliman, Moaaz; Hovelson, Daniel H.; Liu, Chia-Jen; McDaniel, Andrew S.; Haller, Michaela J.; Bratley, Jarred; Rahrig, Samantha; Li, Qiang; Briceño, César A.; Tomlins, Scott A.; Rao, Rajesh C.

    2016-01-01

    Non-Hodgkin lymphoma of the orbit and ocular adnexa is the most common primary orbital malignancy. Treatments for low- (extra-nodal marginal zone and follicular lymphomas) and high-grade (diffuse large B-cell lymphoma) are associated with local and vision-threatening toxicities. High-grade lymphomas relapse frequently and exhibit poor survival rates. Despite advances in genomic profiling and precision-medicine, orbital and ocular adnexal lymphomas remain poorly characterized molecularly. We performed targeted next-generation sequencing profiling of 38 formalin-fixed, paraffin-embedded, orbital and ocular adnexal lymphomas obtained from a single-center using a panel targeting near-term, clinically-relevant genes. Potentially actionable mutations and copy-number alterations were prioritized based on gain- and loss-of function analyses, catalogued approved and investigational therapies. Of 36 informative samples, including marginal zone lymphomas (n=20), follicular lymphomas (n=9), and diffuse large B-cell lymphomas (n=7), 53% harbored a prioritized alteration (median=1, range 0–5/sample). MYD88 was the most frequently altered gene in our cohort, with potentially clinically-relevant hot-spot gain-of-function mutations identified in 71% of diffuse large B-cell and 25% of marginal zone lymphomas. Prioritized alterations in epigenetic modulators were common and included gain-of-function EZH2 and loss-of-function ARID1A mutations (14% of diffuse large B-cell lymphomas and 22% of follicular lymphomas contained alterations in each of these two genes). Single prioritized alterations were also identified in the histone methyltransferases KMT2B (follicular lymphoma) and KMT3B (diffuse large B-cell lymphoma). Loss-of-function mutations and copy-number alterations in the tumor suppressors TP53 (diffuse large B-cell and follicular lymphoma), CDKN2A (all subtypes), PTEN (diffuse large B-cell lymphoma), ATM (diffuse large B-cell lymphoma) and NF1 (diffuse large B-cell lymphoma

  9. Expression of WT1, CA 125, and GCDFP-15 as useful markers in the differential diagnosis of primary ovarian carcinomas versus metastatic breast cancer to the ovary.

    PubMed

    Tornos, Carmen; Soslow, Robert; Chen, Shirley; Akram, Muzaffar; Hummer, Amanda J; Abu-Rustum, Nadeen; Norton, Lar