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Primary Excision (primary + excision)
Selected AbstractsInfected urachal cyst ruptured during medical palliationINTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2003Yasuyuki Kojima Abstract Since most cases of urachal cyst are asymptomatic, they are frequently detected after complication by infection. Ruptured urachal cysts are frequently detected after complication by severe infections such as sepsis. We report on a 31-year-old man who was diagnosed preoperatively as having an infected urachal cyst and the decision was made to follow the patient because primary excision was scheduled to be performed a few days later. Symptoms were transiently relieved, but the cyst ruptured during medical palliation. We treated this case with a two-stage surgical procedure. [source] In-transit filia of a melanoma 37 years after primary excisionJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2009B Schilling [source] Patient satisfaction after removal of skin lesionsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2007Y Rissin Abstract Background, Removal of skin lesions is one of the most common surgical procedures, with the number increasing progressively since the 1980s. Objective, We tried to evaluate the satisfaction level of patients after removal of skin lesions and to identify the factors influencing it. Study design, The study group consisted of 138 patients who had skin lesions removed by shaving or primary excision and closure. They were evaluated 1 year after the procedure. Two questionnaires were completed independently by the patient and the surgeon. Results, The main indication for the procedure was suspicion of malignancy, functional disturbance, or aesthetic reason. The satisfaction level (general and specific areas) for patients who had a malignant tumour removed was similar to those who had a benign tumour removed. Females were less satisfied than males (P = 0.05). Younger people were less satisfied with the aesthetic results (P = 0.007). Patients who had at least one significant side-effect were less satisfied than those who did not mention any side-effects (P = 0.038). The higher the level of patient satisfaction, the higher the level of surgeon satisfaction (P = 0.012). Conclusion, Skin lesions removal, although considered to be a minor procedure, leaves scars that sometimes disturb the patient. According to our study, the most prevalent population for dissatisfaction is females and young males. [source] Is head and neck melanoma a distinct entity?BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2006A clinical registry-based comparative study in 5702 patients with melanoma Summary Background, The head and neck region is more heavily exposed to ultraviolet (UV) radiation than any other body site. Therefore, cutaneous malignant melanoma (CMM) of the head and neck area is proposed to have notable differences from melanoma at other body sites regarding clinicopathological features and survival of patients. Objectives, The present retrospective study based on clinical registry data aims to compare clinical features and prognostic factors of head and neck melanoma (HNM) vs. melanoma at other anatomical regions (MOR) in order to detect differences which may be associated to the mode of sun exposure. Methods, The clinical records and histopathological findings of 844 patients with clinical stage I and II invasive HNM were compared with the data of 4858 patients with MOR. Survival analysis was performed using the Kaplan,Meier estimate, and the multivariate Cox proportional hazard model was used to evaluate independent prognostic factors. Results, Melanoma density was clearly higher for HNM than for MOR: this was particularly true for the face, where it was elevated by a factor of 2·6. There was a higher male/female ratio in patients with HNM and they were significantly older than patients with MOR (P < 0·0001). Breslow tumour thickness did not differ between HNM and MOR. However, CMMs at the scalp were significantly thicker and to a higher degree ulcerated. Concerning clinicopathological CMM subtypes, there was an increased proportion of lentigo maligna melanoma among HNM and of nodular melanoma in the scalp and neck regions. Excision margins were narrower and the rate of complete primary excision was lower in HNM than in MOR. Overall, there was no significant statistical difference in cumulative 10-year survival rates according to Kaplan,Meier estimates among patients with HNM (84·6%) and MOR (87·8%). Tumour thickness turned out to be the variable with the highest prognostic impact followed by ulceration in both HNM and MOR. Conclusions, In relation to the skin surface significantly more CMMs were found in the head and neck area than in other anatomical regions. This might indicate, but does not prove, that UV exposure promotes the development of CMM. Although HNM showed specific clinicopathological features, prognosis remained unaffected. Thus HNM seems not to be a distinct subtype of CMM. [source] Basal cell carcinoma with perineural invasion: reexcision perineural invasion?JOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2010Charles J. Bechert Background: Perineural invasion (PI) in basal cell and squamous cell carcinomas, especially of the head and neck, has been reported to indicate an increased morbidity. Reexcision perineural invasion (RPI), a benign mimic of tumoral perineural invasion, may present a difficult histologic differential diagnosis. Methods: We surveyed the medical literature for PI occurring in basal cell carcinomas to investigate the degree to which the reported cases occurred in reexcision specimens vs. primary biopsy specimens. Results: We found large retrospective studies of 14,120 basal cell carcinomas evaluated for PI in which 310 cases of PI were identified (2.2%), and 20 sporadic case reports of basal cell carcinomas with PI. Of 310 cases of basal cell carcinoma with PI, 196 (63%) were in reexcision specimens. Of 20 sporadic reports, 17 (85%) were in reexcision specimens. Conclusion: The high percentage of PI occurring in reexcision specimens vs. primary excisions may indicate that many of the reported cases of basal cell carcinomas with PI are actually examples of RPI. Bechert CJ, Stern JB. Basal cell carcinoma with perineural invasion: reexcision perineural invasion? [source] | ||||||||||