Malignant pilomatricoma of the cheek in an infant

Malignant pilomatricoma (pilomatrical carcinoma) is a rare, locally occurring malignant tumor with a high rate of recurrence in the case of incomplete excision. This tumor has two characteristics. First, recurrences of pilomatrical carcinoma are common; second, distant metastasis is rare, but if it occurs, it is very fatal. It has characteristic features of high mitotic counts, cellular atypia, and local invasion. Although fine needle aspiration and excisional biopsy could help to confirm this tumor diagnosis, pathologic findings are critical. Pilomatricomas have some characteristic features in histological aspect, such as epithelial islands of basaloid cells and shadow cells or ghost cell. Also, various types of immunohistochemical staining are used to confirm the diagnosis. Despite the lack of clear surgical criteria, treatment is a wide local excision with histologically clear resection margins with or without adjuvant radiotherapy.

Chondroid Syringoma on Face

Chondroid syringoma is a rare mixed tumor of the skin which is composed of both mesenchymal and epithelial cells. Its incidence at less than 0.1% and is frequently located on the head and neck. Chondroid syringoma is easily confused with epidermal cysts. Since malignant forms of chondroid syringoma have been reported, accurate and timely diagnosis is important for proper management. We report clinical and histological features of chondroid syringoma in 5 patients treated at our institution. In most of the cases, chondroid syringoma presented as a round, firm, nodular or cystic lesion that had well marginated heterogeneity in sonography. Clinically, all of the lesions were removed by simple excision. Microscopically, all five tumors were well circumscribed and consisted of epithelial, myoepithelial, and stromal components. The epithelial component formed tubules lined by one or more rows of eosinophilic epithelial cells. The outer layer of tubules appeared to be flattened myoepithelial cells. The stroma is myxoid and contained spindle shaped myoepithelial cells. We expect that the clinical, sonographic, and histological data from our report may help clinicians who are confronted with various kinds of analogous facial lesions to decide the most proper management for their patients.

Chondroid Syringoma on Face

Chondroid syringoma is a rare mixed tumor of the skin which is composed of both mesenchymal and epithelial cells. Its incidence at less than 0.1% and is frequently located on the head and neck. Chondroid syringoma is easily confused with epidermal cysts. Since malignant forms of chondroid syringoma have been reported, accurate and timely diagnosis is important for proper management. We report clinical and histological features of chondroid syringoma in 5 patients treated at our institution. In most of the cases, chondroid syringoma presented as a round, firm, nodular or cystic lesion that had well marginated heterogeneity in sonography. Clinically, all of the lesions were removed by simple excision. Microscopically, all five tumors were well circumscribed and consisted of epithelial, myoepithelial, and stromal components. The epithelial component formed tubules lined by one or more rows of eosinophilic epithelial cells. The outer layer of tubules appeared to be flattened myoepithelial cells. The stroma is myxoid and contained spindle shaped myoepithelial cells. We expect that the clinical, sonographic, and histological data from our report may help clinicians who are confronted with various kinds of analogous facial lesions to decide the most proper management for their patients.

Reparation of large coloboma raw surface after facial tumour resection in elderly patients / 中华老年医学杂志

Objective To investigate the surgical reparation of large coloboma raw surface after facial tumour resection in elderly patients.Methods According to the position and characteristics of tumor as well as the age and tolerance of the patients, full thick skin graft, the skin flaps with subcutaneous pedicle and free skin flap were designed and used in the reparation.Results 24 cases with large coloboma raw surface (5 cm×7 cm-12 cm× 16 cm)were treated by the utilization of three approaches after tumor resection.The large coloboma raw surface in all patients achieved the healing with satisfactory appearance.Conclusions After facial tumour resection, the large coloboma raw surface can be repaired by using the skin graft, skin flaps after tumor resection or free skin flap if designed reasonably.The procedure of operation is simple and the therapeutic effect is satisfactory.

Modified V-Y Advancement Flap with Two Horns for Facial Defect Reconstruction

The V-Y advancement flap has been widely used for the reconstruction of cutaneous defects. However, direct closure is impossible without undue tension. To overcome this limitation, the present study introduces a modified design of V-Y advancement flap with two horns and assesses its clinical outcome for facial reconstruction. From June, 2009 through June, 2010, twelve cases of skin tumors were surgically excised and reconstructed with this modified V-Y flap. Defects were located in nasolabial, nasojugal fold, cheek and lower eyelid region. Modified V-Y advancement flap was designed with lateral limbs like horns of V-flap and two horns were extended to the end point of the defect. Design and movement of this flap was demonstrated with photographs and the clinical outcome was described. All flaps survived with primary healing. The follow-up period ranged from 1 month to 12 months with a mean of 5.5 months. Neither short-term nor long-term postoperative complications such as flap necrosis, hematoma, infection were noted. All twelve patients were pleased with their postoperative results and no recurrence of malignant skin tumor was observed. This modified V-Y advancement flap with two horns is a safe, easy, versatile and reliable method for functional and esthetic reconstruction of facial defects.