ABSTRACT
Necrotizing soft tissue infections of the upper extremity have varying microbiologies and etiologies. Risk factors for development include diabetes mellitus, intravenous drug use, peripheral arterial disease, smoking, alcohol abuse, and immunocompromised state. Although clinical examination is the mainstay of diagnosis, laboratory tests and imaging can aid in diagnosis. Surgical débridements usually are needed for treatment, with resultant defects that often require reconstruction. Rates of amputation are reported as 22% to 37.5% and mortality from necrotizing soft tissue infections of the upper extremity from 22% to 34%. Prompt surgical and antimicrobial treatment is necessary to decrease risk of loss of limb or life.
Subject(s)
Necrosis/therapy , Soft Tissue Infections/therapy , Upper Extremity/surgery , Amputation, Surgical , Anti-Bacterial Agents/therapeutic use , Debridement , Fasciotomy , Humans , Medical History Taking , Physical Examination , Surgical Flaps , Upper Extremity/pathologyABSTRACT
Basal cell carcinoma is the most common skin cancer, but may present as anatomically and pathologically unique variants. A careful understanding of the pathophysiology, meticulous preoperative planning, and the use of unique reconstructive techniques to preserve function and cosmesis are key in achieving a satisfactory oncologic result.
ABSTRACT
A solitary fibrous tumor of the pleura (SFTP) presenting with an aberrant arterial supply from the abdominal aorta is extremely rare, and it may be difficult to distinguish from intralobar sequestration (ILS). We report the case of a 38-year-old woman who presented with acute chest pain and was subsequently found to have a 17.5-cm intrathoracic mass. After preoperative arterial embolization of its feeding vessel, this presumed ILS was resected. However, the intraoperative findings revealed a benign SFTP. Here we discuss a unique presentation of a large SFTP radiographically mimicking an ILS, and we propose a safe management strategy for this entity.
