ABSTRACT
A 44-year-old woman presented with marked erythema over right mastectomy scar, while on Herceptin therapy. She had neoadjuvant chemotherapy, modified radical mastectomy, and radiotherapy less than one year earlier for the treatment of invasive ductal carcinoma. On physical examination, no palpable masses were detected in the erythematous skin. A biopsy revealed permeation of the skin lymphatics by emboli of metastatic ductal carcinoma, similar to what is seen in inflammatory carcinoma. The involved skin was excised, followed by immediate reconstruction with transverse rectus abdominis muscle (TRAM) flap. On follow-up, the wound was healing well, with no signs of inflammation.
ABSTRACT
Phyllodes tumour of the breast is a relatively uncommon condition, and rarely invades the chest wall. We report a case of young women who had recurrent large phyllodes tumour invading the chest wall, following mastectomy, chemotherapy and radiotherapy. A multidisciplinary approach was used for radical resection of the tumour, chest wall and reconstruction.
Subject(s)
Breast Neoplasms/pathology , Mastectomy/methods , Neoplasm Recurrence, Local/pathology , Phyllodes Tumor/pathology , Sarcoma/pathology , Thoracic Wall/pathology , Adult , Breast Neoplasms/surgery , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Mammaplasty/methods , Neoplasm Invasiveness , Neoplasm Recurrence, Local/surgery , Phyllodes Tumor/surgery , Sarcoma/surgery , Surgical Flaps , Tomography, X-Ray ComputedABSTRACT
Inhibin B is bidirectionally secreted by Sertoli cells, basal secretion into the circulation exerts negative feedback on follicle-stimulating hormone secretion, and serum inhibin B is considered a marker of spermatogenesis. The precise role of apical secretion is unknown. The objective of our work was to study the relationship between seminal inhibin B and spermatogenesis. Dimeric inhibin B was measured by immunoassay in seminal plasma of volunteers with normozoospermia (n = 10, group 1), in men after vasectomy (n = 10, group 2), and in men with azoospermia (n = 50, group 3). Testicular biopsy and testicular sperm extraction were performed in men with azoospermia. Seminal inhibin B levels were higher in men in group 1 than in men in groups 2 and 3 (P <.0001). In seminal plasma, inhibin B presents a positive correlation with alpha glucosidase activity (r =.37, P =.002). Seminal inhibin B is inversely related with serum FSH (r = -.58, P <.001), and presents a weak positive correlation with serum testosterone concentration (r =.29, P =.03). No difference was found between inhibin B levels in seminal plasma of patients with nonobstructive or obstructive azoospermia, and between positive or negative outcome of TESE. We conclude that inhibin B secretion by Sertoli cells is differentially regulated. The contribution of accessory sex glands limits the use of seminal plasma inhibin B as a marker of spermatogenesis.
