Giant Basal Cell Carcinoma of the Lateral Neck: A Case Study.

A giant basal cell carcinoma (GBCC) is a rare variant of basal cell carcinoma (BCC) that is larger (>5 cm) and more aggressive. While BCC is usually surgically excised as a small, local tumor, cases of GBCC represent a considerable portion of BCC malignancies and mortality. The growth of GBCC is hypothesized to be multifactorial, and due to the successful treatment of BCC, available data is limited. We present a case of GBCC found during routine post-mortem dissection in a 92-year-old male cadaver. The neoplasm showed predilection to periauricular soft tissue invasion, despite demonstrating high-risk characteristics for metastasis. Microscopic analysis demonstrated an infiltrative growth pattern and neurotropism. Perineural spread could be observed on gross dissection, indicating a worse prognosis, but there was no evidence of lymphatic or hematogenous spread. This is most likely due to the stromal dependence of BCC. Local invasion of the primary tumor likely compromised head and neck function, but there was no secondary tumor evidence. There were no histopathological findings that indicate an aggressive growth or metastatic transformation of the tumor. Therefore, while a conclusion about duration cannot be made due to the anonymity of the cadaver, duration of growth likely was a significant factor in mortality.

Bilateral Gastrocnemius Tertius Muscles: Cadaveric Findings of a Rare Variant.

The posterior compartment of the leg typically contains three muscles in the superficial flexor group: the gastrocnemius, plantaris, and soleus. The gastrocnemius has medial and lateral heads (MH and LH) that originate from the medial and lateral condyles of the femur, respectively. However, a third head (TH) of the gastrocnemius, is a rare accessory muscle bundle of the gastrocnemius muscle that covers the surface of the popliteal fossa. Bilateral THs of gastrocnemius were identified in a 67-year-old male during a routine educational cadaveric dissection. Both gastrocnemius TH muscles consisted of a superficial belly with distinct neurovasculature heads and originated from the lateral condyle of the femur and inserted into the Achilles tendon. To our knowledge, the co-existence of bilateral gastrocnemius TH muscles has only been reported once. The male donor was found to exhibit an anatomical anomaly and could be clinically underdiagnosed due to its clinically silent nature and the lack of reports. Insight into the potential implications of bilateral and unilateral gastrocnemius TH and identification during clinical evaluation offers a path for future research to better identify and manage cases of gastrocnemius TH and its effects.

Hair cell morphological patterns and polarity organization in the sea lamprey vestibular cristae.

The inner ear of the sea lamprey was examined by scanning electron microscopy, antibody labeling with tubulin, Myo7a, Spectrin, and Phalloidin stain to elucidate the canal cristae organization and the morphology and polarity of the hair cells. We characterized the hair cell stereocilia bundles and their morphological polarity with respect to the kinocilia. We identified three types of hair cells. In Type 1 hair cells, the kinocilia were slightly longer than the tallest stereocilia. This type was located along the medial bank of the crista and their polarity, based on kinocilia location, was uniformly pointed ampullipetally. Type 2 hair cells that had kinocilia that were much longer than the stereocilia, were most abundant in the central region of the crista. This type of hair cell displayed variable polarity. Type 3 hair cells had extremely long kinocilia (~40-50 µm long) and with extremely short stereocilia. They were mostly located in the lateral zone crista and displayed ampullipetal polarity. Myo7a and tubulin antibodies revealed that hair cells and vestibular afferents are distributed across the canal cristae in the lamprey, covering the area of cruciate eminence; a feature that is absent in more derived vertebrates. Spectrin shows hair cells of varying polarities in the central zone. In this zone, some cells followed the main polarity vector (lateral) like those in medial and lateral zones, whereas other cells displayed polarities that carried up to 40° from the main polarity vector.

The Absence of a Proper Hepatic Artery: A Case Report.

BACKGROUND Pancreaticoduodenectomy, liver transplantation, cholecystectomy, and surgical management of traumatic injuries are all dependent on in-depth knowledge of the anatomy of the common hepatic artery and its subsequent divisions. The common hepatic artery arises from the celiac trunk, which is the first major branch of the abdominal aorta. The common hepatic artery bifurcates into the gastroduodenal artery traveling inferiorly behind the duodenal bulb and the proper hepatic artery continues laterally toward the liver within the hepatoduodenal ligament. The proper hepatic artery provides the right gastric artery before dividing into the left and right hepatic arteries. Anatomical variations in the common hepatic artery and its subdivisions are common and this case report identifies a seemingly undocumented novel variation. CASE REPORT 80-year-old female donor who died of lung adenocarcinoma presented with an anatomical variation of the common hepatic artery discovered during necroscopy. The donor had a common hepatic artery that gave rise to the left hepatic artery, then continued until it bifurcated into the gastroduodenal artery and right hepatic artery. The cystic artery originated from the left hepatic artery, traveling anteriorly over the bile duct and portal vein. The donor seems to have no proper hepatic artery and instead had a novel variation of the common hepatic artery. CONCLUSIONS The observation of this variation underscores the importance of not only being familiar with the standard anatomy but also for variations that can occur. It also furthers support of the standard of preoperative imaging for surgical patients to help identify and prepare for variations.