Novel role of fluorescent in situ hybridization technique (FISH) in recommended surgical margins of dermatofibrosarcoma protuberans: A preliminary study.

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare skin tumor. There is no standard recommendation for its surgical management. The currently used histological analysis are HES (hematoxylin eosin saffron) staining and immunohistochemistry for CD34 expression in particular cases. Fluorescent in situ hybridization (FISH) technique is only used to qualify the DFSP as translocated or non-translocated and is not used as a diagnostic method. The aim of our study was to determine by FISH (as a diagnostic method) whether cancerous cells that could not be identified through HES staining±immunohistochemistry were present at the two-centimeter margins that were found to be tumor-free. METHODS: Samples from patients who underwent surgery between 2010 and 2018 were collected. Intralesional and peripheral (at 2cm margins) paraffin slides were included. An average of 7.4 slides per specimen was analyzed. Firstly, the preselected slides were reread by a senior pathologist to confirm the absence of microscopic findings of DFSP at 2cm margins. Secondly a FISH analysis was used as a quantitative diagnostic approach, in order to find the t(17;22) translocation. RESULTS: Among the seven specimens that included 2cm margins, two samples presented one or more translocations, which were not visible in standard morphology assessments at two centimeters tumor-free margins. CONCLUSIONS: FISH analysis can have a new role in defining tumor-free margins. This would reduce the incidence of disease recurrence after resection and improve the post-operative complementary care.

Coverage of radial forearm flap donor site with full thickness skin graft and Matriderm®: An alternative reliable solution?

PURPOSE: After harvesting a radial forearm flap (RFF) an optimal aesthetic and functional restitution of the donor site is required. In order to cover the secondary defect of the donor site, several solutions are currently available, but there is still no real evidence of the most reliable option. A retrospective study was conducted in order to evaluate a new technique of forearm coverage with artificial dermis: the association of full thickness skin graft (FTSG) with Matriderm®. METHODS: Our study included all RFF performed during a 34-month period. Forty-three forearm secondary defects after harvesting a RFF (16 men, 27 female) were included. Forearm donor site was covered using three techniques: a simple FTSG, split thickness skin graft (STSG) with Matriderm® or FTSG with Matriderm®. Clinical evaluations based on residual functionality, skin quality and aesthetic result were assessed using respectively the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Vancouver Scar Scale (VSS) score and a blind panel questionnaire. RESULTS: FTSG with Matriderm® showed an improved DASH (10.6/100) and VSS score (5.5/13) if compared to the other techniques, mean surgeon satisfaction score was 3/5, mean patient satisfaction score was 3/5 in the FTSG with Matriderm® group. CONCLUSION: The results of this study revealed that the new association of FTSG with Matriderm® improves the DASH score and the aesthetic outcomes resulting to be a reliable solution in treating full thickness forearm skin defects after RFF harvesting.

[Recurrent nevus: Case-report about a pagetoid form occurring from a congenital nevus in infancy]. / Une forme pagétoïde de pseudomélanome d'Ackerman secondaire à un naevus congénital dans l'enfance : à propos d'un cas.

INTRODUCTION: Recurrent nevus (RN) is a cutaneous benign tumour with similarities with malignant lesions. Typically, it occurs after a partial resection of commun-acquired nevus. Its incidence varies from 0.3 to 27% according to the studies. We present here a pediatric case of a pagetoid form of a recurrent nevus occurring from a congenital nevus. CASE REPORT: A congenital nevus was removed from a 9-month-old girl. Pathologists concluded to a commun-acquired nevus of complete exeresis. Two other cutaneous lesions appeared and we decided to realise a total removal. Analysis showed a recurrent nevus with some atypical histological features. No recurrence has occurred during the three post-operative of follow-up. DISCUSSION: It is an interesting case because of the occurrence of a RN after the removal of a congenital nevus in a child. Furthermore, it displayed some atypical histological features. Practicians, such as surgeons, dermatologists or pathologists, have to be aware of the risk of misdiagnosis with this lesion, which presents some similarities with SSM melanoma. It would be interesting to determinate some markers to statuate about its benign feature. There is no management recommendation about this lesion but it seems to be necessary to remove it to eliminate a malignant tumour.

Isolated unilateral temporalis muscle hypertrophy: First case in an 8-year-old boy and review.

INTRODUCTION: Isolated unilateral temporalis muscle hypertrophy (IUTMH) was first described in 1990 and few cases have been published since then. This disease occurs mainly in adults. There is no clear etiology of IUTMH, but bruxism is one of the risk factors. Only two cases have been described before the age of 20 years. To our knowledge, no cases have been described in persons younger than 15 years old. We report the first case of IUTMH in an 8-year-old and review the literature. MATERIAL AND METHODS: This section is separated into 3 parts: (1) search for and description of clinical cases of IUTMH in our department; (2) literature search to find similar cases; (3) data analysis of all cases found. RESULTS: Ten patients, including our case, were found over a period of 23 years: five females and five males with a mean age of 32.8 years. One patient was 15 years old. Time between onset and diagnosis was 16.7 months. Half of the patients reported pain and three had experienced bruxism. Most of the patients had non-surgical treatment. One patient evolved favorably with no treatment. One recurrence occurred 10 years later. DISCUSSION: IUTMH can occur in childhood in a high-stress environment. Diagnosis is based on the history and clinical and imaging findings. Biopsy helps to confirm the diagnosis, but electromyograms and neurological tests contribute little. Bruxism should be taken into account. The treatment with the least inconvenience must be given.

Classification proposed of malignant intraosseous odontogenic tumors (MIOT).

Malignant intraosseous odontogenic tumors (MIOT) of the jaws are very rare. The diagnosis is difficult. Clinical, paraclinical and histological diagnostic criteria, strict are well established. But the International Union Against Cancer (UICC) does not provide TNM classification that will allow harmonization of the treatment. Indeed, despite their location, they cannot be classified as primary tumors of the oral cavity because of their localization in the bone marrow, making them systematically classified as T4. We propose a classification taking into account the clinical and radiological data.

Development of a method to determine essential oil residues in cow milk.

Over the past few years, the use of essential oils in breeding has been gaining ground because of their wide range of application, especially in terms of antimicrobial activity, and the current emphasis on the use of natural compounds, particularly to replace antibiotics. Among the essential oils and their active components, 4 molecules are of great interest and are studied in this paper: carvacrol, thymol, cinnamaldehyde, and diallyl disulfide. In particular, we examined the transfer of essential oil components from animal feed to milk. Because these components could confer an undesirable odor or taste to milk and derived products or interfere with milk processing, it is necessary to quantify their residues in milk. Milk is a complex biological matrix containing large amounts of water, fat, and protein. As a consequence, the extraction of volatile compounds, which are mainly lipophilic, is often critical. In this work, a method based on solid-phase microextraction coupled with gas chromatography-mass spectrometry was developed and optimized. We evaluated the effect of several parameters on the sensitivity of the method: fiber type, fiber to sample contact, extraction temperature, extraction time, agitation, and salt addition. The best results were obtained using a divinylbenzene-carboxen-polydimethylsiloxane (50/30 µm) fiber in headspace mode at 34.6°C for 32.6 min without agitation or salt addition. Standard calibration curves were constructed, and the limits of detection and quantification and ranges of linear response and repeatability were evaluated. Detection limits ranged from 25 to 50 µg/L, quantification limits from 50 to 75 µg/L, and variation coefficients from 23.5 to 36.6%. Therefore, the optimized methodology was able to evaluate whether significant transfer of essential oil components from feed to milk occurred, and the method is simple and solvent-free. We applied the method to milk samples from cows whose feed included thymol, carvacrol, cinnamaldehyde, or diallyl disulfide as feed additives at the recommended dose and at twice the usual dose. None of the 4 essential oil components were found in milk samples, regardless of the dose administered.