Adjuvant anabolic agents: a case report on the successful use of oxandrolone in an HIV-positive patient with chronic stasis ulceration.

Chronic venous stasis ulcers and HIV represent 2 prevalent disease processes in the urban wound care setting. To best serve our patients, it is important that the wound care team carefully consider the impact of comorbidities and consider use of nutritional interventions. In this article we report the use of the anabolic agent oxandrolone to successfully treat an HIV-positive man with stasis ulceration.

Distant skin and soft tissue metastases from sarcomas.

BACKGROUND AND OBJECTIVES: This small series documents the clinical and pathological features and the rarity of distant skin and soft tissue metastases from sarcomas. MATERIALS AND METHODS: Five cases of sarcomas from different anatomical locations that had metastasized to skin and subcutaneous soft tissue were identified in three women and two men. The age range was 41-77 years. The primary tumors had wide excisions, followed by either radiation or chemotherapy, or both. The histological types were epithelioid sarcoma, malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, and leiomyosarcoma. Metastases occurred to the skin and soft tissue of the chest wall, leg, breast, and abdominal wall. The diagnosis was established by excision biopsies for three cases and by needle biopsy and fine-needle aspiration for two cases. RESULTS: Three patients died within 7 months of the diagnosis of soft tissue metastases that were always histologically high grade and never solitary. One patient is alive with lung metastasis discovered 17 months after excision of primary. Lung metastases occurred either simultaneously or within a short period after soft tissue metastases. CONCLUSION: Distant skin and soft tissue metastases from sarcomas are very rare and often occur as a terminal event.