ABSTRACT
We present two cases of neonates born with symmetric aplasia cutis congenita associated with intrauterine fetal demise of cotwins during the early second trimester. Fetus papyraceus resulting in aplasia cutis congenita is a rare association with many clinical presentations, including extratruncal symmetric lesions and small linear, arcuate, and triangular lesions when twin intrauterine demise occurs after the first trimester.
Subject(s)
Ectodermal Dysplasia/pathology , Fetal Death/pathology , Fetus/pathology , Adult , Diseases in Twins/pathology , Ectodermal Dysplasia/diagnosis , Female , Humans , Infant, Newborn , Male , PregnancyABSTRACT
BACKGROUND: Adjuvant radiotherapy (ART) has been recommended for squamous cell carcinoma(SCC) with a high risk of recurrence, particularly perineurally invasive disease. The utility of ART is unknown. This study compares reported outcomes of high-risk SCC treated with surgical monotherapy(SM) with those of surgery plus ART (S + ART). METHODS: The Medline database was searched for reports of high-risk SCC treated with SM or S + ART that reported outcomes of interest: local recurrence, regional or distant metastasis, or disease-specific death. RESULTS: There were no controlled trials. Of the 2,449 cases of high-risk SCC included, 91 were treated with S + ART. Tumor stage and surgical margin status before ART were generally unreported. In 74 cases of perineural invasion (PNI), outcomes were statistically similar between SM and S + ART. In 943 high risk SCC cases in which clear surgical margins were explicitly documented, risks of local recurrence,regional metastasis, distant metastasis, and disease-specific death were 5%, 5%, 1%, and 1%, respectively. CONCLUSIONS: High cure rates are achieved in high-risk cutaneous SCC when clear surgical margins are obtained. Current data are insufficient to identify high-risk features in which ART may be beneficial. In cases of PNI, the extent of nerve involvement appears to affect outcomes, with involvement of larger nerves imparting a worse prognosis.
