ABSTRACT
BACKGROUND AND AIMS: Soft-tissue reconstruction of the vulva following resection of malignancies is challenging. The function of perineal organs should be preserved and the reconstructed area should maintain an acceptable cosmetic appearance. Reconstruction with local flaps is usually sufficient in the primary phase after a radical vulvectomy. Numerous flaps have been designed for vulvar reconstruction usually based on circulation from the internal pudendal artery branches. In this paper we introduce our modification of the gluteal fold V-Y advancement flap as a primary reconstruction after a radical vulvectomy. PATIENTS AND METHODS: Twenty-two patients were operated with a radical vulvectomy because of vulvar malignancies. The operation was primary in eight and secondary in 14 patients. The reconstruction of the vulva was performed in the same operation for each patient. RESULTS: All flaps survived completely. Wound complications were registered in three patients. Late problems with urinary stream were corrected in two patients. A local recurrence of the malignancy was observed in six patients during the follow-up period. CONCLUSIONS: Gluteal fold flap is easy to perform, has a low rate of complications and gives good functional results. Even a large defect can be reconstructed reliably with this method. A gluteal fold V-Y advancement flap is sensate and our modification allows the flap to be transposed with lesser dissection as presented before.
Subject(s)
Carcinoma, Squamous Cell/surgery , Melanoma/surgery , Paget Disease, Extramammary/surgery , Plastic Surgery Procedures/methods , Surgical Flaps , Vulva/surgery , Vulvar Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Buttocks , Female , Follow-Up Studies , Humans , Middle Aged , Perineum/surgery , Treatment OutcomeABSTRACT
A new case of macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) syndrome is described. The patient presented typical congenital findings in utero, although the syndrome was diagnosed postnatally. The M-CMTC syndrome should be considered when there is a marked fetal overgrowth and progressive macrocephaly with no indications of maternal hyperglycemia or fetal hyperinsulinism. Our patient also had unilateral pleural effusion, curved femur and frontal bossing.
Subject(s)
Fetal Macrosomia/diagnostic imaging , Telangiectasis/diagnostic imaging , Ultrasonography, Prenatal , Abnormalities, Multiple/diagnostic imaging , Adult , Diagnosis, Differential , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Trimester, Third , SyndromeSubject(s)
Attitude to Health , Congenital Abnormalities/diagnosis , Prenatal Diagnosis/psychology , Biomarkers/blood , Chromosome Aberrations/blood , Chromosome Aberrations/diagnosis , Congenital Abnormalities/blood , Female , Finland , Humans , Patient Satisfaction , Pregnancy , Prenatal Diagnosis/methods , Risk Factors , Surveys and Questionnaires , alpha-Fetoproteins/analysisABSTRACT
A 17-year-old woman was referred for amniocentesis due to a low maternal serum alpha-fetoprotein (AFP) concentration in a voluntary screening test. The fetal karyotype was 48,XXYY, and the pregnancy was terminated. Autopsy of the fetus disclosed agenesis of the corpus callosum and unusual facial features.
Subject(s)
Prenatal Diagnosis , Sex Chromosome Aberrations/diagnosis , alpha-Fetoproteins/analysis , Abortion, Induced , Adolescent , Agenesis of Corpus Callosum , Amniocentesis , Female , Humans , Intellectual Disability/genetics , Karyotyping , Male , Pregnancy , X Chromosome , Y ChromosomeABSTRACT
Chimerism in humans is usually found only because of discrepancies in unique blood group typing or sex chromosome complements. We describe a case found because of an inherited chromosomal translocation. A female carrier of the balanced reciprocal translocation t(14;20)(q31;q13.3) had a twin pregnancy. After birth the B-twin, a girl, was found to have the balanced translocation. The A-twin, a severely malformed and stillborn boy, had two different karyotypes; a normal 46,XY and an unbalanced translocation derivative 46,XY,-14, +der(14)t(14;20)(q31;q13.3). He was a dispermic chimera, formed by two fertilized oocytes.
