Pathological assessment of tumor biopsy specimen and surgical sentinel lymph node dissection in patients with melanoma.

INTRODUCTION: Actual trends of cutaneous malignant melanoma show a faster increase then other forms of cancer. Early detection and diagnosis, and accurate pathologic interpretation of the biopsy specimen is extremely important for the treatment and prognosis of clinically localized melanoma. The surgical approach to cutaneous melanoma patients with clinically uninvolved regional lymph nodes remains controversial. MATERIALS AND METHODS: A retrospective study of melanoma cases was conducted in the "Casa Austria" Department of Plastic and Reconstructive Surgery, Emergency County Hospital, Timisoara, Romania. We have analyzed the medical records of 21 patients that underwent surgical treatment for different stages of melanoma in the period 2008-2012. For histopathological diagnosis of melanoma and the sentinel lymph node(s) status, tissular fragments were routinely processed. For the difficult cases, additional immunohistochemical investigation was done. RESULTS: A positive family history was noted in two cases. The presence of different sizes and localization of pigmented nevi was found in 38% of the cases. Different types of melanoma like superficial spreading melanoma, nodular melanoma or lentigo malignant melanoma and acral lentiginous melanoma was described. The surgical treatment consisted in all cases in wide excision of the primary tumor and prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination. A positive biopsy of the sentinel lymph node was noted in 4.9% of the cases. CONCLUSIONS: The surgical treatment combining the wide excision of the primary tumor with respect to safe oncological limits with the prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination had the confirmation done by the pathologic interpretation of the biopsy specimen showing that all the patients had a Breslow index more than 1.5 mm.

Experimental morphologic and radiologic study of the integration of bone grafts into the host tissue and of the dynamics of the graft-receptor interface.

Bone is the second tissue in terms of number of transplants after blood. There is an increased trend of incidence of severe bone lesions with comminuted fractures, with significant lack of substance, as well as an increased incidence of cancer types combined with therapeutic advances in recent decades, allowing for large surgical interventions that affect the bones and create significant defects in bone and contribute to the overall increase in the number and complexity of bone transplants. Autografts may be used singly or in various combinations, with significantly better effects than other implant materials. Use of autografts is limited by complications from the receptor site, mainly related to infections and undetectable necrotic areas on initial microscopic examination, which prevent proper incorporation of autografts, but also those of the donor situs. The aim of the study was to assess the integration of tibial bone grafts into the femur of Wistar rats by radiologic exam and histological evaluation. We concluded that the fixing of the graft to the host tissue may be subject to some microenvironment influences. The presence of the periosteum on the grafts is certainly an asset during transplantation. We confirm once again that the ability of transplanted periosteum of osteoformation and reactivation. Our observations regarding the contribution of bone marrow endorse the view of its active role in bone formation.