Cutaneous metastasis of inflammatory breast carcinoma mimicking an erythema annulare centrifugum: a sign of locally recurrent cancer.

Erythema annulare centrifugum (EAC) is a clinical reaction pattern that includes lupus erythematosus, spongiotic dermatitis (particularly pityriasis rosea), pseudolymphoma and cutaneous B-cell lymphoma. However, it can be the result of cutaneous metastasis by an internal carcinoma. We present the case of a 38-year-old woman with bilateral inflammatory breast cancer following multimodal therapy. After chemotherapy, the patient developed EAC on her back, clinically suspect of subacute cutaneous lupus erythematosus. A skin biopsy of annular lesion revealed dermal lymphatic infiltration by inflammatory breast carcinoma. Immunohistochemically, HER2 overexpression and negativity for hormone receptor are the hallmarks of this disease. Cutaneous metastasis by inflammatory breast carcinoma mimicking EAC is rare, and it has not been described in extramammary locations. Its recognition by the dermatologist is important because it can be a clinical manifestation of locally recurrent cancer.

[Nocardia nova brain abscess]. / Absceso cerebral por Nocardia nova.

Nocardia nova is an uncommon pathogen for human beings. We describe an immunocompetent patient who acquired multiple cerebral abscesses. A surgical drainage yielded a sulpha-trimethoprim susceptible N. nova strain. The patient recovered uneventfully after a prolonged treatment with sulpha-trimethoprim.

Tumor mixohialino inflamatorio de las zonas distales de las extremidades / Inflammatory Myxohyaline Tumor of the Distal Extremities

El tumor mixohialino inflamatorio de las áreas distales de las extremidades (TMHIADE) es un sarcoma de bajo grado de malignidad extremadamente infrecuente, con tendencia a la recurrencia local tras su extirpación quirúrgica, pero con un bajo potencial metastásico. Presentamos el caso de una mujer de 49 años que consultó por una tumoración asintomática de lento crecimiento en la zona pretibial derecha, que inicialmente sugirió el diagnóstico de lipoma. El estudio histopatológico mostró la presencia de un infiltrado inflamatorio polimórfico inmerso en una matriz mixoide e hialina. Entremezcladas entre las células inflamatorias existían varias poblaciones de células tumorales: en primer lugar, unas células atípicas de morfología fusiformes; en segundo lugar, unas células epitelioides bizarras, algunas de las cuales eran multinucleadas y recordaban a los virocitos o células de Reed-Sternberg; por último, unas células de citoplasma amplio multivacuolado que recordaban a los lipoblastos. Estos hallazgos clínico-patológicos permitieron el diagnóstico de tumor mixohialino inflamatorio de las áreas distales de las extremidades. A pesar de que la tumoración se extirpó con márgenes quirúrgicos amplios, presentó una recidiva local tres meses después que fue tratada con nueva extirpación quirúrgica y radioterapia (AU)

Inflammatory myxohyaline tumor of the distal extremities is an extremely rare low-grade sarcoma with a tendency to produce local recurrence after surgical excision, but with a low metastatic potential. We present the case of a 49-year-old woman with a slow-growing asymptomatic tumor on the right pretibial region that was initially considered to be a lipoma. Histopathology revealed the presence of a polymorphic inflammatory infiltrate within a myxoid and hyaline matrix. Interspersed between the inflammatory cells were 3 different populations of neoplastic cells: atypical spindle-shaped cells; bizarre epithelioid cells, some of which were multinucleated and resembled the virocytes or Reed-Sternberg cells; and cells with abundant, vacuolated cytoplasm, similar to lipoblasts. These clinical-pathologic findings led to a diagnosis of inflammatory myxohyaline tumor of the distal extremities. Although the tumor was excised with wide surgical margins, local recurrence developed after 3 months and was treated with re-excision and radiotherapy (AU)

[Inflammatory myxohyaline tumor of the distal extremities]. / Tumor mixohialino inflamatorio de las zonas distales de las extremidades.

Inflammatory myxohyaline tumor of the distal extremities is an extremely rare low-grade sarcoma with a tendency to produce local recurrence after surgical excision, but with a low metastatic potential. We present the case of a 49-year-old woman with a slow-growing asymptomatic tumor on the right pretibial region that was initially considered to be a lipoma. Histopathology revealed the presence of a polymorphic inflammatory infiltrate within a myxoid and hyaline matrix. Interspersed between the inflammatory cells were 3 different populations of neoplastic cells: atypical spindle-shaped cells; bizarre epithelioid cells, some of which were multinucleated and resembled the virocytes or Reed-Sternberg cells; and cells with abundant, vacuolated cytoplasm, similar to lipoblasts. These clinical-pathologic findings led to a diagnosis of inflammatory myxohyaline tumor of the distal extremities. Although the tumor was excised with wide surgical margins, local recurrence developed after 3 months and was treated with re-excision and radiotherapy.

Adverse reactions to injectable aesthetic microimplants.

New inert materials such as polymerized silicones, Bioplastique, Artecoll, and Dermalive are now being used as injectable aesthetic microimplants. These substances are better than the old ones because they tend not to migrate and do not usually produce much of a host immune response. Adverse reactions after injection of these materials are rare, although there are a few reported cases as a result of bad technique or anomalous granulomatous reactions. We report on four patients with unsightly results after cosmetic microimplants, including one of Artecoll, one of Dermalive (to the best of our knowledge, the latter is the first such case reported), and two of silicone. This report describes the histopathologic features of cutaneous reactions to these injectable aesthetic materials.

Subcutaneous nodules following treatment with aluminium-containing allergen extracts.

We describe two patients who developed multiple itching nodules following immunization with vaccines adsorbed on aluminium hydroxide. Both patients had been treated with vaccines for extrinsic asthma and rhinitis for 4 and 10 years respectively. The lesions were persistent and lasted for several years. Histopathological findings were those of a foreign body reaction. Aluminium was most probably involved in the pathogenesis of these lesions because its presence could be demonstrated in macrophages using energy-dispersive X-ray microanalysis. Although some symptomatic relief was achieved with topical corticosteroids and oral antihistamines, treatment was unsuccessful.

Acute exanthem and pancreatic panniculitis in a patient with primary HIV infection and haemophagocytic syndrome.

We report a patient with an acute infection with the human immunodeficiency virus (HIV), who initially presented due to a mononucleosis-like illness that included a rash on the upper trunk and limbs, and oral ulceration. The patient developed a haemophagocytic syndrome with severe systemic involvement. Three weeks after the initial presentation, lesions of a pancreatic panniculitis appeared on both legs.

[Pulmonary leiomyosarcoma]. / Leiomiosarcoma pulmonar.

We present the case of a young patient with leiomysarcoma of the lung that was at first diagnosed as a hydatid cyst. Pathological tissue analysis was needed for firm diagnosis. This rare tumor, of which fewer than 100 cases have been reported worldwide in the literature, needs to be considered as a differential diagnosis when lung cancer is suspected, given that leiomysarcoma has a better prognosis. Treatment is mainly surgical.

[Anatomopathologic changes in the testis following prolonged treatment with LHRH agonists. Experimental study in rats]. / Cambios anatomopatológicos en el testículo tras un tratamiento prolongado con agonistas LHRH. Estudio experimental en ratas.

Presentation of a study conducted on 20 male Wistar rats treated for 3 months with Leuprolide (LHRH agonist). Analysis of pathophysiological testicular changes resulting from the treatment and extent of recovery at 3 months of therapy discontinuation, relating those changes to testosterone plasma levels in peripheral blood. Serum testosterone fell to 1.17 +/- 0.30 ng/ml in the treated group, shifting to figures overlapping with normal values within 3 months of discontinuing treatment. Such decreased testosterone levels translate into significant testicular histological damage. Three months after interruption of treatment there is nearly complete recovery of such damage, with just around 10% tubules without spermatozoa, with unchanged germinal line. We conclude that the marked suppression in testosterone levels caused by LHRH agonists translates into a significant degeneration of the seminiferous tubule, which appears to be reversible 3 months after treatment discontinuation.

[Polyarteritis nodosa as a cause of sensory motor polyneuropathy.Apropos of a case]. / Poliarteritis nodosa como causa de polineuropatía sensitivomotora. A propósito de un caso.

We present a case of nodose polyarteritis (NPA) in a 65-years-old man with clinical manifestations at the level of the peripherical nervous system (PNS) as a subacute sensorimotor polyneuropathy. We believe that this is an interesting case due to the outlined symptomatology and the first clinical signs, not as common as the multiple mononeuropathy. The diagnosis was established through biopsy of muscle-nerve, without observing aneurysms at the Divas and with negative results for the Hepatitis B markers. Response to corticoid and immunosuppressive therapy was positive.

[Melanoma of the nasal cavity]. / Melanoma de fosa nasal.

Presenting a case of nasal Melanoma, in a patient previously diagnosed and treated from Rhabdomyosarcoma of the same nasal cavity. In our Department has been treated with surgery plus thymostimulin (TP-1 Serono) after surgery. Subject reviewed and clinic features, diagnostic difficulties and nowadays immunotherapy commented.

[Infraorbital bone hemangioma]. / Hemangioma óseo infraorbitario.

Osseus hemangioma is a rare tumor. Its concept and a etiology are not well established. We preset a review and a case of this tumor located in the upper maxilla. Clinical, of this exploration and pathology are studied in this paper. Antigen in factor VIII has been observed. Considerations on different diagnosis are made.

[Olfactory neuroblastoma. A clinical and morphological study]. / Neuroblastoma olfatorio. Estudio clínico y morfológico.

A clinical and morphological study about neuroblastoma with olfactory differentiation are made. This study includes: TAC, vanimil mandelic acid urine determination, optic microscope, immunohistochemical technique, neuropeptidal, in situ hybridization, DNA analysis by flow cytometry and electronic microscope.