Management of giant anal condyloma by wide local excision and anoplasty.

AIM: Treatment of giant condyloma acuminatum, is controversial, especially in human immunodeficiency virus (HIV)-positive patients, owing to concern over wound healing, complications, risk of progression to carcinoma and a high recurrence rate. The aim of this study was to evaluate the outcome after extensive local excision with V-Y anoplasty. METHOD: Nine patients were identified from a prospective database, six of whom were HIV positive. All patients had a giant perianal condyloma acuminatum extending into the anal canal and perianal region, which required wide excision with V-Y reconstruction. Postoperative complications, recurrence and continence were all determined. RESULTS: Nine patients were included (eight men, median age 40 years), six seropositive for HIV infection. A bilateral V-Y anoplasty was performed in six patients, and unilateral in two. There were no postoperative infections, graft failures or flap necrosis. The mean follow-up was 92 (2-137) months. One patient developed local recurrence treated with excision under local anaesthesia. CONCLUSIONS: Extensive local surgery of giant perianal condyloma with anoplastic reconstruction gives good results even in HIV-positive patients.

Prostitutas: infecciones vaginales y lesiones cervicales en la citología cervicovaginal / Prostitutes: Vaginal infections and cervical lesions in cervicovaginal cytology

Objetivo Analizar las citologías cervicovaginales de prostitutas de la ciudad de Valencia (España) con el fin de detectar infecciones vaginales y lesiones cervicales precancerosas y de cáncer cervical para su correcto tratamiento. Diseño y método Durante 6 años (2002–2007) analizamos 756 citologías de prostitutas referidas a nuestro laboratorio a partir de las tomas de muestras en el centro de Medicus Mundi, según el proceso técnico habitual de Papanicolaou. Se comparan con un grupo control de 880 citologías del año 2007 en mujeres de 15 a 43 años. Resultados Entre 12 y 60 años, la edad media de las prostitutas fue de 30,74 años. La mayoría eran extranjeras (99%). En 170 casos (22,46%) se encontró una infección vaginal. Las más frecuentes fueron la vaginosis bacteriana (VB) en 84 casos (11,11%) y los hongos en 54 casos (7,14%). En 32 casos hubo LSIL (lesiones escamosas intraepiteliales de bajo grado) (4,23%) y en 8 casos hubo HSIL (lesiones escamosas intraepiteliales de alto grado) (1,05%). Sólo hubo un caso (0,13%) de cáncer infiltrante y 5 casos (0,66%) de coilocitosis. Conclusiones Hay mayor prevalencia de: a) infecciones vaginales, VB, tricomonas (p<0,001) y cándidas (p<0,05) en las prostitutas que en la población normal, y b) lesiones cervicales: atipias de significado incierto y LSIL (p<0,001) y HSIL (p<0,01). No hubo diferencias significativas en el cáncer cervical entre ambos grupos (AU)

Objective To analyze the cervicovaginal cytologies of prostitutes in the city of Valencia (Spain), and to detect vaginal infections, precancerous cervical lesions and cancerous lesions in order to provide correct treatment. Design and method During a 6-year period (2002–2007) we analyzed 756 cytologies from prostitutes, sent to our laboratory from samples taken by the Medicus Mundi center (Papinicolaou technique). These cytologies were compared with a control group of 880 cytologies taken in 2007 from women aged 15–43 years old. Results The mean age of the prostitutes was 30.74 years (range 12–60 years). Most (99%) were foreigners. Vaginal infection was found in 170 women (22.46%). The most frequent were bacterial vaginosis in 84 women (11.11%) and yeasts in 54 (7.14%). Low-grade squamous intraepithelial lesions (LSIL) were found in 32 women (4.23%) and high-grade squamous intraepithelial lesions (HSIL) in eight (1.05%). Infiltrating cancer was found in only one patient (0.13%). Koilocytosis was found in five patients (0.66%). Conclusions The prevalence of vaginal infections, bacterial vaginosis and Trichomonas (P<0.001) and Cándidas (P<0.05) is higher in prostitutes than in non-prostitutes. Cervical lesions [atypical squamous cells of undetermined significance (ASCUS) and LSIL (P<0.001) and HSIL (P<0.01)] were also more frequent in prostitutes than in non-prostitutes. No significant differences were found in cervical cancer in the two groups (AU)

Cáncer de ovario recidivante como carcinosarcoma / Ovarian cancer recurring as carcinosarcoma

A continuación se presenta un caso de cáncer seroso de ovario, intervenido y tratado con quimioterapia y que, tras 8 años, presenta recidiva como carcinosarcoma. La mujer fallece 3 años después debido a la progresión de la enfermedad (AU)

We present a case of serous ovarian cancer, which was treated with surgery and chemotherapy. Eight years later the cancer recurred as carcinosarcoma. The patient died three years later due to disease progression( AU)

Síndrome de Meigs y falso síndrome de Meigs: sendos casos / Meigs syndrome and false Meigs syndrome: one of each type

Presentamos un caso de síndrome de Meigs y otro de falso síndrome de Meigs. El síndrome de Meigs se diagnosticó en una mujer de 49 años, con tumor de ovario derecho (fibrotecoma), ascitis y derrame pleural izquierdo. El CA 125 fue normal. Tenía el antecedente de mastectomía radical por cáncer de mama izquierda, ductal infiltrante. Se sospechó clínicamente metástasis en ovario del cáncer de mama. El diagnóstico de síndrome de Meigs se estableció preoperatorio al conocer su ingreso en neumología por derrame pleural. La paciente tardó 1 año en acceder a la intervención. El falso síndrome de Meigs se diagnosticó en una mujer de 39 años, con tumor de ovario derecho (cáncer endometrioide sólido-cordonal), ascitis y derrame pleural derecho. El diagnóstico también fue preoperatorio. Estos síndromes deben ser conocidos por el neumólogo, con el fin de poder remitir a la paciente a ginecología para la intervención, ya que tras ella remiten la ascitis y el derrame pleural, salvo cuando se trata de un FSM con estadio avanzado de la enfermedad (AU)

Basal cell carcinoma with prominent central palisading of epithelial cells mimicking schwannoma.

Basal cell carcinoma (BCC), the most common malignant neoplasm of skin, may show a wide spectrum of histologic appearances. The presence of peripheral palisades is a very characteristic feature of BCC but, to our knowledge, central nuclear palisading has never been described. We report two cases of BCC exhibiting striking central nuclear palisading with Verocaylike bodies, in a pattern reminiscent of schwannoma. Peripheral palisades and clefts were also present in most tumor nodules and lobules, giving the neoplasms the overall configuration of otherwise typical solid BCC. In addition, foci of conventional BCC could be found adjacent, and in transition, to schwannoid areas. The immunohistochemical study showed strong reactivity for keratins (AE1 and AE3) in tumor cells, whereas no immunostaining for S-100 or muscle-specific actin was found. This previously undescribed histological feature of BCC should lead us to include BCC in the list of tumors to be considered in the differential diagnosis of a cutaneous neoplasm with schwannoid features.

[Adenomatoid tumor of the testicular vaginal tunic: apropos of a case]. / Tumor adenomatoide de Túnica vaginal testicular: a propósito de un caso.

The authors present a case of adenomatoid tumour of the vaginal testicle tunica, found by chance during a post-mortem study in a 70-year old male. After reviewing the literature they reveal its infrequency. According to the latest, histochemical and ultrastructural investigations carried out by several authors, its origin is mesothelial and therefore it may be called a benign mesothelioma.