Lesions Observed Post Mortem in Post-hatchling Loggerhead Sea Turtles (Caretta caretta) from a Head Start Programme.

Head start programmes are ex-situ conservation procedures consisting of the captive rearing of sea turtle hatchlings for several months in order to avoid high mortality rates in the first year of life. Studies of the diseases of hatchling and post-hatchling turtles belonging to these programmes are scarce. We describe the gross and histological lesions found in 78 post-hatchling loggerhead sea turtles (Caretta caretta) that died during captive rearing in the conservation programme of the Cape Verde-Canary Islands, initiated with 113 hatchlings. The main organ systems affected were respiratory (57.69%), integumentary (41.02%) and digestive (41.02%), affecting 94.87% of the animals. Other less frequently affected organ systems were cardiovascular (3.85%), excretory (3.85%), muscular (2.56%) and reproductive (1.28%). The most common lesions were different types of dermatitis (41.02%), mainly ulcerative and/or heterophilic ulcerative dermatitis; these lesions were compatible with a traumatic origin caused by biting and subsequent infection with gram-positive cocci. Purulent and/or fibrinonecrotizing rhinitis associated with mixed populations of bacteria were commonly detected respiratory lesions (21.79%). Acute interstitial pneumonia was the most common form of pneumonia diagnosed (20.51%). Fibrinonecrotizing stomatitis associated with sparse gram-negative rods was the most common digestive tract lesion (29.49%). A possible explanation for the high mortality rate (88.50%) observed in this study could be the occurrence of a decrease in water temperature during the growth phase of the turtles. Despite the limitations caused by an absence of microbiological studies, the survey provides useful information on the lesions found in post-hatchling loggerhead turtles from this head start programme. In addition to maintaining water temperature above 20°C, attention must be paid to lesions that can easily be detected, such as dermatitis, rhinitis and stomatitis.

Sectional anatomic and tomographic study of the feline abdominal cavity for obtaining a three-dimensional vascular model.

BACKGROUND: Unlike dogs, feline abdominal studies are rare. Note that anatomical estudies in felines are scarce and almost unique using feline cadaver by means of sectional anatomy and computed tomography (CT) or magnetic resonance imaging (MRI). Aims: In this study, a non-pathological vascularization model of feline abdomen was conducted on three adult cats was using anatomical and diagnostic imaging techniques. METHODS: A live pet cat and two cat cadavers were used in this study. Cat cadavers were injected with colored latex to show well-differentiated vascular structures and serial sections of cat abdomen were then provided. Computed tomography was performed by injecting an iodinated contrast medium through the cephalic vein of a live cat immediately before scanning. The CT images showed the arterial and venous vascular formations hyper-attenuated with two tomographic windows. The correlation between anatomical sections and their CTs was studied to identify vascular and and visceral structures. RESULTS: Hyper-attenuated vascular structures with the contrast medium were identified and marked along their path in the series of Dicom images with the Amira program. In this approach, sequentially and semiautomatically, vascular volumetric reconstruction was obtained without visceral formations. With the OsiriX program, volumetric reconstruction was automatic and maintained the fidelity of all visceral and vascular formations. CONCLUSION: We conclude that these improved prototypes could be used in veterinary clinics as normal vascular models and as a basis for obtaining future 3D models of vascular anomalies such as portosystemic shunts.

Anatomical assessment of intrathoracic cardiovascular structures using fast spin-echo double inversion recovery and steady-state free precession magnetic resonance imaging in a normal cat.

In human medicine, non-contrast cardiac magnetic resonance imaging (CMRI) is routinely used to assess the cardiovascular system. In this study, using non-contrast CMRI, we provide a thorough description of the normal appearance of the intrathoracic cardiovascular structures in one healthy cat using a magnet operating at a field of 1.5-Tesla. The CMRI protocol was based on the use of fast spin-echo double inversion recovery and steady-state free precession pulse sequences in oblique short-axis, vertical long-axis, and horizontal long-axis imaging planes. After imaging the feline heart, four cadaver cats injected with latex substance into their arterial and venous systems were sectioned to facilitate interpretation of the intrathoracic cardiovascular structures to the corresponding CMRI. The fast spin-echo double inversion recovery images showed the best evaluation of gross intrathoracic anatomy, giving excellent contrast of the myocardium and vessels walls as they appeared with intermediate signal intensity compared to the lumen that appeared with low signal intensity. By contrast, steady-state free precession images showed details of the heart cavities and vascular lumen due to the high signal intensity of fast-flowing blood. The results of this study provide some anatomic detail for the heart and associated vessels as seen by non-contrast CMRI in the domestic cat.

Isolation of Naegleria fowleri from a domestic water tank associated with a fatal encephalitis in a 4 month-old Venezuelan child.

This study describes the association of household water system contamination with the pathogenic Free-Living Amoeba (FLA) Naegleria fowleri and a case of fatal Primary Amoebic Meningoencephalitis (PAM) in a child from the state of Monagas in Venezuela. Amoebae were initially identified by microscopy from a sample of cerebrospinal fluid (CSF) from the child. Direct DNA extraction and specific PCR/sequencing for N. fowleri was also carried out from the same CSF sample. In order to determine a possible environmental source of infection, water samples from the water tank of the child's home and also water bodies recently visited by the child and his family, were examined for the presence of N. fowleri by culture and PCR/sequencing. The results obtained from the collected water samples revealed that only the water tank of the house was positive for N. fowleri. PCR/sequencing showed that the strains isolated from the patient and the water tanks were 100 % identical. Therefore, the house water tank was confirmed as the source of infection in this case, possibly as a result of the occasional immersion of the child´s head under the water while bathing. This case highlights a novel source of thermally polluted water and another threat of N. fowleri infection.

The study of microanatomy of intestinal epithelium in the Chinese soft-shelled turtle (Pelodiscus sinensis).

The microanatomy of the intestinal epithelium in the Chinese soft-shelled turtle (CST) was studied by light and transmission electron microscopy (TEM). The small intestinal epithelium (SIE) was single layered or pseudostratified. The enterocytes contained mitochondria or mitochondria and lipid droplets. The enterocytes were arranged tightly in the apical parts of epithelium and connected by desmosomes and interdigitations. The large intestinal epithelium (LIE) was pseudostratified and the enterocytes did not contain lipid droplets. Enterocytes were arranged compactly in the apical part, forming spaces in the middle and basal parts of epithelium. Numerous mucous cells were scattered in the epithelium and there were intraepithelial lymphocytes (IELs) with their pseudopodia extended into the intestinal lumen. This study provides detailed features of intestinal epithelium in the Pelodiscus sinensis that could be related to function. In addition, these findings are discussed in relation to other vertebrates.

Evidencia científica de la marcha nórdica en Fisioterapia: revisión bibliográfica / Scientific evidence of nordic walking in Physioterapy: Bibliographic review

Objetivo: Describir la evidencia científica de la marcha nórdica como tratamiento fisioterapéutico. Estrategia de búsqueda: Se utiliza PubMed, Cochrane Library, CINAHL, SportsDiscus, Web of Science, SCOPUS y ScienceDirect, para ubicar ensayos clínicos aleatorizados de los últimos 5 años. Selección de estudios: De los ensayos encontrados, 15 cumplieron los criterios de selección y 13 de buena calidad con la escala de Jadad. Síntesis de resultados: Los estudios refieren la aplicación del tratamiento en el síndrome metabólico, obesidad, trastornos osteomusculares, vasculares, párkinson, respiratorios y cardiacos, con recomendaciones de práctica a intensidad moderado-vigorosa de 150 min semanales. Conclusiones: La marcha nórdica es recomendable para programas de fisioterapia, y actividades de la vida diaria, sobre todo en la enfermedad pulmonar obstructiva crónica, cardiopatías y síndrome metabólico (AU)

Objectives: Describe the scientific evidence Nordic walking as physiotherapy. Search strategy: PubMed, Cochrane Library, CINAHL, SportsDiscus, Web of Science, Scopus and ScienceDirect is used to locate randomized clinical trials of the past 5 years. Study selection: Of the trials found, 15 met the selection criteria and 13 met the good quality criteria with the Jadad scale. Summary of results: The studies concern the application of the treatment in metabolic syndrome, obesity, musculoskeletal disorders, vascular, Parkinson's disease, respiratory and heart diseases, with practical recommendations of exercises of moderate-vigorous intensity of 150minutes per week. Conclusions: Nordic walking is recommended for physiotherapy programs and daily activities, especially in chronic obstructive pulmonary disease, heart disease and metabolic syndrome (AU)

Three-dimensional time of flight magnetic resonance angiography of the heart and associated vessels in a cat.

The aim of this study was to describe the normal magnetic resonance angiography (MRA) of the heart and associated vessels in a mature female cat using a 1.5-Tesla magnet. Non-contrast enhanced MRA was performed using a three-dimensional time of flight (TOF) sequence in parasagittal and dorsal aspects. Relevant cardiac and vascular structures were labelled on three-dimensional Time of flight images. Time of flight imaging showed details of the heart cavities and vessels lumen due to the high signal intensity of fast-flowing blood compared with bones, muscles, and lungs, which appeared with low signal intensity. Three-dimensional TOF sequences provided adequate anatomical details of the heart and good differentiation of the vascular structures that could be used for interpretation of cardiac images and to assist in future MRA studies.

Sectional anatomic and computed tomography features of the nasal and oral cavities of the one-humped camel (Camelus dromedarius).

The purpose of the study was to provide a description of normal cross-sectional anatomy of the camel nasal and oral cavities using computed tomography (CT) and macroscopic cross-sections. Transverse images of two isolated camel cadaver heads were obtained by an axial CT equipment. Computed tomography scans were processed with a detailed algorithm using nasal and soft tissue windows settings and compared with the corresponding frozen cross-sections of the heads, to assist in the accurate identification of nasal and oral structures. In our study, nasal window provided excellent anatomic details of nasal conchae, bones and teeth; however, other soft tissue components of the nasal and oral cavities are better differentiated using a soft tissue window. These CT images are intended to be a useful anatomic reference in the interpretation for clinical CT imaging studies of the nasal and oral cavities in dromedary camels.

Using massive vehicle positioning data to improve control and planning of public road transport.

This study describes a system for the automatic recording of positioning data for public transport vehicles used on roads. With the data provided by this system, transportation-regulatory authorities can control, verify and improve the routes that vehicles use, while also providing new data to improve the representation of the transportation network and providing new services in the context of intelligent metropolitan areas. The system is executed autonomously in the vehicles, by recording their massive positioning data and transferring them to remote data banks for subsequent processing. To illustrate the utility of the system, we present a case of application that consists of identifying the points at which vehicles stop systematically, which may be points of scheduled stops or points at which traffic signals or road topology force the vehicle to stop. This identification is performed using pattern recognition techniques. The system has been applied under real operating conditions, providing the results discussed in the present study.

Actinomicosis primaria de pared abdominal simuladora de sarcoma de partes blandas / Primary abdominal wall actinomycosis sarcoma simulator

La actinomicosis es una patología poco frecuente y su manifestación en la pared abdominal es más infrecuente aún. Está causada por Actinomyces israeli, una bacteria filamentosa, anaerobia estricta, gram positiva, que es comensal en el organismo y que en su forma patógena produce fibrosis, tejido de granulación y abscesos. La forma más frecuente es la cérvico-facial. Presentamos un caso de actinomicosis de pared abdominal diagnosticado postoperatoriamente, con sospecha prequirúrgica de proceso tumoral, por lo que queremos hacer especial mención acerca de la importancia del diagnóstico diferencial de actinomicetoma ante la presencia de una masa abdominal (AU)

Actinomycosis is an uncommon disease, and abdominal wall actinomycosis is rare. It is caused by Actinomyces israeli, a filamentous, gram-positive, anaerobic bacteria that lives in our organism and when the infection progresses, granulomatous tissue, extensive reactive fibrosis and necrosis, abscesses are formed. Infection involving the cervicofacial area is most common. We report a case of abdominal wall actinomycosis diagnosed postoperativerly with preoperative suspected tumor process, so we want to make special mention in the differential diagnosis of actinomycetoma with an abdominal mass (AU)

Conservación de la rodilla con colgajo libre plantar en sarcoma de miembro inferior. Caso clínico / Knee preservation with free plantar fillet flap in lower limb sarcoma. Case report

La cirugía conservadora del miembro es el objetivo ideal a lograr en el tratamiento del sarcoma de extremidades. La tasa de amputaciones en este tipo de tumores se ha reducido considerablemente. La combinación de cirugía conservadora de miembro y radioterapia proporciona los mismos resultados oncológicos con la ventaja de preservar el miembro y su función. A pesar de esto, todavía existen indicaciones de amputación de extremidades, como cuando se trata de masas que afectan al eje neurovascular principal del miembro, entre otras. En estos casos, puede ser útil el uso de colgajos fileteados para preservar la longitud del miembro o para cubrir estructuras nobles. Presentamos el caso clínico de un paciente con sarcoma fusocelular de alto grado de la rodilla en el que empleamos un colgajo libre plantar fileteado para preservar la articulación (AU)

Limb sparing surgery is a desirable goal in the treatment of lower limb sarcoma. Amputation rates in the treatment of this kind of tumours have showed a dramatically reduction. The combination of limb sparing surgery and radiotherapy achieve the same oncological results with the advantages of extremity and function preservation. Despite this fact there are still indications of limb amputation as mass involvements of the major neurovascular structures of the limb, among others. In those cases, fillet flaps may be used to preserve additional length or cover vital structures. We report a case of a patient with high-grade fusocellular sarcoma where the use of a free plantar fillet flap allows us to preserve the knee-joint (AU)

Evaluation of the in vitro activity of commercially available moxifloxacin and voriconazole eye-drops against clinical strains of Acanthamoeba.

PURPOSE: Acanthamoeba is an opportunistic pathogen which is the causal agent of a sight-threatening ulceration of the cornea known as "Acanthamoeba keratitis" (AK) and, more rarely, an infection of the central nervous system called "granulomatous amoebic encephalitis" (GAE). The symptoms of AK are non-specific, and so it can be misdiagnosed as a viral, bacterial, or fungal keratitis. Furthermore, current therapeutic measures against AK are arduous, and show limited efficacy against the cyst stage of Acanthamoeba. Moxifloxacin, a fourth generation fluoroquinolone, has been used with other drugs to treat GAE, but its efficacy as a treatment for AK is not known. Voriconazole has been used to treat AK; however, its cysticidal efficacy is not known. Both drugs are commercially available as eye-drops. The aim of this study was to evaluate the in-vitro activity of these eye-drops against Acanthamoeba compared to two reference drugs (chlorhexidine and amphotericin B) which are currently used to treat AK and GAE. METHODS: The sensitivity of two clinical and one type strain of Acanthamoeba to the commercial concentrations of the four drugs was evaluated with a colorimetric assay. Mature cysts were incubated with voriconazole to determine their sensitivity to this drug. The effects on cell proliferation and cell toxicity were determined using standard procedures with commercial kits. RESULTS: The four compounds were active against the Acanthamoeba strains in this study. Although it prevented encystation, moxifloxacin's amoebicidal activity was low. Voriconazole activity was greater than that of the other drugs, even at a concentration lower than in commercial eye drops. It was effective against cysts and decreased cell proliferation, with low cellular cytotoxicity. CONCLUSION: Voriconazole could be used against AK as a first-line treatment or in combination. Moxifloxacin is an interesting adjuvant to consider as it is effectively prevents encystation of the amoeba which often complicates infection resolution. In addition, moxifloxacin is effective in preventing secondary bacterial infections.

Estudio anatomopatológico de aislados de Leptospira spp., provenientes de Nicaragua en Mesocricetus auratus como biomodelo / Anatomopathologic study of Leptospira spp., isolated in Nicaragua in Mesocricetus auratus as biomodel

Objetivo. El objetivo de este trabajo fue caracterizar en el biomodelo Mesocricetus auratus la sintomatología y lesiones anatomopatológicas que provocan 5 aislados clínicos de Leptospira spp., provenientes de Nicaragua. Materiales y métodos. Con este fin se inocularon 50 hámster por vía i.p con 1mL del cultivo de cada una de las cepas en fase exponencial teniendo una concentración celular de 7.5 x 106 leptospira/mL (10 animales por cepa), evaluándose signos de la enfermedad, mortalidad durante 14 días, lesiones anatomopatológicas macroscópicas y microscópicas mediante tinción con hematoxilina-eosina y tinción de Warthyn Starryn. Resultados. Todas las cepas presentaron alta mortalidad, mostrando un cuadro tanto clínico, como lesional característico de la infección experimental. Además, causaron la muerte al 100% de los animales entre el tercer y décimo día postinfección. En el estudio anatomopatológico la cepa del serogrupo Ballum y la del serogrupo Pomona produjeron focos de hemorragias específicamente en el riñón y pulmones. De forma similar ocurrió una congestión hepática y renal, mientras que la hemorragia renal fue observada con mayor frecuencia en la cepa del serogrupo Pomona, diferenciándose del resto de las cepas que mostraron esta lesión con menos frecuencia. Conclusiones. Este trabajo permitió una mayor caracterización de estas cepas siendo utilizadas como futuras candidatas vacunales frente a una nueva epidemia de Leptospirosis en Nicaragua.

Objective. The aim of this study was to characterize the symptomatology and anatomopathological lesions caused by 5 clinical isolated Leptospira spp. from Nicaragua in a Mesocricetus auratus biomodel. Materials and methods. 50 hamsters were inoculated via i.p with 1mL of the culture of each strain in exponential phase having a cellular concentration of 7.5 x 106 leptospira/mL, (10 animals per strain). Signs of the disease, mortality during 14 days, and macroscopic and microscopic anatomopathological lesions by haematoxylin-eosin and Warthyn Starryn stain technique were evaluated. Results. All the strains presented high mortality, showing clinical lesions of the experimental infection. Death to 100% of the animals was caused between the third and tenth day post-infection. In the anatomopathologic study, the strains of the Ballum and Pomona serogroup produced haemorrhaging specifically in the kidney and lungs. The animals manifested hepatic and renal congestion, while the renal haemorrhage was observed with more frequency in the strain of the Pomona serogroup, differing from the other strains, which presented this lesion less frequently. Conclusions. This work allowed a better characterization of these strains in order to use them as future vaccine candidates for future Leptospirosis epidemics in Nicaragua.

Comparación entre líneas de ratones en el ensayo de aberraciones cromosómicas en médula ósea / Comparison between mice lines in bone marrow chromosomal aberrations testing

Objetivo. El objetivo de este trabajo fue comparar los índices espontáneos e inducidos en ratones de ambos sexos de las líneas Balb/c, NMRI, OF-1 y C57BL/6/cenp, mediante el ensayo de aberraciones cromosómicas en células de la médula ósea. Materiales y métodos. Con este fin se determinó la línea más eficiente, sobre la base de la aparición significativa de índices espontáneos más bajos e índices inducidos altos a sustancias mutagénicas como la ciclofosfamida (CF). Resultados. Se obtuvo como resultado que la línea Balb/c en ambos sexos difiere significativamente de las demás líneas evaluadas. En esta línea se encontró el menor número de células totales con aberraciones estructurales y un mayor número de inducción de aberraciones cromosómicas cuando es utilizada la CF como mutágeno. Conclusiones. Este trabajo permitirá utilizar la mejor línea de ratones como biomodelo en este ensayo de genotoxicidad, además que le confiere a esta técnica citogenética mayor veracidad y robustez.

Objective. The aim of this study was to compare spontaneous and induced rates in mice of both sexes of lines BALB / c, NMRI, OF-1 and C57BL/6/ cenp, by testing chromosomal aberrations in bone marrow cells. Materials and methods. For this purpose, the most efficient line was determined, based on the significant appearance of lower spontaneous rates and higher induced rates to mutagen substances such as cyclophosphamide (CP). Results. The result obtained was that line Balb / c, in both sexes, differs significantly from the other lines tested. The lesser total number of cells with structural aberrations was found in this line and a greater number of induction of chromosomal aberrations when CP was used as a mutagen. Conclusions. This work will give way to the use of the best line of mice as bio model in this genotoxicity test, and will also give this cytogenetic technique greater veracity and robustness.

Salt gland adenitis as only cause of stranding of loggerhead sea turtles Caretta caretta.

The present study describes pathological and microbiological findings in 9 stranded loggerhead sea turtles Caretta caretta, whose only observed lesion was bilateral purulent salt gland adenitis. Histological lesions ranged from the presence of abundant eosinophilic material associated with bacterial colonies in the lumen of the central ducts of the glandular lobules to the destruction of the glandular tissue and presence of abundant eosinophilic material composed of heterophils and cell debris, lined by multinucleated giant cells. Aeromonas hydrophila, Staphylococcus sp., and Vibrio alginolyticus were the bacteria most frequently isolated. Plasma concentrations of sodium and chloride and plasma osmolality from 2 turtles suffering from salt gland adenitis were, respectively 45.7, 69.2, and 45.7% higher than the mean value for healthy turtles. These cases suggest that failure to maintain homeostasis due to severe lesions in the salt glands can cause stranding and/or death of loggerhead sea turtles.

Systemic mycosis caused by Trichophyton spp. in an olive ridley sea turtle (Lepidochelys olivacea): an immunohistochemical study.

CASE HISTORY: A sub-adult female olive ridley sea turtle (Lepidochelys olivacea) was found floating off the coast of Gran Canaria, Canary Islands, Spain. CLINICAL AND PATHOLOGICAL FINDINGS: The turtle was lethargic and weak, and died one day after it was found. Necropsy was performed and selected samples of lung and liver were routinely processed for histopathological and immunohistological studies. Grossly, round, ulcerative lesions were observed on the rear flippers. The liver, spleen, coelomic wall, gastric serosa, lungs and urinary bladder were covered by various amounts of fibrin and small granulomas. Histopathologically, a severe fibrinous and granulomatous polyserositis (liver, spleen, stomach, urinary bladder, coelomic wall), severe fibrinous pleuritis and severe multifocal granulomatous pneumonia were diagnosed. Numerous fungal hyphae were observed associated with the lesions. Specific monoclonal and heterologously absorbed polyclonal antibodies served as the primary reagents for identification of aspergillosis, candidiasis, fusariosis, geotricosis, dermatophytosis, scedosporiosis, and zygomycosis. All hyphae were identified as Trichophyton spp., because a strong and uniform reactivity was obtained only with an heterologously absorbed polyclonal antibody raised against somatic antigens of Trichophyton spp. DIAGNOSIS: Systemic mycosis caused by Trichophyton spp. CLINICAL RELEVANCE: There are no known previous reports of Trichophyton spp. causing skin disease or systemic mycotic infection in sea turtles. The usefulness of immunohistochemistry for identifying fungi in sea turtles is reinforced.

Three-dimensional MRA study of the normal canine thorax: MIP sections and volume rendering.

The purpose of this study was to investigate the feasibility of three-dimensional contrast-enhanced magnetic resonance angiography (3D-CE-MRA) for the non-invasive anatomical evaluation of the thoracic vasculature in five normal Beagles. After intravenous gadolinium administration and a cardio-respiratory gating protocol, fast 3D gradient echo pulse sequence MRA was performed employing a 1.5 Tesla magnet and a human thorax coil. Three-dimensional vascular software was applied. Sagittal, transverse and dorsal maximum intensity projection (MIP) sections and volume rendering (VR) images were obtained and labelled. Anatomical literature, dissections and gross sections were employed to assist the identification of the vascular structures. With improvements in scanner technology, MIP sections and VR images are a promising, non-invasive and accurate method of evaluating the canine thoracic vasculature. Images provide a reference material for clinical studies of the canine thorax for radiologist-surgeon teamwork assessment and also encourage the development of this technique in veterinary medicine.

Tratamiento local de metástasis cutánea facial de cáncer de colon mediante colgajo submentoniano / Local management of colon carcinoma metasasis in the face with a submental flap

Las metástasis cutáneas de los tumores del aparato digestivo son lesiones infrecuentes que aparecen en pacientes con estadíos avanzados de la enfermedad, frecuentemente ya intervenidos del tumor primario. Son lesiones que aparecen de novo, de características variables y crecimiento rápido; suelen localizarse en tronco o extremidades inferiores y se diagnostican precozmente, lo que hace fácil su extirpación y el cierre directo del defecto. Presentamos el caso de un paciente con cáncer de colon en estadío avanzado con lesión metastásica facial de 6 cm de diámetro en mejilla derecha. Esta lesión ulcerada y maloliente, precisaba curas diarias y empeoraba la calidad de vida del paciente. Se procedió a su extirpación y para cobertura realizamos un colgajo submentonianoipsilateral con excelente resultado. Este colgajo proporciona un tejido muy parecido al del defecto, creando mínimas secuelas de la zona donante que queda oculta en el área de sombra submandibular, por lo que representa una alternativa terapéutica ideal en defectos faciales de tamaño medio (AU)

Cutaneous metastasis of the digestive tract are infrequent lesions appearing in patients with advanced disease. Most of these patients have been already operated of their primary tumour. Lesions are variable in aspect, arising de novo and evolving with rapid growth. They usually lie in the trunk or lower extremities thus facilitating an early diagnosis and management with simple extirpation and direct closure. A case-report of a patient with advanced colonic canceris here presented. At admission he presented a cutaneous matastasic lesion in the right cheek; it was a 6 cm ulcerated, bad -smelling lesion which needed daily dressings affecting patient’s normal life. The lesion was removed using successfully a submental flap as coverage. The submental flap provides a very similar tissue to facial defects, leaving no donor area sequelae which is in addition well hidden, being consequently a good tool for midsize facial defects (AU)