Lymphedema. A significant health problem for women with breast cancer in Jordan.

OBJECTIVE: To investigate the frequency of breast cancer related lymphedema in our region, and to heighten its awareness among health workers. METHODS: This is a cross-sectional study of patients treated with breast cancer at King Hussein Cancer Center, Amman, Jordan, between January 2004 and December 2009. We excluded patients with bilateral breast cancer. A total of 515 patients were included. We asked the patients to complete questionnaires that included questions related to arm symptoms. Lymphedema was defined as 2 cm or more difference between the 2 upper limbs' girths. RESULTS: The incidence of lymphedema was 21.1%. The subjective evaluation by the patients overestimated the figure (35%). Most patients (75.3%) had limb symptoms, such as pain, numbness, and limitation of movement. In most patients with lymphedema, the symptoms were mild, but in 17 patients (15.6%) the effects were severe. CONCLUSION: Lymphedema continues to be a common health problem in our region. Most patients have mild lymphedema, but in some patients the effects on daily activities are severe. It is important for health workers to understand the significance of this problem and its associated morbidity.

Popliteal lymph node dissection for metastatic squamous cell carcinoma: a case report of an uncommon procedure for an uncommon presentation.

Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is rarely involved with metastasis. Popliteal lymph node dissection is uncommonly performed and not frequently discussed in the literature. We present a case of squamous cell carcinoma of the heel with popliteal and inguinal metastasis. This is followed by a description of the relevant anatomy of the popliteal fossa and the technique of popliteal lymphadenectomy.

Ileocaecal intussusception secondary to metastatic phyllodes tumour of the breast.

A patient with phyllodes tumour of the breast is discussed. During follow-up, she presented with intestinal obstruction caused by ileocaecal intussusception. The cause of the intussusception was metastatic phyllodes tumour, which is a unique presentation.

Perineal hernia, another incisional hernia?

A secondary perineal hernia is a type of incisional hernia of the pelvic floor, occurring after pelvic surgery such as abdominoperineal excision of the rectum and pelvic exenteration. Our aim is to review the available literature on the subject. This report reviews a recently repaired case, followed by a review of the available literature on the presenting condition, concentrating on approaches and methods of repair. Perineal hernias are uncommon, and not many surgeons face them. It is not known if and how these hernias could be prevented. The method and approach of repair should probably be individualized, but we believe that the use of a mesh is important in the repair of such hernias because of the significant tissue defect prevailing in most of the cases, in addition to the unhealthy tissues related to the use of radiotherapy. The laparoscopic approach has been recently utilized and its use is expected to increase.