Malignant melanoma of the scrotum

Malignant melanoma of the scrotum is the rarest of primary genitourinary melanomas, with only 17 cases having been reported between 1949 and 2005. We report one such case, which presented as a nonhealing ulcer over the right hemiscrotum.     

Repair of spondylolytic defect with a cable screw reconstruction

We present the clinical and radiological results of surgical repair for refractory spondylolysis in 20 patients at a minimum follow-up of 2 years. Seventeen of them were reassessed after 5 years. The Oswestry scores revealed good to excellent results in 90% (18/20 patients), indicating a good outcome with surgical repair using two techniques: the Scott procedure or pedicle screw and wire technique. Radiological pseudarthosis was 10%, which was quite consistent with reported series. CT scanning of the 14 patients after a mean of 13 months revealed complete healing of the fracture in 7 patients, partial in 2 and frank non-union in 5. Overall, CT examination with reversed gantry showed only 7/14 (50%) healing, indicating that radiological healing on plain X-ray is not always suggestive of complete bony healing. However, CT healing is not a sine qua non of good to excellent clinical outcome.

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Résumé Nous présentons les résultats cliniques et radiologiques des 20 patients présentant une récidive de spondylolyse avec un minimum de recul de 5 ans (7.5 ans). Le score d’Oswestry a montré un bon et un excellent résultat chez 90% des patients (18/20) en utilisant deux techniques, la technique de Scott ou la technique des vis pédiculaires avec fil métallique. La pseudarthrose radiologique est de 10%. Un scanner réalisé chez 14 patients avec un recul de 13 mois a montré une guérison complète de la fracture chez 7 patients, partielle chez 2 et une pseudarthrose dans 5 cas. L’examen au scanner a mis en évidence que le taux de guérison radiologique n’était que de 50%, néanmoins cette consolidation scannographique n’est pas nécessaire pour avoir un bon résultat final sur le plan clinique.

     

Primary malignant giant cell tumor of bone: a series of three rare cases

The purpose of this research was to study incidence; clinical, histological, and radiological features; and outcome of primary malignant giant cell tumor (PMGCT). The authors retrospectively reviewed all cases of giant cell tumor (GCT) in which a diagnosis of GCT was related to sarcoma treated in their department between 1997 and 2004. Three cases of PMGCT were found according to the criterion of Hutter and Dahlin. Histological and radiological records of all the three cases were reviewed. In these three cases of PMGCT, the initial clinical and radiological findings were the same as those for benign giant cell tumor. Wide excision of the tumor was performed in all three cases. In two cases, knee arthrodesis was performed, and in one case a custom-made total knee replacement was performed. PMGCT was diagnosed on initial biopsy in one patient, in the second patient it was diagnosed in the excised specimen, and in third case it was only diagnosed after local recurrence 6 months after initial treatment. All the patients died within 5 months of detection of recurrence and metastasis. PMGCT has a very poor prognosis. Histological examination is highly significant in such cases. Awareness about this entity, adequate biopsy, and sampling of specimen can aid in early diagnosis, which may improve the overall prognosis.     

Targeting Inflammation in Ovarian Cancer Through Natural Antioxidants,Potential Therapeutic and Preventive Implications

There is extensive experimental data to supportthe hypothesis that Reactive oxygen species (ROS)accumulation is one of the major underlying mechanismfor carcinogenesis. Many forms of cancer are associatedwith excessive accumulation of ROS including ovariancancer. It is now well understood that ROS productionshould be scavenged by antioxidant defence mechanism/DNA damage response of the human body to maintainnatural homeostasis (Kruk and Aboul-Enein, 2017).Dysregulation of this balance leads to many inflammatorydiseases including the high risk of developing cancer. HighROS concentration is associated with accumulation ofmutations which over the years leads to development ofcancer. Metabolic pathways including aerobic oxidationin mitochondria respiratory are the major source of ROSwhich in turn effect different signalling pathways (Krukand Aboul-Enein, 2017).     

Preoperative fundoscopy versus optical coherence tomography to detect occult maculopathy during cataract surgery preassessment

PurposeTo assess the proportion of maculopathy detectable only on optical coherence tomography (OCT) versus slit lamp indirect ophthalmoscopy (SLIO) during cataract assessment.MethodsPopulation: Consecutive patients attending cataract assessments. Data collection: All patients underwent OCT and SLIO. SLIO findings were recorded before reviewing OCT. Scans were examined to compare with recorded SLIO findings. Primary outcome: analyse the proportion of eyes with maculopathy missed by SLIO. Secondary outcome: to assess the proportion of patients with maculopathy on OCT, the incidence of maculopathy in the fellow eye on OCT and proportion with cataracts too dense to allow SLIO or OCT.ResultsSix hundred twenty-six patients were enroled. Eighty (12.8%) had maculopathy detectable only on OCT which included: 26 (4.2%) epiretinal membrane (ERM), 25 (4%) dry age-related macular degeneration (AMD), 19 (3%) vitreomacular traction (VMT), 5 (0.8%) lamellar macular hole (LMH), 2 (0.3%) cystoid macular oedema (CMO) and 1 (0.2%) wet AMD. 166 (26.5%) had maculopathy on OCT, of which only 48 (7.7%) had known history of maculopathy. In fellow eyes, 29 (4.6%) had significant findings and 29 (4.6%) were unable to have SLIO or OCT due to dense cataract.ConclusionsA quarter of the patients had occult maculopathy. One-tenth of the occult maculopathy were missed without OCT, with ERM, dry AMD, VMT, LMH, CMO and wet AMD being the primary missed diagnosis. Less than 5% had occult maculopathy in fellow eye, and <5% had dense cataracts where neither SLIO nor OCT was not possible.Subject terms: Signs and symptoms, Health care