An exceptional case of malignant glomus tumor and a review of the literature

Malignant glomus tumors (MGTs) are exceptional but pose diagnostic and therapeutic challenges. Wide resection is the recommended treatment method, however, no data are available concerning adjuvant therapies.We present an exceptional case of extradigital deep-seated MGT of the forearm, with an exceptional bone infiltration. Despite being treated with wide resection, the patient had an optimal functional outcome, no functional loss, no motor or sensitive deficits and has returned to his full daily activity.     

Prediction of Significant Conduction Disease through Noninvasive Assessment of Cardiac Calcification

Aims: Cardiac calcification is associated with coronary artery disease, arrhythmias, conduction disease, and adverse cardiac events. Recently, we have described an echocardiographic‐based global cardiac calcification scoring system. The objective of this study was to evaluate the severity of cardiac calcification in patients with permanent pacemakers as based on this scoring system. Methods and Results: Patients with a pacemaker implanted within the 2‐year study period with a previous echocardiogram were identified and underwent blinded global cardiac calcium scoring. These patients were compared to matched control patients without a pacemaker who also underwent calcium scoring. The study group consisted of 49 patients with pacemaker implantation who were compared to 100 matched control patients. The mean calcium score in the pacemaker group was 3.3 ± 2.9 versus 1.8 ± 2.0 (P = 0.006) in the control group. Univariate and multivariate analysis revealed glomerular filtration rate and calcium scoring to be significant predictors of the presence of a pacemaker. Conclusion: Echocardiographic‐based calcium scoring correlates with the presence of severe conduction disease requiring a pacemaker.     

Capsular contracture in subfascial breast augmentation: recommendations and treatment

Capsular contracture is the most common long-term complication of breast augmentation. In subfascial breast augmentation, there had been reports of 0% to 2% of capsular contracture (Serra-Renom et al., Plast Reconstr Surg 116:640–645; Ventura and Marcello, Aesthetic Plast Surg 29:379–383; Tijerina et al., Aesthetic Plast Surg 34:16–22; Graf et al., Plast Reconstr Surg 111(2):904–908). Graf et al. mentioned a 2.3% of capsular contracture grade II in 263 patients that underwent subfascial breast augmentation (Graf et al., Plast Reconstr Surg 111(2):904–908). There are several theories that can explain the presence of a capsular contracture, and the most described are: the microbiology theory and the contamination of the pocket due to a foreign body (Araco et al., Plast Reconstr Surg 124(6): 1808–1819; Schaub et al., Plast Reconstr Surg 126(6): 2140–2149). In 5?years, 35 patients with breast augmentation were considered for surgical treatment for capsular contracture. From 35 patients, only 4 patients were operated by us initially, the remaining 31 came to us as new patients with a capsular contracture. Each patient had different characteristics and was classified with the Baker scale. Depending on the grade (I–IV) and clinical characteristics of the patient, the surgical treatment was selected between a subcapsular pocket, total capsulectomy with or without implant, or radiation of the capsule. Thirty-five patients were considered for surgical treatment for a capsular contracture. All of our patients had great outcome at short and long term without any signs of complications. Twenty-seven patients were followed for 2?years postop, and 8 patients treated with a subcapsular pocket have less than 2?years of follow-up. In patients with less mammary gland tissue, a subcapsular pocket had reduced the risk of complications of a total capsulectomy due to close relationship between the skin and the capsule. There are several complications that could be present with a total capsulectomy, which are: tissue necrosis, breast irregularities, and/or damage to the skin. This technique had produced great results in patients with lo mammary tissue and a capsular contracture. Capsular contracture is the most common long-term complication in breast augmentation. There are several techniques that can be reproduced to have better outcomes and reduce the risk of complications. We recommend the use of these strategies to help in the treatment of capsular contracture.