Malignant melanoma of the mucous membranes of the head and neck: three case reports

Primary malignant melanoma of the oronasal region is rare. When it does occur, it is difficult to manage, and the prognosis is not good. Early diagnosis and radical surgical management appear to offer the best hope of curing the disease. We report 3 new cases of malignant melanoma of the mucous membranes of the head and neck. Despite the generally poor outlook, 2 of these patients underwent excision of the tumor and remained disease-free 2 years later; the other patient refused surgery and was lost to follow-up.     

Evaluation of skin biopsies for fungal infections: role of routine fungal staining

Background: The diagnosis of cutaneous fungal infection is usually made on clinical examination of the lesion and direct microscopic examination of skin scrapings with potassium hydroxide. Histopathological examination is rarely required to confirm dermatophytic infections. There is often a discord between the clinical and histopathological findings and many times clinical appearance can have a poor histopathological correlation. Methods: This retrospective study was carried out on all skin biopsies received in a period of 1 year. The clinical details of all cases were retrieved and slides were reviewed. Routine fungal staining periodic acid‐Schiff (PAS) stain was performed in all cases. Results: Of 403 skin biopsies received in 1 year, material for further staining was available in 338. On re‐examining the slides stained with PAS stain, fungi were identified in 34 cases (10%), of which fungal infection had been suspected clinically in five cases. Conclusions: Use of routine stains like PAS can help to reach a correct diagnosis and initiate appropriate treatment. Fungal staining should be done in skin biopsies with non‐specific clinical details and microscopic findings for best patient management.     

Characterization of the integrin alpha v beta3 in arteriovenous malformations and cavernous malformations

BACKGROUND: Alpha V beta 3 (alphavbeta3) is an integrin specifically expressed on the endothelial cells of central nervous system (CNS) neoplasms. However, no data exist on the expression of alphavbeta3 in vascular malformations of the CNS. In this study, we investigate the expression of alphavbeta3 in arteriovenous malformations (AVMs) and cavernous malformations (CMs). METHOD: Frozen samples of AVMs from 12 patients and CMs from 5 patients were obtained intraoperatively. Once the final pathology had been confirmed, immunohistochemistry was performed using an antibody to the integrin alphavbeta3. The alphavbeta3 expression pattern was graded according to the percentage of positively staining vessels. RESULTS: Ten of 12 AVMs demonstrated alphavbeta3 immunopositivity. Six of these 10 AVMs had moderate or strong staining. Most notably, 5 of the 6 moderate or strongly staining AVMs came from patients 22 years of age or younger. Four of these 6 AVMs had previously been embolized. None of the cavernous malformations demonstrated alphavbeta3 immunopositivity. DISCUSSION: alphavbeta3 may contribute to the formation of AVMs in younger patients. alphavbeta3 may also provide a potential therapeutic target. The lack of alphavbeta3 expression in cavernous malformations, despite their high vascular densities, suggests that the pathophysiology of their formation differs from that of AVMs.