Fibrolipoma of the lip treated by diode laser surgery: A case report

<p>Abstract</p> <p>Introduction</p> <p>Several neoplasms of the adipose tissue can involve the soft tissues of the head and neck region. These neoplasms are mainly treated surgically and an accurate histological examination is mandatory for a precise diagnosis.</p> <p>Case presentation</p> <p>We report a case of fibrolipoma involving the lower lip of a 43-year-old man, which was successfully treated by diode laser surgery. This approach allowed adequate resection of the neoplasm with minimal damage to the adjacent tissues, thus reducing post-surgical scarring.</p> <p>Conclusion</p> <p>Diode laser surgery for the treatment of benign lesions of the oral mucosa appears to be a convenient alternative to conventional blade surgery and has proved to be effective for the excision of fibrolipoma of the lip. The possibility of avoiding direct suture after excision is surely helpful when aesthetic areas, such as the lip, are surgically treated. For these reasons, and also considering the lower histological alteration of the specimen obtained with diode laser surgery if adequately used, the diode laser is undoubtedly a good alternative to conventional surgery.</p

Methodological study to evaluate the psychometric properties of FACIT-CD in a sample of Brazilian women with cervical intraepithelial neoplasia

Background: The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. The aim of this study was to evaluate the psychometric properties of the FACIT-CD questionnaire in Brazilian women diagnosed with CIN. Methods: The properties of the FACIT-CD questionnaire were tested on a sample of 439 women seen at the Department of Prevention of Barretos Cancer Hospital, including 329 patients who were diagnosed with CIN and 110 women who were not diagnosed with the disease. The analysed parameters included internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient), structural validity, convergent validity (correlation with the SF-12 and EORTC QLQ-CX24 questionnaires), discriminant validity (according to disease status, and self-rating of health), sensitivity, and responsiveness. Results: The Cronbach alpha values of the FACIT-CD scales were higher than 0.70 with the exception of the relationship scale (0.66). The FACIT-CD reproducibility was satisfactory, with variation in the intraclass correlation coefficients ranging between 0.50 and 0.83, although the 95% confidence interval (CI) was lower than 0.40 (0.33-0.64) on the treatment satisfaction scale. Regarding structural validity, only one item on the physical well-being scale was not kept in the original domain. The expected correlations between the FACIT-CD and SF-12 were not confirmed, whereas the correlations between the FACIT-CD and EORTC QLQ-CX24 were confirmed. The questionnaire was able to discriminate the groups according to disease status and self-rating of health. The sensitivity was low for the relationship scale and moderate for the other scales. The responsiveness of the FACIT-CD questionnaire varied between the groups that denominate the self-perception of health as no change, improvement or worsening. Conclusion: Our results are encouraging and indicate that the FACIT-CD questionnaire is a promising tool for the analysis of the quality of life of women with CIN.The postdoctoral fellowship was supported by Sao Paulo Research Foundation (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo - FAPESP, Sao Paulo, Brazil). Process number: FAPESP 2014/10158-3. The funding body had no role in the design of the study and collection, analysis and interpretation of data and in writing the manuscript.info:eu-repo/semantics/publishedVersio

MASCC/ISOO expert opinion on the management of oral problems in patients with advanced cancer

Purpose: The Palliative Care Study Group in conjunction with the Oral Care Study Group of the Multinational Association for Supportive Care in Cancer (MASCC) formed a sub-group to develop evidence-based guidance on the management of common oral problems in patients with advanced cancer. Methods: This guidance was developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews and trials, respectively. Guidance was categorised by the level of evidence, and “category of guideline” (i.e., “recommendation”, “suggestion” or “no guideline possible”). Results: Twelve generic suggestions (level of evidence – 5), three problem-specific recommendations and 14 problem-specific suggestions were generated. The generic suggestions relate to oral hygiene measures, assessment of problems, principles of management, re-assessment of problems and the role of dental/oral medicine professionals. Conclusions: This guidance provides a framework for the management of common oral problems in patients with advanced cancer, although every patient requires individualised management

Buccal soft tissue lipoma in an adult Nigerian: a case report and literature review

<p>Abstract</p> <p>Introduction</p> <p>Lipomas are benign mesenchymal neoplasms composed of mature adipocytes, usually surrounded by a thin fibrous capsule. They are uncommon intra-oral tumors with 1% to 4% occurring in this region. The literature is scanty on lipomas occurring in the buccal soft tissue, especially in our environment.</p> <p>Case presentation</p> <p>We present a case of a 35-year-old woman of the Tiv ethnic group of Nigeria who presented with a slow growing left cheek swelling that was treated by intra-oral local excision.</p> <p>Conclusion</p> <p>The purpose of this report is to highlight the existence of this rare but not uncommon disease even in our environment and to emphasize that a high index of suspicion is needed in making a diagnosis. Surgical excision as treatment is associated with an excellent outcome.</p

A low-cost HPV immunochromatographic assay to detect high-grade cervical intraepithelial neoplasia

Objective To evaluate the reproducibility and accuracy of the HPV16/18-E6 test. Methods The study population was comprised of 448 women with a previously abnormal Pap who were referred to the Barretos Cancer Hospital (Brazil) for diagnosis and treatment. Two cervical samples were collected immediately before colposcopy, one for the hr-HPV-DNA test and cytology and the other for the HPV16/18-E6 test using high-affinity monoclonal antibodies (mAb). Women with a histologic diagnosis of cervical intraepithelial neoplasia grade 2 or 3 were considered to be positive cases. Different strategies using a combination of screening methods (HPV-DNA) and triage tests (cytology and HPV16/18-E6) were also examined and compared. Results The HPV16/18-E6 test exhibited a lower positivity rate compared with the HPV-DNA test (19.0% vs. 29.3%, p<0.001) and a moderate/high agreement (kappa = 0.68, 95% CI: 0.60-0.75). It also exhibited a significantly lower sensitivity for CIN2+ and CIN3+ detection compared to the HPV-DNA test and a significantly higher specificity. The HPV16/18-E6 test was no different from cytology in terms of sensitivity, but it exhibited a significantly higher specificity in comparison to ASCH+. A triage test after HPV-DNA detection using the HPV16/18-E6 test exhibited a significantly higher specificity compared with a triage test of ASCH+ to CIN2+ (91.8% vs. 87.4%, p = 0.04) and CIN3+ (88.6% vs. 84.0%, p = 0.05). Conclusion The HPV16/18-E6 test exhibited moderate/high agreement with the HPV-DNA test but lower sensitivity and higher specificity for the detection of CIN2+ and CIN3+. In addition, its performance was quite similar to cytology, but because of the structural design addressed for the detection of HPV16/18-E6 protein, the test can miss some CIN2/3+ lesions caused by other high-risk HPV types.Cancer Prevention Department, Center for the Researcher Support and Pathology Department of the Barretos Cancer Hospital. This study was supported by CNPq 573799/2008-3 and FAPESP 2008/57889-1info:eu-repo/semantics/publishedVersio

Agreement between clinical and histopathologic diagnoses and completeness of oral biopsy forms

Abstract The present study aimed to assess the rate of agreement between clinical and histopathological diagnoses and to report the frequency of completed forms for specimens that were subjected to histopathological examination and retrospectively examined. Data from 8,168 specimens submitted to histopathological examination were retrieved from the records. A total of 5,368 cases were included. Agreement was defined based on the definition of lesion nature according to its diagnostic category. Sensitivity, specificity, and positive and negative predictive values were calculated for each diagnostic category. The highest rate of agreement was observed for periapical lesions (92.6%), followed by potentially malignant disorders (90.1%) and non-neoplastic proliferative disorders (89.3%). Low rates of histopathological confirmation of the clinical impression were observed for mesenchymal tumors (25.0%) and cysts (44.2%). Sensitivity values were > 0.70 for all lesions, except for cysts (0.51). Specificity was relatively high, ranging from 0.97 to 1.00. The frequency of incomplete biopsy forms ranged from 16.8% (malignant tumors of oral mucosal epithelium) to 51.0% (nonspecific inflammatory reaction). The most frequently completed biopsy forms corresponded to epithelial malignant tumors (83.2%) and glandular inflammation (72.3%). In conclusion, there was an acceptable level of agreement. The low level of completeness of biopsy forms indicates little awareness about the relevance of gathering detailed information during clinical examination

Comprehensive molecular characterization of the hippo signaling pathway in cancer

Hippo signaling has been recognized as a key tumor suppressor pathway. Here, we perform a comprehensive molecular characterization of 19 Hippo core genes in 9,125 tumor samples across 33 cancer types using multidimensional “omic” data from The Cancer Genome Atlas. We identify somatic drivers among Hippo genes and the related microRNA (miRNA) regulators, and using functional genomic approaches, we experimentally characterize YAP and TAZ mutation effects and miR-590 and miR-200a regulation for TAZ. Hippo pathway activity is best characterized by a YAP/TAZ transcriptional target signature of 22 genes, which shows robust prognostic power across cancer types. Our elastic-net integrated modeling further reveals cancer-type-specific pathway regulators and associated cancer drivers. Our results highlight the importance of Hippo signaling in squamous cell cancers, characterized by frequent amplification of YAP/TAZ, high expression heterogeneity, and significant prognostic patterns. This study represents a systems-biology approach to characterizing key cancer signaling pathways in the post-genomic era