Foam sclerotherapy : the Maltese experience

Objectives: To describe demographics and outcomes of a new sclerotherapy service – Foam sclerotherapy (FS), for venous disease at Mater Dei Hospital, Malta Methods: The data of a consecutive series of patients undergoing FS were prospectively entered into a database and the results analysed. Medical notes of patients were also reviewed. Patients underwent detailed venous duplex scanning before and after each intervention and at follow-up visits. Results: 121 patients underwent a total of 204 FS procedures between November 2008 and October 2011. 22% were male and 78% of the procedures were done in female patients. 151 (74%) of procedures were done in patients above the age of 50 years. 74(37%) interventions were for recurrent varicose veins and 113(55%) for chronic venous insufficiency (CEAP4-6). 77 (38%) patients had active or healed venous ulceration as the indication for treatment. 83% of ulcers healed after foam sclerotherapy during the follow up period. 88.3% (143/162) of veins treated were completely occluded while 11.7% (19/162) were partially occluded. In the majority (64%) only one treatment session was required. One patient sustained an anaphylactic reaction to the sclerosant. No deep vein thromboses, cardiovascular events, pulmonary embolism or other major complications were reported. Skin staining was reported in 21.5% of cases. Conclusions: Foam sclerotherapy is a safe and cheap treatment modality resulting in high rates of venous ulcer healing and successful venous occlusion and a very low complication rate. The success rate of foam sclerotherapy in Malta is comparable to that reported in the literature.peer-reviewe

An awkward looking pilomatrixoma

Pilomatrixoma is a rare and benign skin tumor of the hair follicle that tends to develop in the head and neck area. We report a case and briefly review the literature.peer-reviewe

Bilateral breast reduction surgery at Mater Dei Hospital : analysis of physical and psychological symptoms using the BREAST-Q

Introduction: The literature describes the high patient satisfaction rate after breast reduction. In this retrospective study, we use the BREAST-Q to analyse satisfaction with breast appearance and physical, psychosocial and sexual well-being of patients who underwent bilateral breast reduction (BBR) at Mater Dei Hospital (MDH). We also looked into whether age, co-morbidities and weight of breast tissue removed makes a difference to the overall satisfaction rate. Method: Permission to use the BREAST-Q questionnaire and translate it into Maltese was obtained from Mapi Reasearch Trust. The questionnaire was offered either in Maltese or in English, after an official translation was produced following a linguistic validation process. All patients who underwent BBR at MDH under the care of both consultant Plastic Surgeons were invited to complete the BREAST-Q questionnaire via a telephone call and asked to come to MDH to fill it in. Other patient specific information was obtained from their hospital notes. Results: We hope to demonstrate a better quality of life following surgery and aim to compare the results of this study to others carried out worldwide. In this way we can better understand the local situation and see where there is the room for improvement. Conclusion: In this world of evidence-based medicine, the BREAST-Q is ideal for a holistic approach in analysing patient satisfaction after BBR. Having local data at hand makes it easier for patients who are interested in undergoing the surgery to associate themselves with other local individuals.peer-reviewe

Adenolipomas : a case series of 16 patients over 5 years

Introduction: An adenolipoma is a benign, rare variant of a lipoma and is histologically very similar to a lipoma but contains eccrine glands amongst the mature adipose tissue. According to our knowledge, this case series of adenolipomas, is the largest one in the literature. The aim is to increase awareness about this variant of lipoma.Method: The data was collected retrospectively from the histopathology department and patients’ notes.Results: We had a total of 16 cases of adenolipomas between 2013 and 2017 in our hospital. 75% of the patients were being managed by General Surgeons. 88% of them occurred in female patients and the patients’ age varied between 15 and 64 years. The most common location of adenolipomas was the thighs and the largest diameter of the histology specimen varied between 15 and 100mm. 31% were encapsulated, 25% had apocrine glands present and 6% had myxoid changes. None of them had mast cells present. No recurrences were documented.Conclusion: It is a benign lesion and awareness amongst pathologists is imperative so that it can be identified histologically.peer-reviewe

Lymphoma of the Cervix

Primary non-Hodgkins lymphoma of the uterine cervix is a very rare diagnosis. A 54-year-old woman presented with a 3-month history of postmenopausal bleeding per vaginum. On examination, a friable, fungating lesion was seen on the cervix. Histology revealed a CD 20 positive high-grade non-Hodgkin’s diffuse large B cell lymphoma from cervical biopsies and endometrial curettage. She was diagnosed as stage IE after workup and subsequently treated with six cycles of R-CHOP chemotherapy followed by radiotherapy of the involved field