A case of extramammary inguinal Paget disease in a male patient: surgical treatment with an abdominal advancement cutaneous flap

Extramammary Paget disease (EMPD) is a rare neoplasm. The clinical case of a 55-year-old man with a two-year history of a pruritic, painless erythematous skin rash on the inguinal region and scrotum is described. After a delay due to improper diagnosis and improper treatments, the patient came to the attention of the Division of plastic surgery. He underwent a punch biopsy and the pathology report came back as EMPD. Surgical excision was carried out, and an abdominal advancement cutaneous flap was performed for the defect repair. This is the first description of a reconstruction after surgical removal of inguinal EMPD with a flap of this type and we think that this type of treatment can be useful and reliable for disease localization in the groin area, especially for patients that present an excess of abdominal skin

Fenestrated Adipofascial Reverse Flap: A Modified Technique for the Reconstruction of Fingertip Amputations.

4sireservedAims of the Study: Fingertip injuries can be treated in different ways, including shortening with primary closure, skin graft, and local or distant flaps. Several local flaps for the reconstruction of the amputated fingertip were described. We present our experience with a new concept of homodigital adipofascial reverse flap that avoids the second surgical stage and allows a complete and anatomically perfect reconstruction of nail bed, with preservation of the nail lamina. Materials and Methods: Between March 2014 and February 2015, five patients with digital amputations (distally to the nail matrix) were treated using the Fenestrated Adipofascial Reverse (F.A.R.) flap. The patients were evaluated measuring 2-point discrimination (2PD) value and range of motion of the distal interphalangeal joint (DIP). Scar evaluation was performed using the Vancouver Scar Scale (VSS). Results: All the flaps completely survived. A normal nail grow has been observed in first two-three months of post operatory follow-up. Length of the digits was preserved and good aesthetic as functional outcome were archive. The F.A.R. flap provided excellent coverage of fingertip defects and preserved finger length. After 1 year of follow, the mean static 2PD value at the reconstructed finger was 4.2 mm (range 3-5 mm), reconstructed fingers' mean range of motion for the DIP joint was 78 degrees and the VSS score ranged from 0 to 2 (mean score: 0.6). No complications were reported. Conclusions: F.A.R. flap is one of the most useful techniques in order to achieve all the goals in fingertip reconstructionmixedIdone, F; Sisti, A; Tassinari, J; Nisi, G.Idone, F; Sisti, Andrea; Tassinari, Juri; Nisi, Giusepp

Labia Minora Reduction: A Growing Female Need.

Labia Minora Reduction: A Growing Female Nee

Cooling Composite Graft for Distal Finger Amputation: A Reliable Alternative to Microsurgery Implantation.

BACKGROUND: Finger amputations are the most common injuries to the upper limb. There are many options in the management of fingertip or finger amputations. We report our experience using cooling composite graft (Hirase technique) for distal finger amputation, as alternative to microsurgery implantation. PATIENTS AND METHODS: We collected a case series of eight patients and report on the clinical outcomes after a 10-month follow-up period. RESULTS: The amputated part survived almost completely in six patients; in these cases, the fingertip amputations were classified, according to the Allen classification, as level I in two cases, level II in three cases and level III in one case. CONCLUSION: Re-implantation of an amputated finger with the Hirase technique is possible and can provide good distal soft-tissue coverage and recovery of sensory and motor functions. We believe that re-attachment of the amputated portion as a composite graft represents an important alternative to microsurgery

Comparison of Allergan, Mentor, and Sientra Contoured Cohesive Gel Breast Implants: A Single Surgeon's 10-Year Experience.

Comparison of Allergan, Mentor, and Sientra Contoured Cohesive Gel Breast Implants: A Single Surgeon's 10-Year Experience

Superior Pedicle Mammaplasty without Parenchymal Incisions after Massive Weight Loss.

BACKGROUND: After considerable weight loss, the breast suffers significant deformation. The ptotic breast is characterized by a lack of superior pole, tissue excess in the inferior pole, down-migration of nipple-areola complex (NAC) with redundancy to skin tissue. The authors describe a mastopexy technique based on a modulated and progressive reshaping, back rotation, and suspension of mammary gland parenchyma without parenchymal incisions. METHODS: Forty-five patients with bilateral moderate or severe breast ptosis underwent mastopexy from January 2011 to January 2014 with complete detachment of breast from the pectoralis major muscle and the plication line of parenchyma without any parenchymal incision. Patients were followed up for one year, reporting any complication, and measuring the jugulum-NAC distance. The outcomes were assessed by the patients as well as the surgical team. RESULTS: The aesthetic outcomes were good or excellent in all patients. The new mammary contour and the distance between the jugular fossa and the nipple were stable during this time with a good filling of upper pole. No major complications were reported. CONCLUSIONS: This technique gave good breast shape, long-term projection, and upper pole fullness, without parenchymal incisions. It restores breast shape and projection, especially in post-bariatric patients. A similar technique has not been described yet

Synchronous and metachronous malignancies after malignant struma ovarii in the seer database

BACKGROUND/AIM: Second primary tumors (SPTs) often occur, either synchronous or metachronous. Struma ovarii is a rare ovarian tumor represented by thyroid tissue in the ovary. Among other factors, production of thyroid hormones by the tumor or a shared genetic predisposition can further influence the development of SPTs. The occurrence of SPT, either synchronous or metachronous, following a long follow-up, has never been considered extensively. PATIENTS AND METHODS: We analyzed the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2011 to follow-up all the cases of malignant struma ovarii in an effort of calculate the occurrence of SPTs in this cohort of patients. RESULTS: We identified 21 patients with malignant struma ovarii in the period between January 1973 and December 2011. In a follow-up period of 219.57 person-years, 3 patients had SPT. One patient had synchronous thyroid sclerosing carcinoma, 1 patient had metachronous papillary adenocarcinoma with a latent time of 7 years and 1 patient had synchronous salivary ductal carcinoma. CONCLUSION: Up to date, only thyroid synchronous tumors have been reported in the literature. A synchronous and a metachronous thyroid tumor, plus a synchronous salivary gland tumor, were found. A significant association between malignant struma ovarii and thyroid/salivary gland cancer is herein demonstrated