Squamous cell carcinoma is a type of skin cancer with abnormal proliferation of keratinocytes. Its incidence reaches approximately 20% of cases of non-melanoma skin cancer, which has increased in recent decades due to growth in life expectancy, increased sun exposure, the use of tanning beds and improved detection of this type of tumors. We present a patient who was diagnosed with a squamous cell skin carcinoma in the chest wall, treated initially with surgical resection. A few years recurred in the same place, so the patient received radiotherapy with poor response. Ultimately a new surgical approach was performed with a wide margin resection by a multidisciplinary surgical team. Multidisciplinary management in this type of procedure is important so that the long-term result is optimal for the patient.
Bacteria of the genus Actinomyces are non-spore-forming filamentous, Microaerophilic or strict anaerobic, Gram-positive bacilli, mainly belonging to the human commensal flora of the oropharynx, gastrointestinal tract, and urogenital tract; Actynomicosis israelii is most frequently isolated in human infection by this bacteria (90% of the cases), and is a very rare, generally a polymicrobial granulomatous infection which affects the cervicofacial (55% of all cases), abdominopelvic (22%) and thoracic (15%) regions, causing formation of abscesses, woody fibrosis and sinus discharge of characteristic sulfur granules. We present the case of a 42 year old patient with no prior medical history who presented to the emergency room with acute onset abdominal pain in the lower right quadrant, leukocytosis and neutrophilia, as well as ultrasonographic images which suggested acute appendicitis, the patient underwent laparoscopic appendectomy and cultures of abscesses surrounding the appendix were positive for A. israelii, which was also isolated in the histopathological specimen. The patient underwent antimicrobial treatment with ampicilin-sulbactam for a three month period postoperatively.
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