Primary cutaneous mucinous carcinoma (MC) is a rare epithelial neoplasm derived from the sweat glands. Herein, we report a case of MC located on the head. A 66-year-old woman underwent excision of a nodular tumor with a reddish brown surface on the left parietal region. Histopathology revealed a neoplasm extending from the reticular dermis into the subcutaneous fat. The tumor cell aggregates showed cribriform and solid lobules and were embedded in lakes of mucin, separated by thin, fibrous septae. Focally single neoplastic cells were arranged in an Indian-file pattern. The tumor cells displayed an eosinophilic cytoplasm, large basophilic nuclei and some discrete nuclear atypia. Vascular spaces, filled by densely packed erythrocytes between the septae, were also observed. We compared the mucinous component with the tumor cell and the stromal component by light microscopy. Analyzing the tumor by an image analysis system in Alcian-blue-stained serial sections, we found the averaged total tumor area measuring 99.7 mm2. The area of the mucinous component measured 92.4 mm2, that of the tumor cells 3.7 mm2 and that of the stromal component 3.6 mm2. The extensive checkup of the patient disclosed no evidence for a further malignant neoplasm. After excision of the tumor an adjuvant radiotherapy was performed. The patient was free of recurrence and metastatic spread of the mucinous carcinoma during a 4-year follow-up.
We repor there on a 16-year-old patient who presented with pain and swelling in the hypothenar eminence as well as loss of sensibility in the fingers of the region innervated by the ulnar nerve; this happened 2-3 weeks after an injury by a glass splinter in his proximal palm. A pseudoaneurysm could be verified by duplex sonography. The patient wished to avoid any graft for arterial bridging for religious reasons. On the basis of an the Allen test preoperatively and the intraoperative findings, an adequate blood supply of the finger by the radial artery was expected. Thus, in respect to the patients wish, the aneurysm was resected without bridging. The patient recovered perfectly. 4 years later, an MR-angiography showed the deep and superficial transverse palmar arc to be supplied by a voluminous radial artery. The ulnar finger arteries originated from the deep arc, the radial finger arteries from the superficial arc. In this paper, the criteria pro and contra grafting the ulnar atery at Guyons's canal will be discussed.
The ischemic ulceration resp. the ischemic necrosis of the intestine's internal wall located proximal to an obstruction is a rare complication. At present this diagnosis is established by the radiologist alone. The knowledge of this disease--which is at the time being abscure in its origin--is of great importance to the surgeon, who has to try to resect both, the obstructes and the ischemic-ulcerative regions, in order to avoid insufficiency of the anastomosis postoperatively. The oral border of the alteration can be determined by a frozen section during the operation. In this connection the fatal complications of total necrosis of the large and small intestines resp. is demonstrated for the first time.
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