In this study, SIL-A was technically feasible and safe option for appendicitis. The SIL-A group had more favorable outcomes such as shorter time to start diet and less hospital stay after surgery than the CL-A group. However, superficial incisional surgical site infection rate was higher in the SIL-A group than in the CL-A group, an effort to reduce superficial incisional SSI should be made.
Matrix metalloproteinases (MMPs) are proteolytic enzymes that play important roles in cancer progression and metastasis. Although serum MMP expression is known to correlate with the primary lesion of breast cancer, there has yet to be a study regarding the correlation between serum MMP expression and metastatic lesions, particularly lymph nodes. The present study evaluated the correlation of serum and lymph node MMP expression with axillary node metastasis. The preoperative serum levels of MMP-2 and MMP-9 in 77 patients with breast cancer and in 10 patients with benign breast tumor were determined by ELISA and zymography. One hundred and twelve axillary lymph nodes were collected for zymography during breast cancer surgery. Significantly higher serum levels of MMP-2 and MMP-9 were found in breast cancer patients compared to patients with benign tumor. High serum levels of MMP-2 and MMP-9 were significantly associated with node metastasis. ELISA and zymography results for serum MMP-2 and MMP-9 correlated significantly, with a Pearson correlation coefficient (r) of 0.76 for MMP-2 (P=0.001) and 0.81 for MMP-9 (P=0.001). In terms of lymph node, total MMP-2, MMP-9 and MMP-9 activity were significantly higher in metastatic than in non-metastatic nodes. There was a correlation between serum and lymph node MMP-9 levels on zymographic measurements (r=0.34, P=0.011), but not in terms of MMP-2 levels. Serum MMP-9 levels may have a diagnostic value for predicting axillary node metastasis.
Primary carcinoma of ectopic breast tissue is rare. We present a 57-year-old female patient with a large erythematous bulging mass in the right axilla. Imaging studies did not reveal any other lesions except for the one detected in the right axilla. Wide excision with axillary lymph node dissection was performed. The pathology report revealed a poorly differentiated carcinoma with no surrounding lymphoid tissue or lymphovascular infiltration or noncancerous breast tissue. We think that in our case the tumor was probably derived from a primary carcinoma of ectopic breast tissue rather than from a metastatic tumor or occult breast cancer. One year later, the patient presented with a local recurrence at the ipsilateral breast. Mastectomy with chemotherapy was performed. After three cycles of chemotherapy, imaging studies revealed distant metastases. This case report and literature review describe the characteristics of ectopic breast cancer in the axilla and reflects on which initial management strategy is appropriate.
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