98% of pathologists surveyed are aware that SSA/P is a precursor lesion to colorectal cancer, the majority agree on diagnostic criteria, and a significant number feel that there needs to be greater communication and awareness among pathologists and gastroenterologists about SSA/P.
HighlightsCondylomata lata are a cutaneous manifestation of secondary syphilis and can be misdiagnosed as condylomata acuminata (warts caused by human papillomavirus), anal cancer, chancroid, haemorrhoids, tuberculosis and lymphogranuloma venereum.Condylomata lata are flesh coloured or hypo pigmented, macerated papules or plaques.We present a case of a 49-years-old gentleman who initially presented to primary care with perianal pain and peri-anal skin changes who was referred to the colorectal clinic under the two-weeks rule with suspected anal cancer. The diagnosis was confirmed by biopsy and positive standard tests for syphilis.Once condylomata lata is suspected or diagnosed, refer promptly to sexual health clinic for further investigations, treatment, contact tracing and follow up.Early treatments with intramuscular benzathine benzylpenicillin prevent serious neurological and cardiac complication.
Mǔllerian cysts or paramesonephric cysts arise from the fused embryonic ducts, which typically regress in the uterus. These cysts are usually located paravertebrally. We present an unusual case of a Mǔllerian cyst developing within the mesentery of the ileocecum that was successfully resected. The patient presented to our surgical unit with abdominal pain and swelling. She underwent all the necessary tests to rule out other pathologies before she underwent right hemicolectomy. The patient was discharged without complications. Histopathology confirmed the presence of female reproductive tract epithelium, which was conclusive of a Mǔllerian cyst or paramesonephric cyst. Mǔllerian cysts are rarely malignant, and they are usually treated surgically. The incidence of Mǔllerian cysts is one in 105,000, with almost equal sex distribution. Their unusual intraperitoneal location further demonstrates their uncommon presentation.
Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS) is used to triage patients for sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). We assessed the detection rate of lymph node metastases by PAUS in a screening unit and evaluated associations between clinicopathological factors and PAUS positivity. Patients and Methods: This was a single-centre retrospective analysis of data extracted from a hospital breast cancer database and clinical records. Clinical, radiological, and pathological and prognostic indices were compared between PAUS-positive and PAUS-negative patients subsequently found to have lymph node metastases on histopathological analysis. Results: Two hundred and two patients were eligible for analysis. 50.5% of lymph node-positive patients were correctly identified as PAUS positive. Patients with PAUS-positive lymph nodes had less favourable disease characteristics, namely clinically palpable lymph nodes, higher Nottingham prognostic index (NPI), high lymph node burden according to the European Society of Medical Oncology (ESMO) group classification, and larger, grade 3 tumours with lymphovascular invasion and extranodal spread. Moreover, PAUS-positive patients had more macrometastases and lymph node involvement than PAUS-negative patients. Conclusion: PAUS-positive patients and PAUS-negative (SLNB-positive) patients have different clinicopathological characteristics. The presence of LVI, extranodal spread, grade 3 histology, or large tumours with poor prognostic indexes in PAUS-negative patients should be regarded with caution and perhaps prompt second-look ultrasound examination.
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