Adipocere, “grave wax,” is a waxy or greasy decomposition product formed by hydrolysis and hydrogenation of tissue fats. Once formed, it appears stable for extended periods. Adipocere has generally been considered to result from bacterial action, commonly in warm, damp, anaerobic environments. However, its frequency, rate of formation, factors affecting its formation and physical characteristics are not well defined. To study the frequency, time course, and effects of temperature and clothing on adipocere formation, we submerged human adipose tissue samples in aquaria under controlled conditions and conducted serial observations. Adipocere formed with high frequency, within a few months, in tissues submerged in warm tap water; similar changes took longer, 12 to 18 months in cold water submersion. Presence of clothing over the tissue appeared to accelerate adipocere formation.
BACKGROUND Anal gland carcinoma is a rare entity. The authors conducted a joint study of cases coded as definite or possible anal gland carcinoma from the archives of the Armed Forces Institute of Pathology and the Canadian Reference Center for Cancer Pathology. METHODS Seven cases of potential anal gland carcinoma were identified from the Canadian files and 12 from the Armed Forces Institute of Pathology archives. Of these 19 cases, 14 had adequate material to allow clinical, histologic, and immunohistochemical analysis. RESULTS Seven of these 14 cases met a modified World Health Organization (WHO) definition of anal gland carcinoma. The mean age of these patients was 66 years (range, 60–72 years), with a male‐to‐female ratio of 6:1. The tumors were composed of haphazardly dispersed, small glands with scant mucin production that invaded the wall of the anorectal area with no obvious intraluminal component observed clinically or microscopically. Immunohistochemical studies were performed on all seven of these cases, revealing cytokeratin (CK) 7+/CK 20− expression in six cases, and CK 7+/CK 20+ expression in one case. The remaining seven cases showed no intraluminal component but did not meet a modified WHO definition of anal gland carcinoma. This group included three mucinous adenocarcinomas (two clinically arising in anal fistulas), all of which were CK 7+/CK 20+, and a rectal‐type adenocarcinoma that was CK 7−/CK 20+. There was also a tumor interpreted as probable rectal‐type adenocarcinoma that was CK 7+/CK 20+, and a tumor interpreted as probable squamous cell carcinoma that was CK 7−/CK 20−. The seventh tumor in this group, which could not be classified, was CK 7+/CK 20−. CONCLUSIONS A useful and discriminating definition of anal gland carcinoma is an anal canal tumor composed of haphazardly dispersed, small glands with scant mucin production invading the wall of the anorectal area without an intraluminal component. The glands are positive for CK 7. Cancer 2001;92:2045–9. © 2001 American Cancer Society.
Tunga penetrans is a burrowing flea that is prevalent in Central and South America, the Caribbean, tropical Africa, India, and Pakistan, and rarely is imported to the United States. Tungiasis results from the cutaneous infestation of humans by the gravid female flea, T. penetrans. We report a case of tungiasis in a female who had been on a missionary expedition along the Brazilian Amazon River. The clinical presentation, life cycle, differential diagnosis, military and historical aspects, and treatment are discussed.
The hazards presented by the Central American tropical environment are myriad. We report a case of cutaneous myiasis caused by the human botfly, Dermatobia hominis, in a soldier who had participated in military operations in Central America. The clinical presentation, treatment, and unique life cycle of the human botfly is discussed.
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