Sipple’s syndrome is a multiple endocrinopathy usually involving the adrenal medulla and the thyroid. In the present case, a malignant pheochromocytoma metastasized to the pericardium and both lungs. The patient was known to have had a calcified right suprarenal mass for 8 years. He was admitted to the emergency room with symptomatology consistent with pericardial tamponade, but despite intensive management, he expired.
A lesion of nevus sebaceus with multifocal basal-cell carcinomas was excised by Mohs' fresh-tissue technique. Histologically, most of the foci of basal-cell carcinomatosis were of the superficial type, but the few more deeply situated foci had adamantinoid features. The malignancies extended well beyond the clinically discernible margins of the nevus sebaceus. Spontaneous healing of the wound of ablation resulted in a satisfactory appearance.
We have reviewed modifications in scalp reduction instrumentation that have enabled the physicians of the group to substantially reduce patient discomfort and operative time. Simultaneously, we are assured that the risk of errors relative to the optimal size of the excisions, correct plane of undermining, and the possibility of excessive blood loss are minimized. The incorporation of this instrumentation has reduced the average scalp reduction procedure time, in our hands, from 70 to 35 minutes without increasing the complication rate.
A thickened posterior tracheal stripe (wider than 4.5 mm) was identified on the lateral check radiographs of 20 patients with squamous cell carcinoma of the esophagus. Autopsy studies confirmed that peri-esophageal lymphatic involvement was responsible for the thickening of the stripe in the nonobstructed esophagus. This sign appeared on the lateral chest radiograph as early as 6 months prior to the development of symptoms in 50% of the cases studied.
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