HighlightsClear cell sarcomas are rare malignancies of the soft tissue.Clear cell sarcoma share characteristics with malignant melanoma, but modern techniques are able to distinguish the tumours.Timely and accurate primary diagnosis is important, as tumour size larger than 5 cm is correlated to a more sinister prognosis.Surgical treatment is imperative, the role of radiotherapy and chemotherapy remain unknown.Follow-up in a multidisciplinary setting is recommended.

Clear cell sarcoma (CCS) previously known as malignant melanoma (MM) of the soft tissue, although, similar in morphology to MM, contemporary histopathologic and cytogenetic techniques have made this diagnosis obsolete, as it is now possible to distinguish between CCS and MM. CCS is often diagnosed in young adults with median age of 25 years. Overall mortality is generally poor, and the 5-year survival is between 40 and 60%. Hence, early diagnosis and radical surgery are key in the treatment of this extremely rare malignancy of the soft tissue comprising only about 1% of all sarcomas. This article present an overview of this rare malignancy.

BackgroundFlaps are increasingly popularized in reconstructive surgery and there is need to test and increase their reliability. Color Doppler ultrasound has been stated to be valuable in flap planning. The aim of this study was to conduct a systematic review and meta-analysis of the literature of Color Doppler ultrasound targeted pedicled perforator flaps and provide information on outcomes and complication rates.MethodA systematic review and meta-analysis were conducted for articles published until April 2017 in PubMed and Embase. We aimed to include randomized clinical trials, meta-analysis, prospective studies, case-control studies, and cohort studies written in English. We included studies where CDU was used to identify the perforator(s) prior to surgery. We evaluated the quality of the included studies using checklists recommended by the Cochrane group.ResultsFrom the initial 219 studies, only 12 studies using Color Doppler targeted pedicled perforator flaps in 252 cases met the inclusion and exclusion criteria. Eleven of these were case series and one a prospective study. The incidence of major complications was 8% (21/252) and minor complications was 14%, comprising of mostly necrosis 8% (24/252) and venous congestion 8% (21/252).ConclusionsThe reconstructive success rate following pedicled perforator flap reconstruction targeted by CDU appears to be high and the procedure provides a wide scope of applications and margin of safety. It is evident that the risk of venous congestion is 11 times greater in the lower extremities than the truncus, a finding that needs further attention in future studies.Level of Evidence: Level IV, risk/prognostic study

HighlightsWe present a case of Idiopathic scrotal calcinosis, rare benign tumor.Controversy concerning the origin of ICS remains, whether the nodules are the result of dystrophic calcification of preexistent epidermal inclusion cysts or if they have emerged de novo.Idiopathic scrotal calcinosis can be sexually invalidating.Golden standard in surgical excision.

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Combination of anaesthesia and surgery induces significant perturbations of physiological parameters in both young and adult spontaneously breathing rats undergoing surgery. These observations further enlighten the need for detailed physiological monitoring under these experimental conditions. Although some statistically significant differences in activated caspase-3 profiles were detected between experimental groups, the overall extent of neuronal cell death remained very low under all conditions questioning, thereby, the physiological significance of apoptotic neurodegeneration in the context of anaesthesia and surgery.

HighlightsWe present a case of PAAG mediated breast augmentation resulting in breestfeeding difficulty.Overall management involved clinical examination, ultrasound, X-ray, MRI, microscopic evaluation, antibiotics and surgical removal of PAAG material.PAAG has been associated with worse breast cancer outcomes.

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