Surgical Reconstruction of a Large Defect after Excision of Infiltrative Squamous Cell Carcinoma in the Scalp and Occipital Region: A Case Report

Squamous cell carcinoma(SCC)of the scalp is the second most prevalent skin cancer,following basal cell carcinoma.Notably,it has the capability to infiltrate the skull,dura mater,and even brain tissue.The cornerstone of treatment is the surgical removal of the lesion,with a particular focus on the depth of invasion,which is directly correlated with recurrence rates.Post-surgical strategies may involve immediate or delayed cranial bone reconstruction and repair of scalp defects using either artificial dermis or skin grafts.In the case presented,a substantial defect necessitated more than a single flap for primary repair.Hence,a single pedicle double-island flap was designed for reconstructing the occipital area.Due to increased tension on the flap following cranial bone repair,the bone repair was temporarily deferred.Postoperative care included adjuvant chemotherapy and radiotherapy to mitigate the risk of SCC recurrence.

Decreased invasion ability of hypotaurine synthesis deficient glioma cells was partially due to hypomethylation of Wnt5a promoter

Glioma is one of the lethal central nervous system tumors.The infiltrative and invasive growth nature makes it difficult to identify the boundary between glioma and the normal tissues,resulting in inevitable recurrence after surgery operation.Gliomas do not metastasize,so to prevent the residual tumor from proliferating or invading is a key challenge.Previous report indicated that hypotaurine could facilitate glioma invasion and suppress demethylases’activities.Using a hypotaurine synthesis deficient U251 cell line,we proved that the cells invasion ability was impaired.Gene expression profile analysis exhibited that knocking down one of the key enzymes of hypotaurine synthesis,2-aminoethanethiol dioxygenase(ADO),significantly affected the extracellular matrix-receptor process.Of that process,Wnt5a expression was severely upregulated by decreased intracellular ADO expression.Cells cultured at the presence of hypotaurine showed a decrease in intracellular Wnt5a protein and mRNA levels.This phenotype was due to hypermethylation of Wnt5a promoter,which was most likely the result of hypotaurine’s inhibiting demethylases activities.Collectively,this study demonstrated that hypotaurine synthesis deficient U251 cells were prone to epigenetic modification and Wnt5a seemed to be a tumor suppressor under that circumstance.This tumor suppression effect is warranted to be reevaluated in real tumor samples and the relevant evidence might contribute to develop new glioma interference strategies.

Olfactory schwannoma:a case report

Objective Intracranial schwannomas are frequently located in the VIII cranial nerve, followed by the V and VII cranial nerves, but are quite rare in the olfactory cranial nerves. Here, we report a case of an olfactory schwannoma and review the literature to improve the diagnosis and treatment of olfactory schwannoma. Methods We report a case of olfactory schwannoma in a 51-year-old Chinese man who experienced dizziness and no other symptoms.Results Magnetic resonance imaging(MRI) showed a neoplastic mass located on the anterior cranial base to the right of the midline and near the cribriform plate and sphenoidal plane. The lesion travelled through the cribriform plate into the nasal cavity. This mass was initially thought to be an olfactory groove meningioma. We performed a craniotomy for surgical excision, and the tumor was completely resected, and the skull base was reconstructed at the same time. There were no complications during surgery, and the patient recovered well. The histopathological diagnosis was a schwannoma.Conclusion Olfactory schwannomas are extremely rare and similar to olfactory ensheating cell tumors, and the immunohistochemical staining of leukocyte antigen 7(Leu7/CD57) can be used to identify them. Although the standard treatment of olfactory schwannoma remains unclear, in all reports, most patients can have excellent prognosis after an effective surgical resection.

Metastatic intracranial large-cell neuroendocrine carcinoma:a study of two cases

Objective The occurrence of large-cell neuroendocrine carcinoma(LCNEC), a kind of neuroendocrine tumor(NET), in the cranium is extremely rare. Here we report two such cases and review the literature in order to improve the diagnosis and treatment of intracranial LCNEC.Methods We report two cases of metastatic intracranial LCNEC. In case 1, the patient was diagnosed with lung carcinoma and underwent chemotherapy. Brain metastases were found six months later. The lung and intracranial lesions in case 2 were found at the same time. Results Intracranial multiple-tumor resection was performed in case 1 and the patient died 2 months later. Case 2 patient underwent surgery followed by chemotherapy with etoposide and carboplatin. Six months postoperatively, a recurrence lesion was found in the left cerebellar hemisphere. The patient was treated surgically. At present, a year after the diagnosis, the patient is still alive.Conclusion NETs of the intracranial region are extremely rare, and hence, most of our knowledge is based on lung NETs, and standard treatment strategies for intracranial NETs remain unclear. Our patients had different survival times probably due to different treatments, indicating that effective surgical resection and subsequent multi-agent chemotherapy should be administered to promote long-term survival of intracranial LCNEC patients.