Pleomorphic adenoma(mixed tumor)of the upper lip:A case report

BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.

Evidence-Based Nursing Practice of Reducing Immune-Related Skin Toxicity of Tumor Patients Guided by Sensitive Indicators

Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.

Clinical Efficacy and Adverse Reactions of Photodynamic Therapy in the Treatment of Malignant Skin Tumors and Precancerous Skin Diseases

The purpose of the study was to investigate the efficacy and safety of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases.First of all,100 patients with malignant skin tumor and pre-cancer skin disease admitted to our hospital from January 20,2018 to September 18,2018 were selected,and all of them adopted photodynamic therapy.The 100 patients included 40 cases of basal cell carcinoma,14 cases of squamous cell carcinoma,7 cases of proliferative erythema,9 cases of Bowen’s disease and 39 cases of solar keratosis.Among the 100 patients,77 cases had excellent curative effect,18 cases had good effect and 5 cases had poor effect,and the overall effective rate was 95%(95/100).After 6 months of follow-up,5 cases of basal cell carcinoma,2 cases of squamous cell carcinoma,0 cases of proliferative erythra,1 case of Bowen’s disease and 3 cases of solar keratosis recurred,with an overall recurrence rate of 14%(14/100).The adverse reactions of pruritus were 90%(90/100),81%(81/100),90%(90/100)and 3%(3/100).Therefore,the application of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases is not only effective,but also safe and not easy to relapse.

Calcium Glucarate Prevents Tumor Formation in Mouse Skin

Objective Calcium Glucarate (Cag), Ca salt of D-glucaric acid is a naturally occurring non-toxic compound present in fruits, vegetables and seeds of some plants, and suppress tumor growth in different models. Due to lack of knowledge about its mode of action its uses are limited in cancer chemotherapy thus the objective of the study was to study the mechanism of action of Cag on mouse skin tumorigenesis. Methods We have estimated effect of Cag on DMBA induced mouse skin tumor development following complete carcinogenesis protocol. We measured, epidermal transglutaminase activity (TG), a marker of cell differentiation after DMBA and/or Cag treatment and [3H] thymidine incorporation into DNA as a marker for cell proliferation. Results Topical application of Cag suppressed the DMBA induced mouse skin tumor development. Topical application of Cag significantly modifies the critical events of proliferation and differentiation TG activity was found to be reduced after DMBA treatment. Reduction of the TG activ

Expression of p63 and Cyclooxygenase-2 and Their Correlation in Skin Tumors

To study the expression of p63 and cyclooxygenase-2 （cox-2） in skin tumors and evaluate the correlation between p63 and cox-2, the expressions of cox-2 and p63 were measured by streptavidin-peroxidase complex immunohistochemical technique in 17 cases of skin squamous cell carcinoma （ SCC ） , 19 cases of Bowen＇s disease（Bowen）, 11 cases of actinic keratosis（AK）, 12 cases of seborreic keratosis（SK） and 13 specimens of normal skin. Our results showed that the expression of p63 in skin squamous cell carcinoma, Bowen＇s disease and actinic keratosis were significantly higher than that in seborreic keratosis, while the expression of p63 in seborreic keratosis was significantly higher than that in normal skin. The expression of cox-2 in skin squamous cell carcinoma, Bowen＇s disease and actinic keratosis were significantly higher than that in seborreic keratosis, while no statistical difference was noted in the expression of cox-2 between seborreic keratosis and normal skin. Cox-2 expression was positively correlated with the high p63 expression in malignant skin tu- mors. The increased expression of cox-2 and p63 may play an important role in the development of skin tumors and work synergetically in malignant skin tumors.

Contour Extraction of Skin Tumors Using Visual Attention and GVF-Snake Model

Contour extraction of skin tumors accurately is an important task for further feature generation of their borders and sur-faces to early diagnose melanomas. An integrated approach, combining visual attention model and GVF-snake, is pro-posed in the paper to provide a general framework for locating tumor boundaries in case of noise and boundaries with large concavity. For any skin image, the visual attention model is implemented to locate the Region of Interests (ROIs) based on saliency maps. Then an algorithm called GVF-snake is utilized to iteratively drive an initial contour, deriving from the extracted ROIs, towards real boundary of skin tumors by minimizing an energy function. It is shown from ex-periments that the proposed approach exceeds in two aspects compared with other contour-deforming methods: 1) ini-tial contours generated from saliency maps are definitely located at neighboring regions of real boundaries of skin tu-mors to speed up converges of contour deformation and achieve higher accuracy;2) the method is not sensitive to nois-es on skins and initial contours extracted.

Investigation of Well-Balanced kV X-Ray Imaging Conditions between Skin Dose and Image Noise for Dynamic Tumor Tracking Irradiation

Purpose: The purposes of this study were to estimate accumulated kV X-ray imaging dose throughout dynamic tumor tracking (DTT) irradiation by Vero 4DRT system and to address an analytical skin dose formula for well-balanced kV X-ray imaging conditions between skin dose and image noise. Method: First, skin dose was measured using kV X-ray tube, chamber, and water-equivalent phantoms. Next, imaging dose for six patients in DTT treatment was computed using log files. Subsequently, scattered dose ratio was calculated by amount of ionization in front of flat panel detector (FPD) for fields with size of maximum and the chamber for 0 - 200 mm-thickness phantoms and tube voltage of 60, 80, 100, 120 kV, respectively. Furthermore, image noise was computed from FPD images. Results: The skin dose was greater by a factor of 1.4 - 1.6 than those in Synergy XVI system. The image noise in FPD, ?was expressed as N = 0.045×(1/QFPDen)0.479, where QFPDen denotes amount of ionization in front of FPD. Then, skin dose, D (N, t, v) was formulated as (0.045/N)(1/0.479)/QFPDen/mAs (t, v) ×D/mAs (v), where QFPDen/mAs (t, v) and D/mAs (v) denote amount of ionization in front of FPD and skin dose per mAs, respectively. Using the formulae, it has been demonstrated that skin dose with 120 kV has become lower than any other tube voltage in this study. Conclusion: Using skin doses for the phantom, the skin dose throughout DTT irradiation was estimated as 0.50 Gy. Furthermore, skin dose by kV X-ray imaging was described as a function of image noise, phantom thickness, and tube voltage, suggesting image noise may be reduced with higher X-ray tube voltage in this phantom study.

Clinical and Pathological Studies of Meningioma-Glioma Mixed Tumor

Meningioma-glioma mixed tumor is rare central nervous system tumor. It is necessary to study its clinical and pathological characteristics as well as its possible genesis. This case was a 54-year-old man who was readmitted for recurrent glioma. Magnetic resonance imaging showed a big mass in right temporal lobe which was confirmed as meningioma-glioma by immunohistochemical analysis. Specific immunohistochemical staining is significant in tumor differential diagnosis, and helps to confirm tumor histic origin. By pathological studies, we found that glioma could stimulate adjacent normal meninges into neoplastic proliferation.

Mixed Tumor of the Appendix: A Rare Tumor Association

Malignant tumors of the appendix are rare. They are present in 0.1% to 0.5% of appendectomy specimens: confirmed upon histological analysis. Mixed tumors in the appendix are exceptional. We report a mixed mucinous cystadenoma with a moderately differentiated adenocarcinoma of the appendix in a 64-year-old patient presented to the emergency room with bowel obstruction syndrome.

Clinical Study of Aminolevulinic Acid-mediated Acid Photodynamic Therapy Combined with Surgical Therapy of Skin Malignant Tumor

The purpose of the study was to analyze the effects of aminolevulinic acid-mediated photodynamic therapy(ALA-PDT)combined with surgery and its prognostic implications.Firstly,70 cases of skin malignant tumors admitted to the dermatology department of our hospital from January 2017 to December 2018 were selected and divided into observation group and control group according to the random number table,with 35 patients in each group.Observation group adopted the ALA-PDT combined with surgery therapy,and control group adopted surgery therapy.Two groups of patients were last follow-up to December 2019.The results showed that the total effective rate of clinical treatment in the observation group was significantly higher than that in the control group(P<0.05),indicating that based on the basis of conventional surgical treatment,combined use of ALA-PDT can effectively improve the clinical therapeutic effect and better promote the patient’s health recovery.Therefore,combined with surgical treatment,ALA-PDT can improve the clinical efficacy of skin malignant tumors with fewer adverse reactions,high safety,low recurrence rate and ideal long-term prognosis.

The Frequency of Skin Tumors and Infections in Patients with Autoimmune Diseases

Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases, whose pathogenesis results from the activation of B and T lymphocytes reacting against antigens of the body’s own tissues (defined as self). Objective: To record skin tumors and infections in all autoimmune diseases gathered together in a one pathological state, compared with renal transplant recipients and normal control. Patients and Methods: Four hundred patients with different autoimmune diseases were examined. Fifty patients with pemphigus (15 males, 35 females) are aged from 20 - 70 (41.23 ± 3.89) years. Fifty patients with systemic lupus erythematosus (50 females) are aged from 17 - 45 (30.58 ± 10.08) years. One hundred patients with vitiligo (59 males, 41 females) are aged from 9 - 71 (42.89 ± 5.28) years. One hundred patients with alopecia areata (42 males, 58 females) are aged from 7 - 52 (38.67 ± 9.52) years. One hundred patients with psoriasis (56 males, 44 females) are aged from 7 - 71 (47.36 ± 8.62) years were evaluated. One hundred twenty kidney transplant recipients’ (101 males, 19 females) ages ranged from 14 - 70 (45.43 ± 4.63) years. All patients were examined thoroughly for any cutaneous manifestations and tumors and the findings were compared with the general population as a control group, which consisted of 500 healthy control individuals whose ages ranged from 20 - 71 (44.53 ± 11.48) years. This case series, descriptive, controlled study was performed in Baghdad Teaching Hospital from June 2014 to October 2015. Results: In renal transplant recipients, the findings were observed as follow herpetic infection in 30(25%), bacterial 12(10%) while fungal 24(20%) patients. These infections appeared early in the course of immunosuppression. While the tumors were noticed, the benign tumors were the commonest manifestations, which included viral warts in 45(37.5%) followed by actinic keratosis 15(12.5%), seborrheic keratosis 14(11.6%), sebaceous hyperplasia 13(10.8%) and keratoacanthoma 1(0.8%). While the malignant tumors were basal cell carcinoma 4(3.3%) followed by squamous cell carcinoma 3(2.5%), and kaposi’s sarcoma 4(3.3%), Bowen’s disease 1(0.8%). These malignancy usually appeared late in the course of immunosuppression. In pemphigus, viral warts were observed in 4(8%) cases;fungal infection was seen in 4(8%) cases and bacterial infections in 2(4%) of cases and herpetic infection in only 1(2%) of case;no tumors were found in all patients. In vitiligo, viral warts were observed in 2(2%) cases, while seborrhic keratosis and sebaceous hyperplasia were observed in 1(1%) case;herpetic and fungal infections were seen in 3(3%) of cases while bacterial infections were recorded in 2(2%) of cases but no tumors were found in all patients. In alopecia areata viral warts were observed in 9(9%) of cases, sebaceous hyperplasia in 1(1%) case, herpetic and bacterial in 3(3%) of cases and fungal in 4(4%) of cases;no tumors were found in all patients. In systemic lupus erythymatosus (SLE) viral warts were observed in 4(8%) of cases, herpetic infection in 12(12%) of cases, fungal infection in 10(20%) of cases, bacterial infection in 3(3%) of cases and sebaceous hyperplasia in only 1(2%) of case, but no tumors were seen. In psoriasis, viral warts were observed in 14(14%) of cases, herpetic infection in 10(10%) of cases, bacterial infection in 3(3%) of cases, fungal infection in 2(2%) of cases, sebaceous hyperplasia in 2(2%) of cases and seborrhiec hyperkeratosis in 1(1%) case, while no tumors were demonstrated. In healthy control individuals, herpetic infection was present in 36(7.2%) and viral warts in 52(10.4%) individuals, fungal infection in 29(5.8%) of individuals and regarding tumors solar keratosis was present in 24(4.8%);basal cell carcinoma and squamous cell carcinoma were present in 2(0.4%) individuals of each. Conclusions: Patients with autoimmune diseases were protected against infections and tumors while kidney transplant recipients had no such protection although all these groups were on prolonged immunosuppression.

Porocarcinoma in a palm reconstructed with a full thickness skin graft: A case report

BACKGROUND Porocarcinoma is a rare type of skin cancer that originates from sweat gland tumors.It is an aggressive malignant skin cancer that is difficult to diagnose clinically owing to its rarity and similarity to squamous cell carcinoma(SCC).CASE SUMMARY This case involved a 92-year-old woman,a farmer by profession,presented with an exophytic and verrucous mass on her left palm that had formed 2 years prior and caused chronic pain and frequent bleeding.Initially,the patient was diagnosed with SCC using a punch biopsy;however,a repeat biopsy with addi-tional immunohistochemical tests was performed for porocarcinoma.Ultimately,the patient was diagnosed with porocarcinoma and reconstruction was planned using a full-thickness skin graft.After treatment,the range of motion of the palm was preserved,and the aesthetic outcome was favorable.At 6 mo of follow-up,the patient was satisfied with the outcome.CONCLUSION Porocarcinoma is commonly misdiagnosed as SCC;therefore,clinicians should consider porocarcinomas when evaluating mass-like lesions on the hands.

Boundary layer flow and heat transfer of a micropolar fluid near the stagnation point on a stretching vertical surface with prescribed skin friction

The steady laminar mixed convection boundary layer flow and heat transfer of a micropolar fluid near the stagnation point on a stretched vertical surface with prescribed skin friction were considered.The governing partial differential equations were transformed into a system of ordinary differential equations,which were then solved numerically using the shooting method.Results for the stretching velocity,the local Nusselt number,the temperature,and the velocity profiles are presented for various values of the mixed convection parameter λ and material parameter K when the Prandtl number is equal to 1.Both assisting（heated plate） and opposing（cooled plate） flow regions are considered.It is found that dual solutions exist for both assisting and opposing flows.

Primary ascending colon cancer accompanying skip metastases in left shoulder skin and left neck lymph node: A case report

BACKGROUND Lymph node skip metastases are common in lung,breast,and thyroid cancer patients,but are rare in colon cancer patients.Specifically,lymph node skip metastases occur in 1%-3%of colon cancer patients.Previous reports have demonstrated colon cancer skip metastases involving the retropancreatic and portocaval lymph nodes and Virchow's node;however,reports involving skip metastases into the left neck lymph nodes and left shoulder skin are extremely rare,as are related reports of clinical treatment and prognosis.CASE SUMMARY A 44-year-old Chinese man was admitted to the hospital for evaluation of persistent shoulder pain for 3 d and a cutaneous mass(3.0 cm×2.0 cm)on the left shoulder.The left shoulder cutaneous mass was excised and bisected,revealing tissues with a fish-like appearance.The pathologic diagnosis of the cutaneous mass suggested a signature[CDX-2(++),CK20(++),Ki-67(+)>50%]of infiltrating or metastatic colorectal adenocarcinoma.An enhanced computed tomography scan of the abdomen revealed chronic appendicitis with fecal stone formation,cecal edema,and a pelvic effusion.A colonoscopy revealed a cauliflower-like mass within the ascending colon area that involved the lumen.The surface of the ascending colon mass was eroded and bleeding;a biopsy was performed.The pathologic diagnosis of the colonoscopy biopsy was an ascending colon mucinous adenocarcinoma.The patient underwent a laparoscopic radical resection of the right colon based on the pathological diagnosis.The tumor was 5.0 cm×4.5 cm×1.8 cm in size and infiltrated the entire thickness of the intestinal wall with vascular tumor thrombi.No nerve tissue involvement was noted.The ileum and colon resection margins were negative.The postoperative pathologic analysis revealed non-metastatic involvement of ileocecal,pericolic,or peri-ileal lymph nodes.The postoperative medical examination revealed palpably enlarged lymph nodes in the left neck,and the following color Doppler ultrasound examination of the neck confirmed enlarged lymph nodes in the left neck.After surgical resection and pathologic diagnosis,a common pathologic signature consistent with resected cutaneous mass and right colon was identified,suggesting skip metastasis of left cervical lymph nodes.The patient was then treated with eight courses of chemotherapy and under followup evaluations for 4 years;currently,no tumor recurrences or metastases have been noted.CONCLUSION We report an abnormal skip metastasis involving the left shoulder skin and left neck lymph node in a patient with ascending colon adenocarcinoma.Specifically,we observed non-metastatic involvement of the lymph nodes around the tumor site but with metastases to the cervical lymph nodes.The standard surgical operations were performed to resect the cutaneous mass,tumor tissue,and cervical lymph nodes,followed by chemotherapy for eight courses.The patient is healthy with no tumor recurrences or metastases for 4 years.This clinical case will contribute to future research about the abnormal skip metastasis in colon cancers and a better clinical treatment design.

The improvement of living quality for the patient with carcinoma of esophagus: Reconstruction for the defect of pharynx and cervical esophagus with inferior antebrachial skin flap on the basis of retaining the laryngeal function

Objective To investigate the effect of reconstruction for inferior pharyngeal and cervical esophagus defect with inferior antebrachial skin flaps on the living quality of patients after surgery. Method Perform radical operation of the tumor, but retain larynx and trachea. Free antebrchial skin flaps were used to reconstruct the defect of inferior pharynx and cervical esophagus. Roll the skin flap to form a skin tube, and then carry out anastomosis with floor of mouth and cervical esophagus. Result The laryngeal function was retained after surgery. And permanent orifice of trachea was unnecessary. The effect was satisfying. The vocalization wasn’t affected and food-intake through oral was normal in the 2 patients followed up. Conclusion It is a feasible way to reconstruct the inferior pharynx and cervical esophagus defect caused by radical operation of the tumor at pharynx and cervical esophagus. It can improve the living quality of patients effectively.

Fine needle aspiration analysis of misdiagnosis of 2 cases with skin singular leiomyoma

This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of cells was as follows.

A New Hybrid Model for Segmentation of the Skin Lesion Based on Residual Attention U-Net

Skin segmentation participates significantly in various biomedical applications,such as skin cancer identification and skin lesion detection.This paper presents a novel framework for segmenting the skin.The framework contains two main stages:The first stage is for removing different types of noises from the dermoscopic images,such as hair,speckle,and impulse noise,and the second stage is for segmentation of the dermoscopic images using an attention residual U-shaped Network(U-Net).The framework uses variational Autoencoders(VAEs)for removing the hair noises,the Generative Adversarial Denoising Network(DGAN-Net),the Denoising U-shaped U-Net(D-U-NET),and Batch Renormalization U-Net(Br-U-NET)for remov-ing the speckle noise,and the Laplacian Vector Median Filter(MLVMF)for removing the impulse noise.In the second main stage,the residual attention u-net was used for segmentation.The framework achieves(35.11,31.26,27.01,and 26.16),(36.34,33.23,31.32,and 28.65),and(36.33,32.21,28.54,and 27.11)for removing hair,speckle,and impulse noise,respectively,based on Peak Signal Noise Ratio(PSNR)at the level of(0.1,0.25,0.5,and 0.75)of noise.The framework also achieves an accuracy of nearly 94.26 in the dice score in the process of segmentation before removing noise and 95.22 after removing different types of noise.The experiments have shown the efficiency of the used model in removing noise according to the structural similarity index measure(SSIM)and PSNR and in the segmentation process as well.

Medical images classification for skin cancer using quantitative image features with optical coherence tomography

Optical coherence tomography(OCT)is employed in the diagnosis of skin cancer.Particularly,quantitative image features extracted from OCT images might be used as indicators to classify the skin tumors.In the present paper,we investigated intensity-based,texture-based and fractalbased features for automatically classifying the melanomas,basal cell carcinomas and pigment nevi.Generalized estimating equations were used to test for differences between the skin tumors.A modified p value of<0.001 was considered statistically significant.Significant increase of mean and median of intensity and significant decrease of mean and median of absolute gradient were observed in basal cell carcinomas and pigment nevi as compared with melanomas.Significant decrease of contrast,entropy and fractal dimension was also observed in basal cell carcinomas and pigment nevi as compared with melanomas.Our results suggest that the selected quantitative image features of OCT images could provide useful information to differentiate basal cell carcinomas and pigment nevi from the melanomas.Further research is warranted to determine how this approach may be used to improve the classification of skin tumors.

Bipedicled Mini V-Y Advancement Flap for Skin Defect of the Face

In young patients, even small circular facial defects after the excision of benign skin tumors present a reconstructive challenge. The usefulness of a V-Y advancement flap for reconstructing such defects is well documented. We refined this technique as a mini V-Y advancement flap consisting of two subcutaneous pedicles that vascularize the skin island via subdermal plexus lateral bridges. This technique was used for 21 middle-aged or younger patients with a small benign skin lesion. None of them experienced any postoperative complications. Aesthetically excellent results were found in all patients. This small advancement flap could be attempted as an alternative to fusiform excision of small skin lesions, particularly in younger patients.

Mixed neuroendocrine non-neuroendocrine tumors:The quest for evidence

Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are rare mixed tumors containing both neuroendocrine and non-neuroendocrine components that occupy at least 30%of the whole tumor.Biologically,both components appear to derive from an identical cellular precursor undergoing early dual differentiation or late transdifferentiation.While our understanding of MiNENs has improved in recent years,many areas of uncertainty remain.In this context,setting diagnostic criteria capable of capturing the continuum of disease biology while providing clinically meaningful information in terms of prognosis and response to treatments appears vital to advance the field and improve patients’outcomes.Evidence is needed to generate robust classification schemes,and multi-institutional cooperation will likely play a crucial role in building adequately powered cohorts to address some of the most pressing questions discussed in this Editorial.What is the minimum representation for each component needed to define MiNENs?How can the epidemiology of MiNENs change according to different diagnostic definitions?How can we generate the clinical evidence nee-ded to optimize the management of MiNENs?