Ovarian cancer is usually confined intraperitoneally. Distant metastases at presentation is unusual. Its spread via lymphatics is uncommon, and metastasis to axillary lymph nodes is very rare. We report two cases with presentation of axillary lymphadenopathy without breast involvement. Computed tomography scan identified the ovarian masses. Both had elevated Serum Ca 125. The first case had a Grade 2 ovarian endometrioid carcinoma. The second case had a high-grade serous ovarian carcinoma. These cases illustrate the rarity of axillary lymphadenopathy from ovarian cancer. It is important to identify the primary ovarian carcinoma in order to offer appropriate management. Despite surgery and chemotherapy, both succumbed within 3 years from diagnosis.

BACKGROUND: We all know that lymph-node metastasis is an important factor for poor clinical outcome in breast cancer prognosis. Tumor deposit refers to a discrete collection of cancer cells that is found in the lymph nodes or other tissues adjacent to the primary tumor site. These tumor deposits are separate from the primary tumor and are often considered as a manifestation of lymph node metastasis. In gastric and colorectal cancer, tumor deposits in the lymph node drainage area have been included as independent prognostic factors. The question arises whether tumor deposits should also be considered as prognostic factors in breast cancer patients. This article aims to provoke some thoughts on this matter through a case study and literature review.
METHODS: A 70-year-old female patient was found to have a right breast lump for over 2 years. On January 3, 2023, a core needle biopsy of the right breast lump was performed, and the pathology report indicated invasive carcinoma. Subsequently, on January 17, 2023, the patient underwent right breast-conserving surgery, sentinel lymph node biopsy, and right axillary lymph node dissection. The postoperative pathological staging was determined as stage IIB. The patient received chemotherapy, radiotherapy, and endocrine therapy. At present, nearly one year after the surgery, no obvious signs of metastasis have been observed in the follow-up examinations, but the long-term prognosis is still unknown.
CONCLUSIONS: There is a need for increased focus on the matter of tumor deposits in the lymph node drainage region, as well as a requirement for further clinical investigation to ascertain the relevance of tumor deposits in the prognosis of individuals with breast carcinoma.

Unicentric Castleman disease, particularly the hypervascular variant subtype, commonly presents as a localized lymphadenopathy without systemic symptoms. Surgical excision is often curative for this subtype, leading to a good prognosis. However, some patients with autoimmune complications may require additional systemic therapy along with surgery. Accurate diagnosis through a combination of clinical, radiological, and pathological findings is crucial for optimal management.

Flap-based reconstruction techniques have shown promise in preventing scar contractures and enhancing healing in fold areas by providing vascularized and thick tissue. We report a septic rupture of the superficial femoral artery treated with an arterial allograft and covered with a contralateral pedicled Deep Inferior Epigastric Artery Perforator (DIEP) flap. The patient presented favorable outcomes, including optimal healing at 8 months, with no functional limitation. A literature review also discusses alternative pedicled perforator flaps. These modern techniques present several advantages, including reliability, and can be of great interest in complex vascular surgery cases.

The most common tumours in the brachial plexus are benign schwannomas, followed by neurofibromas and malignancies, originating from the peripheral nerve sheath. The clinical manifestations of brachial plexus tumours are variable according to their location, extension, neurological elements involved and pathology. Brachial plexus tumours are rare in the upper extremity, and axillary schwannoma is uncommon. This case reports a 59-year-old woman with a tumour in her left axilla for two years, gradually enlarging with numbness in her left little finger. Microsurgical interfascicular dissection operation was performed to remove the tumour. Νumbness disappeared after the procedure, and no tumour recurrence was observed during the 30-month follow-up. To the best of our knowledge, plexiform schwannoma of the brachial plexus in the axilla has not been reported so far. In this article, such a case is reported, where this tumour was diagnosed by the histopathological examination and confirmed with immunohistochemistry.

Extramammary masses are infrequently encountered in breast examinations. They may occur in the chest wall and axilla as neighbors of the breast. It is important to determine the nature of the lesion. However, some benign tumors, such as granular cell tumors (GCTs), also show malignant characteristics, which leads to misdiagnosis. To the best of our knowledge, multimodal ultrasound features of GCT have not been elucidated. We report two cases of women with GCTs encountered upon breast cancer screening; the tumor was not located in breast tissue. The first patient was a 37-year-old woman who presented with a slow-growing mass in the right breast and the GCT was located in the pectoralis major muscle. The second patient was a 52-year-old woman who presented with a palpable left axillary mass and the GCT was located in the axilla. Mammography failed to detect the masses in the two patients upon breast cancer screening. However, two-dimensional ultrasonography revealed a solid heterogeneous hypoechoic mass. Shear wave elastography showed that the masses had an increased hardness compared with the surrounding tissue. Further contrast-enhanced ultrasonography showed that the contrast patterns of the two masses were different. In case one, contrast-enhanced ultrasonography showed an inhomogeneous annular high enhancement, and the dynamic curve showed rapid enhancement and regression. In case two, contrast enhanced ultrasound showed slight enhancement around the lesion but no enhancement inside. Postoperative pathology confirmed that the GCT was benign in both cases. The patients showed no signs of recurrence at the 2-year follow-up. Here, we report two cases and present the multimodal ultrasonography findings of this tumor for the first time. Radiologists and surgeons should be aware of these imaging manifestations and include them in their differential diagnoses.

Upper extremity access sites are the preferred access sites for hemodialysis. With the improvement of the survival in dialysis population, most patients outlive the dialysis access lifespan. As such, some patients exhaust the vascular access options of the upper extremities, which necessitates the search for new access sites. While lower extremity grafts and hemodialysis reliable outflow devices are potential alternatives, these access sites are plagued with recurrent lesions at the venous anastomosis and subsequent thrombosis leading to poor access survival. Within this framework, the axillary-based dialysis access was developed to address these challenges. In this report, we describe a 70-year-old woman who exhausted her upper extremity access sites and eventually underwent a chest wall arteriovenous graft (AVG) that connected the right axillary artery to the right axillary vein. This chest wall AVG remained functional without any intervention for more than 3 years. In conclusion, chest wall AVG access can be a viable option for hemodialysis patients who have exhausted the access sites of the upper extremities, while potentially minimizing complications seen in other methods of vascular access.

Polymastia or supernumerary breast is an anomaly of the embryonic development of the mammary gland resulting in ectopic breast tissue. We report an exceptional case of a unilateral axillary supernumerary breast in a 71-year-old patient which became enlarged after menopause. The diagnosis was confirmed on anatomopathological study which revealed no sign of malignancy otherwise. In our case, it was a proliferation of glandular tissue, without areola or nipple, rarely reported in the literature, and corresponding to Kajava class IV. The patient underwent surgical treatment in order to resolve the problem of aesthetic discomfort and to limit the risk of malignant transformation.

Neurofibromatosis type 1 (NF1) is an autosomal dominant genodermatosis that may also occur as the result of a spontaneous mutation. The diagnosis can be established by the presence of two of the seven National Institutes of Health (NIH) diagnostic criteria; several dermatologic manifestations are NIH criteria used to establish the diagnosis: axillary and inguinal freckling, café-au-lait macules, and neurofibromas. Mucosal evaluation of the eyes may detect a fourth criteria: pigmented iris hamartomas (Lisch nodules). The remaining NIH criteria include optic path glioma, distinctive osseus lesions, and a positive family history of the condition. A breast cancer 2 (BRCA2) positive woman with NF1 and chronic lymphocytic leukemia is described. Patients with NF1 have an increased lifetime risk to develop breast cancer, gastrointestinal stromal tumor, malignant glioma, malignant peripheral nerve sheath tumor, and rhabdomyosarcoma. Chronic lymphocytic leukemia occurring in NF1 patients is rare; including my female patient reported in this paper, chronic lymphocytic leukemia has only been reported in three individuals with NF1--two women and one man. The man and the other woman presented with advanced chronic lymphocytic leukemia and treatment with antineoplastic therapy at diagnosis; the man achieved clinical remission and the woman passed away from complications associated with therapy-refractory progression of her leukemia. My female patient required treatment 41 months after diagnosis and had a good clinical response; she has been without significant disease progression for 34 months. Similar to NF1, breast cancer 1 (BRCA1) and BRCA2 mutations are associated with an increased lifetime risk of developing cancer--particularly breast and ovarian carcinoma. An increased risk of chronic lymphocytic leukemia has also been demonstrated in patients with mutations of either BRCA1 or BRCA2. Also, albeit uncommon, either BRCA1 or BRCA2 mutation has been detected in women with NF1 who develop breast cancer. In conclusion, the development of chronic lymphocytic leukemia in NF1 patients may be coincidental and not associated with the underlying genodermatosis; however, the occurrence of chronic lymphocytic leukemia in my patient with NF1, in part, may be related to her BRCA2 positivity.

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