Matrix metalloproteinase-2 expression in laryngeal preneoplastic and neoplastic lesions

Matrix metalloproteinase-2 (MMP-2), a member of gelatinases, is particularly important in the digestion of nonfibrillary and denaturated collagens; thus, it may play a role in tissue remodeling and in the invasion of malignant cells. The expression of MMP-2 has not yet been described in preneoplastic lesions of the larynx thus far. The purpose of this study was to evaluate whether the expression of MMP-2 plays a role in early laryngeal carcinogenesis. Laryngectomy specimens of 20 invasive carcinoma cases were studied. The slides with atypical hyperplasia, carcinoma in situ, and invasive carcinoma were selected from laryngectomy specimens. On these slides, 23 atypical hyperplasia and 17 carcinoma in situ areas were identified. MMP-2 expression was scored immunohistochemically on paraffin tissue sections using the avidin-biotin-peroxidase method. MMP-2 expression in all three groups was statistically different. A sequential increase in MMP-2 expression correlated significantly with the hypothesis of multistep carcinogenesis. In contrast, MMP-2 expression was not related to tumor stage, lymph node metastasis, or differentiation in squamous cell carcinomas. In conclusion, this sequential increase in MMP-2 expression points to an altered expression of MMP-2 in early neoplastic transformation in laryngeal mucosa, followed by an increasing expression during the progression of the disease.

Lack of TP53 mutations in a case of porokeratosis palmaris, plantaris et disseminata

A 73-year-old man with porokeratosis palmaris, plantaris et disseminata is presented. He had punctate, guttate and annular hyperkeratotic papular lesions widespread on his body with thorn-like hyperkeratosis on the palms and soles. Lesional skin did not show mutations of TP53 exons 5-6, 7, 8.

Sacrococcygeal extraspinal ependymomas: the role of coccygectomy

BACKGROUND

Ependymomas, the common glial tumors of the spinal cord, occur occasionally outside the central nervous system and are called exstraspinal ependymomas (EEP). EEPs are found primarily in sacrococcygeal region during childhood. The pathogenesis and the treatment of the sacrococcygeal (SC) ependymomas are still controversial. Therefore, we present our case with metaanalysis of other case reports to determine the optimal treatment modality for SC EEPs.

METHODS

A metaanalysis of case reports of SC EEPs, including the current case, was conducted. Also all available case reports of EEPs, without age limit, were analyzed to determine the distribution of EEPs localization.

RESULTS

EEPs usually are found in teratoma localizations such as the SC area, ovary, paraovarian structures, and medastinum. The distribution of EEPs localization differs with age. Local recurrence rate of EEPs after coccyx excision is zero, however, it increases to 71% when the coccyx was left behind.

CONCLUSION

The identical clinical characteristics of the SC teratomas and EEPs imply that the SC EEPs may be monophasic teratomas as their ovarian counterparts are named. Coccyx excision is an important part of the surgical treatment of these tumors, with an apparent decrease in the recurrence rate.

Effective treatment of persistent papular acantholytic dermatosis with cyclosporine

We describe a patient with persistent papular acantholytic dermatosis provoked by phototoxic reaction to his usual perfumed soap and shaving foam. Therapy with systemic and topical corticosteroids failed to improve the patient. Treatment with cyclosporine was found to be effective.

Prostatic carcinoma presenting with painless parotid mass

Metastasis of prostate cancer to the parotid gland is exceedingly rare, with only 4 cases reported in the literature. We present the case of an 83-year-old white man who had a painless parotid mass that was diagnosed as metastatic prostate cancer. Immunohistochemical staining with prostate-specific antigen was positive. This is the first case of prostate cancer presenting with a painless parotid mass. Prostate cancer can be metastatic to the head and neck region, and this should be kept in mind when treating patients with this disease.