15 patients successfully received submental artery perforator flaps with its pedicle elongated. The lesions were located in tongue,oropharynx,gingiva,mandible,auricle,infraorbital skin,buccal mucosa and parotid gland.All patients are satisfied with the reconstruction. 15 patients’ donor sites were recovered well and the flaps survival was 100% with no post-operation or further major complications occurred

Schizophrenia is associated to somatic disorders especially cardio-vascular and auto-immune. Through this case report, we describe an association with hypertrophic osteoarthropathy (HPO). For this patient it was a paraneoplastic paraneoplastic syndrome secondary to lung cancer. This syndrome is rare but important to recognize since it could hide a life-threatening condition.

Kikuchi-Fujimoto Disease (KFD), also called histiocytic necrotizing lymphadenitis, is a rare benign self-limiting condition, commonly characterized by cervical lymphadenopathy and fever. KFD must be included in the differential diagnoses of lymphadenopathy. Clinicians and pathologists should be aware of the occurrence of this entity, for early diagnosis.

Lymphoma work-up involves immunohistochemical stains to help reach the diagnosis. It is imperative to have clinical information and sound knowledge of staining pattern of antibodies to avoid misinterpretation of results. We describe two cases in which pre-biopsy steroid hindered antigenic profile, leading to “cytoplasmic granular staining” and causing delay.

We report a rare case of postoperative recurrence of MLS in the left thigh with ectopic and metachronous pericardial metastases. He was found to have a cardiac abnormality that was initially thought to be a pericardial cyst, but was later pathologically confirmed to be MLS metastasis.

Primary pulmonary synovial sarcoma (SS) is a rare neoplasm. Its clinicoradiologic attributes are not yet well defined. We report the observation of a patient followed for primary pulmonary synovial sarcoma. we report the radio-clinical features of this rare tumor.

Nephrotic syndrome may be the first clinical manifestation of neoplasms, such as paraneoplastic syndrome. Several studies have been identified the association of cancer with nephrotic syndrome, although laboratory and histological markers that correlate the presence of NS and melanoma, are still needed.

Recurrence rate of renal cell carcinoma in the lungs after five years of nephrectomy is 93%. The occurrence of RCC after 16 years of nephrectomy as pulmonary metastasis is rare and needs to be considered in patient presenting with pulmonary nodules after a long interval since nephrectomy.

lactating adenosis are benign breasts neoplasm usually seen during pregnancy and lactation. We present a rare case of bilateral complex benign lactating adenosis in 19 year old female patient presented with lactating adenosis mimic cancer growth after giving birth. Histopathology confirm diagnosis and Simple mastectomy was the treatment of choice.

Breast cancer is the first cancer associated with cutaneous metastasis (CM). The clinical presentation of these metastases is very broad. We report an original case of carcinoma en cuirasse associated with zosteriform metastasis that announced the developing of contralateral breast cancer.”

We present four cases of intravascular large B-cell lymphoma (IVLBCL), a rare malignancy with poor outcomes. The exclusive presence of lymphoma cells in blood vessels leads to a heterogenous presentation and poor diagnostic yield with traditional initial diagnostic tools. Timely diagnosis and treatment can lead to improved outcomes.

Patients who have undergone upper aerodigestive tract (UADT) cancer surgery are a real challenge in prosthetic rehabilitation. Many clinicians tend to shift towards an implant-supported prosthesis. Thus, we first reviewed a specific type of implant rehabilitation: the connecting bars. Then two clinical cases are described in this article.

Gastric MALT lymphoma is a common type of non-Hodgkin's lymphoma that has the potential for cure in patients found to have concomitant Helicobacter pylori infection.1,2 This case report explores the evaluation, diagnosis, and treatment of H. pylori negative MALT lymphoma in a patient with a history of a RYGB.

Hem-o-lok clips are widely used in laparoscopic surgery. Hem-o-lok clips migration into the bile duct can lead to stone formation and granulation tissue hyperplasia. This report discusses a case wherein four clips migrated into the bile duct after laparoscopic bile duct exploration. The patient successfully underwent laparoscopy and choledocholithotomy.

Waldenström Macroglobulinemia (WM)/lymphoplasmacytic lymphoma (LPL) is often differentiated from myeloma based on the presence of lytic bone lesions (LBL). However, WM/LPL can present with LBL and management is poorly understood. We describe a case of an 81-year-old woman with LPL who presented with LBL and was successfully treated with chemoimmunotherapy.

Brigatinib was recently approved for the treatment of anaplastic lymphoma kinase-positive non-small cell lung cancer and is dosed according to a one-dose-fits-all paradigm. We aimed to identify a pharmacokinetically-guided precision dosing strategy to improve treatment response with brigatinib through simulations using a previously published pharmacokinetic-pharmacodynamic model. Dosing strategies explored were the approved 180mg QD, the highest tolerable dose tested in clinical trials: 240mg QD, and two precision dosing strategies targeting the median trough concentrations following 180mg QD, and 240mg QD. We investigated the impact of alternative dosing regimens on progression-free survival (PFS), overall survival (OS), and the probability of developing a grade ≥2 rash or grade ≥2 amylase increase. Median PFS and OS increased by 1.6 and 7.8 months, respectively between the currently approved dosing strategy and precision dosing to the median trough concentration of the 240mg dosing strategy, with only a minor increase in the probability of developing toxicity.

Pembrolizumab is more widespread use clinically with Pembrolizumab being recommended as a first-line therapy for advanced NSCLC. At the same time, some new adverse reactions have also been discovered, including hyperpigmentation. We hereby present a 77-year-old Chinese female with primary bronchial lung cancer. Genetic testing showed negative for EGFR and ALK. Immunohistochemical analysis showed tumor proportion score (TPS) of PD-L1 was 80% on tumor cells. Then the patient received pembrolizumab 200mg every three weeks, as the first-line therapy. Two courses after initiation pembrolizumab, hyperpigmentation appeared on her face and back of the hand. The right middle lobe mass and mediastinal lymph node metastasis progressed after nine courses after initiation of pembrolizumab, and the patient’s entire face turned black. It potentially indicates that cutaneous adverse events of hyperpigmentation, might be a negative predictor of response to pembrolizumab in metastatic lung adenocarcinoma patients.

Here we present a unique case of Harlequin syndrome without Horner syndrome after contralateral Th3 intradural tumor resection. Harlequin sign in our case presented probably to resection of sympathetic nerves while removing meningioma. Syndrome is rare in neurosurgical procedure, but we think that surgeons must be aware of it.

Dose escalation to target volume during High Dose Rate brachytherapy was effectively employed to treat locally advanced cervical cancer patients who experienced prolongation of overall treatment time (OTT) due to the COVID-19 pandemic. It was tried to achieve acceptable oncological outcomesو while respecting the dose constraints of organs at risk.

Background: Malnutrition is a common complication in children with cancer. Cancer treatment and malnutrition can disrupt gut microbiome diversity and composition. This study aims to compare the dietary intakes between children with solid tumors post-chemotherapy and healthy controls, and investigate associations between the dietary intakes and the gut microbiome. Procedure: Children (7-18 years) with solid tumors were recruited during year 1 after the completion of chemotherapy from Children’s Healthcare of Atlanta, Atlanta, Georgia. Healthy controls were recruited via flyers. Children completed the Block Kids Food Screener for dietary intakes in the past week. Fecal specimens were collected and processed for the gut microbiome. QIIME2 and Mann-Whitney U tests were conducted to answer the research questions. Results: Forty-nine children (25 cancers vs 24 controls) were analyzed. Two groups had no differences in age, race, sex, and body mass index. Children with solid tumors reported significantly higher mean daily intakes of macronutrients: calories, protein, fat, carbohydrate, and fiber, and antioxidant nutrients (vitamin E, vitamin C, and selenium) than controls. Children with adequate vitamin B6 had a higher Chao1 diversity index than children with inadequate or excessive intake (P = 0.0004). Children with excessive selenium intake had a trend of higher Pielou’s_e index than children with inadequate intake (P = 0.091). Conclusion: Children with cancer reported significantly higher intakes of macronutrients and antioxidant nutrients than healthy children, but no differences in major energy ratios. Macronutrients, particularly antioxidant nutrients, were associated with disruptions of the gut microbiome in children with solid tumors.

Rosai-Dorfman disease (RDD) is referred to as Sinus Histiocytosis Massive Lymphadenopathy (SHML) of unknown origin. We are reporting a rare case of Rosai Dorfman disease, a case of 6 years old male with a history of multiple painless bilateral submandibular and cervical lymphadenopathy.

This clinical case first time reports a coexistence of FANCD2 and NF1 mutations in malignant triton tumor (MTT) patient and as the initial operation, the complete resection has crucial influences on the prognosis and recurrence of MTT.

Merkel Cell Carcinoma (MCC) is a rare dermatologic malignancy with propensity for metastasis to lymph nodes, skin, lung, liver, bone, and brain. Metastasis to the stomach is rare with only 13 reported cases. We discuss the outcomes of a partial gastrectomy for the treatment of symptomatic MCC with gastric metastasis.

Introduction/Objectives: We evaluated the length of time immunocompromised children (ICC) remain positive for SARS-CoV-2, identified factors associated with viral persistence and determined cycle threshold (CT) values of children with viral persistence as a surrogate of viral load. Methods: We conducted a retrospective cohort study of ICC at a pediatric hospital from March 2020-2021. Immunocompromised status was defined as primary, secondary or acquired due to medical comorbidities/immunosuppressive treatment. The primary outcome was time to first-of-two consecutive negative SARS-CoV-2 Polymerase chain reaction (PCR) tests at least 24 hours apart. Testing of sequential clinical specimens from the same subject was conducted using the Centers for Disease Control (CDC) 2019-nCoV Real-Time RT-PCR Diagnostic Panel assay. Descriptive statistics, Kaplan-Meier curve median event times and log-rank-sum tests were used to compare outcomes between groups. Results: Ninety-one children met inclusion criteria. Median age was 15.5 years (IQR 8-18 yrs), 64% were male, 58% were white, and 43% were Hispanic/Latinx. Most (67%) were tested in outpatient settings and 58% were asymptomatic. The median time to two negative tests was 42 days (IQR 25.0,55.0), with no differences in median time by illness presentation or level of immunosuppression. Seven children had >1 sample available for repeat testing, and 5/7 (71%) children had initial CT values of <30, (moderate to high viral load); 4 children had CT values of <30 3-4 weeks later, suggesting persistent moderate to high viral loads. Conclusions: Most ICC with SARS-CoV-2 infection had mild disease, with prolonged viral persistence >6 weeks and moderate to high viral load.