Orbital lymphoma presenting as an unstable ocular prosthesis: a salutary lesson

We report the unusual presentation of an extranodal marginal zone B-cell lymphoma presenting as instability of an ocular prosthesis. More commonly, the stability of an ocular prosthesis can be affected by orbital implant migration, sunken superior sulcus, eyelid malformations, shallow inferior fornix, and contracted sockets (Charlton & Weinstein, 1995). Although rare, this case highlights the importance of meticulous examination of the socket, including careful palpation for any potential masses. To our knowledge, instability of an ocular prosthesis in association with orbital lymphoma has not been described previously.

Metachronous bilateral submandibular gland metastases from carcinoma of the breast

Metastases to the salivary glands from distant neoplasms are unusual, with most reported cases involving the parotid gland. Metastatic deposits in the submandibular gland are extremely rare with bilateral involvement not previously reported. We present the case of a patient with advanced breast carcinoma who has had metachronous involvement of both submandibular glands and review the literature on this subject.

Relationship between human papillomavirus infection and overexpression of p53 protein in cervical carcinomas and lymph node metastases

Overexpression of p53 protein is common in cervical carcinoma. We investigated archival biopsies from 26 cervical cancer patients (24 with available lymph nodes) to determine the relationship between p53 overexpression and HPV infection at the cervix and lymph nodes. Twelve cervical carcinoma patients had p53 protein in cervical biopsies detectable by immunohistochemistry using monoclonal antibody DO-1, and 22 were positive for HPV DNA in polymerase chain reaction assays (16, contained HPV-16; 3, HPV-18; and, 3 HPV-X). Seven cervical cancer patients had one or more lymph nodes positive for p53 protein, and all but one of these were concordantly p53 positive at the cervix. However, detection of p53 protein in cervical biopsies was predictive neither of the expression of p53 at draining lymph nodes (P > 0.1) nor of the occurrence of metastases (P > 0.1). Fourteen patients were positive at one or more lymph nodes for HPV DNA. Cervical positivity for HPV DNA was associated significantly with concordant HPV positivity at the lymph nodes (P = 0.039) and was predictive of metastases (P = 0.019). There was no association between positivity for p53 and for HPV DNA at primary cervical carcinomas or at the lymph nodes (all P > 0.1). We conclude that, although detectable p53 protein is a common feature of cervical carcinomas, it is not predictive of metastases and is independent of HPV infection.

Localized amyloidosis of the genito-urinary tract

Localized amyloidosis of the uro-genital tract is uncommon. It often simulates a neoplastic process. We describe our experience with three cases of localized amyloid of the bladder and one each of the ureter, prostate and corpora spongiosa.

Work injured nurses group

The Work Injured Nurses Group (WING) was started as the RCN Back Group by one of the RCN solicitors, who was very concerned about the social isolation and lack of [Illegible word] available for nurses following injury.