A Case of Langerhan's Cell Histiocytosis of Temporal Bone

We present a case of isolated Langerhans' cell histiocytosis in a six year old child who presented with right otorrhoea, retro-aural swelling and hearing loss. The preoperative provisional diagnosis was cholesteatoma, per operative differential diagnosis was rhabdomyosarcoma and final histological and immunohistochemistry diagnosis was Langerhans' cell histiocytosis.

Vascular Endothelial Growth Factor (VEGF) expression by immunohistochemistry as a prognostic factor in gastric carcinoma

Introduction and Aim: Diagnosis of gastric cancer continues to remain a challenge, considering the widespread prevalence of precancerous lesions. The local progression and systemic spread are significantly influenced by tumor angiogenesis and lymphangiogenesis. This study aimed to evaluate the immunohistochemical expression of VEGF and  its relationship to tumor grade and stage.   Materials and Methods: This cross sectional study was carried out among 30 patients with gastric carcinoma. The specimens were fixed in buffer formalin, embedded in paraffin, sections were stained with Hematoxylin–Eosin and immunohistochemistry was performed for VEGF as per the standard operating procedure. Evaluation was performed using the VEGF score, based on the intensity of reaction and percent of positive cells.   Results: The reaction for VEGF was positive in 27 from 30 cases (90%). VEGF expression was observed in the cytoplasm of tumor cells, with granular pattern. A strong correlation was found between VEGF expression and lymph node status and grade of the primary (p value <0.014), but not with the stage of the tumor.   Conclusion: VEGF over expression has significance with respect to only site and grade of the tumor and hence the usefulness of targeted therapy in such cases has to be evaluated by molecular studies.

Ledderhose Disease: Pathophysiology Diagnosis and Management

INTRODUCTION

Ledderhose's disease, also known asplantar fibromatosis, is a rare benign nodular hyperplasia of the plantar aponeurosis. The disease is locally aggressive and can be managed very well conservatively. In patients who present with severe pain on weight-bearing might require surgical excision.

CASE REPORT

We would like to report about a case of 40-year-old female with bilateral Ledderhose's disease. She was treated conservatively to no avail. On surgical excision of the fibrosis tissue, the patient gives complete relief of symptoms. In this paper, we would to discuss both the conservative and surgical methods adopted to prevent post-operative complications.

CONCLUSION

Ledderhose disease is a rare benign aggressive disease which presents as nodules over the sole of the foot. The disease is usually manageable conservatively. Wide margin surgical excision of the nodule in severe cases will provide pain-free mobilization and prevent recurrence.