OBJECTIVE:To determine whether lower uterine segment involvement (LUSI) correlates with recurrence and survival in women with stage I endometrial adenocarcinoma who do not receive postoperative radiotherapy on the basis of this histologic criterion.STUDY DESIGN:Eighty patients with endometrial adenocarcinoma stage I who underwent surgery between 1989 and 2002 were divided into 2 groups according to the presence of LUSI. Group 1 consisted of 25 patients with LUSI; group 2 consisted of 55 patients without LUSI. The 2 groups were compared with regard to prognostic factors and outcome measures.RESULTS:There were no statistically significant differences between the 2 groups with regard to the following parameters: age and proportion of patients who underwent complete surgical staging and postoperative adjuvant radiotherapy. Pathologic parameters of the 2 groups, such as histologic type, grade and deep myometrial invasion, were comparable. A greater proportion of patients with LUSI had capillary space-like involvement. The patients were followed for a median of 48 months (range, 11-168) from the date of surgery. The overall 5-year recurrence-free survival, disease-specific survival and overall survival rates were 91% (SE .04), 94% (SE .03) and 77% (SE .06), respectively. There was no significant difference between the two groups with regards to these measures (P < .05).CONCLUSION:In patients with state I endometrial cancer, the presence of lower uterine segment involvement does not correlate with their outcome.

Polymorphous sweat gland carcinoma is an unusual, recently described variant of low-grade malignant adnexal neoplasm of the skin characterized by a prolonged clinical course and predilection for the extremities. We describe a case of recurrent polymorphous sweat gland carcinoma in a 56-year-old man who presented with multiple large skin nodules distributed along the flexor surface of his left arm. The lesions were treated by surgical excision; multiple local recurrences, as well as the development of new lesions, were observed over a period of 5 years. No distant metastases have been observed so far. The clinical differential diagnosis and management of these unusual lesions are discussed.

Although calcinosis of the scrotum was first described in 1883 by Lewinski [1] its nature and cause have remained elusive. Hutchinson in 1888 [2], emphasized that these calcific masses appear with no evidence of underlying cause. Various theories regarding the etiology and pathogenesis of the condition have been proposed, non has been widely accepted. “Idiopathic scrotal calcinosis” (ICS), a term applied by Shapiro in 1970 [3], is most commonly used. About 118 cases have been reported. A series of five cases is reported in which scrotal calcinosis developed. A review of the literature and a discussion on the etiology in this disease is also included.

Cutaneous horn (cornu cutaneum) is the grossly descriptive term applied to clinically distinctive, highly confined, exophytic projections on the skin surface, Such keratotic projections can develop in association with a wide variety of epidermal lesions ranging from benign to malignant, including seborrheic keratosis, verruca vulgaris, actinic keratosis, Bowen's disease, and squamous cell carcinoma, The importance of accurate determination of the nature of the condition at the base of the lesion is paramount.The tumor is encountered mainly on sun-damaged skin of elderly people, most commonly on the upper part of the face, ears, penis, or extremities, and even on the trunk.(1-3) They usually occur after the fifth decade but may be seen in younger people. Surgery is the treatment of choice. We report four illustrative cases occurring in the head and neck region.

A man developed acne keloidalis-like lesions in the scalp during treatment with diphenylhydantoin and carbamazepine for epilepsy. These drugs were suspected to play a role in the pathogenesis of this skin disease in an unusual location, based on clinical evidence and on the in vitro test, mast cell degranulation (MCD).