BACKGROUNDThere are limited data on the etiology, clinical characteristics, and optimal treatment of vulvar basal cell carcinoma (BCC).OBJECTIVEThis retrospective review may aid in treatment decisions for vulvar BCC.MATERIALS AND METHODSA retrospective review of our institutional CoPath database was performed, using search terms to identify cases of vulvar BCCs from 2000 to 2018.RESULTSA total of 35 cases of vulvar BCC were included. Patient age ranged from 33 to 97 years with a mean age of 70 years. Of the 35 cases, 28 (80%) involved the cutaneous vulva, 6 (17%) involved the suprapubic area, and 1 (3%) involved the clitoris. Most vulvar BCCs were treated by wide local excision (46%) and vulvectomies (37%), with 3 cases treated with Mohs (11%) and 2 with electrodesiccation and curettage (6%). Preoperative tumor sizes were 0.86 cm(2) for Mohs, 0.94 cm(2) for excision, and 1.54 cm(2) for vulvectomy. The mean margins were 3 mm for Mohs, 4.4 mm for wide local excision, and 6 mm for vulvectomy. Most cases (77%) were identified and treated by gynecology.CONCLUSIONMohs micrographic surgery should be considered for the advantages of being tissue sparing, evaluating the complete peripheral and deep margin, and avoiding the costs and risks of general anesthesia.

Continuous-flow ventricular assist devices (CF-VADs) are used increasingly in pediatric end-stage heart failure (ESHF) patients. Alongside common risk factors like oxidant injury from hemolysis, non-pulsatile flow constitutes a unique circulatory stress on kidneys. Post-implantation recovery after acute kidney injury (AKI) is commonly reported, but long-term kidney outcomes or factors implicated in the evolution of chronic kidney disease (CKD) with prolonged CF-VAD support are unknown. We studied ESHF patients supported > 90 days on CF-VAD from 2008 to 2018. The primary outcome was CKD (per Kidney Disease Improving Global Outcomes (KDIGO) criteria). Secondary outcomes included AKI incidence post-implantation and CKD evolution in the 6–12 months of CF-VAD support. We enrolled 134 patients; 84/134 (63

Basal cell carcinoma (BCC) of the sun-protected genital region is rare. We examined all penoscrotal BCC at a single institution over an 18-year period. A total of 7 cases were identified, 5 scrotal and 2 penile. Four cases (57%) were treated with Mohs micrographic surgery (MMS) and 3 cases (43%) with conventional excision. A prior retrospective review of vulvar BCC at our institution during the same time period showed that MMS was utilized in 4 (11%) of 35 cases. Functional preservation is vital when performing surgery on the genitals and tissue-sparing MMS provides optimal tumor clearance and outcomes for both males and females.