Syringocystadenocarcinoma papilliferum in situ is extremely rare. A 51-year-old female presented with a solitary yellowish patch on the scalp, accompanied by hair loss and a protruding mass. Histopathological evaluation revealed a large number of sebaceous glands and mild papillomatosis without hair follicles. The tumor contained many cystic spaces filled with amorphous material and a connection to the epidermis. The tumor cells showed papillomatous projections and were multilayered with nuclear atypia but no dermal involvement or lymphovascular invasion. On immunohistochemical analysis, the tumor cells showed immunopositivity for carcinoembryonic antigen, Ki-67, epithelial membrane antigen, and gross cystic disease fluid protein-15. Therefore, the patient was diagnosed with syringocystadenocarcinoma papilliferum in situ originating from a nevus sebaceus. The tumor was removed by wide excision, and no recurrence was observed. Our case report supports the multistep pathogenesis of syringocystadenocarcinoma papilliferum originating from a nevus sebaceus.

Syringocystadenocarcinoma papilliferum in situ is extremely rare. A 51-year-old female presented with a solitary yellowish patch on the scalp, accompanied by hair loss and a protruding mass. Histopathological evaluation revealed a large number of sebaceous glands and mild papillomatosis without hair follicles. The tumor contained many cystic spaces filled with amorphous material and a connection to the epidermis. The tumor cells showed papillomatous projections and were multilayered with nuclear atypia but no dermal involvement or lymphovascular invasion. On immunohistochemical analysis, the tumor cells showed immunopositivity for carcinoembryonic antigen, Ki-67, epithelial membrane antigen, and gross cystic disease fluid protein-15. Therefore, the patient was diagnosed with syringocystadenocarcinoma papilliferum in situ originating from a nevus sebaceus. The tumor was removed by wide excision, and no recurrence was observed. Our case report supports the multistep pathogenesis of syringocystadenocarcinoma papilliferum originating from a nevus sebaceus.

Background and Objectives: Pacemaker (PM) implantation is a well-accepted treatment option for patients with paroxysmal atrial fibrillation (AF) and related tachycardiabradycardia syndrome (TBS). Data on the long-term clinical outcomes after radiofrequency catheter ablation (RFCA) or PM implantation are sparse. Methods: The medical records of 217 patients with TBS were retrospectively assessed.Outcomes in patients who underwent RFCA (n=108, 49.8%) were compared to those with PM implantation (n=109, 50.2%). The clinical outcomes were sinus rhythm maintenance, conversion to persistent AF, additional procedure or crossover, and the composite of cardiovascular hospitalization and death. Results: During the follow-up period (mean 3.5±2.0 years), the RFCA group, compared to the PM group, showed better sinus rhythm maintenance (adjusted hazard ratio [aHR], 0.27;95% confidence interval [CI], 0.15–0.46; p=0.002) and less progression to persistent AF (aHR, 0.20; 95% CI, 0.06–0.63; p=0.006). Additional procedure or crossover did not differ significantly between the groups (aHR, 2.07; 95% CI, 0.71–6.06; p=0.185 and aHR, 0.69; 95% CI, 10.8–2.67; p=0.590, respectively). Most RFCA patients (92.6%) did not require pacemaker implantation during long term follow-up period (>3.5 years). The composite endpoint of cardiovascular rehospitalization and death was not significantly different between the groups (aHR, 0.92; 95% CI, 0.50–1.66; p=0.769).Background and Objectives: Pacemaker (PM) implantation is a well-accepted treatment option for patients with paroxysmal atrial fibrillation (AF) and related tachycardiabradycardia syndrome (TBS). Data on the long-term clinical outcomes after radiofrequency catheter ablation (RFCA) or PM implantation are sparse. Methods: The medical records of 217 patients with TBS were retrospectively assessed.Outcomes in patients who underwent RFCA (n=108, 49.8%) were compared to those with PM implantation (n=109, 50.2%). The clinical outcomes were sinus rhythm maintenance, conversion to persistent AF, additional procedure or crossover, and the composite of cardiovascular hospitalization and death. Results: During the follow-up period (mean 3.5±2.0 years), the RFCA group, compared to the PM group, showed better sinus rhythm maintenance (adjusted hazard ratio [aHR], 0.27;95% confidence interval [CI], 0.15–0.46; p=0.002) and less progression to persistent AF (aHR, 0.20; 95% CI, 0.06–0.63; p=0.006). Additional procedure or crossover did not differ significantly between the groups (aHR, 2.07; 95% CI, 0.71–6.06; p=0.185 and aHR, 0.69; 95% CI, 10.8–2.67; p=0.590, respectively). Most RFCA patients (92.6%) did not require pacemaker implantation during long term follow-up period (>3.5 years). The composite endpoint of cardiovascular rehospitalization and death was not significantly different between the groups (aHR, 0.92; 95% CI, 0.50–1.66; p=0.769). Conclusions RFCA is an effective alternative to PM implantation in patients with TBS.In these patients, successful RF ablation of AF is related to a higher rate of sinus rhythm maintenance compared to PM implantation, and the composite outcome of cardiovascular rehospitalization and death is similar.

SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome includes a variety of inflammatory bone disorders associated with dermatologic pathology. A 57-year-old female presented with pustulosis on both hands that had persisted for several months. She also had lower back pain without trauma history. On physical examination, tenderness on her lower back and left anterior chest wall pain were found, and claudication was observed. Radiological studies including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT showed endplate lytic changes in her spine, a focal hypermetabolic lesion in a left rib, and costochondral junction. These findings raised doubt on the presence of metastatic bone lesions, and there was no indication for primary cancer after a complete medical checkup. Palmoplantar pustulosis was well controlled by treatment with acitretin. The osteitis associated with SAPHO syndrome usually presents as osteosclerosis, while reports on osteolytic lesions are rare. We report herein a rare case of SAPHO syndrome associated with bone lesions resembling bone metastasis.
Acitretin ; Acne Vulgaris ; Acquired Hyperostosis Syndrome ; Female ; Hand ; Humans ; Hyperostosis ; Low Back Pain ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis ; Osteitis ; Osteosclerosis ; Pathology ; Physical Examination ; Positron-Emission Tomography ; Ribs ; Spine ; Thoracic Wall

No abstract available.
Agaricales ; Dermatitis

Although hair loss in Cronkhite-Canada syndrome (CCS) developed frequently, its exact mechanism has not been elucidated. Thus, we attempted to investigate the histopathologic features of hair loss with scalp biopsy in one case of CSS. The patient complained of persistent diarrhea and diffuse hair loss of the scalp 1 month prior to the hospital visit. CCS has been already diagnosed through colonoscopy and medical examination. Scalp biopsy was performed to evaluate hair loss of the patient, and pathologic examination showed increased telogen hairs (anagen to telogen is 7:8) without specific dermal inflammation and miniaturization of hair follicles. The patient was treated with topical and systemic steroids, and hair loss has almost completely recovered in 5 months. In this case, we investigated the clinical and pathological features of hair loss through scalp biopsy in one case of CCS and reported them with a review of the literature.
Alopecia ; Biopsy ; Colonoscopy ; Diarrhea ; Hair ; Hair Follicle ; Humans ; Inflammation ; Intestinal Polyposis ; Miniaturization ; Scalp ; Steroids

No abstract available.
Exanthema ; Mucositis ; Mycoplasma ; Stevens-Johnson Syndrome

Proliferative myositis is a rare, benign, probably pseudosarcomatous fibroblastic proliferation that typically presents as a rapidly growing soft tissue mass. Its relative rarity, fast growth rate, and unique histopathologic findings may lead to misdiagnosis as a malignant lesion and unnecessary radical surgical excision. A 57-year-old female presented with a non-tender, well-defined, indurated, solitary, hard papule on the median sulcus of the tongue for 2 weeks. Histologic examination revealed numerous fibroblastic or myofibroblastic spindle cells and large ganglion-like cells infiltrating between and around the muscle fascicles. Immunohistochemical staining showed positivity for vimentin, smooth muscle actin, and CD68 and negativity for S-100. Based on these characteristic clinical findings and histopathologic features, the patient was diagnosed with proliferative myositis. Here, we report a rare case of proliferative myositis on the tongue and recommend considering proliferative myositis in the differential diagnosis when a physician encounters a rapidly grown soft tissue mass.
Actins ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Fibroblasts ; Humans ; Middle Aged ; Muscle, Smooth ; Myofibroblasts ; Myositis* ; Tongue* ; Vimentin