Introduction: Basal cell nevus syndrome (BCNS) (Gorlin-Goltz syndrome or Nevoid basal cell carcinoma syndrome) is a rare inherited multisystem and tumor-predisposing disorder caused by the patched tumor suppressor gene mutations and suppressor of fused gene. Its diagnosis follows a set of criteria based on specific cutaneous features and radiologic findings. Although an autosomal dominant disorder with a high degree of penetrance, BCNS has variable expression making its diagnosis difficult. The limited epidemiologic data among Asians especially in the Philippines hamper early detection or cause frequent misdiagnosis of the condition. Case report: A 56-year-old Filipino female with Fitzpatrick skin type V presented with early onset multiple basal cell carcinomas and bilateral palmoplantar pits. Radiologic investigation reveals odontogenic keratocyst, calcification of the falx cerebri, bridging of the sella turcica, bifid/splayed ribs and vertebral anomalies. The patient exhibits coarse facial features and bilateral cataracts. Cranial computed tomography scan shows cerebrocerebellar atrophy with ventricular dilatation. Management included wide excision of the nodular basal cell carcinomas (BCC), application of 5-flourouracil cream on the superficial BCC and electrodessication and curettage of the smaller lesions. Oral acitretin was also prescribed. Conclusion This is a case that highlights the approach to diagnosis, clinical features and management of BCNS in a Filipino patient. Since various phenotypic presentations may exist among dark-skinned individuals, early diagnosis poses a challenge among physicians. Epidemiologic and prevalence studies among Filipinos may be done to aid in the diagnosis and early management of this rare genodermatosis.
Basal Cell Nevus Syndrome ; Carcinoma, Basal Cell

The history of the Department of Anatomy of the College of Medicine of the University of the Philippines can be chronicled from its humble beginnings in 1907 to its continued existence through the COVID-19 pandemic. This article briefly describes its historical development, current undertakings, and future directions in relation to its mission and vision.
COVID-19 ; Medicine ; Universities

Objective: We aim to determine the association between preoperative CT scan findings of thyroid cartilage invasion, cricoid cartilage invasion, and paraglottic space involvement with tumor extension to the thyroid gland on final histopathology among patients with laryngeal squamous cell carcinoma (SCC) in a tertiary hospital in the Philippines. Methods: Patients with histopathologically-confirmed laryngeal SCC who underwent total laryngectomy with thyroidectomy while admitted at the public ward of the Department of Otorhinolaryngology, Philippine General Hospital, from January 2013 to December 2019 were included. CT scans were reviewed by 2 blinded independent radiologists. CT scan data including subsite/s involved, thyroid cartilage/cricoid cartilage erosion, paraglottic space involvement, thyroid gland involvement, and thyroid gland involvement on final histopathology were gathered. Clinicopathologic data such as age, T Stage, early tracheostomy, and time between CT scan and surgery were also collected and analyzed. Fisher’s exact test was computed for both clinicopathologic and CT scan data with a significant value having p<0.05. Cramer’s V and phi coefficient were computed for nondichotomous and dichotomous variables, respectively. Odds ratio was also computed for dichotomous variables with p<0.05 on Fisher’s exact test. Results: Fifty-nine (59) men and 4 women were included, aged 43 to 81 years old. Most patients were classified as T3 (n=18) and T4 (n=41) (total=93.7%), with most having transglottic primary tumors (n=29, 46%), and only 8 (12.7%) patients having subglottic tumor involvement on final histopathology. Thyroid cartilage erosion or invasion were noted in 63.4% (n=40) of patients’ CT scans and 58.7% (n=37) of patients’ final histopathology reports. Cricoid cartilage and paraglottic space involvement were often not reported on final histopathology results. Thyroid gland involvement was only noted in the final histopathology reports of 5 patients (7.9%). Significant association between cricoid cartilage findings (p=0.032, Cramer’s V=0.318) or thyroid gland involvement on CT scan (p=0.018, Phi=0.384; OR 13 95% CI 1.797, 94.035) with thyroid gland involvement on final histopathology was noted. The rest of the variables had no significant association with thyroid gland involvement on final histopathology. Conclusion Cricoid cartilage involvement (erosion or invasion) and thyroid gland involvement on CT scan are associated with thyroid gland involvement on final histopathology in patients with laryngeal SCC. Patients with these CT scan findings may stand to benefit more from thyroidectomy to ensure good margins of resection.
Laryngeal Neoplasms ; Thyroidectomy ; Carcinoma ; Epithelial Cells

Objective: We aim to determine the association between preoperative CT scan findings of thyroid cartilage invasion, cricoid cartilage invasion, and paraglottic space involvement with tumor extension to the thyroid gland on final histopathology among patients with laryngeal squamous cell carcinoma (SCC) in a tertiary hospital in the Philippines. Methods: Patients with histopathologically-confirmed laryngeal SCC who underwent total laryngectomy with thyroidectomy while admitted at the public ward of the Department of Otorhinolaryngology, Philippine General Hospital, from January 2013 to December 2019 were included. CT scans were reviewed by 2 blinded independent radiologists. CT scan data including subsite/s involved, thyroid cartilage/cricoid cartilage erosion, paraglottic space involvement, thyroid gland involvement, and thyroid gland involvement on final histopathology were gathered. Clinicopathologic data such as age, T Stage, early tracheostomy, and time between CT scan and surgery were also collected and analyzed. Fisher’s exact test was computed for both clinicopathologic and CT scan data with a significant value having p<0.05. Cramer’s V and phi coefficient were computed for nondichotomous and dichotomous variables, respectively. Odds ratio was also computed for dichotomous variables with p<0.05 on Fisher’s exact test. Results: Fifty-nine (59) men and 4 women were included, aged 43 to 81 years old. Most patients were classified as T3 (n=18) and T4 (n=41) (total=93.7%), with most having transglottic primary tumors (n=29, 46%), and only 8 (12.7%) patients having subglottic tumor involvement on final histopathology. Thyroid cartilage erosion or invasion were noted in 63.4% (n=40) of patients’ CT scans and 58.7% (n=37) of patients’ final histopathology reports. Cricoid cartilage and paraglottic space involvement were often not reported on final histopathology results. Thyroid gland involvement was only noted in the final histopathology reports of 5 patients (7.9%). Significant association between cricoid cartilage findings (p=0.032, Cramer’s V=0.318) or thyroid gland involvement on CT scan (p=0.018, Phi=0.384; OR 13 95% CI 1.797, 94.035) with thyroid gland involvement on final histopathology was noted. The rest of the variables had no significant association with thyroid gland involvement on final histopathology. Conclusion Cricoid cartilage involvement (erosion or invasion) and thyroid gland involvement on CT scan are associated with thyroid gland involvement on final histopathology in patients with laryngeal SCC. Patients with these CT scan findings may stand to benefit more from thyroidectomy to ensure good margins of resection.
Laryngeal Neoplasms ; Thyroidectomy ; Carcinoma ; Epithelial Cells

BACKGROUND

Proficiency in performing thoracentesis is a key competency recommended in the Medical Schools Objective Project (MSOP) adopted by the American Association of Medical Colleges, USA, that medical students should possess prior to graduation, although they often do not practice it clinically until the later stages of their training. Thiel-embalmed cadavers, which offer a lifelike experience with less irritation than formalin-preserved cadavers, have been increasingly used as early as 1st year medical school to teach such procedures because of their feel-like and look-like real patients. There are no studies on the use of Thiel- cadavers for simulated thoracentesis among medical students in the Philippines.

To evaluate the attitudes and perceptions of medical students on the use of Thiel-soft embalmed cadavers for simulated thoracentesis as to the understanding of thoracic anatomy, overall learning experience, and confidence in performing the procedure in the cadaver and possibly in the clinical setting.

This is a descriptive cross-sectional study among Learning Unit III medical students in the University of the Philippines conducted from June 13 to 17, 2022. In the final station of the Organ System Course 205 of the Department of Anatomy's LEAP II program, a simulated thoracentesis procedure was set up using a Thiel-preserved cadaver with artificially created pleural effusion. After watching and studying thoracic anatomy, watching a video on how thoracentesis was performed by a general surgeon, students performed the procedure, and were asked to answer a 6-question Likert-scale survey to assess their perceptions and attitudes of the simulation procedure. Data was analyzed using descriptive statistics.

Most of the students strongly agreed that practicing thoracentesis on the soft cadaver has improved their understanding of the anatomical basis of doing thoracentesis (97%) and of the steps of the procedure (94.9%). Similarly, when asked about how they felt doing the simulated thoracentesis, almost all (98%) strongly agreed that it was an enjoyable and stimulating learning experience. Majority strongly agreed (68%) that they felt capable doing the procedure on a soft cadaver against less than half (38.4%) feeling capable of doing it in the clinical setting. Almost all (97%) strongly agreed that simulated thoracentesis on a soft-embalmed cadaver should be part of the learning competencies of medical students because of the skills they learn by doing the procedure.

Integrating a simulated thoracentesis using a Thiel-preserved cadaver early in the course of a student’s medical education, provided students with a better understanding of the anatomy of the thoracic wall and the anatomical basis of doing this simulation procedure. Though confidence in performing the procedure in a soft cadaver is higher than in a clinical setting, the latter setting may need repeated training to further hone their skills. Practicing thoracentesis on soft-embalmed cadavers significantly enhanced medical students' understanding and enjoyment of the procedure. This innovative approach can be considered by anatomy educators as an integrative learning activity when teaching thoracic cage anatomy. This can also be extended to senior medical students and residents across different specialties.