Head and Neck Neoplasms ; pathology ; Humans ; Male ; Middle Aged ; Neurilemmoma ; pathology ; Neurofibroma ; pathology ; Scalp ; pathology

Carcinosarcoma is a biphasic tumor composed of an intimate admixture of epithelial and mesenchymal element, both of which are malignant. Primary cutaneous cases are extremely rare. There have been reported only 18 cases of cutaneous carcinosarcoma in the world and only one case can be found in the korean pathology literature. Therefore it has been difficult to characterize the clinical course of carcinosarcoma of the skin. We present a further case of primary cutaneous carcinosarcoma in a 86-years-old woman with exophytic and hemorrhagic mass on scalp. Histologic and immunohistochemical studies revealed both squamous cell carcinoma and spindle cell sarcomatoid change intermingled in the same tumor. The clinical and histologic findings of cutanous carcinosarcoma were described.
Carcinoma, Squamous Cell ; Carcinosarcoma* ; Female ; Humans ; Pathology ; Scalp* ; Skin

BACKGROUND: The patients of trichotillomania seem to have received much attention based on patients behavioral psychological aspects, but most of the patients are met in dermatological clinics. Dermatological observation of the lesion dose not seem to not sufficient. OBJECTIVE: The purpose of this study is to exarnine clinical and histopathological characteristics of the lesion of trichotillomania. METHODS: We have observed 28 cases of the trichotillornania and exarnined their cutaneous lesions and histopathological featwres. Histopathological examination with vertical serial sections was done in 21 cases. Because hai folllicles are independent of each other and a usual 5 thickness vertical sect,ion shows only very limited numbers of the hair follicles, authors accomplished sectioning of the biopsied scalp tisue to have 300 serial sections cut and 60 representative sections observed to allow the fullest qiiantitative and qualitative examinations of the follicular pathology of the lesion. RESULTS: The important featuies are as follows. 25 cases(89.2%) were under 18 years old with a slight male predorninance(M:F=1.3:1). Only in 2 cases, psychiatric consultation was made. The degree of involvement was vari ble from less than 5%(6 cases) of the scalp up to 100% involvement of the scalp(3 cases). Thr rnean duration of illness was 12.5 months. The involved hair follicles showed one of the following five roots of hairs they are new hairs with tapered ends, broken short hairs, vellus or intermediate hairs, comedone-like hair bodies or empty follicle orifices. Microscopical observation of thr epilat,ed hairs was done in 16 cases, of which in 13 cases there were no telogen roots of terminal hairs, The histopathological results were as follows : 1. Catagen follicles were increased in 20 cases(95.2%). The actual number of catagen follicles was 1386(37.5%) out of a tota 3695 follicles observed in the total examined slides. 2. Trichornalacia were seen ir 11 cases(52.4%). The actual number of hairs with trichomalacia was 195(10.5%) out of a total 1005 hair canals observed. 3. Pigment clumps of the follicular infundibula were seen in 9 cases(42.9%). The actual number of the pigment-laden infundibula was 148(17.9%) out of a total 826 infundibula observed. 4. Destruction of the hair canal wall were seen in 4 cases(19.0% ). The actual number of destructed hair canal wall was 190(10.2%) out of a total 1863 hair canals observed. Hernorrhage around the follicles was not seen. CONCLUSION: The involved areas of trichotillomania were varied in size up to the whole scalp and showed four different type of hairs. Histopathologically catagen follicles increased in almost all cases with 37.5% of all follicles examined. Trichomalacia, pigmented clumps, and the destruction of hair canals were seen by less frequently.
Adolescent ; Hair ; Hair Follicle ; Humans ; Male ; Pathology ; Scalp ; Trichotillomania*

The Viewing Wand is a frameless stereotactic device to provide image-based intraoperative navigation, allowing accurate neurosurgical planning and procedures. The authors applied the frameless stereotactic device called "ISG Viewing Wand" to 30 cases of intracranial lesions and evaluated for its usefulness and limitation. The Viewing Wand was used in 3 cases in conjunction with CT and 27 cases with MRI. The actual error of this system after the registration was judged by the operating surgeon to be less than 2mm in CT or MR image. The useful registrations were possible in 25(83%) out of 30 cases. But it was not useful in 5 cases, because of movement of fiducial markers in 2 cases and head movement after registration in 3 cases. In 25 cases having useful registration, the wand was helpful to localize the lesion for designing the scalp incision and bone flap, as well as the extent of surgical resection of lesions. As a whole, the viewing wand was found to be reliable and accurate. The system is a useful navigational aid that allows a direct approach to intracranial pathology without the drawbacks of application and the limitations of a frame-based stereotactic device.
Fiducial Markers ; Head Movements ; Magnetic Resonance Imaging ; Neuronavigation* ; Pathology ; Scalp

Humans ; Male ; Middle Aged ; Scalp ; pathology ; Skin Neoplasms ; diagnosis

A case of nerve sheath myxoma also called as neurothekeoma in a 33-year-old woman is described. The lesion appeared as a painful, elevated nodule on the scalp for several months, without an appreciable increase in size. Microscopically, it showed typical histologic characteristics of nerve sheath myxoma, and tumor cells revealed strong, positive reaction for S-100 protein and negativity for epithelial membrane antigen (EMA) on immunohistochemical staining. These immunohistochemical findings of this case support the view that the origin cells of this tumor may be schwann cells rather than perineurial cells. The histogenesis and differential diagnosis of this tumor are discussed.
Adult ; Diagnosis, Differential ; Female ; Humans ; Myelin Sheath/*pathology ; Myxoma/*pathology ; *Scalp ; Skin Neoplasms/*pathology

Adult ; Female ; Humans ; Nevus, Pigmented ; congenital ; pathology ; Scalp ; pathology ; Skin Neoplasms ; congenital ; pathology

Atretic encephaloceles or myelomeningoceles are frequently solid due to hamartomatous proliferation of fibrous tissue and blood vessels. Because of the fibrous nature of the tumor with no cystic cavity and unusual location with no connection to CNS, they are frequently regarded as insignificant hamartomas. Apart from this terminology, they are also described as cutaneous meningiomas or hamartomas with ectopic meningothelial elements by the presence of meningothelial cells. We report a case of atretic encephalocele in the parietal scalp of an 8 year-old boy and a case of myelomeningocele in the posterior mediastinum of a 31 year-old woman. The terms atretic encephalocele and myelomeningocele are more appropriate for these cases because they include their pathogenesis and the non-neoplastic nature of the lesion.
Adult ; Case Report ; Child ; Encephalocele/*pathology ; Female ; Human ; Magnetic Resonance Imaging ; Mediastinal Neoplasms/*pathology ; Mediastinum/*pathology ; Meningomyelocele/*pathology ; Scalp/*pathology

A case of alopecia universalis in a 45-year-old male was reported. The hair loss initiated on the eyebrows and progressed to the whole body, but the scalp hairs were well preserved. Histopathologic features of eyebrows were compatible findings with alopecia areata. This is a unique case of alopecia universalis without any involvement of scalp hairs.
Alopecia/*pathology ; Case Report ; Extremities ; Eyebrows/pathology ; Genitalia, Male ; Hair/*pathology ; Human ; Male ; Middle Age ; Scalp/*pathology ; Skin/pathology

OBJECTIVETo improve the recognition and treatment of Chinese cutis verticis gyrata.

METHODSBased on the review of the etiopathology, clinical features, diagnosis, classification and treatment of the disease in the literatures, six patients with the cutis verticis gyrata were treated with the skin graft or the expanded scalp flap.

RESULTSThe operative effects were satisfactory during 6 months to 5 years of the follow-ups. No recurrence was found in all cases. Two patients treated with skin graft had lead to baldness, four patients treated with the expanded scalp flap had been good appearance.

CONCLUSIONSThe method of the expanded scalp flap is good and effective treatment for the cutis verticis gyrate.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Scalp ; abnormalities ; Scalp Dermatoses ; pathology ; surgery ; Tissue Expansion ; methods ; Young Adult