M.N. Saad

Aggressive pilomatrixoma in a child: a case report

Calcifying epitheliomas of Malherbe (pilomatrixomas) are benign calcifying tumours that arise from the hair matrix and present as a slow-growing dermal or subcutaneous mass most commonly located in the head and neck. Recurrences after tumour removal are rare. There have been reports in the past of invasive pilomatrixoma in the pre-auricular area (Krausen et al., 1974; Rothman et al., 1976; Sasaki et al., 1976; Arole et al., 1983), as well as other locations such as the right arm (Gromiko, 1927) and the upper back (Lopansri and Mihm, 1980). Two cases were also reported in adults by Weedon et al. in 1980. None of these tumours has occurred in children.

Correction of developmental breast abnormalities with a permanent expander/implant

Patients with developmental breast abnormalities often present to the plastic surgeon at a young age. We report our experience with 4 cases of unilateral breast abnormality (3 hypoplastic and 1 tuberous) treated with a Becker permanent expander/implant. Our approach is to insert the expander/implant, expand intermittently to keep pace with growth of the other breast and remove the filling valve under local anaesthesia on maturity. The techniques and advantages of this approach are illustrated and discussed.

Tumour thickness in malignant melanoma: the limitations of frozen section.

This paper reports a prospective study to compare maximal tumour thickness values of the same lesion obtained by frozen and paraffin sections in 20 patients with malignant melanoma over a one-year period. Significant differences were found between tumour thickness values obtained by frozen section and paraffin section. There was no constant relationship between the two sets of values. As present prognostic and therapeutic criteria are based on tumour thickness measurements obtained from paraffin sections, we recommend that clinical decisions should not be based on results obtained from frozen sections.

Paraffinoma of the male breast: a case report

A case of paraffinoma of the male breast is reported following injections of paraffin in a male transexual.

Median cleft of the upper lip in association with bilateral hexadactyly and accessory toes

Abstract Median clefts of the upper lip are rare. A case is described in which a median cleft of the upper lip was associated with symmetrical bimanual hexadactyly and bilateral accessory toes. A thorough search of the literature has revealed two similar cases and it is suggested that the association is sufficiently constant to form a recognisable syndrome.

Rhinophyma in a negro: Case report

A case of rhinophyma in a negro patient is reported. The cause of rhinophyma and its association with acne rosacea is discussed. It is suggested that racial factors may be relevant in this incompletely understood condition.

The control of carotid arterial haemorrhage in head and neck surgery by balloon catheter tamponade and detachable balloon embolisation

Radical surgery in the neck is hazardous after irradiation. Rupture of the carotid artery may lead to uncontrollable haemorrhage. Reported mortality rates following this serious complication are between 18% and 50% (Heller and Strong, 1979). We describe a simple method for controlling acute carotid haemorrhage using a standard Fogarty biliary catheter, with selective detachable balloon embolisation for permanent occlusion of the carotid artery.

Subtotal premaxillectomy; a salvage procedure in selected cases of bilateral cleft lip and palate

Subtotal premaxillectomy with preservation of the posterior plate of the premaxilla and the premaxillary-vomerine suture line was carried out in six selected cases of severe bilateral cleft lip and palate between the ages of four and eight years. The long term results are shown and it is concluded that although the procedure does not seem to affect mid-facial growth adversely, it should be reserved for very selective cases and only as a last resort.

The “crescentic” ellipse: a note on technique

In certain areas of the face, an ideal surgical scar should be curved to lit in perfectly with the lines of facial expression. This is particularly applicable to the nasolabial fold, the cheek, around the mental prominence and the frontotemporal junction. The classical elliptical excision of a skin lesion invariably results in a straight scar (A). This disadvantage can be overcome by modifying the ellipse in a crescentic fashion (B). It will be noted that the two sides of the ellipse are of equal length and this becomes obvious when hooks are inserted at each end. Only the inner side of the ellipse is undermined before suturing. The Author