Małgorzata Radoń-Pokracka

Expression of Vascular Endothelial Growth Factors VEGF- C and D, VEGFR-3, and Comparison of Lymphatic Vessels Density Labeled with D2-40 Antibodies as a Prognostic Factors in Vulvar Intraepithelial Neoplasia (VIN) and Invasive Vulvar Cancer

OBJECTIVE The aim of this study was to compare the immunohistochemical expression of vascular endothelial growth factors VEGF-C and D, as well as the expression of VEGFR-3 in VIN and vulvar invasive cancer and to compare the density of lymphatic marker D2-40 antibody in both groups, and to compare them with different clinicopathologic features. MATERIALS & METHODS The study was performed using tissue material and clinical data from 100 women diagnosed with VIN and 100 women diagnosed with invasive vulvar cancer. RESULTS No significant differences were found in the expression of VEGF-C and -D or VEGFR-3 between those patients with VIN and those with invasive vulvar cancers. Weak expression of VEGF-C was confirmed only in two cases of the analyzed series; in all cases, expression of VEGF-D and VEGFR-3 was observed. The strongest expression of VEGF-D and VEGFR-3 was observed in the group of invasive cancers. The highest density of lymphatic vessels per 2 mm was observed in VIN. In the cancer group, small lymphatic vessels with a narrow oval lumen were observed. Moreover, in two cases of vulvar cancer, the presence of intratumoral lymphatic vessels was observed. CONCLUSIONS These results suggest that lymphangiogenesis begins at the preinvasive stage of vulvar carcinogenesis and suggests the important role of VEGF-C, VEGF-D, VEGFR-3 and LV (D2-40) as prognostic factors in the process of carcinogenesis in the vulvar area.

Recurrent vulvar melanoma in 35-year-old pregnant women.

Vulvar melanoma represents between 3% and 10% of vulvar neoplasms. We present a case of a 34-year-old pregnant woman presenting with a pigmented lesion on the left labium majus; she reported no family history of melanoma. The histological diagnosis was malignant melanoma, superficial spreading type, with Breslow thickness of 0.9 mm; the excision was complete. Eight months before, an atypical genital nevus was completely excised from a nearby location. The pregnancy was finished by cesarean delivery at term, and 3 months later, another pigmented lesion was noticed near but not within the scars. Partial right vulvectomy was performed, and histological diagnosis was malignant melanoma of superficial spreading type, with Breslow thickness of 0.7 mm. The specimen obtained in the first operation was reviewed, and although histological examination was diagnostic for atypical genital nevus, Vysis Melanoma Fluorescence in situ hybridization Probe Kit revealed increased copy numbers of RREB1, which could be consistent with a diagnosis of malignant melanoma.

Neurocutaneous melanosis in a newborn identified prenatally by non-invasive imaging

Dermatology Review/Przegląd Dermatologiczny 2018/4 A 21-year-old pregnant woman (gravida 1 para 1) was referred to the Department of Obstetrics and Perinatology for sonographic examination, which revealed a fetus at 29 + 6 weeks with an irregular cystic-solid subcutaneous mass of heterogeneous echogenicity (16 × 10 × 9 cm in size) covering the surface of both shoulders and the dorsal chest wall (fig. 1). No increase in tumor size was detected up to the delivery. The neonate was a boy, born in good condition by cesarean section after 39 weeks of gestation. At birth, he was found to have multiple congenital melanocytic nevi. An extensive nevus was noted on the trunk, covering the thorax, loins, buttocks and both thighs, having a circumferential distribution. It was hairy and partially composed of large, elevated tubers (figs. 2, 3). Because of the suspicion of neurocutaneous melanosis (NCM), the newborn was given an magnetic resonance imaging (MRI) examination which showed the presence of multiple hiperintense lesions, from 3 to 6 mm in diameter, in the cerebellum, medulla oblongata, the enteral part of the pons, left thalamus, calcarine sulcus, and in the parietal-occipital sulcus. Skin biopsy revealed a melanocytic proliferation Letter to the editor/List do Redakcji

Screening performance for callosal agenesis in prenatal life. Single center study

OBJECTIVES 1) To analyze screening performance of second trimester scan for ACC, 2) to evaluate the agreement between ultrasound and MRI and 3) to compare prenatal and postnatal diagnosis. METHODS It was a prospective observational study. All patients with fetuses suspected of ACC were referred to prenatal MRI (pMRI). RESULTS One subject was not confirmed by pMRI with the diagnosis of ACC. This case demonstrated partial ACC in neonatal MRI (nMRI). CONCLUSION Sensitivity of second trimester scan for callosal agenesis of 73% and specificity of 99%. Prenatal MRI and US has similar amount of misdiagnoses.

Autosomal dominant polycystic kidney disease diagnosed in utero. Review

Autosomal dominant polycystic kidney disease (ADPKD) is one of most common inherited renal diseases. It is estimated that very early onset ADPKD affects even 2% patients. The purpose of this article is to provide a comprehensive review of genetics, prenatal diagnosis and prognosis in very early onset autosomal dominant polycystic kidney disease.