Hidradenocarcinoma is a rare malignant adnexal tumour which arises from the intradermal duct of eccrine sweat glands. The head and neck are the most common sites of hidradenocarcinoma, but rarely it can occur on the extremities. As it is an aggressive tumour, regional lymph nodes and distant viscera are the most common sites of metastasis. Diagnosis is confirmed by histopathology and immunohistochemistry. Hidradenocarcinoma should be differentiated from benign and malignant adnexal tumours. Being an aggressive and rare tumour, no uniform treatment guidelines have been documented so far for metastatic hidradenocarcinoma. Wide local excision is the mainstay of the treatment, but because of high local recurrence, radiotherapy in a dose of 50Gy–70Gy and/or 5-fluorouracil and capecitabine-based combination chemotherapy may be given to further improve local control. Other treatment strategies are targeted therapies like trastuzumab, EGFR inhibitors, PI3K/Akt/mTOR pathway inhibitors, hormonal agents like antiandrogens, electrochemotherapy, or clinical trials.

Background: With increasing anti-PD-1 therapy use in patients with melanoma and other tumor types, there is interest in developing early on-treatment biomarkers that correlate with long-term patient outcome. An understanding of the pathologic features of immune-mediated tumor regression is key in this endeavor.Materials and methods: Histologic features of immune-related pathologic response (irPR) following anti-PD-1 therapy were identified on hematoxylin and eosin (H&E)-stained slides in a discovery cohort of pre-and on-treatment specimens from n ¼ 16 patients with advanced melanoma. These features were used to generate an irPR score [from 0 ¼ no irPR features to 3 ¼ major pathologic response on biopsy (MPR bx , 10% residual viable tumor)]. This scoring system was then tested for an association with objective response by RECIST1.1 and overall survival in a prospectively collected validation cohort of pre-and on-treatment biopsies (n ¼ 51 on-treatment at 4-week timepoint) from melanoma patients enrolled on the nivolumab monotherapy arm of CA209-038 (NCT01621490).Results: Specimens from responders in the discovery cohort had features of immune-activation (moderate-high TIL densities, plasma cells) and wound-healing/tissue repair (neovascularization, proliferative fibrosis) compared to nonresponders, (P 0.021, for each feature). In the validation cohort, increasing irPR score associated with objective response (P ¼ 0.009) and MPR bx associated with increased overall survival (n ¼ 51; HR 0.13; 95%CI, 0.054-0.31, P ¼ 0.015). Neither tumoral necrosis nor pretreatment histologic features were associated with response. Eight of 16 (50%) of patients with stable disease showed irPR features, two of which were MPR bx , indicating a disconnect between pathologic and radiographic features at the 4-week ontherapy timepoint for some patients.Conclusions: Features of immune-mediated tumor regression on routine H&E-stained biopsy slides from patients with advanced melanoma correlate with objective response to anti-PD-1 and overall survival. An on-therapy biopsy may be particularly clinically useful for informing treatment decisions in patients with radiographic stable disease. This approach is inexpensive, straightforward, and widely available.

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The temporomandibular joint forms one of the most fascinating and complex synovial joints in the body. Movements of the temporomandibular joint are regulated by an intricate neurological controlling mechanism, which is essential for the system to function normally and efficiently. Lack of such harmony may cause disruptive muscle behavior or structural damage to any of the components. The management of refractory pain and dysfunctions in the temporomandibular joint poses challenge both to the oral physician and maxillofacial surgeon. Arthrocentesis is a simple, minimally invasive technique that can be used instead of more invasive procedures in patients with pain that fails to respond to conventional conservative measures. This review provides a full comprehensive overview of the literature about the various technical and prognostic aspects in relation to arthrocentesis of the temporomandibular joint, and every clinician must take into account this consideration when performing this procedure in treating patients with temporomandibular disorders.