ObjectiveThe aim of this study was to evaluate over time circulating γδ T lymphocytes in melanoma patients in terms of frequency, effector functions, and relationship with clinical stage and evolution, by comparing preoperative values to those obtained at a mean follow-up of 36 months or in the event of recurrence or disease progression, and to those of healthy controls. Also, we correlated the presence of tumor-infiltrating γδ T lymphocytes with clinical evolution of melanoma.ResultsMean frequencies of circulating γδ T cells before and after melanoma removal were very similar and comparable to healthy subjects, but patients who progressed to stage III or IV showed a significantly decreased frequency of circulating Vγ9Vδ2 T cells. The distribution of Vγ9Vδ2 memory and effector subsets was similar in healthy subjects and melanoma patients at diagnosis, but circulating γδ T cells of patients after melanoma removal had a skewed terminally-differentiated effector memory phenotype. Highly suggestive of progressive differentiation toward a cytotoxic phenotype, Vγ9Vδ2T cells from patients at follow up had increased cytotoxic potential and limited cytokine production capability, while the opposite pattern was detected in Vγ9Vδ2T cells from patients before melanoma removal.ConclusionsFollow-up data also showed that tumor infiltrating γδ T cells were significantly associated with lower mortality and relapse rates, suggesting that they may serve as a prognostic biomarker, for human melanoma.

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Mr. P.G., a 65-year-old male was referred to casualty by his family physician, following the complaint of a painful swelling in his left testicle, that was accompanied by a burning sensation on passing urine. Throughout the course of his admission at the local state hospital, a number of investigations were carried out. An ultrasound scan of both testicles, as well as a computed tomography scan of the abdomen and pelvis, delineated extensive thickening of the scrotal skin, as well as subcutaneous gas formation surrounding both testicles with extension to the penis and the right inguinal region. The patient was diagnosed with Fournier's gangrene, which is likely to be a complication of his uncontrolled Type II diabetes mellitus. This condition is classified as a rare and potentially life-threatening disease. Following the diagnosis, the patient received a right orchidectomy, circumcision, as well as subsequent rounds of scrotal debridement and wound cleaning. Pharmacological therapy was provided to relieve his symptoms.