An uncommon case of multiple multiform venous aneurysms of the cephalic vein of a seventeen-year-old girl is presented. The case is discussed in the light of the related literature.

In various human cancers, dysfunction of the E-cadherin-catenin complex is associated with a decrease in cellular and tissue differentiation, and with higher invasive and metastatic potentials. The objective of this study was to investigate E-cadherin and alpha-catenin expression in superficial noninvasive papillary TCC and invasive TCC, and correlate these results with pathological and clinical parameters. We have used immunohistochemistry to localize Ecadherin and alpha-catenin in 56 formalin-fixed, paraffin-embedded tissue blocks from 41 patients with superficial bladder cancer and 15 with invasive bladder cancer. The 46 male and 10 female patients had a mean age of 67 years, with range of 40 to 82 years. The mean follow-up time was 33.4 (range 5-120) months. Tumor grade 1:2:3 ratios were 5:32:19. In superficial bladder tumor, abnormal expression of E-cadherin and alpha-catenin was demonstrated in 37 and 71% of the tumors, respectively. In advanced bladder tumor, abnormal expression of E-cadherin and alpha-catenin was demonstrated in 80 and 100% of the tumors, respectively. Differences in expression of E-cadherin and alpha-catenin could be discerned between superficial and advanced bladder tumors (p=0.004, p=0.024, respectively). However, the association between E-cadherin and alpha-catenin expression and tumor grade was not statistically significant (p>0.05). In addition, the expression of E-cadherin and alpha-catenin did not correlate with tumor number and size (p>0.05). We have demonstrated that abnormal expression of E-cadherin and/or alpha-catenin occurs in more than 85% of bladder carcinomas and correlates significantly only with advanced stage. Nevertheless, these observations need to be confirmed in larger prospective clinical studies.

Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis and may be produced by some cancer cells. Several recent reports have documented that increased expression of VEGF is associated with risk of recurrence or decreased recurrence-free survival in papillary thyroid cancers (PTC). The aims of this study were to determine whether immunohistochemical expression of VEGF is related to local and distant recurrence of PTC and to evaluate the relationship between hypervascularization and VEGF expression in papillary thyroid carcinomas. VEGF expression was examined immunohistochemically in 48 papillary carcinomas. Ten normal thyroids were used as controls. Patients were followed for 61.7 (range 24-143) months. Twelve of the patients had local and distant recurrences. VEGF immunostaining, blinded for clinicopathological data, was evaluated semiquantitatively by two pathologists. The difference between the recurrent (n:12) and nonrecurrent (n:36) carcinomas was statistically significant (p:0.001). VEGF expression was also stronger in papillary thyroid carcinomas than in normal thyroid tissues. The mean microvascular densities were significantly higher than in normal thyroid tissues. These data indicate that VEGF staining is strongly associated with increased frequency of local and distant recurrence in PTC and that the immunohistochemical profile of the expression may be used as a marker for predicting which tumors have metastatic potential.

EGFR (epidermal growth factor receptor), p53, and proliferative markers provide some clues as to the formation of several tumours. In this study the mechanism of the genesis of parathyroid adenomas was investigated using immunohistochemistry. Sections of parathyroid adenomas from 12 cases were stained using PCNA (proliferating cell nuclear antigen), EGFR, and p53 immunohistochemistry. Correlations between PCNA LI (labelling index), EGFR expression, p53 expression, age, serum parathormone, Ca and P levels, and tumour diameter were investigated. PCNA LI was 45.8+/-33.1 (mean+/-standard deviation) and all the cases were somewhat positive. Five cases (41.67 %) were EGFR positive. Maximum 10 % of the cells were positive in these cases. All the cases were p53 negative. There was a correlation between PCNA LI and serum parathormone level (r=0.607, p=0.036). According to these results, parathormone synthesis is high when the proliferative activity of parathyroid adenoma is high. Four of the five EGFR-positive patients were below 35 years of age. These data may indicate that formation of parathyroid adenoma in young patients is related to a mechanism involving EGFR. Absence of p53 expression suggests that p53 mutation is not a common component of parathyroid adenomas.

A 28‐year‐old man presented to our clinic for the evaluation of widespread black spots and cysts, in which recurrent infections could not be controlled by topical and systemic antimicrobials. He was first noted at birth to have a rudimentary toe on the right foot. By the age of 8 years, he had developed pitting on the neck and sole, many of which contained black dots. Over subsequent years, pigmented papules representing pigmented basal cell carcinomas (BCCs) also began to appear on the neck and chest. The patient gave a history of recurrent abscesses and cysts developing on the lesions after the age of 14 years. His personal history was negative for epileptiform attacks and congenital cataract. There was no parental consanguinity and no family history of any similar skin condition. Dermatologic examination revealed aggregated, linear, discrete, dilated, follicular orifices plugged with keratinous material on both sides of the neck, extending down to the upper chest. In some areas, these comedo‐like pits were associated with erythematous papules, nodules, cysts, and scars. Some follicules had a rudimentary hair, and others no hair at all. In addition, there were multiple, small, black, glistening papules, characteristic of pigmented BCCs (Fig. 1). Interfollicular hypopigmentation was also observed. On the medial edge and sole of the right foot, there was a linear patch of pitting. There was also a skin‐colored, soft, 2 cm pedunculated nodule arising from the medial aspect of the great toe, which was diagnosed as a rudimentary toe (Fig. 2). The rest of the physical examination was normal. The patient's general health was good. 1 Multiple, small, black, glistening papules on the upper chest typical of pigmented basal cell carcinoma 2 Linear patch of pitting on the medial edge and sole of the right foot and a skin‐colored, soft, 2 cm, pedunculated nodule arising from the medial aspect of the great toe (rudimentary toe) Histopathologic examination of the skin lesions revealed dilated and invaginated keratin‐filled follicular structures and well‐defined, keratin‐filled cysts. A peri‐infundibular inflammatory infiltrate was also observed. Multiple BCCs were detected adjacent to nevus comedonicus (Fig. 3). 3 Nests of basal cell carcinoma adjacent to a lesion of nevus comedonicus (hematoxylin and eosin, × 10) The patient was treated with amoxicillin/clavulanic acid, plus daily applications of tretinoin gel 0.025% and benzoyl peroxide 5% with some improvement. Cryosurgery with liquid nitrogen was performed on the smaller BCCs. In addition, the larger BCCs and some persistent painful cysts were surgically removed. The patient remains under observation and is well.