We report a case of a 30-year-old, previously healthy man who presented at our clinic with complaints of increasing dysphagia and globus sensation for about 2 years. In addition, he noticed an increasing submental swelling. On examination, the patient revealed a massive swelling of the floor of the mouth, which had displaced the tongue cranially. MRI imaging showed the lesion to be a homogeneous, cystic lesion, clearly at a distance from the surrounding mucous tissue. Surgery was performed, and the tumor was resected completely. Histologic examination of the resected tissue was consistent with a dermoid cyst located in the floor of the mouth. Although dermoid cysts are rarely located in the oral cavity, it should be included in differential diagnosis. Surgery is the treatment of choice.

Microcystic adnexal carcinoma is a rare cutaneous neoplasm characterized by slow but locally aggressive growth, which normally does not lead to systemic metastasis. Frequent local recurrences are reported, which are most likely due to insufficient operative technique. We present the fourth case of cervical ipsilateral metastatic microcystic adnexal carcinoma in an otherwise healthy woman. The patient presented with a previously diagnosed but not completely resected microcystic adnexal carcinoma in the area of the right posterior scalp and two palpable ipsilateral lymph nodes. The tumor was resected using intraoperative snap frozen histological evaluation of the resection borders. In the same procedure two lymph nodes were resected from the right neck. The lymph nodes were histologically assessed and showed infiltration by small strains of tumor cells. After exclusion of a second primary tumor, e.g., mammary carcinoma, as the cause for cervical lymph node metastases, we performed a modified radical neck dissection with resection of the sternocleidomastoid muscle and the accessory nerve, which was histologically proven to be perineurally infiltrated by tumor cells. In this second procedure the histological evaluation of the specimen showed no sign of remaining tumor infiltration. After exclusion of distant metastasis the patient was irradiated with 60 Gy. The patient is well 1 year after the initial treatment without signs of recurrence.

Salivary leakage can be a major symptom of valve failure or incorrect positioning of indwelling voice rehabilitation valves in a tracheo-oesophageal fistula. Usually, removal of the valve for a short time leads to shrinking of the fistula or a simple valve replacement procedure resolves the problem. If the fistula, however, does not close spontaneously, symptoms persist and the fistula may have to be closed surgically. In a retrospective study, data of 103 patients who underwent laryngectomy and primary voice rehabilitation between 1989 and 1998 with either the Provox or the Eska-Herrmann prosthesis were compared with regard to surgical fistula closure requirement. A total of 55 patients underwent laryngectomy and primary voice rehabilitation with the Eska-Herrmann and 48 with the Provox prosthesis. Initial tumour treatment also included post-operative radiotherapy for all patients in the study. In total, surgical fistula closure had to be performed in three patients, all of whom had been treated with the Provox prosthesis. The time span between initial voice rehabilitation and surgical closure of the fistula was 5 months, 21 months and 24 months in all three patients respectively. None of the fistulas developed in relation to recurring tumour disease. The Provox prosthesis seem to have a higher risk of developing fistulas necessitating surgical intervention, even years after initial tumour therapy, than the Eska-Herrman prosthesis. These complications may be due to the larger tracheo-oesophageal fistula necessary to fit the larger diameter of the Provox prosthesis.

Background: The aim of the study was to assess prospectively the evolution of multiple clinical parameters throughout the first trimester of pregnancy. Method: A transvaginal ultrasound examination and a blood test was weekly performed until the 13th gestational week in a group of healthy volunteers. A total of 25 spontaneously conceived singleton pregnant women with good pregnancy outcome finally completed the study. The evolution of 10 transvaginal ultrasound parameters, 5 Doppler measurements and 6 serum parameters was studied.Results: An increasing trend with advancing gestation was evident for the mean gestational sac (MSD) and amniotic sac (AS) diameters, trophoblastic rim, CRL and serum progesterone. The uterine, umbilical and fetal cerebral arteries PI decreased with advancing gestation. The FM yolk sac (YS) diameter and b-hCG levels showed an initial rise and a final decrease. A great interindividual variation was evident for the b-hCG titer. The YS/CRL progressively approached to 0, whereas the MSD/CRL and the AS/MSD progressively approached to 1. The corpus luteum diameter, corpus luteum arteries PI, subehorionic arteries PI, complement levels (C3 and C4), platelet count and activated partial thromboplastin time experienced minimal changes. Conclusion: First trimester normograms for multiple clinical parameters are provided. P02The first results of the ultrasound transvaginal screening in early pregnancies in Kazan city, Tatarstan, Russia In 1 January 2000 in order of Tatarstan Health Care Ministry transvaginal first trimester screening was introduced in Kazan city. All pregnant women have to be examined in one of 5 the medical centers.We present the results of six month screening for all pregnant women between 10 and 14 weeks gestation. Method: Routine transvaginal ultrasound examination included the measurement of fetal crown-rump length, nuchal translucency and estimation of fetal anatomy. Results: A total 1620 pregnant women of 10±14 weeks of gestation were examined from January till June 2000. All abnormalities were detected at the 12±13 weeks gestational ages. The increasing of nuchal translucency thickness were found in 23 cases, 7 of them chromosomal defects had, in this group in 5 cases cystic hygroma with hydrops were identified.In 12 cases structural anomalies were found: 1-body stalk anomaly, 1 case-omphalocele with liver in it, 1-holoprosencephaly with proboshisis and microphtalmia, 1-encephalocele, 3-acrania, 5-anencephaly. In the cases of holoprosencephaly and encephalocele nuchal translucency measured at 10±11 week was normal. Conclusion: Even the first results of early pregnancy transvaginal screening show its great significance in our city. The most adequate period for transvaginal screening is 12±13 weeks. P03The value of ultrasound screening for fetal abnormalities in the first trimester Objective: Evaluation of routine screening in the early pregnancy by transvaginal sonography (TVS) in an unselected population. Design and methods: A routine ultrasound examination was offered to ...

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