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Biomedical subjects

I M Reingold

Publications and source records attributed to I M Reingold.

At least 19 recordsLinked to original sources

Epithelioma cuniculatum pedis, a variant of squamous cell carcinoma.

The rare lesion of epithelioma cuniculatum pedis may be recognized by the gross appearance of a slow-growing, bulky, "squashy," non-healing, exophytic mass of long duration on the sole, exuding foul-smelling purulent keratin debris from numerous sinuses, and biopsies showing extensive infiltrating plaques of keratinizing, well-formed, squamous epithelium forming walls for numerous sinuses filled with purulent material. The rarity of the lesion, the slow growth, and biopsies showing relatively benign-appearing well-differentiated squamous epithelium caused considerable diagnostic difficulty to clinicians and pathologists. The tumor failed to heal, extensively penetrated the soft tissues, ultimately destroyed the metatarsal bones, and invaded the skin of the dorsum of the fott. The lesion should be treated as a slow-growing, well-differentiated squamous cell carcinoma by wide local excision or by amputation when extensive growth causes deformity of the foot or penetration of the metatarsal bones.

Adult

Cutaneous metastases from hepatomas.

Three cases of hepatomas metastasized to the skin in a series of 88 patients with hepatomas. The skin metastases differed from the usual dermal nodules, such as fibromas, inflammatory granulomas, and adnexal tumors, by their rather sudden appearance as solitary or multiple, nonulcerative, painless, firm, reddish-blue nodules on the scalp, chest, and shoulder. Biopsies of these nodules were necessary in order to confirm the diagnosis of the cutaneous metastases, which appeared before the primary tumors were recognized. Microscopically, the skin tumors were adenocarcinomas in two instances and hepatocellular carcinoma in one. The skin metastases were a late manifestation of the primary tumors; the patients died within three weeks to six months after the appearance of skin tumors. Necropsies showed widespread metastases.

Adenocarcinoma

Venous aneurysms of the parotid gland.

Venous aneurysms of the parotid gland are rare lesions that have distinctive clinicopathologic features. Clinically, they appear suddenly and manifest as masses in the parotid area. Characteristically, these masses are compressible, fill on release of pressure, and increase in size when the head is lowered below the heart and when the Valsalva maneuver is performed. Also, venous aneurysms are nonpulsatile. Definitive diagnosis, however, requires phlebography. Pathologically, these lesions represent aneurysmal dilatation of a segment of a vein and are frequently thrombosed. Surgical excision is the treatment of choice.

Aged

Multicentric dermal-type cylindromas of the parotid glands in a patient with florid turban tumor.

Dermal-type cylindromas of parotid glands in a patient with turban tumor, and various adnexal tumors, represent a rare diathesis, apparently not reported previously. A Caucasian man, born in 1916, had a scalpectomy for turban tumor in 1957. In 1957, 1960, and 1974, dermal type cylindromas were excised from portions of both parotid glands, developing from intercalated and striated ducts; they were considered benign, based on long term followup. Adrexal tumors included multiple dermal cylindromas, trichoepitheliomas, eccrine spiradenomas, and Bowen's disease, and occurred on almost all skin surfaces. In November, 1976, a portion of a right parotidectomy included a 3.5 X 3-cm malignant tumor having the characteristics of an invasive poorly differentiated spindle cell epidermoid carcinoma, which showed no evidence of originating from a malignant basal cell tumor. Several encapsulated and developing benign basal cell tumors were included in the specimen. Dermal-type cyclindromas of the parotid gland are considered to be a variant of basal cell ademona, or monomorphic adenoma, basal cell type, since they consist of similar cell components, although of somewhat different arrangement and with prominent focal deposition of hyaline. Dermal-type cylindromas should be excised conservatively as they appear. They must be differentiated from adenoid cystic carcinoma, which is an infiltrating neoplasm and requires a radical surgical approach.

Adolescent

Hemangiopericytoma of the parotid gland with a review of the literature.

Hemangiopericytoma, a rare vascular tumor characterized by pericytes, has been confused with benign lesions. The tumor cannot be identified clinically and requires histopathologic examination. Although the five year survival rate is good, the 10 year survival rate is poor for tumors in the head and neck region. Aggressive treatment with wide surgical margins appears warranted. Surgery in combination with radiotherapy has improved the poor prognosis. A case of hemangiopericytoma of the parotid gland, the eighth known in the surgical literature, is presented which illustrates the difficulty in the diagnosis and treatment of this lesion.

Hemangiopericytoma