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M E Verhaegh

Publications and source records attributed to M E Verhaegh.

7 recordsLinked to original sources
PubMed2001

Microcystic adnexal carcinoma: an uncommon tumor with debatable origin.

BACKGROUND: Microcystic adnexal carcinoma is an uncommon skin appendage neoplasm exhibiting both pilar and sweat duct differentiation. This tumor remains a subject of controversy as to its differentiation profile, histogenesis, and classification which is reflected in the nomenclature used to designate the neoplasm in question. Beyond this controversy the tumor remains a diagnostic challenge because of its rarity, the histologic mimicry it may display, and its banal cytologic appearance; it also poses a therapeutic challenge, as it is characterized by slow but aggressive and destructive local growth extending beyond clinical margins together with a high tendency for perineural invasion and recurrence. OBJECTIVE: We report two cases of this unusual tumor illustrating some of its characteristics. Our review emphasizes the divergent opinions concerning its differentiation profile and its origin. An organoid nevus as the origin of microcystic adnexal carcinoma in one of our patients is discussed in this context.

Adult↗
PubMed1997

[Mohs' method of micrographic surgery as treatment for recurrent basal cell carcinoma].

OBJECTIVE: Evaluation of Mohs' micrographic surgery as treatment for recurrent basal cell carcinoma of the skin. DESIGN: Retrospective. SETTING: University Hospital Maastricht, the Netherlands. METHOD: In the period April 1992 to December 1995, 91 recurrent basal cell carcinomas (88 patients) were treated by Mohs' micrographic surgery. Medical records were analysed retrospectively with respect to different aspects. RESULTS: The mean age of the patients was 69 years. The recurrent basal cell carcinomas, with an mean diameter of 19.7 mm, were mainly localized on the nose and forehead. There were equal numbers of solid and morphea-like types of basal cell carcinomas. Most of these tumours had been treated by means of surgical excision in the past. The last treatment had taken place 3 years previously on average. Reconstruction was performed by means of primary closure, a graft or a flap. The mean follow-up period after Mohs' micrographic surgery was 12 months, in which one tumour recurred. CONCLUSION: Mohs' micrographic surgery is a surgical technique which provides the best prospect of total tumour removal together with maximal functional and cosmetic preservation. Mohs' micrographic surgery is of particular value for the treatment of recurrent basal cell carcinomas.

Adult↗
PubMed1997

Transforming growth factor-beta and bcl-2 distribution patterns distinguish trichoepithelioma from basal cell carcinoma.

BACKGROUND: Trichoepithelioma (TE) and basal cell carcinoma (BCC) have many features in common both clinically and histologically. Despite these many similarities TE and BCC represent different biological entities. OBJECTIVE: Recently, bcl-2 and CD34 have been reported as reliable markers in distinguishing the two types of tumor. Transforming growth factor-beta (TGF-beta), a multifunctional regulator of both cell growth and differentiation, was evaluated in this study. METHODS: The immunohistochemical expression of TGF-beta was compared with the distribution patterns of bcl-2 and CD34 in five BCCs, five TEs, and seven borderline cases. RESULTS: All five TEs showed a diffuse cytoplasmic staining of tumor cells for TGF-beta, whereas four of five BCCs were TGF-beta negative. Of the seven equivocal cases of TE/BCC, five tumors demonstrated TGF-beta positivity in combination with negative bcl-2 staining corresponding to TE. The remaining two cases demonstrated the opposite staining pattern, characteristic for BCC. CONCLUSION: The TGF-beta staining pattern appears to be a helpful additional marker together with bcl-2 in differentiating between TE and BCC. The demonstrated staining differences may relate to the distinct origin and biological behavior of the two tumors and may therefore be of value in subsequent patient management.

Adult↗
PubMed1995

Expression of the apoptosis-suppressing protein Bcl-2 in non-melanoma skin cancer.

Basal cell carcinoma (BCC) is typically a slow-growing malignant tumour, composed of cells similar to those in the basal area of the epidermis. We investigated the expression of bcl-2 (B-cell leukaemia/lymphoma-2) in BCC, and also in squamous cell carcinoma (SCC) of the skin. The proto-oncogene bcl-2 encodes a protein which inhibits programmed cell death (apoptosis). The protein is expressed in basal cells in normal human epithelium, but not in the suprabasal cell layers. Immunohistochemical localization using a monoclonal anti-Bcl-2 antibody revealed bcl-2 expression in all the BCCs (15 patients). SCCs did not express bcl-2 (five patients). The positive Bcl-2 staining of BCC tumour cells supports the hypothesis that BCCs originate from the basal layer of the epidermis. The bcl-2 expression of BCC tumour cells also suggests a neoplastic transformation caused by extended cell survival rather than increased cell proliferation. This type of neoplastic growth is possibly associated with less aggressive tumour behaviour.

Apoptosis↗
PubMed1993

Adhesion molecule expression in venous leg ulcers.

The final stage of chronic venous insufficiency (CVI) is ulceration. Several theories have been suggested to explain the skin changes and ulcerations. However, none of these can fully account for all the alterations which occur. Adhesion molecules are considered to play an important role in inflammatory reactions and in the process of wound healing. The aim of our study was to investigate the expression of intercellular adhesion molecule-1 (ICAM-1), endothelial leucocyte adhesion molecule-1 (ELAM-1), and vascular cellular adhesion molecule-1 (VCAM-1) in venous leg ulcers. Skin biopsies from 8 patients were taken from the surrounding skin of venous ulcers. ICAM-1 showed a weak to moderate expression on the endothelium of capillaries directly below the venous ulcer. A moderate expression of ICAM-1 was found on capillaries in the papillary dermis around the ulcus, similar to that of normal controls. A strong expression of ELAM-1 was only found on capillaries in the infiltrate directly under the ulcer. Some specimens also showed a moderate expression of ELAM-1 around the ulcus. Expression of VCAM-1 was subsequently found to be negative in all patients. The results suggest a disturbed inflammatory reaction in venous leg ulcers. In the area around the ulcer, where healing should initiate, the adhesion of monocytes and lymphocytes to the endothelium and the migration of these cells to the wound area were found to be insufficient.

Adult↗