Limited frequency of malignant change in lobular endocervical glandular hyperplasia

IntroductionAlthough lobular endocervical glandular hyperplasia is a benign disorder of the uterine cervix, its potential as a precursor of minimal deviation adenocarcinoma has been reported. However, the natural history of the disease and the frequency of malignant change are not fully understood. We evaluated the frequency of malignant change of clinical lobular endocervical glandular hyperplasia and explored useful parameters indicating malignant change.MethodsThe clinical courses of 175 patients with cervical multi-cystic lesions who visited Shinshu University Hospital between June 1995 and June 2019 were retrospectively analyzed. We examined the results of follow-up and outcomes of the patients diagnosed with lobular endocervical glandular hyperplasia and investigated the frequency of malignant transformation.ResultsOf the 175 patients, 15, 84, and 76 were clinically diagnosed with suspected malignancy, suspected lobular endocervical glandular hyperplasia, and suspected nabothian cyst, respectively. Of these patients, 69 patients with suspected lobular endocervical glandular hyperplasia were followed, and 12 underwent hysterectomy after a mean follow-up of 57.1 (range: 3–154) months due to lesion enlargement (increase in tumor diameter of >20%) and/or worsening cytology. Of these 12 patients, two had lobular endocervical glandular hyperplasia with atypia and one had minimal deviation adenocarcinoma. Of 69 patients, the rate of malignant change was 1.4% (1/69). The growth rates of the lesions for these three patients during follow-up were significantly higher than those of nine patients who underwent surgery with lobular endocervical glandular hyperplasia without atypia and 48 follow-up cases of suspected lobular endocervical glandular hyperplasia. The cut-off value of the growth rate suggesting malignant transformation was 38.1% (84.6% sensitivity and 100% specificity). Tumor size and cytology did not change in the remaining 57 cases continuing follow-up.ConclusionAn increase in tumor size and worsening cytology are important parameters for detecting malignant transformation of lobular endocervical glandular hyperplasia during follow-up. However, the frequency of malignant change of this disease may be limited. These results suggest that conservative management may be an option for clinical lobular endocervical glandular hyperplasia.

Moles (melanocytic naevi)

Many types of melanocytic naevi or moles are very common in children and can cause a lot of anxiety. This chapter gives information on how to diagnose the different types and recognize worrying features. A description of the scenarios for investigation of the uncommon congenital melanocytic naevi is included with onward referral and management suggestions. Acquired melanocytic naevi are very common and usually benign but features suggesting possible malignant change are emphasized and risk factors outlined. Brief descriptions of the variants of melanocytic naevi are given with clinical images. The chapter concludes with a description of the very rare malignant melanoma and its management in children.

Recent advances in the management of penile cancer

Penile cancer is a rare condition and can be very complex to manage. Advances in surgical techniques, imaging, pathological classification and patient pathways have led to improved patient care. The diagnosis of pre-malignant change, penile cancer and metastatic disease along with advances in their treatment are detailed in this review which aims to update clinicians from multiple specialties and countries on penile cancer.

Nevus sebaceous of Jadassohn of face with infundibular and keratinous cyst in an adolescent Arab male-a rare case report

Nevus Sebaceous of Jadassohn is rare hamartomatous skin lesion. We report an interesting case of an Adolescent Arab male 18yr old, who presented to us with a velvety plaque of 7cm length in his left preauricular area. Excision biopsy revealed Nevus sebaceous of Jadassohn with infundibular and keratinous cyst. The lesion is present since birth started as a tiny lesion and grown to the current size. No such large sized lesion on the face has ever been reported in the medical literature till date. We advise an early excision as they have strong potential for malignant change.