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In dermatology, a keloid is one of the most common skin morphological abnormalities caused by excessive proliferation of fibroblasts. Keloids that are large or occur near important joint sites often cause varying degrees of physiological dysfunction in patients, therefore requiring medical treatment. A boy with congenital syndactyly developed huge keloids at the surgical site after undergoing surgical correction treatment. After treatment using trepanation combined with superficial radiotherapy (SRT-100) in our hospital, most of the boy’s keloids shrank and flattened. The affected foot returned to its normal appearance, and the boy could wear shoes normally. The boy did not complain of pain, numbness, or any other distinctive discomfort after completing the treatment. This suggested that the combination of trepanation and SRT-100 may be one of the options for treating hypertrophic keloids that cannot be treated by surgical excision.

Background: The E3 ubiquitin ligase neural precursor cell expressed developmentally downregulated 4-1 (NEDD4-1) negatively regulates phosphatase and tensin homolog deleted on chromosome 10 (PTEN) protein levels through polyubiquitination and proteolysis, but its significance in lung cancer is still unclear. This study investigated the expression and the role of NEDD4-1 in tumor development and chemosensitivity of lung adenocarcinoma (ADC). Methods: We retrospectively investigated the expression and significance of NEDD4-1, PTEN, and p-Akt proteins in 135 paired ADC and adjacent noncancerous tissue specimens using immunohistochemistry. Furthermore, we evaluated the relationship between NEDD4-1 expression and clinicopathologic characteristics and prognosis. The effects of small interfering RNA against NEDD4-1 on proliferation and chemosensitivity were examined in A549 cells in vitro using 3- (4,5-dimethylthiazol-2-yl) -5-(3-carboxymethoxyphenyl) -2-(4-sulfophenyl)- 2H-tetrazolium method. The ability of migration and invasion of A549 cells was tested by transwell assay. Moreover, reverse-transcription quantitative polymerase chain reaction and Western blotting analyses were used to determine the expression of NEDD4-1, PTEN, phosphoinositide 3-kinase (PI3K)/Akt activity, and its downstream target proteins. Results: NEDD4-1 protein was significantly upregulated in lung ADC tissues, whereas it was weak or negative in normal lung epithelial cells. The expression of NEDD4-1 in ADC (78.5%, 106/135) was significantly much higher than that in adjacent normal lung tissue (13.3%, 29/135, P < 0.01), and it was associated with lymph node metastasis, tumor-node-metastasis (TNM) stage, and chemotherapy resistance. PTEN expression was downregulated in lung ADC (60.7% vs. 100.0% in noncancerous specimens, P = 0.007), and was negatively correlated with lymph node metastasis, histological variants, clinical stage, chemoresistance. In addition, expression of p-Akt in ADC tissues (71.1% 96/135) was much higher than that in adjacent lung epithelial cells (6.7%, 9/135, P < 0.01). Kaplan-Meier and multivariate analysis demonstrated that expressions of NEDD4-1 and PTEN were both independent risk factors for survival in patients with lung ADC. NEDD4-1 knockdown in vivo decreased proliferation, migration, and invasion and improved chemosensitivity to cisplatin and paclitaxel in A549 cells. NEDD4-1 knockdown also significantly enhanced PTEN expression and inhibited p-Akt activity and downstream target proteins. Conclusions: NEDD4-1 upregulation may contribute to the progression of lung ADC. NEDD4-1 may regulate the proliferation, invasion, migration, and chemoresistance of lung ADC cells through the PI3K/Akt pathway, suggesting that it may be regarded as a therapeutic target for the treatment of lung ADC.

Objective To investigate the clinical manifestations and pathological characteristics of pulmonary papillary adenocarcinoma with psammoma bodies metastasis to right frontal lobe of brain. Methods The clinical manifestations, pathological features and differential diagnosis were studied in one case of pulmonary papillary adenocarcinoma with psammoma bodies metastasis to right frontal lobe. Related literatures were also reviewed. Results A 56-year-old male suffered from intermittent headache for 3 years in fronto-occipital region without significant incentives. Cranial MRI examination revealed a space-occupying lesion in right frontal lobe, which was considered as meningioma. In operation, the tumor located in the right frontal lobe was tough and red-grey in color, with clear boundary and abundant blood supply. Histopathological examination revealed the tumor was arranged in papillary pattern. The tumor cells were large, with eosinophilic cytoplasm, round or oval nuclei and small red nucleoli. Especially, a plenty of psammoma bodies were found in tumor tissue and mesenchymal tissue. Immunohistochemical staining found that the tumor cells were positively expressed for cytokeratin (CK), epithelial membrane antigen (EMA), CK19, thyroid transcription factor-1 (TTF-1) and Napsin A, and showed focal positive expression of P53. Ki-67 labeling index was 5%-10%. The tumor cells were negative for glial fibrillary acidic protein (GFAP), S-100 protein (S-100), thyroglobulin (TG), Galectin-3 protein, progestrone receptor (PR) and vimentin (Vim). Combined with the results of chest 18F-FDG-PET CT, the final diagnosis was pulmonary papillary adenocarcinoma with psammoma bodies metastasis to right frontal lobe. The patient underwent auxiliary radiotherapy and chemotherapy after operation. The patient was followed for 12 months and no recurrence was seen. Conclusions This case is very rare. Understanding the patient's history and differentiating from other primary intracalvarium tumors is one of the key steps to give the right pathological diagnosis and clinical therapy. In order to avoid disdiagnosis, the diagnosis needs to be differentiated from other primary intracalvarium tumors, including papillary meningioma, papillary tumor of choroid plexus, papillary ependymoma, papillary glioneuronal tumors as well as metastatic papillary thyroid carcinoma. DOI: 10.3969/j.issn.1672-6731.2015.06.009

Objective To investigate the clinical manifestations and pathological features of parotid gland papillary acinic cell carcinoma metastasis to left cavernous sinus. Methods The clinical manifestations, pathological features and differential diagnosis were studied in one case of parotid papillary acinic cell carcinoma metastasis to left cavernous sinus. Related literatures were also reviewed. Results The patient was a 50-year-old female who presented paroxysmal dizziness for 5 months and blurred vision in her left eye for 10 months. The MRI examination showed left parasellar space-occupying mass in the cavernous sinus. In operation, the tumor was located in the superior wall of left cavernous sinus, soft and red-grey in color, with abundant blood supply. The histomorphological examination revealed the tumor cells were arranged in solid, acinar or papillary pattern. The tumor cells were large, with eosinophilic cytoplasm, round or oval nuclei and small nucleoli. Immunohistochemical staining found that the tumor cells expressed cytokeratin (CK), epithelial membrane antigen (EMA), vimentin (Vim) and S-100 protein (S-100), and showed weak positive expression of glial fibrillary acidic protein (GFAP) and focal positive expression of P53 protein. Ki-67 labeling index was about 5%-10% . The tumor cells were negative for neuroendocrine markers and pituitary hormone protein markers. This case was difficult to differentiate from other primary intracalvarium tumors, including papillary meningioma, papillary tumor of choroid plexus, papillary ependymoma, papillary glioneuronal tumors as well as chordoma. According to the medical history and the comparison of histomorphology and immunophenotyping between parotid gland tumor cells and left cavernous sinus tumor cells, the final diagnosis was metastatic papillary parotid acinar cell carcinoma of the left cavernous sinus. The patient was followed for 21 months and no recurrence was seen. Conclusion It is very rare and to our knowlege it is the second case with metastasic papillary parotid acinar cell carcinoma in the cavernous sinus. Understanding the patient's history and differentiating from other primary intracalvarium tumors is one of the key steps to give right pathological diagnosis and clinical therapy. doi：10.3969/j.issn.1672-6731.2013.12.008

The article focuses on the successful treatment of hypertrophic neurodermatitis using superficial radiation therapy (SRT‑100), resulting in significant improvement and lesion disappearance. Topics include the challenges in managing neurodermatitis, the efficacy of superficial radiation therapy, and the development of a treatment plan based on existing literature and safe radiotherapy doses.