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The Buschke–Löwenstein tumor (BLT), also known as giant condyloma acuminatum, is a rare, exophytic tumor, arising from pre-existing warty lesions associated with human papillomavirus (HPV) infection, particularly strains 6 and 11, which are considered to have low oncogenic potential. BLT presents as a large, cauliflower-like growth typically affecting the penis, vulva, vagina, perineum, scrotum, anus, and perianal area. Despite being a benign lesion, BLT is locally aggressive with a high recurrence rate, and can potentially undergo malignant transformation into squamous cell carcinoma, contributing to an overall mortality rate of 20–30%. The primary treatment is complete surgical excision with wide margins, frequently requiring complex reconstructive techniques for defect coverage. We report on a 68-year-old patient, with multiple comorbidities, who presented with a two-year history of a large exophytic tumor in the genital region, affecting the penis, along with progressive erectile dysfunction and urinary problems. The tumor was surgically excised with oncological safety margins, and reconstruction was performed using advancement and rotation flaps from the scrotum and intact penile skin. Histopathological examination confirmed the diagnosis of Giant Condyloma (Buschke–Löwenstein tumor), showing acanthosis, papillomatosis, parakeratosis, and koilocytic cell collections, with positive immunohistochemical staining for p16, p63, and ki67. Postoperatively, the patient had a good clinical outcome and a complete surgical cure. This case highlights the critical need for timely intervention and comprehensive management strategies in treating giant condyloma, given its potential for local invasion and substantial impacts on patient quality of life. Early diagnosis and thorough surgical excision are crucial for effective management and to reduce the high recurrence, morbidity and malignant transformation risk associated with this condition. [ABSTRACT FROM AUTHOR]

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Tumor nerve compressions in the upper limb are relatively rare, usually involving ganglion cysts and benign tumors. We present a case series of five patients with peripheral nerve compression in the upper limb due to tumor or cystic masses- ulnar nerve compression in the Guyon’s tunnel due to a ganglion cyst, large median nerve schwannoma compressing anterior interosseous nerve and median nerve, voluminous lipoma compressing median nerve in the proximal forearm, superficial branch of radial nerve compression by a synovial cyst and elbow region lipoma compressing radial nerve. In the beginning, those benign lesions are asymptomatic but, as they continue to grow adjacent to a peripheral nerve clinical manifestations appear progressively as compressive neuropathies. After a preoperative imagistic analysis, tumor resection with careful dissection, in order to preserve the neurovascular structures, is the elective surgical procedure in order to obtain an optimal functional recovery. [ABSTRACT FROM AUTHOR]

Lymphedema represents a chronic condition with impaired lymphatic transport, having primary and secondary etiologies. The most common type of secondary lymphedema in western countries is represented by breast cancer related upper limb lymphedema. This condition, once installed, determines limb structure changes, progressive functional impairment, specific complications, consequently impacting the quality of patient’s life. An accurate diagnosis is mandatory, using both clinical and imagistic methods with clear definition disease extent as per standardized staging systems, in order to further provide an adequate therapeutic strategy. The main therapeutic goal in patients with lymphedema is represented by limb volume reduction with subsequent symptoms relief, improving quality of life and avoiding complications such as recurrent infections. Through this paper, we aim to present a comprehensive overview of current therapeutic options of breast cancer upper limb related lymphedema. Therapeutic approach comprises of non-surgical (conservative) therapy, which is mandatory as initial therapy and surgical procedures for selected cases. Most patients with lymphedema benefit from conservative treatment alone. In non-responsive cases, in patients with progressive disease, in late stage complicated lymphedema, and also recently added as prophylactic strategy, surgical treatment, trough recent developed techniques, offer very good results in long-term control of disease. Surgical options are classified firstly in physiologic procedures that aim to create new lymphatic channels, promote physiologic drainage of the lymph and should be considered early in the course of the disease, and secondly ablative procedures that reduce through liposuction or various excision techniques the volume of the affected limb. Both types of techniques can be combined to ensure the best functional outcome of the patient. [ABSTRACT FROM AUTHOR]

Traumatic dog bite total scalp avulsion is a rare condition. We present a case report on an emergency case, a 52 year old female patient with total scalp avulsion treated in our clinic, with a complex reconstruction using a free microsurgical latissimus dorsi transferred flap. [ABSTRACT FROM AUTHOR]

Treating complex abdominal wall defects is challenging for the reconstructive surgeon as there are many possible complications and high reccurence rates. To date, there is no consensus on a definition of complex abdominal wall defects, as the level of complexity can be different from case to case. Thorough knowledge of the etiology of defects and relevant anatomy, adequate management during hospitalization and in postoperative period are key elements in obtaining optimal functional results. Although the etiology of abdominal wall defects is varied, reconstructive goals are well established, including recovery of structural integrity to ensure visceral coverage and maintenance of intraabdominal pressure, prevention of hernia formation, if possible with an aesthetic pleasant result; long hospitalizations increasing morbidity and costs should be avoided. Choosing the right therapeutic strategy may be very demanding, because there is no standard treating protocol to guide the management of these patients.. We present, through five clinical cases, our experience with managing abdominal wall defects having in mind the general reconstructive priciples and trying to individualize the treatment for each of them. [ABSTRACT FROM AUTHOR]

The thumb is responsible for 40% of the hand function. Therefore, when resurfacing of the thumb is required, cross-finger flap may prove very useful. In this paper, we reported three cases where cross-finger flaps were used successfully in order to cover soft tissue defects of the thumb's distal phalanx. No major complications were encountered. All patients were satisfied with the cosmetic aspect of the reconstruction procedure (9 on VAS). All the fingers were fully functional, with a mean TAM score of 266° for the donor fingers and a mean DASH score of 2.16 after 1 year from injury. Using this technique, we obtain good quality soft and bulky tissue to restore the original form of the thumb in order to prevent function loss by reducing length and primary suture of the finger. Therefore, we consider this method very effective in covering vital structures with almost no morbidity related to the donor site. Alongside other previous papers describing this technique, we concluded that the cross-finger flap is a versatile reconstruction procedure. [ABSTRACT FROM AUTHOR]

The thumb is responsible for 40% of the hand function. Therefore, when resurfacing of the thumb is required, cross-fi nger flap may prove very useful. In this paper, we reported three cases where cross-fi nger flaps were used successfully in order to cover soft tissue defects of the thumb`s distal phalanx. No major complications were encountered. All patients were satisfi ed with the cosmetic aspect of the reconstruction procedure (9 on VAS). All the fi ngers were fully functional, with a mean TAM score of 266° for the donor fi ngers and a mean DASH score of 2.16 after 1 year from injury. Using this technique, we obtain good quality soft and bulky tissue to restore the original form of the thumb in order to prevent function loss by reducing length and primary suture of the fi nger. Therefore, we consider this method very effective in covering vital structures with almost no morbidity related to the donor site. Alongside other previous papers describing this technique, we concluded that the cross-fi nger flap is a versatile reconstruction procedure. [ABSTRACT FROM AUTHOR]