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- Perianal Paget Disease: Different Entities With the Same NamePublication . Santos, Marisa D.; Soares, Filomena; Presa-Fernandes, José M; Silva, Donzília SousaExtramammary Paget disease (EMPD) is a rare form of cancer that involves skin areas rich in apocrine glands. The common sites of occurrence include the vulva, perianal region, perineum, and axilla. Perianal Paget disease (PPD) is a subset of EMPD, which arises in the perianal skin. The disease commonly presents with a thickened plaque-like lesion with erythema or white scaly appearance. It is generally classified into two categories based on the origin of the tumor cells: (1) primary PPD if the tumor arises from intraepidermal cells and (2) secondary PPD if cancer originates from the underlying colorectal or urinary tract neoplasm. Due to its rarity, only a few sporadic case reports have been published in the literature, and treatment methods are yet to be standardized. In light of this, we report two PPD cases with different etiopathogenesis and staging: one involved only the perianal skin without regional or metastatic disease, and was not accompanied by visceral adenocarcinomas although there was a previous history of sigmoid adenocarcinoma; the other was probably secondary to an anal canal tumor spreading with disseminated disease involving the perianal and perineum area with bilateral inguinal, pelvic lymph node, and liver metastasis. The treatment plans and the outcomes of both cases were necessarily different from each other.
- First World Consensus Conference on pancreas transplantation: Part II – recommendationsPublication . Boggi, Ugo; Vistoli, Fabio; Andres, Axel; Arbogast, Helmut P.; Badet, Lionel; Baronti, Walter; Bartlett, Stephen T.; Benedetti, Enrico; Branchereau, Julien; Burke, George W.; Buron, Fanny; Caldara, Rossana; Cardillo, Massimo; Casanova, Daniel; Cipriani, Federica; Cooper, Matthew; Cupisti, Adamasco; Davide, José; Drachenberg, Cinthia; de Koning, Eelco J.P.; Ettorre, Giuseppe Maria; Fernandez Cruz, Laureano; Fridell, Jonathan A.; Friend, Peter J.; Furian, Lucrezia; Gaber, Osama A.; Gruessner, Angelika C.; Gruessner, Rainer W.G.; Gunton, Jenny E.; Han, Duck-Jong; Iacopi, Sara; Kauffmann, Emanuele Federico; Kaufman, Dixon; Kenmochi, Takashi; Khambalia, Hussein A.; Lai, Quirino; Langer, Robert M.; Maffi, Paola; Marselli, Lorella; Menichetti, Francesco; Miccoli, Mario; Mittal, Shruti; Morelon, Emmanuel; Napoli, Niccolò; Neri, Flavia; Oberholzer, Jose; Odorico, Jon S.; Öllinger, Robert; Oniscu, Gabriel; Orlando, Giuseppe; Ortenzi, Monica; Perosa, Marcelo; Perrone, Vittorio Grazio; Pleass, Henry; Redfield, Robert R.; Ricci, Claudio; Rigotti, Paolo; Paul Robertson, R.; Ross, Lainie F.; Rossi, Massimo; Saudek, Frantisek; Scalea, Joseph R.; Schenker, Peter; Secchi, Antonio; Socci, Carlo; Silva, Donzília Sousa; Squifflet, Jean Paul; Stock, Peter G.; Stratta, Robert J.; Terrenzio, Chiara; Uva, Pablo; Watson, Christopher J.E.; White, Steven A.; Marchetti, Piero; Kandaswamy, Raja; Berney, ThierryThe First World Consensus Conference on Pancreas Transplantation provided 49 jury deliberations regarding the impact of pancreas transplantation on the treatment of diabetic patients, and 110 experts' recommendations for the practice of pancreas transplantation. The main message from this consensus conference is that both simultaneous pancreas-kidney transplantation (SPK) and pancreas transplantation alone can improve long-term patient survival, and all types of pancreas transplantation dramatically improve the quality of life of recipients. Pancreas transplantation may also improve the course of chronic complications of diabetes, depending on their severity. Therefore, the advantages of pancreas transplantation appear to clearly surpass potential disadvantages. Pancreas after kidney transplantation increases the risk of mortality only in the early period after transplantation, but is associated with improved life expectancy thereafter. Additionally, preemptive SPK, when compared to SPK performed in patients undergoing dialysis, appears to be associated with improved outcomes. Time on dialysis has negative prognostic implications in SPK recipients. Increased long-term survival, improvement in the course of diabetic complications, and amelioration of quality of life justify preferential allocation of kidney grafts to SPK recipients. Audience discussions and live voting are available online at the following URL address: http://mediaeventi.unipi.it/category/1st-world-consensus-conference-of-pancreas-transplantation/246.