Latest Updates

Sarcoma: Vascular Tumors (EHE and Angiosarcoma)

Anne Grand'Maison, MD, John M Kane III, MD, Kilian Salerno, MD
    • The potential use of propranolol for beta-adrenergic blockade in the treatment of advanced angiosarcoma
    • Antiendoglin antibody (TRC 105) targeted therapy in clinical trials for the treatment of advanced angiosarcoma
    • The fusion gene WWTR1-CAMTA1 as an important diagnostic tool in challenging cases of epithelioid hemangioendothelioma

Surgical Treatment of Female Stress Urinary Incontinence: Pubovaginal Slings

Alex Gomelsky, MD, Tameem Islam, MD, Umar R Karaman, MD

    • • ARF PVS has similar outcomes to MUS procedures in index patients.
      • ARF PVS is the procedure of choice for women undergoing concomitant repair of urethrovaginal fistula, urethral diverticulum, or urethral mesh erosion.
      • Outcomes after ARF PVS in women with recurrent SUI may be similar to those in women undergoing primary repair.

Upper Extremity Compartment Syndrome

Jacob M Kirsch, MD, Jeffrey N Lawton, MD, Simon Lee, MD
    • Acute compartment syndrome (ACS) of the upper extremity is commonly associated with trauma; however, over 20% of cases occur in the absence of a fracture.
    • A high index of suspicion is required for ACS, particularly in the obtunded or insensate patient.
    • Clinical examination findings can be highly variable and have a low sensitivity. Always perform serial examinations and monitor for any change over time.
    • Pain out of proportion to passive stretch of the involved compartment is often the most reliable clinical sign.
    • Compartment pressure measurements can be used to aid diagnosis but should not be used independently to diagnose ACS.
    • Surgical management consists of an emergent thorough fasciotomy of all involved compartments.
    • Functional outcomes following fasciotomy are generally good if addressed acutely. Higher complication rates may occur following delayed diagnosis and management.

Hypertension

Marc P Bonaca, MD, MPH
    • Increasing recognition of the importance of home-based and ambulatory blood pressure monitoring reflected in expanded indications for use
    • Specific guidance from professional societies with regard to patients with chronic kidney disease
    • Recent clinical outcomes trials adding important data about optimal treatment targets
    • Recent clinical outcomes trials adding important data regarding treatment in the elderly

Adjustment Disorder and Its Clinical Management

Mauro Giovanni Carta, MD, Antonio Preti, MD
    • Adjustment disorder is an often-applied diagnosis in clinical settings.
    • Despite its prevalence, few hints are available about its treatments.
    • In people who died by suicide, a past diagnosis of adjustment disorder is often found.
    • A past diagnosis of adjustment disorder is related to high all-cause mortality.

Rare Fibroblastic and Myofibroblastic Tumors

Yu Liang, MD, PhD, Laleh Melstrom, MD, MS, FACS, Vasilena Zheleva, MD
    • Advances in cytogenetic analysis allowing more accurate diagnosis of these rare tumors, some of which have specific gene rearrangements
    • Advances in targeted therapies such as crizotinib for tumors with ALK gene rearrangements
    • Advanced in radiation therapy allowing dose escalation to the target with sparing of normal tissue (as in intensity modulated radiotherapy)

Rare Fibroblastic and Myofibroblastic Tumors

Yu Liang, MD, PhD, Laleh Melstrom, MD, MS, FACS, Vasilena Zheleva, MD
    • Advances in cytogenetic analysis allowing more accurate diagnosis of these rare tumors, some of which have specific gene rearrangements
    • Advances in targeted therapies such as crizotinib for tumors with ALK gene rearrangements
    • Advanced in radiation therapy allowing dose escalation to the target with sparing of normal tissue (as in intensity modulated radiotherapy)

Axillary Metastasis with Occult Primary Breast Cancer

Roberto Diaz, MD, PhD, Laila Khazai, MD, Anne Kuritzky, MD, Christine Laronga, MD
    • • Use of breast MRI in the detection of occult primary breast cancer
    • • Use of immunohistochemical stains to identify the primary tumor source
    • • Emerging role of breast conservation in the treatment of occult primary breast cancer
    • • Need for ipsilateral breast radiation in occult primary breast cancer
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