Introduction: Merkel Cell Carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of the skin. The main characteristics are frequent local recurrences and disseminations to regional lymph nodes and distant organs. MCC within the lymph nodes in the absence of a primary site is rare and few cases have been reported by the literature.

Case Report: We report a case of MCC presenting as a painless mass in the left inguinal area for 6 months in a 48-year-old women. The histopathology of the excised lesion revealed a poorly differentiated basophilic small cell tumor. The immunohistochemical study finding the diagnosis of a metastatic MCC. Despite extensive clinical and radiological investigation, we failed to identify the origin of the tumor.

Conclusion: Rare cases of MCC confined to a lymph node without an apparent primary site have been reported. We report a new case of MCC in the inguinal lymph node without identification of the primary site.

Background: The US Preventive Services Task Force (USPSTF) recommends screening for smokers based on age, pack-years of smoking, and years since past smokers quit (quit-time). Previous studies determined low dose computerized tomography (LDCT) to be the best method, but have not identified the population at highest risk. This study sought the percentage of lung cancer patients that would have been excluded by USPSTF criteria.

Method: A retrospective chart review identified 170past and present smokers who had undergone lung cancer resection at Hackensack Meridian Health (HMH) hospitals between September 15, 2014 and 2016. Data was collected from the Society of Thoracic Surgeons database. Descriptive statistics and Wilcoxon Rank-Sum tests were used to analyze differences between included and excluded patients.

Results: The percentage of patients that would have been excluded by screening criteria was 46.5% (95% CI: 38.8-54.3%). The difference between ages of included and excluded patients was not quite significant (p=0.051), with only17.1% (95% CI: 11.7-23.6%) of all patients excluded by age. Pack-years of included patients were significantly higher than of the excluded (p<0.001), and 25.3% (95% CI: 18.9-32.6%) had insufficient pack years. Quit-time was also a significant variable (p<0.001) and excluded 37.9% (95% CI: 29.1-49.4%) of past smokers. The percentage included by USPSTF criteria increased from 53.5% to 59.4% when quit-time was set to 25 years, and61.2% when extended to 30 years.

Conclusion: USPSTF criteria would have excluded almost half of the ever-smokers with surgically resectable lung cancers. Age would not have excluded a significant percentage, but inclusion criteria should account for smokers with less than 30 pack-years or who quit over 15 years ago. Future reviews should examine screening efficacy in larger databases. Prospective studies should investigate correlation between age and smoking history, and look to include secondhand smoking and occupational exposure as risk factors for screening.

Introduction: Breast Surgery especially augmentation is a common procedure worldwide. Literature reports relationship between chronic seroma and Anaplastic Large Cell Lymphoma (ALCL) has increased. Recently we reported the first case in Mexico. Risk factors should be evaluated. Seroma seems to be a common event after this type of surgery. Chronic seroma seems to be most common symptom in ALCL

Methods: Survey was conducted during Security Conference in breast implant augmentation, to know features as breast implants ratio in private practice of plastic surgeons, type of implant used, surgical technique and complications. Descriptive statistics including measures of central tendency were estimated.

Results: 72 members answered the survey. Implant placement is a procedure performed frequently. Preference is textured implants with volume between 300cc and 360cc. The most common complication was seroma. Reoperation was related with capsular contracture and patient no satisfaction.

Discussion: Seroma is a common complication. Possible relation with biofilm and Anaplastic Large Cell Lymphoma should be evaluated. Lymphoma is not a common finding in breast implant but long lasting infection can be considered as risk factor. Measures to prevent seroma should be proposed. Analysis from the type of textured in the coverage of the implant should be evaluated.

Conclusion: This information allows us to take further action to direct sessions, courses and conferences, to decrease the frequency of seroma and prevent complications being one of the procedures most frequently performed by the membership.

In spite of the good organ preservation strategies available for locally advanced Head and Neck Squamous Cell Carcinoma (HNSCC), failure rates have been reported to be as high as 35-50%. There has been an increasing interest in predicting response to treatment, to aid early intervention and better outcomes. FDG-PET is a standard modality for post treatment evaluation, however it is still under utilized as a pre-treatment investigative modality. Several articles have described quantitative parameters in pre-treatment FDG-PET to prognosticate patients and determine likelihood of response to treatment however they are still not used commonly. This article was a review of the literature available on pre-treatment FDG PET quantitative parameters and their value in predicting failure. A thorough review of literature from MEDLINE and EMBASE was performed on pre treatment quantitative parameters in HNSCC. Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG) were reliable parameters to predict response to organ preservation therapy, disease free and overall survival. SUVmax was an inconsistent parameter. MTV and TLG may help predict poor response to organ preservation to initiate early surgical salvage or modify therapeutic decisions to optimize clinical outcomes. Routine incorporation into PET reporting may provide additional information over SUVmax alone.

Thyroglobulin levels ≥50 μg/L following thyroidectomy and I131 ablation correlate with poor prognosis in patients with high risk Differentiated Thyroid Cancer (DTC). We describe a case of a 54 year old woman with differentiated thyroid cancer and high thyroglobulin up to 220 μg/L following thyroidectomy and I131 ablation who demonstrated marked response to a novel immunotherapy involving autologous tumor cell transfected with a GMCSF/bi-shRNA furin expressive plasmid (Vigil). Activity is highlighted by four year disease free survival in correlation with immune activation as measured by ELISPOT assay of peripheral blood mononuclear cell reaction to autologous tumor. Further investigation with Vigil in differentiated thyroid cancer is warranted.