Post Excision Research Articles

Cutaneous tissue samples show significant shrinkage during histopathological work-up: a real-world study.

Excision and histological examination of cutaneous neoplasms are very common diagnostic and therapeutic procedures in dermatological practice. There are often discrepancies between tissue seize in vivo and after histopathological work-up. This may raise questions according to tumor sizes or safety margins. To investigate the effect of excision and histological processing on the properties of cutaneous neoplasms in real-life 401 specimens in 324 patients were prospectively investigated. Delineated excision margins of cutaneous neoplasms were documented prior to (T0) and post excision (T1). Length, width and thickness were measured after ≥48 h of formalin fixation (T2) and after sectioning (T3) on final histological slices. Accompanying parameters such as patient age, gender, anatomical site, and tumor entity were evaluated. All post-processed tissue exhibited a significant (P<0.001) median (interquartile range) reduction in length, width and thickness of 21.0% (9.5-30.0), 30.7% (20.0-40.0), and 28.0% (4.8-46.7), respectively, irrespective of site, patient age or tumor entity. Maximum median (IQR) reduction for the length and the width was observed right after excision (17.0% [4.3-25.0] and 14.0% [11.1-28.6] reduction). No significant median (IQR) tissue changes between T1 and T2 were observed (length: 4.8% (-4.3-13.3); width: 0% (-17.6-11.1); thickness 0% (-32.0-20.0). Subgroup analyses showed significantly greater tissue shrinkage in younger patients and for tissue sample sites (trunk or lower extremities). Most relevant shrinkage of cutaneous samples occurs right after excision. Age- and site-depended tissue contractility can influence these effects. Formalin fixation does not affect tissue shrinkage. Smaller tissue sizes on histopathological reports are to be expected.

Malignant proliferating trichilemmal tumor in male: A rare case entity with diagnostic dilemma

Abstract Trichilemmal tumor is a rare hair follicle tumor that is, thought to occur from a malignant transformation of a benign trichilemmoma. The tumor develops from the outer root sheath of the hair follicle. The patient underwent a wide local excision with 1 cm clear margin. The defect was covered by split thick skin graft harvested from ipsilateral thigh after consulting the plastic surgery department. Trichilemmal cyst can be misdiagnosed as other cutaneous lesions. Like in our case, initial FNAC was suggestive of a epidermoid cyst but post excision Histopathological examination gave us the real picture of a trichilemmal tumor. Recurrent tumors are very rare and can get misdiagnosed as squamous cell carcinoma. Malignant proliferating trichilemmal tumors are rare cutaneous tumors that are very rare in males. These tumors can be misdiagnosed as squamous cell carcinoma and require external stimuli for malignant conversion from benign counterparts. Wide local excision is sufficient for treatment.

Non-Vascularized Fibular Bone Graft for Giant Cell Tumor of the Distal Ulna: A Case Report

Abstract: Cases of bone giant cell tumors (GCT) are rarely found, generally benign and locally aggressive tumors. Surgical resection is the universal standard for treatment of bone GCT. Non vascularized fibular graft (NVFG) is useful in the reconstruction of skeletal defects, especially in cases of scarred and avascular recipient sites and patient with tumor surrounded by poor tissue condition. We report a 53-year-old woman, with a lump in her left hand for three years. X-ray examination revealed a mass with firm border and regular edge that reached the epiphysis expansively with thinning of the cortex in the distal region of the left ulna. Tumor excision was performed with open reduction internal fixation (ORIF) and fibular bone graft. To date, GCT is one of the most obscure and intensively examined bone tumors, and its histological images do not predict the clinical outcome. Moreover, many unanswered questions regard to the treatment and prognosis without any consensus regarding the ideal treatment selection. NVFG osteosynthesis shows encouraging results, and adequate therapy, wound care and patient compliance affect the patient’s outcome. In conclusion, NVFG and internal fixation are effective options for post tumor excision, and osteosynthesis has encouraging result. Keywords: non vascularized fibular graft (NVFG); giant cell tumor; bone graft; ulna

Factors predicting seizure outcome after surgical excision of meningioma: SOLID-C guideline for prophylactic AED

BackgroundSeizures are commonly seen among meningioma patients and may cause impaired quality of life. These patients can be effectively treated with surgery. Still, many patients have persistent seizure episodes after surgery. The factors which are associated with worsening of seizure episodes remain critical in improving the quality of life for such patients. In this study, we aim to analyze the clinical and histopathological factors to predict the post excision seizure-outcome in meningioma and need of antiepileptic prophylaxis for these patients. MethodsAdult patients who underwent primary resection of meningioma at our institute between 2007 and 2020 were included in the study. Eligibility criteria were as follows: (i) Surgery for newly-diagnosed biopsy proven meningioma, (ii) Presence of pre-operative seizure (iii) A follow-up period ≥ 12 months. ResultsOf the 1145 patients in this series, 333 patients were recruited in study. The major determinants of prophylactic anti-epileptic were tumour size (S), Oedema (O), location (L), inclusion body (I), antiepileptic drugs (D) and surgical complication (C). The factors independently associated with poor seizure control after surgical resection were presence of brain parenchyma invasion (p < 0.001), pre-operative use of > 2 antiepileptics (p = 0.016) and presence of intranuclear inclusion bodies (p = 0.001). ConclusionsThe identification and consideration of factors associated with prolonged seizure control after surgery may help us to guide treatment strategies aimed at improving the quality of life for patients with meningiomas. Authors have proposed a SOLID-C guideline to avoid the blanket approach of prophylactic AED in patients undergoing for meningioma resection.

SAT193 Double Trouble: A Case of Ipsilateral Double Parathyroid Adenoma

Abstract Disclosure: J.P. Suelto: None. G.D. Wassmer: None. Background: Eighty percent of the cases of Primary Hyperparathyroidism is caused by a single adenoma and only about 15% are multiglandular adenoma. Parathyroid imaging like Sestamibi is less sensitive in detecting multiglandular disease. Clinical Case: A 63 year-old female presented with intermittent left lower back pain for 7 years. There was no joint pain, weakness, urinary symptoms, constipation and abdominal pain. In 2019, due to persistence of left back pain, abdominal ultrasound done showed a right non-obstructing nephrolithiasis. Ionized and total calcium were elevated at 1.53 meq/L (NV 1.12-1.32 meq/L) and 11.35 ng/dl (NV 8.42-10.23 ng/dl) respectively with normal creatinine, phosphorus and albumin. PTH was elevated at 116.6 pg/ml (NV 10-65 pg/ml). Primary Hyperparathyroidism probably secondary to parathyroid adenoma was considered. Thyroid ultrasound showed right thyroid cyst but no enlarged parathyroid gland. Parathyroid imaging using Dual Isotope Subtraction Method neither showed evidence of adenoma. Patient was advised parathyroidectomy but did not consent hence started on Cinacalcet. In 2021, ionized calcium was still elevated to 1.58 meq/L with elevated PTH 151 pg/ml and low Vitamin D level 22.76 ng/ml (&amp;gt;30 ng/mL). Patient was given Vitamin D3 2000 IU daily and Cinacalcet was up-titrated to 60mg daily. Sestamibi/SPECT CT showed faint focus of radioactivity in the right thyroidal bed area suspicious for parathyroid adenoma or hyperplasia. She then agreed to have parathyroidectomy. There was no decrease in PTH after removal of the right inferior parathyroid gland (measuring 1.8x0.6x0.6cm, weighs 500mg), hence re-exploration was done. It was only after the removal of the right superior parathyroid gland (measuring 2.8x0.9x0.7cm, weighs 1 gram) when the 5 and 10 minute post excision PTH decreased to 123.91 and 76.01 pg/ml respectively from preincision PTH of 407.19 pg/ml. Histopathology showed Parathyroid adenoma of right inferior and superior parathyroid glands. No further evidence of hypercalcemia was noted at 6-month follow-up. Conclusion: Double adenoma is reported in 2% to 12% of patients with primary hyperparathyroidism. This occurs predominantly as bilateral superior in 45% and on same side of the neck in 18%. Sestamibi scanning is poor in the presence of multiglandular disease. It was observed that the presence of oxyphil cells may cause longer sestamibi retention in parathyroid tissues. Given the same amount of oxyphil cells in ipsilateral adenomas, the tracer may be distributed hence faintly seen on imaging. Addition of SPECT/CT/4D CT may improve the anatomical localization. Another reason for false negative imaging in this patient can be due to use of Cinacalcet which may decrease scintigraphy uptake of parathyroid adenoma. The combination of preoperative imaging localization and intraoperative PTH monitoring permits successful surgical outcome. Presentation: Saturday, June 17, 2023

Aesthetic subunit reconstruction of basal cell carcinoma face

Background: Arising from the basal cell layer of epidermis; BCC is one of the most common cutaneous malignancy encountered in elderly (77%) followed by SCC (20%) and malignant melanoma (3%). Method: A prospective observational study was conducted at department of plastic and reconstructive surgery with 50 patients included for over a span of 2 years. Patients with biopsy confirmed BCC lesion over face were included and were grouped on the basis of subunit involved and type of flap done. Results: The 50 patients were included which comprised of 16(32%) males and 34 (68%) females. Mean age was 61±10.2 years. Smallest defect size was of 1.5 cm2 whereas largest defect size was of 5 cm2. Cheek was the most common site of occurrence. Cheek advancement flap was the most commonly performed flap. Conclusions: Reconstruction of facial subunit post BCC excision with local tissue has superior aesthetic outcome in terms of colour and texture than any other modality.

A comparative study of clinical outcome in ALT free flap reconstruction using superficial or deep and single or dual recipient vein anastomosis in different sites

AbstractBackgroundDuring the free flap surgery obtaining a suitable recipient vein is an important factor for successful outcome. As in all other flaps even in ALT flap, single or double venous anastomosis, superficial or deep venous anastomosis is still a matter of debate among the micro vascular surgeons. Though dual vein anastomosis is a time‐tested method, single vein anastomosis has the advantage of reducing the operative time and hospitalization cost. Similarly, in situation where the deep veins are dubious superficial veins are savior. This study explores the outcome of ALT flap using different system of recipient veins.Patients and MethodsRetrospective analysis of the 54 free ALT flaps performed over a period of 5 years from June 2017 till June 2022, was carried out. Out of 54, 38 (63%) were male patients and 16 (37%) were females. The outcome of the flaps was evaluated in single or dual anastomosis group. Similarly, the outcome of the flaps with deep or superficial vein anastomosis was also evaluated. The flaps outcomes are evaluated as favorable (successful as well as partial loss are considered as favorable) and unfavorable (complete loss of the flap).ResultsAmong the 54 flaps, 31 patients had lower limb reconstruction, majority were post‐traumatic defects. Twenty patients had head and neck reconstruction following post malignancy excision. Three patients had upper‐limb reconstruction for post traumatic and burn injury defects. The outcome was analyzed. Twenty patients had dual vein anastomosis, 90% (18 out of 20) of patients had favorable outcome and 10% (2 out of 20) had unfavorable outcome. Thirty‐four patients underwent single vein anastomosis, 94% had favorable outcome and 6% had unfavorable outcome. The result was not statistically significant as p &lt; .05. Seven patients underwent superficial vein recipient anastomosis, and all flaps were (100%) successful and no failure, whereas out of 27 patients who had undergone deep vein anastomosis 25 (92%) had favorable outcome and 2 (8%) had unfavorable outcome. The results were not statistically significant as p &gt; .05.ConclusionAs in other free flaps venous anastomosis compromise is the cause for flap failure in majority of the times. Whenever possible, dual vein anastomosis should be considered. But when impervious, single vein anastomosis can be resorted to without any hesitation. Similarly, unavailability of deep veins should not deter the surgeons. Superficial veins were a savior in such situation and can be advantageous too.

Incidence and risk factors of steroid-induced ocular hypertension following pterygium excision with conjunctival autograft

Background: Topical steroids are used to reduce post-operative inflammation after ocular surgery with the potential risk of ocular hypertension, glaucoma and blindness. There is a paucity of published data globally and locally on steroid-induced ocular hypertension (SiOH) post pterygium excision(PE) with conjunctival autograft (CAG). Objective: We aimed to determine the incidence and risk factors of SiOH post-PE with CAG in Korle-Bu Teaching Hospital, Accra, Ghana. Methods: In this prospective observational study, the demographic and clinical data of patients undergoing PE with CAG were collected and analyzed. Post-operative intraocular pressures (IOP) were measured on days 1, 7, 14, 28, and 42. The cumulative incidence of SiOH (proportion of the increase in IOP ≥10mmHg at six weeks compared to baseline) and mean change in IOP from baseline were computed. Risk factors of SiOH were determined using a multiple logistic regression model. The Kaplan-Meier survival curve was used in estimating the median time to develop SiOH. Results: Overall, 101 patients participated in this study with a mean age of 46.8±11.9 years. The majority (65.3%, n= 66/101) of participants were females. The mean pre-operative IOP in the study eyes was 15.3±3.0 mmHg. The overall mean post-operative IOP was 18.6±2.8 mmHg (p= 0.001). The overall incidence of SiOH six weeks post-PE with CAG was 32.7% (95% confidence interval (CI)= 23.7-42.7%). Male sex was the only independent factor associated with the development of SiOH [odds ratio (OR) = 3.3; 95% CI = 1.1-9.7; p= 0.032]. The median time to develop SiOH was 42 days (95% CI= 37.1-46.9 days, p= 0.022). Conclusion: The study showed that SiOH post-PE is a common complication with an overall six-weeks post-excision incidence of 32.7%. Males are more likely to develop SiOH after PE with CAG. Patients undergoing PE with CAG should be closely monitored postoperatively to prevent complications associated with prolonged raised IOP.

CLINICO-EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH RHINOSPORIDIOSIS AT TERTIARY CARE CENTRE: AN OBSERVATIONAL STUDY

Introduction: Rhinosporidiosis is a rare chronic granulomatous infection of the mucous membranes caused by Rhinosporidium seeberi. It is mostly prevalent in India and Sri Lanka. In India, the disease is endemic to Chhattisgarh, South India (mostly Kerala &amp; Tamil Nadu), West Bengal and Odisha. To observe the clinical presentati Aim: on and epidemiological factors in Rhinosporidiosis. We conducted a descriptive, cross-sectional Materials and Methods: study in 42 clinically diagnosed Rhinosporidiosis cases, who were surgically treated in the department over a period of 1 year, from October 2021 to October 2022 and diagnosis was confirmed by post excision histopathological examination. Results: This study involved 42 clinically diagnosed cases of Rhinosporidiosis. Majority (76.2%) of patients were males and 23.8% were females. The male to female ratio was found to be 3.2:1. Most common age group was 11-20 years. All 42 patients had history of pond bathing and 60% cases were from Rural area. 54.8% of cases belonged to lower middle and 40.5% cases belonged to lower socio-economic class. 97.6% cases had mass in Nose and nasopharynx, most common presenting complaint was Nasal obstruction (92.85%). Most common Site of attachment of mass was Inferior meatus (45.23%) and Nasopharynx (38%). O+ was most common blood group seen in 19 cases (45.23%) followed by A+ in 12 (28.57%), B+ in 8 (19%). The results of the study showed that the disease was associated with male g Conclusion: ender, young and middle age, low socio-economic status, rural population and pond bathing and O+ blood group. Most common site involved was Nose and Nasopharynx and most common attachment of mass was seen in inferior meatus

A Case Report on Recurrent Trichilemmal Carcinoma of Scalp- Role of Clinico-Radiological Correlation

Purpose: To evaluate diagnosis of Trichilemmal carcinoma scalp with clinico-radiological and pathological correlation. Introduction: Trichilemmal carcinoma is a rare slow growing malignant adnexal tumour that originates from the external hair sheath of hair follicle accounting for &lt;0.005% of adnexal carcinoma 1 . It mimics squamous cell carcinoma, basal cell carcinoma, sebaceous carcinoma. Rarity, indolent clinical course inspite of local aggressiveness and a good survival rate post excision further undermine the importance of this unique entity. Herewith, we are reporting a case of recurrent trichilemmal carcinoma of scalp presented to the outpatient department of Radiation Oncology at our institute

Determinants of Keloid recurrence: The Nairobi keloid recurrence scoring system; A cohort, prospective study

BackgroundKeloid disease is a fibro-proliferative disorder characterized by excessive deposition of collagen. Keloids has shown high recurrence rate. We undertook this study to determine what factors influence recurrence of the disease with the aim of developing a keloid recurrence scoring system. MethodsThis was a cohort prospective longitudinal study of patients who presented with keloids, managed by surgical excision followed by post excision radiotherapy. Post-surgery patients were followed up for at least two years to determine recurrence. Variables analyzed included patients’ history, clinical presentation and keloid histology. Data captured were analyzed using SPSS version 21. Student T-test and Chi-square test were used to compare means and frequencies respectively at 95% confidence level (P-Value <0.05). Multi regression analysis was done to determine the contributions of various variables to keloid recurrence. ResultsNinety patients were followed up in the study for duration of two years. Overall keloid recurrence was 21% with male patients having a significantly higher recurrence rate of 31% compared to the female at 12%. The recurrence rates were also higher in familial keloids at 27.7% compared to sporadic keloids at 18.5%. Other factors that influenced recurrence included anatomical location, patient's blood group and histological composition of the keloid. Multiple regression analysis done demonstrated that gender and family history was the biggest contributor to keloid recurrence. ConclusionKeloid recurrence is influenced by many factors including family history, clinical presentation and keloid histology. A Keloid recurrence scoring system encompassing these factors could assist in the determination of post excision management as well as prediction of the likelihood of recurrence.

In-Situ 'Divide' and 'Deliver': A Simple Technique to Preserve Nerves in Chimeric Anterolateral Thigh Flap Harvest.

Anterolateral thigh (ALT) flap is the workhorse for reconstruction in head and neck post cancer excision. Chimeric multi-paddle flaps are useful for composite defects involving skin, mucosa, and soft tissue. The nerve to vastus lateralis (VL) runs along the pedicle, frequently interdigitating with it or the perforators. Sometimes, the nerve may be preserved during harvest but needs to be sacrificed frequently, leading to increased donor site morbidity. We recommend a simple technique to preserve the nerve, wherein the skin paddles or chimeric components are divided in-situ and manipulated around it without causing injury. This technique was used in 27 cases over 5 years. All involved nerves, perforators and pedicles were preserved. The technique can be extended to any flap harvest with multiple perforators with nerves in proximity, when multiple skin islands are desired.

Metastatic Renal Cell Carcinoma: An Enigmatic Nasal Mass.

Metastatic Renal Cell Carcinoma rarely presents in head and neck and is even rarer in the sinonasal region. However, a sinonasal metastatic mass is usually of RCC origin. These metastases may present prior to the renal symptoms or may appear after primary treatment. Report a 60-year lady with epistaxis due to metastatic RCC. Calculate total published cases of sino-nasal metastasis of RCC. Classify according to sequence of primary and metastatic presentation. A computer aided search of PubMed and Google scholar databases was done using pertinent combinations of the keywords "renal cell carcinoma", "nose and paranasal sinus", "metastasis", "delayed metastasis" and "unusual presentation", revealing 1350 articles. 38 relevant articles were included in the review. Our case presented with epistaxis 3years after primary RCC. She had a vascular left sided nasal mass which was excised enblock. Immunohistochemistry confirmed metastatic RCC. She is on oral chemotherapy and asymptomatic 1year post excision. Literature search revealed 116 such cases. 19 patients presented within 10years of RCC while 7 more were delayed metastasis. 17 cases presented primarily with nasal symptoms with subsequent incidental renal mass. Chronology of presentation was unavailable in the rest 73 cases. We recommend to consider the diagnosis of sinonasal metastatic RCC in a patient presenting with epistaxis or nasal mass, particularly with a past history of RCC. Also, any person with known diagnosis of RCC should undergo regular ENT examination for early diagnosis of sinonasal metastasis.

Multiple cerebral abscess caused by Klebsiella pneumonia on post tumor excision procedure

A cerebral abscess can happen due to a nearby brain infection, other rare body parts spread, head injury and surgery procedures. Intracranial Klebsiella pneumoniae infection rarely happens and usually occurs in immunocompromised patients. We reported a case of a 50 years old immunocompetent woman with prior tumor excision that progressed to a cerebral abscess. The patient came to the ER unconscious with progressive right-side weakness, pus from previous operation scar, fever and headache since few days’ pre-admission. Laboratory findings were leukocyte 13.710, neutrophil 9%, CRP 7.6, and negative HIV test. The contrast CT scan resulted in a multiloculated ring enhancement left frontal lobe lesion sized 5.8x6.9x5.0 cm and perifocal oedema. Open craniotomy managed to evacuate ±40cc. The microbiology culture tested positive for Klebsiella pneumoniae. Despite proper technique and administration of prophylaxis antibiotics, severe infection that requires immediate intervention still develops in a small group of patients. Klebsiella pneumoniae is a common pathogen causing cerebral abscess in both immunocompromised and healthy patients. Pus drainage and immediate antibiotics administration improved all symptoms, including hemiparesis. This case highlights the importance of quick and right therapy.

34219 Hypersensitivity reaction to tattoo pigment secondary to checkpoint inhibition

Immune checkpoint inhibitors are known to have a variety of dermatologic side effects, including granulomatous or sarcoidal inflammatory eruptions. Rarely, patients with permanent tattoos have had granulomatous reactions to immunotherapy. We present, herein, a case of a hypersensitivity reaction to purple tattoo in the setting of pembrolizumab. To the best of our knowledge, this is the first case of a non-granulomatous tattoo reaction secondary to a checkpoint inhibitor. The patient is a 43-year-old Caucasian woman with history of stage IIIA melanoma of the right mid back status post wide local excision and positive sentinel node biopsy, on single agent pembrolizumab.

Hypopharyngeal Schwannoma: A Ghanaian Case Report

This article seeks to highlight the need for a high index of suspicion for a hypopharyngeal tumour especially schwannoma in patients presenting with the feeling of a mass in the throat. Schwannoma is a benign schwann cell encapsulated tumour with no genetic predilection. They are rarely found in the hypopharynx and when present may not cause any significant symptoms until they enlarge and cause dysphagia and upper airway obstruction because of laryngeal obstruction. Schwannomas are differentiated from other soft tissue tumours like neurofibromas by the presence of Antoni A and B on histology and strong positivity for S100 protein with no or minimal mitotic activity. These tumours are mainly managed by surgical excision either transorally or via lateral pharyngotomy.We present the case of 28 -year-old man who presented to our facility with the feeling of a mass in the throat of 2 months duration. After flexible nasolaryngoscopy and CT scan of the neck, a hypopharyngeal tumour with a sessile base was found. The tumour was excised endoscopically after elective tracheostomy to secure the airway. Patient’s recovery was uneventful and has remainedasymptomatic one-year post excision of the tumour.

A RARE CASE REPORT OF OCULOFACIAL DENTAL ANOMALIES IN PEDIATRIC AGE GROUP; NANCE- HOREN SYNDROME

Nance-Horen Syndrome, a triad of characteristic facial , dental and ocular abnormalities along with intellectual impairment is a rare X linked genetic disorder[1-4]. Diagnosis is mainly based on clinical association of characteristic facial, ocular and dental anomalies along with mental retardation. In this case report, we presented a patient with Nance-Horen syndrome, who presented in OPD with post cataract excision corneal opacities along with non -ocular anamolies and similar presentation in two other male siblings. Peadiatricion in developing country should know the significance of detailed systemic assessment of patients presenting with oculofacial anomalies to avoid missing important diagnosis like Nance-Horen Syndrome.

A0573 - Continence outcomes in females post mid-urethral sling excision

A0573 - Continence outcomes in females post mid-urethral sling excision

Chronic Sore Throat Mandates Re-Thinking.

A 69-year-old woman presented to the emergency department with sore throat for 6 months. She reported experiencing intermittent fever with productive cough and recent body weight loss. She had no dysphagia, shortness of breath, or night sweats. No history of recent travel or tuberculosis (TB) contacts were reported. She had a medical history of thymoma post excision 4 years ago. Her vital signs revealed temperature of 36.7°C, heart rate of 123 beats/min, respiratory rate of 16 breaths/min, and blood pressure of 163/96 mm Hg.

One versus two adjacent interdigital neuroma excision: a patient outcome study

Objective: We aimed to evaluate patient satisfaction after surgery for both single and two adjacent neuromas. Methods: We reviewed the data of patients treated operatively for interdigital neuromas between 2003 and 2016. We interviewed them and administered the Self-Reported Foot and Ankle Score questionnaire. Patient scores were then analyzed categorically, and variation between groups was assessed. Results: Sixty-two patients were available for review. Thirty-one patients had a single interdigital neuroma excised and 31 had two adjacente interdigital neuromas excised. Twenty-eight of the 31 (90%) patients with a single neuroma had good or excellent results while 23 (74.2%) of those with adjacent neuromas had similar outcomes. One patient with a single neuroma had a poor result while four patients with adjacent neuromas had poor results. The mean score was 41 (excellent) for patients with a single interdigital neuroma and 37 (good) for those with adjacent neuromas (p=0.473). The majority of patients in both groups would undergo surgery again. Conclusion: We found no statistically significant difference in outcomes of patients who undergo surgery for either single or two adjacent interdigital neuromas. General patient satisfaction is good and/or excellent post excision. Level of Evidence II; Prognostic Studies; Retrospective Study.