External ear melanoma is rare, and early diagnosis and treatment are paramount for the patient's survival. Four clinical cases are reported, emphasizing the importance of the routine clinical examination of the ears in the dermatological consultation. The study included male and female patients, aged 60 to 81 years old, with melanocytic lesions in the outer ear, evaluated with detailed physical and dermoscopic examination, leading to the identification of lesions suggestive of melanoma. The cases were treated surgically with excision of the lesion, and the diagnoses were confirmed by histopathological study. The therapeutic approach was instituted early as most cases were diagnosed at an early stage, which directly impacted global survival.
Skin metastases are rare and may occur in the context of a known metastatic disease or be the first clinical sign of an underlying primary tumor. In the case of carcinoid neoplasms, determining whether the cutaneous tumor is primary or secondary and identifying the tumor origin in metastatic cases is not always an easy task. This is the report of a case of cutaneous metastasis presenting as the first clinical manifestation of a previously unknown pulmonary carcinoid tumor, including the discussion of histopathological and immunohistochemical findings that allowed an adequate diagnosis of the tumor etiology and reinforces the importance for dermatologists and dermatopathologists to be familiar with these findings.
Introduction: Ebstein's anomaly is a rare malformation that corresponds to less than 1% of all congenital heart anomalies. It consists in the caudal displacement of the tricuspid valve with retrograde flow to the right atrium due to valvular insufficiency and it is characterized by a variable spectrum of severity, being higher in the neonatal period. Objective: to report an Ebstein's anomaly case which early diagnosis avoided iatrogenic ducts. Case report: a newborn at term, appropriate weight for gestational age, female, was born of natural childbirth, with Apgar score 8/9 from pregnancy without complications. At birth, not in need of resuscitation in the delivery room, but presented heart murmur and fall of saturation, being supported and then forwarded to the NICU. Not present hemodynamic instability. The chest x-ray showed increased cardiac area with increased right atrium. The Transthoracic Echocardiogram showed mild right ventricular dilatation and important of the right atrium, tricuspid valve dysplasia with low implantation of posterior leaflet of tricuspid insufficiency presence important to Doppler, being diagnosed with Ebstein's anomaly. Evolved with progressive improvement of the frame and saturation above 95% on room air to pulse oximetry. Patient follows in outpatient follow-up in use of inotropic and diuretic, remaining asymptomatic. Conclusion: the recognition of the gravity of the picture is relevant to the proper management in order to prevent iatrogenic ducts, which can lead to complications or permanent sequelae.
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