Nevus spilus is a melanocytic cutaneous lesion consisting of a light brown
background macule with numerous superimposed darker maculopapular speckles.
Melanoma arising from a nevus spilus is rare, with less than 40 cases reported
to date. The absolute risk for malignant transformation is not well defined,
lacking a standardized management approach. We report a new case of melanoma
arising from nevus spilus, with the additional peculiarity of multifocality. We
offer our recommendations for the management of the condition.
Ductal eccrine carcinoma (DEC) is a rare sweat gland carcinoma with ductular
differentiation. Clinically, it is characterized by a slowly growing, hardened
plaque or nodule predominantly located on the head and neck. Histologically, DEC
shares similar features to invasive breast carcinoma, thus causing great
diagnostic challenges. We report a 69-year-old woman who presented with a
hardened plaque on the axilla. A skin biopsy was performed and metastatic
invasive breast carcinoma could not be ruled out. Complete excision and further
workup were subsequently conducted, leading to the diagnosis of estrogen
receptor positive DEC with associated axillary lymph node metastases. The
patient received adjuvant radiotherapy to the left axilla and was started on
oral letrozole. She is disease-free 14 months after initial diagnosis.
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