Abstract: 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.

Abstract: 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.

Apesar de infrequente, a alopecia pode ser causada por tumores cutâneos benignos. Os neurofibromas são neoplasias benignas comuns com origem na baínha externa dos nervos. O neurofibroma difuso é uma variante rara de neurofibroma que ocorre tipicamente na cabeça e pescoço de crianças e adultos jovens. Histologicamente caracteriza-se por um tumor infiltrativo, composto por células fusiformes, localizado na derme e tecido celular subcutâneo. Apesar de rara, a transformação maligna já foi descrita. A associação dos neurofibromas difusos e neurofibromatose tipo 1 ainda não está determinada dado que alguns autores contestam a baixa incidência habitualmente referida. Descrevemos o caso de um homem de 42 anos com um neurofibroma difuso do couro cabeludo com aprasentacao de placas de alopecia.

Although infrequent, alopecia can be caused by benign cutaneous tumours. Neurofibromas are common benign tumors that originate in the peripheral nerve sheath. Diffuse neurofibroma is a rare variant of neurofibroma that is thought to occur mainly in the head and neck of children and young adults. Histology generally shows an infiltrative tumor, composed of spindle cells in the dermis and subcutaneous tissue. Despite being rare, malignant transformation has been reported. The association between diffuse neurofibromas and neurofibromatosis type 1 still remains to be determined since some authors question the low incidence usually described. We report the case of a 42-year-old man who had a diffuse neurofibroma on the scalp presenting as alopecic plaques.