[Amelanotic spitzoid melanoma of the digit: a case report]

Melanomas of digit is rare, accounting for 1% of all cutaneous melanomas. We report a new case. Our purpose is to discuss the clinicopathological characteristics and the difficulties encountred in establishing diagnosis of this rare tumor. We report the case of a 25 years old woman, who consulted for nodular and ulcerated lesion of the right index, located in the external face of the metacrapo-phalangial joint. The nodule was biopsied and histopathologic exam concluded to spitzoid melanoma. The surgical margins were involved. The patient refused surgical recovery. She consulted 3 years later with axillary lymph nodes. A wide excision of the tumor with lymph node biopsy were made. Histological study concluded to a tumoral residu incompletely excided with lymph node metastases. Amputation of the second digit with dissection of the axillary lymph nodes was made. The surgical margins were tumor free. Lung metastases appeared with a follow up of two months. The patient died early after starting chemotherapy with Deticen. In our report, clinical presentation was misleading causing a diagnosis and therapeutic delay. Pathologically, all the histological types of melanoma were described in the digit except spitzoid melanoma

[Cutaneous dirofilariasis: two Tunisian cases report]

Cutaneous dirofilariasis is a zoonosis which mainly occurs in dogs and cats. Human dirofilariasis is rare. At our knowledge, only five cases of human dirofilariasis were reported in Tunisia. We report here two new cases of cutaneous dirofilariasis arising in two 19 and 21 year-old patients. The first one was admitted for surgical excision of a paraombilical cutaneous nodule. The second patient presented with multiple erythematous and pruriginous papules. In both cases, the histological examination revealed the presence of a worm diagnosed as Dirofilaria repens. The evolution was favourable after surgical resection in the first case and spontaneously in the second case

[Unusual thyroid lesion]

The incidence of aspergillosis has increased during the past decade with the widespread use of aggressive chemotherapy and immunosuppressive agents. The lungs are the most common primary site of infection. Thyroid involvement is rare, usually asymptomatic, and difficult to make an ante-mortem diagnosis. Our aim is to discuss the epidemiological characteristics, the diagnosis and the histogenesis of this unusual thyroid lesion. Case report A 13-year-old girl, with a past history of lung disease was hospitalised for cervical pseudo-tumoral lesion. Cervical scintigraphy was taken and showed abnormal uptake in the thyroid. A resected specimen of the thyroid showed an extensive abscess with diffuse aspergillus hyphae infiltration. Treatment with amphotericine B was initiated and the evolution was unfavorable. Aspergillus infection frequently disseminates to a variety of organs, thyroid involvement is rare and its prognosis depends on early diagnosis and prompt initiation of therapeutic measures