How skin and liver can lead to diagnosis

A 73-year-old woman was referred by her hematologist for cholestasis of unknown origin. She was recently diagnosed with chronic myelomonocytic leukemia grade 0 in a context of fatigue, night sweats, weight loss and monocytosis. A PET-CT showed hepatosplenomegaly and multiple centimetric adenopathy. The diagnosis was confirmed by a bone marrow aspiration and biopsy. Interestingly, the evolution of the patient is marked by the appearance of cholestasis and an erythematous firm skin nodule of the right forearm. The skin lesion was biopsied to rule out a cutaneous localization of the patient’s known hemopathy.

Cutaneous Localization of Classic Hodgkin Lymphoma Associated with Mycosis Fungoides: Report of a Rare Event and Review of the Literature

Mycosis fungoides and nodal classic Hodgkin lymphoma (cHL) have been reported to occur concurrently or sequentially in the same patient. A long-lasting mycosis fungoides more often precedes the onset of nodal cHL, although few cases of nodal cHL followed by mycosis fungoides have been observed. Skin involvement is a rare manifestation of cHL that may be observed in the setting of advanced disease. The decrease in skin involvement in cHL is mainly due to the improved therapeutic strategies. The concurrent presence of mycosis fungoides and cutaneous localization of classic Hodgkin lymphoma represents a very uncommon event, with only two cases reported so far. Herein, we describe the case of a 71-year-old man, with a history of recurrent nodal cHL, who developed MF and, subsequently, the cutaneous localization of cHL. The clinicopathological features of the two diseases are described focusing on the main differential diagnoses to be taken into consideration, and a review of the literature is performed.

CASE REPORT : LIPOSARCOMA OF THE SHOULDER

Lipoma, a benign neoplasm of adipocytes, is the most common mesenchymal soft tissue tumor of adulthood, but rarely present with huge sizes in their cutaneous localization. Liposarcomas are the second most common soft tissue sarcoma following malignant brous histiocytoma. They comprise approximately 16-18% of all malignant soft tissue tumours. It is most common in the trunk followed by lower extremity, upper extremity and head and neck.. While lipomas can be clinically diagnosed , transformation of lipomas into liposarcoma is rare. Here we report the case of a 55 gentleman, who came with a history of swelling over the right shoulder with a probable malignant transformation due to history of long duration of presence of swelling. Management is usually by wide excision. Local radiation and chemotherapy may be necessary for high grade lesions.

Cutaneous Metastasis of Cervical Cancer: About a Case and Literature Review

Cutaneous metastases of cervical cancer are rare. We report the case of a patient with a secondary cutaneous localization of cervical squamous cell carcinoma treated at the medical oncology department of HASSAN II university hospital in Fez. The patient had a cutaneous nodule in the left axillary fossa appeared 4 years after the end of radiochemotherapy. Histological examination confirmed the metastatic nature of cervical cancer. But considering the presence of multiple metastatic sites in the liver the lung and the bone, palliative chemotherapy has been administered.