Se Yeong Jeong

Heterotopic gastric mucosa in the umbilicus.

Heterotopia refers to the finding of normal tissue in foreign sites, entirely separate from the main organ. Heterotopic gastric mucosa has been observed throughout the alimentary tract, everywhere from the oral cavity to the rectum. However, occurrences in the umbilicus are an extremely rare and peculiar phenomena. We report the case of heterotopic gastric mucosa in the umbilicus.

Giant Acral Melanoma on the Left Thumb of a Korean Patient

The acral regions of the limbs of Asians are predisposed to develop malignant melanoma, but giant-sized acral melanoma has not been previously reported in the Asian population. Giant-sized melanoma implies aggressive tumor invasion and so it is more difficult to achieve a therapeutic cure. A 56-year-old woman presented with a giant acral melanoma of the left thumb with concomitant bone destruction and axillary lymph node metastasis. The initial lesion was a subungual black macule on the left thumb that had grown into a giant 7.0x4.0x3.5 cm-sized melanoma over a 3 year period. The left thumb was amputated and the axillary lymph nodes were completely dissected. During the ensuing 3 months, she underwent adjuvant treatment with interferon-alpha-2a. The interesting feature of this case is that the large melanoma mass of this patient, which was accompanied with adjacent bone destruction and lymph node metastasis, had developed rapidly from a small black macule in the nail matrix, and this black macule was suspected to be a subungual melanoma.

Subcutaneous fat necrosis of the newborn associated with ventricular septal defect and patent ductus arteriosus

In the absence of skin findings, liver biopsy may confirm the diagnosis, but is frequently impossible in the setting of severe coagulopathy. HSV serum serologies are often insensitive, even in advanced disease. Radiographic findings are nonspecific. HSV infection should be suspected in any immunocompromised patient presenting with fever, leukopenia, and elevated aminotransferases. In such patients, careful physical examination for skin findings should be performed, as the identificationofcutaneousHSVwithsecondarydissemination maydirect the early initiationof acyclovir therapy.