An 81-year-old Japanese woman developed a subcutaneous tumor measuring approximately 5.5 × 4.4 cm located close to the upper region of a gynecological surgical wound in the abdominal wall. She underwent uterine resection for suspected uterine myoma at a gynecological clinic 7 years prior. Specimens of the tumor showed several nests of oval or spindle-shaped cells with mild cytologic atypia accompanied by a number of small vessels. In an immunohistochemical examination, the tumor cells tested positive for vimentin, CD10, estrogen receptor, and progesterone receptor. We diagnosed the subcutaneous tumor as endometrial stromal sarcoma (ESS) recurrence originating from the primary uterine ESS, because the investigated specimens of the uterine body excised in the clinic had similar nests of cells observed in the present subcutaneous tumor. Dermatologists should consider the possibility of ESS in the differential diagnosis of a subcutaneous tumor, especially in patients with a history of gynecological disease.[Skin Cancer (Japan) 2015 ; 30 : 102-107]

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A 46-year-old man presented with a black nodule on the left thigh that existed since childhood. He visited our hospital because an additional black nodule developed near the existing one. The patient underwent excisional biopsy and was diagnosed with stage IIIA, pT3aN2aM0 malignant melanoma. He underwent additional excision for repeated local recurrence during the early postoperative period. However 6 years later, the tumor was eventually found to be unresectable. In 7 years later, the patient presented to the emergency department with massive arterial hemorrhage from a red nodule on the front of the left thigh and immediately underwent suture ligation to achieve hemostasis. On the following day, he underwent transcatheter arterial embolization of the deep medial/lateral circumflex femoral artery. Mohs' paste was applied after hospitalization, and the tumor gradually turned dark brown, indicating hemostasis. Thus, transcatheter arterial embolization was effective for hemorrhage due to cutaneous metastatic malignant melanoma.[Skin Cancer (Japan) 2015 ; 30 : 108-112]

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Theoretically, tumor sizes can be expressed with the number of tumor cells, which in turn can be expressed with the number of times of cell division. The number of times of cell division was mathematically expressed as a function of the diameter of a tumor. A corresponding table of tumor diameters and numbers of times of cell division was created for clinical use. With this table, it is possible to determine the time of onset of a metastasis if one has the dates and sizes of a given tumor at different times. Such an analysis was useful to understand three cases of malignant melanoma with an unusual clinical course. The table is also useful to decide the desirable follow-up time prospectively. Theoretically, patients should be examined with in one-tenth of the length of the follow-up times used thus far.[Skin Cancer (Japan) 2015 ; 30 : 113-119]

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A 75-year-old Japanese man presented with a one-year-history of erythema of the lower abdomen. Because the results of a skin biopsy, suggested extramammary paget's disease (EMPD), he was referred to our hospital. Physical examinations revealed erythematous lesions on both side of the groin and leucoderma as well as erythema on the abdomen. Biopsy specimens supported the diagnosis of EMPD. Gross total resection was conducted, and the defect was closed with a local flap. Immunohistological analysis showed no tumor cells stained by CK7 between the two abdminal lesions. From these observations, we diagnosed this patient with locally multicentric EMPD.[Skin Cancer (Japan) 2015 ; 30 : 120-122]

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A 39-year-old women had a history of atopic dermatitis since the age of 4 years. Her eczema had been more severe and was finally erythrodermic. During the course of adult atopic eczema, superimposed herpetic infections occurred repeatedly. At the age of 38 years, a nodule commenced growing on her trunk, and then the number and size of nodules increased. Histopathological findings indicated anaplastic large cell lymphoma (CD30-positive/ALK-negative). As eczema improved by PUVA therapy, the lymphomas regressed. Literatures on atopic dermatitis associated with primary cutaneous anaplastic large cell lymphoma are collected and discussed in this article.[Skin Cancer (Japan) 2015 ; 30 : 123-128]

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