RESUMO
INTRODUCTION AND IMPORTANCE: Polybrachysyndactyly is the combination of malformations and is considered a congenital anomaly that is very difficult to treat. In addition to presenting as a disabling entity, it is a reason for little acceptance under the aesthetic standards established by society. CASE PRESENTATION: 6-year-old male patient with polybrachysyndactyly in all 4 extremities. The parents rejected surgery at a younger age, however, the social/aesthetic pressure exerted on the patient at school and the child's inability to perform activities in a common way, motivated them to make a new decision. CLINICAL DISCUSSION: Different surgical techniques were used on all four extremities. A soft tissue technique was performed on the pinkies of both feet and ray cuts to correct syndactyly of both thumbs of the feet and middle fingers of both hands, and excision. Extirpations were obtained: one thumb of the right foot, one thumb of the left foot and two middle fingers (one of each hand). He was discharged after recovery from surgery. CONCLUSION: Cases of polysyndactyly are considered extremely rare, the first thing to evaluate is the presence of other signs that could be part of a syndromic association in order to proceed with surgical intervention that allows the patient to lead a life as far away from aesthetic stigmas that could damage his mental health. EVIDENCE BASED MEDICINE RANKING: Level IV.
RESUMO
INTRODUCTION AND IMPORTANCE: Nodular melanoma is the second most frequent cutaneous melanoma worldwide and due to its rapid growth rate and non-malignant appearance, is the most aggressive one. In its polypoid form, it is usually found in mucosal areas, but can also be seen on the trunk. This case is presented because it is an unusual manifestation and surgical treatment required wide excision, however, the patient's evolution is favorable. CASE PRESENTATION: 70-year-old female patient shows a progressively growing lesion with irregular border, abnormal color and a heterogeneous appearance. The biopsy yields the histological diagnosis of nodular polypoid melanoma. The surgical technique results in the resection of a 10 × 9 × 67 cm piece with favorable evolution of the patient. CLINICAL DISCUSSION AND CONCLUSIONS: The surgical technique of margin widening is considered a recommended option for polypoid nodular back melanomas. Although the excision is considered vast, the patient's evolution may turn out to be favorable.