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Background: The prognostic benefit of health care service provision and delivery policies for patients with malignant melanoma (MM) is not yet clear., Objective: To analyze the role of health care provision determinants in the initial prognosis of MM., Methods: A multicenter cross-sectional study was conducted at 14 public hospitals and recruited 3550 patients with MM between 2000 and 2009. The study variables were analyzed using univariate and multivariate models to identify their role in the variations observed., Results: In a 10-year period, the number of patients with MM increased by 78.54%, with primary in situ MM (Tis) or MMs with a Breslow thickness <1 mm (T1) representing 51.72% of the total number of MMs in 2000, increasing to 62.23% by the end of the study period (P = .005). Among the variables that explained the variation in MM frequency the year of diagnosis after 2004 (univariate odds ratio [OR], 1.43 [P < .001]; multivariate OR, 1.36 [P = .005]) and diagnosis in centers with specific fast-track referral systems (univariate OR, 1.24 [P = .01]; multivariate OR, 1.59 [P = .025]) were shown to explain the increasing frequency of Tis-T1 MM., Limitations: The primary potential limitation of this study is its retrospective nature., Conclusion: Health care provision policies and interventions aimed at improving accessibility to specialized care appear to explain the increasing frequency of Tis-T1 MM., (Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)

The clinical and morphological features of two patients with solitary extramedullary plasmacytomas of paranasal sinus and nasal cavity are presented. Patients only developed local symptomatology without features of multiple myeloma. They were treated with surgical excision and local radiotherapy. This is the treatment of choice recommended for these localized tumors. Microscopically, one tumor contained a well-differentiated plasma cell population, and the other was made up immature cells. Cytoplasmic staining for IgG was showed in both tumors for immunoperoxidase studies. However, no serum monoclone was detected at the time of diagnosis nor later. Currently, they are alive without evidence of disease 20 and 16 months, respectively, after treatment.

We report 4 cases of rhinosporidiosis in the province of Cáceres. Two had nasal localization and in two ocular conjunctiva was involved. Three patients, two of which came from the same village, had the antecedent of bathing in the same stagnant water. The diagnosis was made by the microscopic observation of characteristic sporangia of Rhinosporidium seeberi in the histopathological study. The lesions did not respond to antibiotic and antiinflammatory treatment. After excision there were no recurrences, and the patients are asymptomatic after 1 1/2 year follow up.

The clinical, morphological, microscopic, immunohistochemical, and ultrastructural findings in a case of primary non-Hodgkin's malignant lymphoma of the prostate gland is reported. The presenting features were not distinct from those of nodular hyperplasia. Following biopsy, the lesion was classified as monoclonal IgM-secreting, low grade, malignant beta-lymphoma. We discuss the good outcome of this case and the prognostic value of several clinical and morphological parameters. Finally, the therapeutic possibilities for this tumor type are compared with those of extranodal lymphomas in other sites.