Primary adenocarcinoma of the vulva, unrelated to the native glands of perineum is an extremely rare neoplasm. Despite awareness of this lesion for over 40 years, the origin is not beyond speculation. The most reasonable hypothesis is based on the remnants of cloacal differentiation during early days of life. Here we report the case of a 60-year-old patient with a vulvar mass, who underwent partial vulvectomy and bilateral regional lymph node dissection. The tumor was composed of papillary and complex glandular structures and exhibited diffuse positivity for cytokeratin 20 and polyclonal CeA, CDX2, and focal positivity with cytokeratin 7. unlike the indolent behavior of this malignant neoplasm according to the literature, we found two metastatic inguinal lymph nodes. She did not receive adjuvant therapy and is still alive, free of disease 38 months after surgery. We present different aspects of vulvar adenocarcinomas with a case report.

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Amyloidosis is characterized by accumulation of amorphous, proteinaceous material in various organs and tissues of the body. Amyloid may accumulate in the thyroid gland in cases of medullary thyroid carcinoma and systemic amyloidosis. Amyloid accumulates extracellularly in the thyroid parenchyma and disrupts the normal follicular patterns. Most of the cases reported up to now were clinically euthyroid, but many presentation forms and overlaps have been reported. Herein we present a patient with toxic nodular goiter with amyloid deposition in the toxic nodule as well as the remaining thyroid tissue.

Lichen aureus is a rare variant of pigmented purpuric dermatosis, which often affects young adults and is localized mainly on the lower extremities. We present here a 31-year-old female who had a solitary golden-brown-color patch on her right leg for 1 year. Punch biopsy of the lesion revealed lymphohistiocytic band-like infiltrate of the papillary dermis with erythrocyte extravasation and hemosiderin deposits. The diagnosis of Lichen aureus was made based on clinicopathologic findings. The dermoscopic findings that support this diagnosis were brownish yellow diffuse coloration of the background, round to oval red dots, globules and patches and twisted red loops. Herein, we present the dermoscopic findings of a 31-year-old female patient with a diagnosis of lichen aureus established with clinical and histopathological features. Keywords: pigmented purpuric dermatosis, lichen aureus, dermoscopy

To the Editor: Calcinosis cutis (CC) is a rare disease characterized by abnormal accumulation of insoluble calcium phosphate crystals in skin and subcutaneous tissues. 1 It is classified in 4 types as etiologically dystrophic, metastatic, iatrogenic, and idiopathic. 2 It is important to determine the type of calcinosis for proper treatment management. Dystrophic type CC is most common. Idiopathic CC is characterized by normal serum calcium and phosphorus. Idiopathic CC, which is the rarest type, is characterized by normal serum calcium and phosphorus levels, its etiology is not clear and is diagnosed by exclusion of other forms of CC. It is generally observed during childhood and adolescence. 3,4 Here, a case with idiopathic calcinosis cutis in the left ear helix is discussed and presented with the literature.