Primary tumours of the heart are often encountered in clinical practice. Different autopsy series estimate the incidence to be anywhere from 0.001% to 0.19%. Cardiac lipoma is a rare type of tumour of the heart and pericardium. It comprises approximately 10–19% of all cardiac tumours. We present a case of a large cardiac lipoma in a fifty-year-old female. She presented with sharp chest pains, palpitations, and dizziness. Acute coronary syndrome was ruled out. A transthoracic echocardiogram showed an abnormal, large, fixed right atrial mass. The mass was noted to be occupying most of the right atrium. It was excised due to its large size and persistent symptoms. On pathophysiology, the mass was definitively diagnosed to be an 80 mm × 70 mm cardiac lipoma. Postoperatively, the patient did well with resolution of her symptoms. This case provides evidence that even large, invasive, symptomatic cardiac lipomas can be successfully resected with good outcomes.

Acrodermatitis enteropathica is a rare skin disorder of zinc deficiency. This case report describes a 91-year-old female nursing home resident who presented with a skin eruption resembling acrodermatitis enteropathica while receiving adequate enteral nutrition (EN) via a percutaneous gastrostomy tube. A low zinc level of 36 mcg/dL confirmed zinc deficiency, and treatment with oral zinc sulfate 220 mg 3 times a day resulted in rapid resolution of the skin lesions. This case supports the notion of close monitoring of patients on long-term EN for clinical manifestations of zinc deficiency, especially in the presence of an unexplained skin rash. Although micronutrient deficiencies are more prevalent in underdeveloped countries and with patients receiving parenteral nutrition, these deficiencies should be kept in mind for patients in developed countries as well as patients receiving EN.

Vancomycin is a commonly used antibiotic for severe Gram-positive bacterial infections, especially for methicillin-resistant Staphylococcus Aureus and coagulase-negative staphylococci infections. Nevertheless, only few cases of toxic epidermal necrolysis have been reported since the introduction of Vancomycin into clinical practice. We report a case of a 35-year-old man who presented with multiple facial abscesses and methicillin-resistant Staphylococcus Aureus bactermia and who was started on Vancomycin and later developed toxic epidermal necrolysis.

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