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Merkel cell carcinoma is an uncommon but aggressive tumour with a high metastatic potential. A rapidly growing, non-tender cutaneous tumour on sun-exposed areas of the body in older patients should raise suspicion of the condition. It may be necessary to combine the patient history with clinical, radiological and pathological findings in order to make the correct diagnosis. Excision with a 1-2 cm margin, direct closure and simultaneous sentinel-node biopsy should be performed without delay. Adjuvant radiation therapy of the tumour site may be relevant. After the diagnosis is made, assessment and treatment should take place in hospitals with special experience of the condition.

Gorlin syndrome is a rare genetic condition in which patients may develop medulloblastomas, jaw cysts and basal cell carcinomas and show congenital skeletal malformations. If left undiagnosed, Gorlin syndrome can have a number of negative consequences. Early diagnosis and good follow-up is important for all patients with rare disorders. We wish to make doctors and dentists aware of Gorlin syndrome so that, whenever the syndrome is suspected or a patient has been diagnosed, the patient is referred for assessment, treatment and follow-up by specialists who know the disorder well. Dermatology departments at university hospitals and departments of medical genetics have a key role to play in assessment and follow-up. A national support group for Gorlin syndrome has been established, consisting of a dermatologist, oncologist, geneticist, paediatrician, specialist dentist, ophthalmologist, orthopaedic surgeon, plastic surgeon, oral and maxillofacial surgeon and counsellors. Patients, relatives and health professionals can contact the Centre for Rare Disorders directly for information about Gorlin syndrome, or to be put in touch with members of the group.

Background: Cardiac dysfunction in the form of reduced systolic and/or diastolic left ventricular function after adjuvant cancer therapy has recently attracted increasing attention. The best-known cardiotoxic agents are anthracyclines and the recombinant antibody trastuzumab. Patients treated with radiotherapy to the thorax are liable to develop coronary artery disease. There are no official guidelines for the preventive treatment of cardiac dysfunction induced by chemotherapy, antibody therapy or radiotherapy. The purpose of this article is to provide an overview of cardiac dysfunction caused by adjuvant cancer therapies and to review possible preventive therapeutic principles., Material and Method: This article is based on a review of the literature derived from a search in PubMed., Results: 27% of those treated with anthracyclines and trastuzumab may develop some degree of cardiac dysfunction. The figure for patients receiving radiotherapy to the thorax is more uncertain. Small-scale studies suggest that anthracycline-induced cardiac dysfunction can be prevented wholly or partially by blocking the renin-angiotensin-aldosterone system and by beta-adrenergic blockade. As yet, there are no results of prospective studies on cardiopreventive treatment during trastuzumab therapy or thoracic radiotherapy., Interpretation: There is a need for randomised, placebo-controlled studies of homogeneous groups of patients in order to determine whether treatment with cardioprotective medication in parallel with chemotherapy, antibody therapy or radiotherapy can prevent or reduce cardiac dysfunction.