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Two patients with medial frontal lobe damage involving the anterior cingulate cortex (ACC) performed a range of cognitive tasks, including tests of executive function and anterior attention. Both patients lesions extended beyond the ACC, therefore caution needs to be exerted in ascribing observed deficits to the ACC alone. Patient performance was compared with age and education matched healthy controls. Both patients showed intact intellectual, memory, and language abilities. No clear-cut abnormalities were noted in visuoperceptual functions. Speed of information processing was mildly reduced only in Patient 2 (bilateral ACC lesion). The patients demonstrated weak or impaired performance only on selective executive function tests. Performance on anterior attention tasks was satisfactory. We tentatively suggest that our findings are inconsistent with anterior attention theories of ACC function based on neuroimaging findings. We propose that the data may imply that the ACC does not have a central role in cognition. We speculate that our findings may be compatible with the view that the ACC integrates cognitive processing with autonomic functioning to guide behaviour.

Abstract: Cutaneous malignant melanoma is a malignant skin tumour derived from melanocytes. In the UK, the incidence of new cases of malignant melanoma is around 8 per 100,000 per year for men and 11 per 100,000 per year for women. The incidence is increasing, especially in women. In 1999, 760 men and 715 women died of malignant melanoma in England, accounting for most of the deaths from skin malignancy. Although the male: female ratio is 2:3 for incidence, more men than women die of malignant melanoma, because men show a higher incidence of poor prognosis tumours. The commonest sites are the legs in women and the trunk in men. Malignant melanoma can occur at any age, but is rare before puberty. After puberty, incidence increases steadily with age, peaking between the ages of 40 and 79. Wide geographic variations are evident, ranging from 4 per 100,000 per year in parts of Scotland to 30 per 100,000 per year in Australia, reflecting variations in sun exposure and skin type. [Copyright &y& Elsevier]