Introduction: Identifying left aberrant hepatic artery during gastrectomy for cancer is occasional. In case of replaced left hepatic artery, its ligation can lead to hepatic injury or ischemia, while preserving it can cause difficulties during lymphadenectomy. In literature there is no consensus regarding preserving replaced left hepatic artery during gastrectomy for cancer. A recent study, analysing adverse effects of ligating an aberrant left hepatic artery, shows in pacients with over 5 times elevated transaminase levels, increase in hospital length and postoperative complications. On the other hand, there are studies that consider ligation of aberrant left hepatic artery safe, the only inconvenient being postoperative transient elevation of transminase levels, when ligated artery diameter is over 1.5 mm. Matherial and methoods: We report the case of a 65 years old male, known with myocardial infarction, admitted for epigastric pain, nausea, vomiting, dysphagia for solids and important weight loss. Upper gastrointesinal endoscopy with biopsy and computed tomography showed eso-gastric tumoral mass, signet ring cell carcinoma, no metastases. Intraopertive, we found replaced left heaptic artery arising from left gastric artery, close to the celiac trunk, its diameter being approximately 1 cm. Total radical D2 gastrectomy with mechanical eso-jejunal Roux-en-Y anastomosis was performed. Postoperative evolution was favourable surgically, but the patient had SarsCov2 infection during hospitalisation The final pathology report showed 18 lymph nodes examined, 5 being with adenocarcinoma metastases. Conclusions: Preserving replaced left hepatic artery during gastectomy for cancer is preferable, lyphadecnectomy not being affected. Potential postoperative complications resulted from ligation of replaced left hepatic artery could have chanced the prognosis.

Despite the advanced technologies, the 12 leads electrocardiogram (ECG) remains an important investigation modality for providing a fast diagnostic of acute coronary syndromes (ACS). This method offers data concerning the presence, extension and severity characterizing the ischemic process (1). The ECG interpretation is still essential during the initial evaluation of patients admitted for ischemia suggestive symptoms (2).
Moreover, being a cheap, non-invasive and accessible technique, ECG continues to represent the gold-standard alternative for the differential diagnostic, for determining the appropriate treatment approach, for selecting patients susceptible of benefiting from reperfusion as well as regarding risk stratification (1).

Lentigo maligna (LM) is a type of melanocytic proliferation, the term being used by clinicians and pathologists for melanoma in situ on chronically sun damaged skin (1) in case that the lesion is confined to the epidermis. The pathology in question is classified as lentigo maligna melanoma (LMM) when it invades the dermis (2), over a protracted period of time (3). They both represent a subtype of malignant melanocytic proliferation according to the World Health Organization criteria (4). Once the dermis is invaded, the prognosis of the lesion is similar to that specific for other types of melanoma (5). Most LM patients display a slowly enlarging pigmented macula or patch which tends to occur in middle aged and older individuals (6), with a slight female preponderance (2).
The preferred method for diagnosing LM is excision (7), secondary to dermatoscopy (8) and biopsy (9). Distinguishing LM from a background of increased melanocytes on chronically sun damaged skin in a small biopsy specimen remains one of the most serious diagnostic challenges for dermatopathologists (10). Histology shows proliferation of atypical melanocytes at the epidermal-dermal junction in small nests or single cells (11).