Multifocal renal angiomyolipoma presenting as massive intraabdominal hemorrhage.

Angiomyolipomata of the kidney are unusual lesions composed of abnormal thick walled blood vessels, smooth muscle and adipose elements. These are asymptomatic and occasionally present with flank pain, a palpable mass or gross hematuria. They may be associated with tuberous sclerosis. The risk of bleeding is increased with size, and lesions greater than 4 cm have more than 50% chance of significant bleeding. An unusual case of multifocal renal angiomyolipoma associated with tuberous sclerosis and presenting as massive intra abdominal hemorrhage is reported.

Ovarian fibroma: an unusual morphological presentation with elevated CA-125.

This paper reports a case of a 42 year old female patient who presented with a large multi septate, predominantly cystic ovarian mass with elevated CA-125 levels. A diagnosis of malignant ovarian tumour was made on grounds of pre operative investigations and radical surgery was planned. Histopathological examination however revealed an ovarian fibroma with cystic change reinforcing the non specificity of CA-125 as a marker of ovarian malignancy and establishing the importance of a proper histopathological examination even in the most obvious of cases.

Follicular thyroid carcinoma with metastasis to skin diagnosed by fine needle aspiration cytology.

In April 2006, a 55-year-old female presented with a thyroid mass and multiple skin nodules on scalp, forehead and neck. Fine needle aspiration cytology of thyroid mass and multiple skin nodules show tumor cells clusters in a repetitive microfollicular pattern on May-Grunwald-Giemsa stain suggestive of follicular thyroid carcinoma with metastasis to skin. Although follicular carcinoma have a propensity for vascular invasion and hematogenous dissemination, skin is not commonly involved. Only a few cases of cutaneous metastasis from follicular thyroid carcinoma are reported in the English language literature.

Nevoid basal cell carcinoma syndrome (Gorlin's syndrome): a case report.

A case of nevoid basal cell carcinoma syndrome is presented and its varied clinical manifestations and multi-system involvement are emphasised. Our case presented with an early onset of symptoms but sought medical help later on for progressively increasing jaw swelling and pain. On further evaluation, multiple pigmented skin papules, palmar pits, multiple jaw cysts, skull bone osteoporosis, bifid ribs and kyphosis were present. Systemic involvement was minimal. There was no significant family history.

Fine needle aspiration of tophi in asymptomatic gout--a case report.

Gout, a chronic hyperuricemic crystal induced arthropathy, may produce soft tissue masses (tophi). Tophi may be found in synovial membranes, periarticular ligaments, tendons, soft tissues as well as internal organs. We present a case in which diagnosis of gout was made by fine needle aspiration of tophus. The patient had a painless nodule over right ankle which was progressively increasing in size. He gave a past history of painful arthropathy, but serum uric acid levels were within normal limits. At this juncture, FNAC of the ankle tophus was performed which revealed aggregated and innumerable dissociated needle-shaped negatively birefringent crystals of monosodium urate (MSU) on polarization microscopy.