Follicular carcinoma of thyroid with synchronous bony and soft tissue metastases.

A 65 years old lady presented with a large thyroid swelling along with a soft, non-tender mass over the left parietal region and a small, hard, non-tender swelling over the volar aspect of right forearm. FNAC reports from the thyroid gland and the swellings over head and forearm all revealed features of follicular neoplasm. Excision biopsy of the forearm swelling showed histology of metastatic poorly differentiated follicular adenocarcinoma of thyroid. The patient underwent total thyroidectomy followed by excision of the mass over the head, a week later. She was discharged in favourable condition with advice to attend oncology department for subsequent management. She is yet to attend surgical outdoor for follow-up.

Prospective evaluation of modified Alvarado score for diagnosis of acute appendicitis.

Modified Alvarado scoring system was evaluated regarding its usefulness in the early diagnosis of acute appendicitis and in reduction of the incidence of negative appendicectomies. One hundred and ten patients with a provisional diagnosis of acute appendicitis were studied prospectively at R G Kar Medical College and Hospital, Calcutta over a period of 10 months. High score was found to be a dependable aid both in the pre-operative diagnosis of acute appendicitis and in the reduction of negative appendicectomies in men and children but the same was not true for women who had a high false positive rate for acute appendicitis.

Unusual presentation of schwannoma.

Schwannomas are slow growing benign tumours arising from the nerve sheath. Two cases of schwannoma arising from the vagus nerve are presented here. One case was found in a 6-year-old boy and another one in a 30-year-old man. In the first case the tumour was detected on the left side of the neck just below the angle of the mandible, and in the second case it was found on the lower part of the right side of the neck. Histopathology confirmed the diagnosis as first one to be of Antoni-A type and the second one to be of Antoni-B type. Both the tumours were excised and on follow-up the patients were doing well.

Stromal sarcoma of breast: a case report.

A 34 years unmarried female was admitted with an ulcerated foul smelling growth in her right breast. On examination the fungating mass measured 17.5 cm x 15 cm in central and lower part of right breast involving the nipple and areola. The ulcer was covered with slough and rest part of the breast appeared bosselated. Her Hb was 4 g/dl and incision biopsy from the margin of the tumour showed histology of sarcoma. The patient was infused 6 units of blood and right sided total mastectomy was done. Histopathological examination confirmed it was a case of stromal sarcoma of breast. Chemotherapy was started with vincristine, adriamycin and cylophosphamide. The patient was doing well in next follow-up.