Unusual association of Meckel's diverticulum with double appendix - A rare finding.

INTRODUCTION: Appendix duplication is an extremely rare congenital anomaly that is seen in 0.004-0.009% of appendectomy specimens. Duplicated appendix may be associated with number of congenital anomalies. PRESENTATION OF CASE: In this case report, we are presenting a rare case of duplicated vermiform appendix with a co-existing Meckel's diverticulum. DISCUSSION: Anomalies of appendix are rare and duplication of vermiform appendix is extremely rare. In 1936, Cave classified appendiceal duplication for the first time which was modified by Wallbridge in 1963 into three types. Concomitant malformations or duplications of the large intestine or the genitourinary system may be present, especially in types B1 and C probably due to their similar embryological origin. Here we are presenting a very rare case report of type B1 appendix anomaly associated with Meckel's diverticulum. CONCLUSION: Surgeons should be aware of these conditions because of the possible clinical implications.

Unusual presentation of follicular carcinoma thyroid with special emphasis on their management.

INTRODUCTION: Follicular carcinoma of thyroid usually behaves in an indolent manner with low metastatic potential. Distant metastases as initial presentation is rare in follicular carcinoma; especially in young patients. PRESENTATION OF CASE: We report the clinical, pathological features and the management of three different cases of follicular carcinoma of the thyroid with unusual presentations at the time of diagnosis. First case presented as thyroid abscess, second case with a large skull swelling in a pre-exiting goiter and the third case with a swelling in the sternum. DISCUSSION: Follicular carcinoma of thyroid is the second category of well-differentiated thyroid cancer that constitutes about 10% of all thyroid malignancies. Blood borne metastasis is common with spread to lung, bone and other solid organs. In less than 10% cases of follicular carcinoma, there is evidence of lymphatic involvement. The patients' presentations above are highly unusual. CONCLUSION: Recognizing these cases has a significant impact on clinical decision-making and prognosis of the patients. Treatment in these patients should be individualized and an alternative therapeutic approach should be considered.

Multiple fibroadenomas in bilateral breasts of a 46-year-old Indian woman - A case report.

INTRODUCTION: Fibroadenomas are among the most common tumours of the female breast, occurring most frequently in women of child-bearing age, especially those under 30 years. PRESENTATION OF CASE: We report a case with a total of 27 fibroadenomas presenting bilaterally of a 46-year-old woman. The histopathologic and immunophenotypic features of the fibroadenomata are described. DISCUSSION: Most fibroadenomas are present as single mass, however the presence of multiple fibroadenomata can be seen in 15-20% of the patients. It has been reported that the average number of masses in cases of multiple fibroadenomas is 3-4 in a single breast but occurrence of more than five fibroadenomas in an individual patient is much less common. CONCLUSION: There are few reports of multiple fibroadenomas. We report this case hoping to expand the literature and to provide insight to aetiology of multiple fibroadenoma formation and advice on management.