Incidental finding of tall cell variant papillary thyroid carcinoma on prostate-specific membrane antigen PET CT scan.

Prostate-specific membrane antigen (PSMA) PET CT is widely used for staging and restaging of prostate cancer. Thyroid and other non-prostatic pathology may be incidentally identified by this imaging modality. Such findings warrant further investigation given their malignant potential. We describe the first reported case of PSMA avid T cell-variant papillary thyroid carcinoma incidentally detected on PSMA PET CT.

Synchronous sinonasal and respiratory papilloma: could long-term positive pressure ventilation be the cause? A rare case report.

This case report describes a rare presentation of synchronous pathologies-sinonasal inverted papilloma (SIP) and recurrent respiratory papillomatosis (RRP)-in a 47-year-old man using continuous positive airway pressure (CPAP) ventilation for progressive obstructive sleep apnoea. As far as we know, this is the first case of concurrent SIP and RRP disease described in the literature. The patient initially presented for management of chronic rhinosinusitis symptoms. He was found to have an extensive nasal lesion on flexible nasendoscopy, for which surgical management was recommended. However, during anaesthetic induction, he obstructed unexpectedly and was found to have an occlusive supraglottic lesion that required expedient ENT airway management. Diagnosis was made clinically and was supported with histopathology of excised tissue. Management involved multiple staged procedures for excision of sinonasal and glottic lesions and regular follow-up and imaging.

Myoepithelioma-like tumour of the vulval region: A case report.

Myoepithelioma-like tumours of the vulvar region (MELTVR) are a newly described group of spindle cell neoplasm. Morphologically, they consist of epithelioid to spindled cells in a myxoid to collagenous stroma and can resemble epithelioid sarcomas, myoepithelial carcinomas or extraskeletal myxoid chondrosarcomas. However, they have a distinct pattern of immunohistochemical staining characterised by positivity for EMA, ER, PR and negativity for cytokeratin, GFAP and S100. Nuclear staining for INI-1 is lost. In addition, they lack the characteristic gene arrangements of these other lesions. MELTVR can recur locally when incompletely excised, however, do not appear to metastasize. We report a case of a MELTVR in a 49-year-old woman arising in the right mons pubis.

Unexpected histopathology of acute appendicitis.

INTRODUCTION: Appendicular diverticula and associated diverticulitis is a rare disease. Patients present commonly with symptoms of acute appendicitis and require laparoscopic or open surgery. Diagnosis is usually made only on histology. Here, we present a rare case of acute diverticulitis of the appendix. CASE PRESENTATION: A 33-year old gentleman presented with right iliac fossa pain of 3 days duration. On admission, appendicitis was diagnosed on Computerized Tomography (CT) scan and laparoscopic appendicectomy was subsequently performed. Intra-operative findings were unremarkable and recovery was uneventful. Histopathology however revealed diverticulitis of appendix with acellular mucin. DISCUSSION: Acute diverticulitis of the appendix is an exceptionally rare condition and reported in 0.004%-2% of appendicectomies. It presents usually when complicated with perforation and bleeding. There is however a strong association with certain malignancies such as mucinous neoplasm, carcinoid and Pseudomyxoma peritoneii. Radiological proven appendicular diverticulum requires early intervention due to higher chance of diverticulitis related complication. Surgeons should be aware about this rare disease and may consider elective surgery in view of potential risk of complications and malignancy. CONCLUSION: We concluded that because of strong malignant association, it would be recommended that all appendix specimens should inspect during and after surgery and concurrent examination of peritoneal cavity is recommended.