Primary Orbital Tuberculosis with Cold Abscess: A Case Report.

Orbital tuberculosis is a rare form of extrapulmonary tuberculosis involving orbital soft tissue, periosteum, bones and lacrimal glands. This is a case report of a 6-year-old male child who presented with swelling of the right upper eyelid. He had normal visual acuity without signs of diplopia or ophthalmoplegia. The tuberculin skin test was reactive and the computed tomography scan showed peripherally enhancing collection with bony erosion and intracranial extension in the extraconal space of the superolateral right orbit. Orbital exploration was done which showed caseous material. The histological examination revealed necrotizing granulomatous tissue. The caseous material on Ziehl Neelsen staining confirmed acid-fast bacilli causing a tubercular abscess. The child is currently on anti-tubercular therapy planned for 12 months. Orbital tuberculosis might or might not be in association with pulmonary tuberculosis and should always be taken into consideration while dealing with chronic inflammatory orbital disease and an orbital mass. Keywords: case reports; orbit; tuberculosis.

Evans Syndrome: A Case Report.

Evans syndrome is defined as the concomitant or sequential association of warm autoimmune hemolytic anaemia with immune thrombocytopenia, and less frequently autoimmune neutropenia. It is associated with non-cross-reacting auto-antibodies directed against antigens specific to red blood cells, platelets or neutrophils. Clinical symptoms could be related to hemolysis and thrombocytopenia. Evans syndrome is a rare diagnosis of exclusion. The first-line treatment of Evans syndrome is intravenous corticosteroids or intravenous immunoglobulins and second-line treatment with rituximab or splenectomy for those who are refractory to steroids. Here is a case of a fifty-year-old- female who presented with bleeding from the mouth and gums, bluish patches over the shin and trunk along with generalised weakness and severe backache. We are interested in reporting this case because the presentation of patients with such scenarios on our part will compel the treating physician to overlook Evans syndrome and get it underdiagnosed. Keywords: case reports; immunoglobulins; neutropenia; thrombocytopenia.

Bilateral Neuroendocrine Carcinoma of Breast: A Case Report.

Primary neuroendocrine carcinomas of the breast are rare of all breast carcinomas. They may be welldifferentiated, poorly differentiated, or invasive breast cancers with neuroendocrine differentiation. They are staged and treated similarly to conventional breast cancer. Herein, we report a case of invasive ductal carcinoma with neuroendocrine differentiation of the breast in a 73 years female with a history of breast lump initially in the lower inner quadrant of left breast and a month later, similar lump at the same site in right breast. Patient underwent Modified Radical Mastectomy bilaterally followed by adjuvant chemotherapy based on Carboplatin and Etoposide regimen.