Summary:Malignant Nodular Hidradenoma is an infrequent highly malignant, primary skin tumor derived from eccrine sweat glands. It has an aggressive course, with high recurrence, high rate of metastases and has very poor prognosis. It has been described as an "orphan"neoplasm. The tumor is similar to its benign counterpart but had additional features such as surface ulceration, numerous mitotic figures and infiltrative growth pattern. Pre-operative diagnosis is difficult by the fine needle aspiration cytology. Malignant nodular hidradenoma of chest wall in 35 years old women, who presented to us with a recurrent rapidly growing swelling over chest wall that grew rapidly over two months after first excision. Tissue diagnosis of first excised specimen was eccrine poroma that was similar to its benign counterpart. criteria for malignancy include poor circumscription, presence of nuclear atypia, mitotic activity, presence of predominantly solid cell islands, infiltrative growth pattern, necrosis, and angio-lymphatic permeation 3-5 .We report a case of malignant nodular hidradenoma in a middle aged woman who presented with a recuurent swelling in right side of lower chest wall. Case report :A 35 years old female presented to us with swelling over right side of chest wall. The swelling was excised and sent for histopathology. The report was ecccrine proroma. But it recurred after two months. The swelling was rapidly increasing in size over the last one and half months. The mass became significantly prominent over the last 15 days prior to presentation resulting in discomfort.Physical examination revealed a large lobulated mass about 20 cmx15cm in size, without ulceration. It was hard, non-mobile, non-fluctuant and adherent to the old scar. The draining area showed no palpable lymphnode. General examination including lungs and liver were normal. Per-operatively, a hard fibrous tumor was observed to infiltrate the muscle but not to underlying ribs. Wide local excision with 1 cm marginal clearance of healthy surrounding tissue was performed along with primary closure. Biopsy was sent to pathological examination.

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Background: Granulomatous mastitis also known as granulomatous inflammatory lesionsof the breast can be divided into idiopathic granulomatous mastitis and granulomatousmastitis occurring as a rare secondary complication of a great variety of other conditions.Treatment is radically different for idiopathic granulomatous mastitis and other granulomatouslesions of the breast, the precise diagnosis is therefore very important. Objectives: The purpose of this study was to find the clinicopathological features ofidiopathic granulomatous mastitis, as well as the authors' experience with surgicaltreatment of these patients. Methods and Materials: A hospital based retrospective study done with twenty diagnosedpatients of idiopathic granulomatous mastitis enrolled from department of surgery, Ad-dinwomen's.medical college hospital, Dhaka in the period between July 2012- July 2015. Results: Mean age of presentation was 38.1 years. All patients had a history of childbirthand breastfeeding. Sixteen (80%) patients were premenopausal. The main clinical featurewas a mass in the breast in all patients and clinical findings suggesting an infection accompaniedthe mass in seven patients (35%). Surgery was the definitive procedure in allpatients. Wide local excision done in all patients. None of the patients received steroids.Median follow-up time was 12 months. During follow-up, two patients (10%) presented withrecurrence. All patients with recurrence had a mass in their breasts on the same side ofprevious disease. Conclusion: Increased recognition of this disease will improve its understanding andmanagement. Long-term follow-up is necessary. Journal of Surgical Sciences (2016) Vol. 20 (2) :51-54

Situs inversustotalis is a rare congenital condition present in approximately 0.01% of thepopulation in which the major visceral organs are reversed from their normal position and canpose difficulties in the diagnosis and management of abdominal pathology. Symptomaticcholelithiasis is very common and laparoscopic cholecystectomy is the gold standard treatmentat present. Laparoscopic surgery in a situation of situs inversus is challenging due tothe mirror-image anatomy. Diagnostic pitfalls and technical details of the laparoscopic cholecystectomyare discussed. Journal of Surgical Sciences (2017) Vol. 21 (1) :48-50