Lipomas are the most common, subcutaneous, and slow-growing tumors composed of fat (adipose tissue). Out of many types of these benign tumors, ossifying lipoma (osteolipoma) is the rarest subtype. Here, randomly distributed trabeculae of lamellar bone are seen within mature adipose tissue. They are featured only as isolated case reports and small case series, thus the true incidence is not known. The most common site for osteolipoma is the head and neck region and they are rarely reported in the lower extremities. Herein, we discuss the case of a 19-year-old man who presented with a progressively enlarging painful mass in the left leg. Radiology was typical of osteoid osteoma. Excision was performed and histopathological examination confirmed the lesion as osteolipoma with no evidence of malignancy. No recurrence of the tumor was observed after 2 years of follow-up. Although osteolipoma is a rare entity, the differential diagnosis of the lesion can be kept in mind whenever we encounter ossification within the adipose tissue.

Multiple synchronous primary carcinoma involving gall bladder, liver and common bile duct are rare and difficult to differentiate with hepatic and extrahepatic bile duct metastasis from single primary. Radiological features, molecular landscape, and even integrated mutational profiling are not of much help. We describe a case of 48-year-old male who presented with jaundice and follow up CT scan raised the suspicion of gall bladder carcinoma with hepatic metastasis. Peroperative frozen section examination revealed adenocarcinoma with involvement of cystic duct margin; however revised common duct margin was free from tumor invasion. Final histopathology on resected gall bladder revealed multifocal adenocarcinoma, while histomorphology of hepatic nodule was consistent with cholangiocarcinoma. Common bile duct a one focus had also revealed adenocarcinoma while cut margins were negative form malignancy. In view of different morphology of gall bladder and hepatic tumor, no continuity of three tumors and single large, firm, non umblicated hepatic nodule, diagnosis of multiple synchronous carcinoma was suggested.