Primary splenic angiosarcomas (PSA) arise from splenic endothelium are rare and impose a diagnostic challenge preoperative. They can present as asymptomatic splenomegaly however; the commonest presentation is abdominal pain. The spleen can rapidly increase in size and can manifest as spontaneous rupture which would cause peritoneal dissemination of disease. Early metastasis of PSA is seen in liver, lungs, lymph nodes and gastrointestinal system. Preoperative diagnosis requires a high index of suspicion and ultrasound, contrast enhanced computerized tomography may essential to differentiate from splenic hemangioma. Splenic angiosarcoma are best treated with splenectomy with a limited disease, with care taken not to rupture and cause spillage. PSA are resistant to adjuvant radiation and chemotherapy. Mortality is high with median survival rate of only 5 months, irrespective of treatment and hence the need to diagnose before complications. Bisphosphonates, adjuvant radiation with chemotherapy have been attempted to increase disease free survival. We report a case of PSA emphasizes on early preoperative diagnosis to avoid progression of the disease.

Lymphangiomas are benign lesions characterized by the proliferation of lymphatic spaces, primarily diagnosed in children. It most often occur in the head, neck, axilla, or groin. Infrequently, intra-abdominal lymphangiomas are diagnosed in adults, primarily located in the mesentery. Author wish to discuss this case due to its rare site and age of presentation.

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An invasive mole (formerly known as chorioadenoma destruens) is a hydatidiform mole that has grown into the muscle layer of the uterus. Invasive moles can develop from either complete or partial moles, but complete moles become invasive much more often than do partial moles. Because these moles invade into the uterine muscle layer, they require chemotherapy and/ or surgery.

The main location of hemangiomas is the head and neck, followed by the trunk and limbs. We present an unusual case of hemangioma with basophilic bodies, which created a diagnostic dilemma. This case had a scalp swelling which was excised and sent for histological examination. It turned out to be a hemangioma on microscopy, however, showed some basophilic structures on the surface of the lesion which were difficult to decode. This case gives us a lesson that only turning pages of a book doesn’t suffice, knowing a detailed clinical history followed by analysis of the same helps in final conclusive diagnosis.