Background:Liver is one of the most common site of metastases in patients with malignancy and the evaluation of space occupying lesions (SOL) of liver in patients with malignancy is important. Its important to differentiate benign from malignant to take necessary decisions.Materials and Methods:We have performed a retrospective analysis of liver SOLs for which fine needle aspiration cytology (FNAC) was done in the year 2011. Risks and benefits associated with FNAC were evaluated.Results:We analyzed 755 patients who underwent FNAC of which 524 patients had secondary metastases to liver, 148 patients had primary hepatocellular carcinoma, 14 cases were benign neoplasms and 53 were nonneoplastic conditions. Histological correlation with FNAC was available in 112 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93%, 90.9%, 98.9%, 58.8%, and 92.8%, respectively. Though there were no incidence of bleeding, two patients developed track metastases following FNAC. One was a case of Hepatocellular carcinoma and the other a case of metastatic breast cancer.Conclusion:FNAC was very much useful in our setup where most of the patients could not afford for Computer tomography (CT) scan and was useful in counseling them especially in patients with advanced malignancy where no active cancer directed therapy is required.

Thyroid surgery evolution is important with a lots of hurdles faced by many surgeons to reach the present stage. The complications from the olden days reduced with improvement in understanding the disease process, development of antibiotics, anaesthesia and now restricted mainly to hypoparathyroidism and recurrent laryngeal nerve injuries. A retrospective analysis of thyroid surgeries performed at BP Koirala Institute of Health Sciences centre from 2007 to 2011 Clinicopathological features and complications were analyzed. Among 203 patients who underwent surgery for thyroid operations, 53 were malignant and 150 were benign cases. Hemithyroidectomy was the most common procedure performed (118 cases). Papillary thyroid cancer was the most common malignant lesion and colloid goiter the most common benign lesion. Postoperative complications occurred in 12 patients-infection in two patients, bleeding requiring reexploration in one patient, hypocalcemia in 6 (5-transient and 1-permanent) and hoarseness of voice in three patients (2-temporary and 1-permanent). FNAC is an easy, cost effective, reliable investigation in experienced hands. Reoperation, primary stage of the tumor and central node dissection are associated with increased complication rates.

Bleomycin is a chemotherapeutic antibiotic used in various malignancies. Its toxicity is mainly lung and skin with marrow sparing effect. Here we would like to describe a characteristic skin reaction developed because of bleomycin in a case of intracranial germ cell tumor. Flagellate erythema which is a self-limiting toxic reaction can cause residual hyperpigmentation.