The incidence of duplication of the vermiform appendix is reported as 0.004 %. Most anomalies of the appendix have been observed in adults and were noticed incidentally during surgery not primarily involving the appendix. Picoli in 1892 reported the first case of appendiceal duplication. Malformations of the appendix may be associated with other visceral anomalies. Several theories have been put forth to explain the developmental anomaly. Duplication of the appendix should be considered in the differential diagnosis of lower abdominal pain, even if the patient reports a previous appendicectomy. Surgeons should be aware of the potential anatomical variations of the vermiform appendix, and careful inspection of the caecum should be performed during laparotomy. Misdiagnosis can cause serious life-threatening complications for the patient and lead to medicolegal problems. This is a case report of a 24-year appendiceal duplication revealed on old female with appendicitis who had laparotomy.

Malignant proliferating trichilemmal tumor (MPTT) is a rare cutaneous tumor predominantly affecting the scalp, eyelids, neck and face of elderly women. It is a large, solitary, multilobulated lesion that may arise within a pilar cyst. These tumors are largely benign, often cystic, and are characterized by trichilemmal keratinization. However, at times, the tumor has an aggressive clinical course and a propensity for nodal and distant metastases. Wide local excision with a 1 cm margin of normal tissue is the treatment of choice. Adjuvant chemotherapy and radiotherapy have been occasionally used to prevent recurrence in MPTT. This is a case report of a recurrent malignant trichilemmal tumor over scalp in a young female patient with nodal metastasis.

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