In the search for a more potent alternative to a single i.m. injection of methotrexate for ectopic pregnancy, a randomized trial was organized. The efficacy of a combination of methotrexate and mifepristone was compared with methotrexate alone in the treatment of unruptured tubal pregnancies. The diagnosis of an unruptured tubal pregnancy was confirmed laparoscopically in 50 patients during a 2 year period. Women were randomized to receive a single i.m. injection of 50 mg/m2 methotrexate alone or a single dose of 600 mg oral mifepristone in combination with the same dose of methotrexate. Both treatment protocols were successful in achieving the resolution of unruptured ectopic pregnancy (18/25 in the methotrexate group and 22/25 in the combination group) following the initial intervention. A second injection was needed in four (16%) cases in the methotrexate group and in one (4%) case in the combination group. Overall, a complete resolution was achieved in 22/25 and 23/25 cases respectively. Unruptured ectopic pregnancy resolved faster in women given the combination of methotrexate and mifepristone compared to women given methotrexate only (P = 0.01). The effect of the methotrexate and mifepristone combination was more pronounced in women with higher human chorionic gonadotrophin concentrations.

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Aggressive angiomyxoma is a rare, locally invasive mesenchymal tumor predominantly presenting in women of reproductive age and also having a moderate-to-high risk for local relapse. Hence, it needs to be differentiated from other mesenchymal tumors occurring in this region. We present here a case of a 40-year-old female presenting with a large, fleshy, pedunculated mass on the right labia majora.

BACKGROUND Head and neck lesions are very commonly encountered superficial lump in cytopathology department and swellings in this region rarely go unnoticed. FNAC (fine needle aspiration cytology) is of great value in early diagnosis and differentiation of large number of infective, benign and malignant lesions in head and neck region. AIMS AND OBJECTIVES To study the spectrum of various head and neck lesions on the basis of FNAC in a tertiary care hospital. MATERIAL AND METHODS This retrospective study was done from outpatient as well as in-patient department with palpable head and neck swellings referred to dept. of pathology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam. A total no of 933 cases were selected during a period of April 2011 to April 2015. The FNAC spectrum of various head and neck lesions are studied. RESULTS Out of 933 cases, 489 (52.4%) were male and 444 (47.5%) were female. Maximum number of patients were in the age group of 11 to 20 years (19.9%). 869 cases show satisfactory smears. In satisfactory smears of FNAC, involvement of lymph node is most common 53.8%, followed by soft tissue and miscellaneous lesions comprising 22.1%, thyroidal lesions 16.9% and salivary gland lesions 7.1%. CONCLUSION Our study found that FNAC can be recommended as a first line of investigation in the diagnosis of head and neck lesions.

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