thyroid tumors producing colony-stimulating factors associated with neutrophilia and/or eosinophilia are very rare and almost all of them concern anaplastic thyroid cancer. Only one case of papillary thyroid carcinoma associated with neutrophilia and one case of medullary thyroid carcinoma associated with eosinophilia have been reported. In this report a 72-year old male patient with metastatic papillary thyroid carcinoma associated with neutrophilia and eosinophilia is described. While investigating the cause of neutrophilia and eosinophilia, a blind bone marrow biopsy of the posterior iliac crest was performed, which showed infiltration by papillary thyroid carcinoma. High blood levels of granulocyte-macrophage colony-stimulating factor (GM-csF) were found using an enzyme-linked immunosorbent assay. As other causes of neutrophilia and eosinophilia were excluded, we assumed that these were paraneoplastic manifestations induced by GM-csF produced by the thyroid tumor. the disease progressed rapidly, despite appropriate treatment which included thyroidectomy and postoperative radioactive 131 I administration. the patient died 11 months after diagnosis because of extensive lung metastasis. Neutrophilia and eosinophilia were stable findings, while serum thyroglobulin levels remained elevated throughout the follow-up period. to our knowledge, this is the first report of a patient with metastatic papillary thyroid carcinoma in whom with neutrophilia and eosinophilia associated with high circulating levels of GM-csF were detected.

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Omental EGISTs remain silent despite a large tumor size. They are diagnosed at a median age of 65 years and show low proliferative activity in the majority (about 80%) of cases. Although the median follow-up period of published cases is only 20 months, mortality appears to be low after R0 resection and is expected to decrease further following the recent introduction of imatinib therapy for high-risk tumors. Accumulating molecular genetic data may lead to improved prognostic classification and patient management.

Large vaginal cysts during pregnancy are rare and can mislead Obstetricians to a false diagnosis, that of “Protruding membranes”. Aspiration of the cyst can be easily performed, resulting in the collapsing of the cyst and an uneventful vaginal delivery can be conducted.