During surgery for colorectal cancer, the inferior mesenteric artery (IMA) may be ligated either directly at the origin of the IMA from the aorta (high ligation) or at a point just below the origin of the left colic artery (low ligation). Sixty patients of left colonic and rectal cancer undergoing elective curative surgery in 2007 and 2008 were selected for this observational study. The resected lymph nodes were grouped into three levels: along the bowel wall (D1), along IMA below left colic (D2), and along the IMA and its root (D3). Statistical analysis was performed with SPSS version 20.0. D2 level was involved pathologically in 20 (33.3 %) and D3 in six out of 44 (13.6 %) patients. The median nodal yield with high and low ligation were 33 and 25, respectively (p= 0.048). Median overall survival for high ligation was 62 months versus 42 months for low ligation (p=0.190). High ligation of the IMA for rectal and left colonic cancers can improve lymph node yield, thus facilitating accurate tumor staging and thus better disease prognostication, but the survival benefit is not significant.

Background: Thyroid carcinoma is one of the common cancers affecting the women in their young age. They vary from being indolent to aggressive cancers. Improvements in diagnostics and understanding the pathophysiology have made the treatment more effective with good long-term results. Methods: Cross sectional record based study at Dept. of Surgery, S.P.Medical College and P.B.M Hospital, Bikaner Results: Maximum 35% belonged to 31-40 years age group followed by 27% individuals in 21-30 years age group. Minimum 6% individuals were found in 11-20 years and >60 years age group.Among 100 patients, 69% were euthyroid, 27% were hypothyroid and 4% were hyperthyroid. Conclusion: Thyroid lesions were more common more in the age group of 3rd-4th decade years. Majority of the patients were females. Multinodular goiter was the most common non-neoplastic lesion and papillary carcinoma was the most common neoplastic lesion.Thus fine needle aspiration is a very useful and indispensible test in the diagnosis of thyroid lesions. Keywords: Thyroid swelling, goiter, FNAC.

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Phyllodes tumors are relatively rare breast lesions that usually occur in the age group of 35-55 years. It is a very rare diagnosis in young girls, particularly at prepubertal age. Because of the uncommon nature of this tumor in children, it may be misdiagnosed leading to inappropriate management. We report a case of a 9-year-old girl who was diagnosed as a case of borderline phyllodes tumor left breast. Simple mastectomy without axillary staging was performed. She has recovered well and is on follow up.

BACKGROUND: GIST is a visceral sarcoma that arises from the gastrointestinal tract. Computed tomography (CT) is an imaging modality of choice for diagnosing GIST. The clinical features and radiologic differential diagnosis of gastrointestinal stromal tumours are discussed by evaluating CT features of GIST in 40 cases. METHODS & MATERIALS: In this study, 40 biopsy proven cases of GIST attending our department from November 2010 to July 2012 are evaluated retrospectively. The CT scan was performed prior to the treatment in all these patients. CT imaging features that were taken into account include tumour location, size/diameter, degree & pattern of enhancement, intraluminal/exophytic, internal necrosis & haemorrhage, perilesional fat stranding, local spread, nodal & distant metastasis. RESULTS: In 26 out of 40 cases (65%), tumour was found in stomach, 8/40 (20%) in small bowel (jejunum & ileum), 4/40 (10%) in omentum and mesentery; and 2 (5%) tumour was found in transverse colon. 28/40 (70%) had exophytic tumour with communication to lumen of gastrointestinal tract or in omentum and mesentery; rest 12/40 (30%) had polypoidal mass. Size of tumour ranged from 4 to 15 cm, with mean of 7.9 cm. 30/40 (75%) cases showed heterogeneous enhancement with necrosis and/or calcification, rest 10/40 (25%) had homogenous enhancement. The CT HU ranged from 35 to 55, with mean of 40. 28/40 (75 %) cases had well defined margins of tumour, and rest 12 (30%) cases showed perilesional fat stranding and loss of fat plane with adjacent organ. 4/40 (10%) cases showed regional nodal involvement and 6/40 (15%) cases shows distant metastasis to liver & lungs. CONCLUSIONS: The stomach was the commonest site of GIST occurrence among our patients. The CT features of GIST were exophytic, ulcerated mass with well-defined tumour margins, and heterogeneous enhancement on post-contrast CT images.