Background and objectives Metastasis to the breast from extra mammary sites is uncommon with an incidence ranging from 1.2 to 2 % in clinical reports. Approximately 300 cases of breast metastasis from extra mammary sites have been reported, mostly in small series or as a single case report. Gastrointestinal adenocarcinoma metastasising to the breast is also very rare and only 30 cases have been reported in the literature. Metastatic deposits within the breast may be difficult to distinguish from primary breast carcinoma. Radiological features and immunohistochemistry especially for steroid hormone receptors (ER/PR) and expression of gross cystic disease fluid protein (GCDFP) and presence of other immunohistochemistry protein factors in breast metastasis which are specific to primary site may be helpful in differentiating these two conditions. Materials and methods In this series of 3 cases of breast as an unusual site of metastasis, we present different cases of adenocarcinoma of stomach, sigmoid colon and kidney with metastasis to the breast and discuss the differential diagnosis and management plans. Conclusion In conclusion, secondary tumors to the breast are rare and thus differentiating primary tumors from metastatic breast carcinoma is important for rational and optimum therapy and avoidance of unnecessary radical surgery. Palpable breast lump without typical radiological signs of primary breast carcinoma in patients with known primary should be suspected of representing metastasis.

<p class="abstract"><strong>Background:</strong> Carcinoma of the temporal bone is rare, accounting for fewer than 0.2% of all the tumours of the head and neck. Despite the recent advances made in oncology, delayed diagnosis is common with temporal bone tumors which lead to significant morbidity and poor surgical outcomes. All cases of persistent otitis media or otitis externa which fails to improve with adequate treatment, temporal bone malignancy should be suspected. The aim of the study was to assess the incidence of temporal bone malignancy in patients with CSOM or external auditory mass<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> It is a prospective study conducted in department of ENT and Head and Neck surgery, Karnataka institute of medical sciences, Hubballi from July 2015- December 2016. All patients with CSOM presenting with otorrhoea and mass in the external auditory canal in our outpatient department were included in the study<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Out of 6496 patients included in our study, 3 patients were found to have temporal bone malignancy. Histopathological examination showed squamous cell carcinoma in all 3 patients. All three patients underwent lateral temporal bone resection with post-operative radiotherapy<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> High level of suspicion is necessary for early diagnosis of temporal bone malignancy especially in patients with CSOM unresponsive to conventional treatment<span lang="EN-IN">.</span></p><p> </p>

A 17-year-old underweight boy came with a classical emergency of diabetic ketoacidosis associated with two additional clinical features; persistently low blood pressure despite adequate fluid resuscitation and hypogonadal features with Tanner stage 3 pubic hair, absent facial, and axillary hair along with a high-pitched voice. These findings triggered an endocrine workup which revealed hypogonadotropic hypogonadism. Suspecting primary pituitary pathology, an magnetic resonance imaging brain, was done which showed a well-defined hyperintense lesion in the pituitary suggestive of pituitary apoplexy. In the absence of headache, diplopia, and visual field defects, this incidental finding posed a dilemma regarding the diagnosis and management of diabetic ketoacidosis in the presence of apoplexy.

We report a rare case of accidental toothbrush swallowing by a normal adult which was successfully removed by rigid esophagoscope. A 25 year young man presented to casualty of KIMS, Hubli, with ingestion of toothbrush accidentally half an hour before. Patient’s general physical examination and systemic examination was normal. Oral cavity, oropharynx and indirect laryngoscopic findings were normal. An emergency upper GI Endoscopy was done and foreign body was confirmed to be present at 35 cm from upper incisor teeth. Foreign body was removed by rigid esophagoscope under GA. Otolaryngologist is the most common medical faculty consulted for management of aero digestive foreign bodies. Toothbrush swallowing in normal adults is a rare accident. Most of them are found in esophagus and spontaneous passage is unknown and hence the need for early removal. [Int J Res Med Sci 2013; 1(4.000): 574-575

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Foreign body aspiration is a potentially life threatening medical scenario. Immediate diagnosis and intervention can save the many adverse outcomes. The aim of our study was to determine the pattern, presentation and management of foreign body aspiration in our population. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a retrospective study carried out in the Department of ENT and Head and Neck Surgery And Surgical Oncology, Karnataka Institute of Medical Sciences, Hubballi comprising of 22 patients with foreign body aspiration admitted to our department from July 2015 to February 2017.All patients with high suspicion of foreign body aspiration were included in our study. All patients underwent rigid bronchoscopy under general anesthesia.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our study, majority of our patients were in the paediatric age group below the age of three years. History was always accidental inhalation of the foreign body. Areca nut was the most common foreign body removed. All patients who underwent successful foreign body removal following rigid bronchoscopy completely recovered from their ailments. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">It could be concluded that rigid bronchoscopy is treatment of choice in management of foreign body aspiration especially in pediatric population. The gold standard for the diagnosis and management of this condition is rigid bronchoscopy under general anaesthesia.</span></p>