Background Benign fibrous histiocytomas are among the most common soft tissue tumors and are made up of a mixture of fibroblasts, histiocytes, and chronic inflammatory cells. These are commonly found in skin and less commonly in deep soft tissues. There are reports of the presence of a malignant counterpart of fibrous histiocytoma in the breast; however, existence of benign fibrous histiocytoma in breast is a very rare occurrence. Case presentation We present here a case of benign fibrous histiocytoma at an uncommon location with a common presentation. This is a case of 45-year-old female patient, who complained of a painless focal area of hardness and itching in the left areolar region that developed gradually for 1 year, with recent onset of areolar skin thickening, erythema, and mastalgia on the left side. Physical examination revealed a focal area of nodular thickening in the areolar region on the left side with erythema and skin excoriation. No mass was palpable in either breast or axilla. A subsequent mammogram showed an area of focal thickening in the areolar region. Ultrasound also showed a similar finding of nodular skin thickening. Paget’s disease was suspected based on clinical and imaging findings. The contralateral breast was normal. Afterward, a core needle biopsy was done, but the histopathology report was inconclusive and showed only a spindle cell lesion. In due course, excisional biopsy was performed and on the basis of morphology and immune-histochemical markers, a diagnosis of benign fibrous histiocytoma was made. Conclusions Benign fibrous histiocytomas are varying soft tissue tumors that show wide variations in anatomic locations, biologic behavior, and pathologic features. Its diagnosis can be very challenging by imaging and even on histopathology. It must be based on the combination of morphological features and immunohistochemistry. Breast is an extremely uncommon location, and its presentation can mimic invasive carcinomas. A number of other benign and malignant skin lesions may be considered as probable differential diagnosis. It is worthwhile to keep these diverse entities in mind as differential diagnosis, with regards to this particular clinical presentation, which can be beneficial in dealing with challenging cases.

A neurodegenerative disorder which is fatal, rapidly progressive and has no effective treatment till date is amyotrophic lateral sclerosis. Almost 90% of all cases occur in the sporadic form, with the rest occurring in the familial form. It is a devastating disease leading to death within 3-5 years in most cases. The diagnosis of AML is difficult to made in spite of acknowledgment for 140 years. It is diagnosed by clinical presentation which is a combination of upper and lower motor neuron signs and electro diagnostic studies which gives information about diffuse motor axonal injury. This neurodegenerative disorder results in degeneration of corticospinal tracts and anterior horn cells and involving motor neurons of the cerebral cortex, brainstem, and spinal cord. There are a variable signs and symptoms of this disease, so the diagnosis is very important for the management and better outcome of the patients. Cause of death in these patients is usually respiratory failure

Background Axillary lymphadenopathy is a common clinical presentation of variety of benign and malignant diseases. However, majority of patients with unilateral axillary lymph node enlargement have an underlying malignancy in which association with breast carcinoma being the commonest one. In most of these patients there will be a discernible primary tumor, either clinically or radiologically. However, in axillary lymphadenopathy with negative mammogram is not very common, and in this case other malignant causes should also be considered in addition to occult breast cancer and these can be metastases from other primary tumors for, e.g., lung, genitourinary tract, gastrointestinal, ovarian, thyroid carcinomas and malignant melanoma. Axillary node is an uncommon site of metastases from Transitional cell carcinoma (TCC) of urinary bladder even from its muscle invasive form, and distant metastasis from low grade superficial tumors without muscle invasion or regional metastasis is a very rare occurrence. Here we present a case of axillary nodal metastases from non-muscle invasive (superficial) bladder cancer without history of local recurrence and regional metastases. Case presentation We present a case of female patient who complaint of hard swelling in right axilla and right breast enlargement. Patient had past history of non-muscle invasive transitional cell carcinoma of urinary bladder (pTa, grade II A) which had been treated accordingly. No recurrence of bladder growth had been observed on serial check cystoscopies. On clinical examination of breast and axilla, right breast appears enlarged and there were palpable hard fixed axillary lymph nodes. Ultrasound showed enlarged malignant looking lymph nodes. Occult breast carcinoma with metastatic axillary lymph nodes was our initial impression; however, subsequent biopsy of axillary lymph nodes showed Transitional cell carcinoma. Conclusions This patient’s case emphasizes the importance of having sound knowledge of natural behavior of primary tumor and common and uncommon sites of distant metastases. The causes of unilateral axillary lymphadenopathy include both benign and malignant disease.