Uterine developmental abnormalities can cause both obstetric and gynaecological complications. Non-functioning rudimentary uterine horn is a rare cause of dysmenorrhoea which usually starts after menarche. Cases with lateral/inferior arrangement of blood supply to the functioning rudimentary horn and lapascopic removal have been described in literature. Ours is a unique case of non-functioning rudimentary horn with an unusual medial arrangement of vasculature successfully treated by laparoscopic excision. We also present a brief review of the literature. The patient presented with irretractable dysmenorrhoea despite hormonal manipulation and analgesics. Following the diagnosis using laparoscopy and hysteroscopy and MRI, the left sided non-communicating rudimentary horn with inactive endometrium was removed laparoscopically. Her symptoms were resolved and this was followed by successful pregnancies. Diagnosis of rudimentary horn with inactive endometrium is difficult. Ultrasound is unreliable. MRI, 3D CT scan and 3D ultrasound are gaining popularity. Accurate, prior identification of the type using laparoscopy and hysteroscopy if necessary is essential. This helps in surgical planning. The laparoscopic approach is increasingly being used to resect these horns due to its safety and merits.

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Background Adrenocortical carcinoma is a rare malignancy (0.5–2 cases/million/year) with a poor prognosis. Hypercortisolism, virilization, and compressive features are among the common presentations of adrenocortical carcinoma. Hematuria is one of the rare initial presentations of adrenocortical carcinoma reported in the literature. We report a case of adrenal carcinoma presenting with microscopic hematuria. Case presentation A 67-year-old Sri Lankan patient with diabetes, hypertension, and ischemic heart disease presented with an acute coronary event. During the routine evaluation, microscopic hematuria was detected without proteinuria or active sediments. She denied any painful micturition, previous similar episodes, or abdominal pain. Further evaluation revealed a hypokalemia with biochemical evidence of hypercortisolism and high testosterone levels with suppressed adrenocorticotropic hormone levels. On imaging, there was evidence of a right suprarenal mass 7 cm × 3 cm × 6 cm in size that was hypoechoic and lobulated and suggestive of a lipid-poor tumor. She underwent adrenalectomy. By the time of surgery 3 weeks later, significant weight gain with features of Cushing syndrome, including hirsutism, skin atrophy, easy bruising without virilization, and proximal myopathy, were noted. Histology identified a right-sided adrenal tumor with capsular and vascular invasion. Hypercortisolism and hematuria disappeared after surgery. The patient was referred for further oncological management. Conclusion This case illustrates a rare presentation of adrenal carcinoma. Awareness of this presentation may facilitate early evaluation and management.

A 43 year old previously healthy woman presented with painful bilateral lower limb swelling for 3 weeks, and fever and polyarthralgia of 3 days duration. She had a history of close contact with cats. Examination revealed moderate hepatomegaly with severe muscle tenderness. She had eosinophilia and elevated creatinine kinase and lactate dehydrogenase. Results of her toxoplasmosis serology were consistent with acute toxoplasmosis. Immunosuppressive conditions were excluded. Bone marrow biopsy revealed marked eosinophilia. According to these findings she was diagnosed as having acute toxoplasmosis complicated with myositis. This was further strengthened by her response to pyrimethamine and sulfadiazine treatment.