INTRODUCTIONPrimary gallbladder carcinoma is a rare aggressive neoplasm of elderly with poor prognosis. The tumour is often unresectable at the time of diagnosis. Metastasis to heart is rare and only 6 cases have been reported in the indexed literature. We herein report a case of gallbladder carcinoma metastasizing to heart.PRESENTATION OF CASEA 54 year old female presented with dyspnoea and chest pain with past history of radical cholecystectomy and palliative chemotherapy for adenocarcinoma of gallbladder. Chest X-ray showed cardiomegaly and 2-D ECHO revealed features of tumour deposits on the surface of myocardium and malignant pericardial effusion. Mini-thoracotomy and pericardial window procedure was done to relieve distressing symptoms and biopsy of pericardial tissue revealed metastatic adenocarcinoma. In spite of intensive care, patient succumbed to disease in the post-operative period.DISCUSSIONPrimary adenocarcinoma of gallbladder is the most common malignancy of biliary tract and fifth most common malignancy of gastro-intestinal system with dismal prognosis. It most commonly spreads to liver and regional lymph nodes, very rarely distant metastasis occurs to kidney, adrenal, thyroid and bones as reported in the literature. Metastasis to heart presents with symptoms of cardiac failure due to pericardial effusion. Even with intensive care patients will invariably succumb to the disease.CONCLUSIONMetastatic spread to heart from carcinoma of gallbladder is very rare. Should a patient be suspected of or an operated case of gallbladder carcinoma present with symptoms of congestive heart failure and massive pericardial effusion, cardiac metastasis should be considered.

No abstract

Ectopic liver (EL) is a rare developmental anomaly in which the liver tissue is situated outside the liver and has no hepatic connection. The real incidence of EL attached to the gallbladder wall is difficult to assess but is reportedly 0.24-0.47% of the population though as with other sites, most of the cases of EL attached to the gallbladder are diagnosed at laparotomy, laparoscopy or during an autopsy. Hepatobiliary Imino-Diacetic Acid (HIDA) scan, besides ultrasonography and computerized tomography, may be helpful in diagnosis. Colour Doppler ultrasound or angiography may demonstrate a feeding vessel.

Solitary fibrous tumor (SFT) is uncommon soft tissue tumors which most frequently occur in the pleura. Most of these tumors project into the pleural cavity in a pedunculated manner from the visceral pleura. Larger tumors in the thoracic cavity may present with dyspnea, chest pain and malaise while smaller tumors are usually asymptomatic. Since its first description in 1931, only 800 cases of such tumors have been reported so far. Here we present a case of a 40 year old housewife with complaints of right sided, vague, dull-aching chest pain for 2 months. Her medical history was unremarkable. Radiologic imaging revealed a large (16.5cm X 10cm) lobulated mass lesion seen in the right hemi-thorax. Right sided postero-lateral thoracotomy was done and the tumor was excised. Histo-patological examination of the cut section showed benign spindle cell tumor. Immunohistochemistry was positive for CD34. Solitary Fibrous Tumor of the pleura is a rare neoplasm and no such case has been reported so far from Manipur, India. We were successful in detecting; planning and complete surgical removal of the SFT of the pleura in our patient and the patient is under monitoring and follow up to detect any recurrence in near future.

Superficial angiomyxomas are rare benign soft tissue tumour usually solitary and predominantly involving the dermis and subcutis. We report a case of 21 years old male who presented with a history of swelling on the left upper anterolateral aspect of neck, measuring 3x2cm with irregular surface, non-tender, mobile and firm in consistency, fixed to the skin but not to the underlying structured. No lymph node was palpable. There was no evidence of any of the components of Carney's complex at the time of presentation. Provisional diagnosis was made as Pleomorphic adenoma by FNAC. Wide local surgical excision was done. Histopathology examination revealed to be superficial angiomyxoma. Here, we present a case of superficial angiomyxoma with a review to its rarity and difficulty in diagnosing and distinguishing from other soft tissue tumour of the skin.