Dermatomyositis is an idiopathic muscle disease characterized by proximal muscle weakness, raised muscle enzymes, characteristic changes in electromyography and typical skin rash and biopsy findings. Dermatological features like Gottron’s sign and papules are considered as pathognomonic for dermatomyositis. Panniculitis is one of the rare findings in DM. Here, we report a case of DM in 37 years old female who presented with only panniculitis and the diagnosis was delayed by more than a year.

Aims: To audit and evaluate the surgical indications, routes of surgery and types of hysterectomies performed along with histopathological analysis of those hysterectomies in respect to disease of endometrium, myometrium, cervix and fallopian tubes and ovaries for benign conditions. Methods: This is retrospective cross sectional study of all hysterectomy specimens received in the department of Pathology, B and C teaching hospital and research center, Jhapa, Birtamode, Nepal from May 2017 to May 2019. Clinical details were received from the data provided by gynecologists in histopathological requisition forms. Only specimens received for the benign indication for hysterectomy were taken. Results: Out of 115 specimens, the number was equal on both abdominal and vaginal route. The common indications were leiomyoma (60%, n=69), abnormal uterine bleeding (24%, n=28) and uterine prolapsed in 11% (n=13). Uterovaginal prolapse was seen commonest indication for hysterectomy in age group of 5th and 6th decade of life. Myometrial pathology was seen in 74% (n=75) comprising mostly of leiomyoma. Endometrial pathology was present in 14% (n=16) and chronic non-specific cervicitis in 24% (n=28). Abnormal tubo-ovarian pathology was found in 40% (n=51). Conclusions: Leiomyoma, abnormal uterine bleding and uterovaginal prolapsed are the common benign conditions undergoing hysterectomy.

Cutaneous horns are cornified hyperkeratotic lesions on the skin, usually present on photo-exposed areas such as the face and scalp. Its presence on the penis is very rare and represents the most unusual site. The role of chronic irritation, phimosis, surgical trauma, and radiotherapy have been implicated in penile horn formation. Penile horns present as elongated, keratinous, white or yellowish projections that range from a few millimeters to centimeters in size arising from the glans penis. Histopathology of the keratotic mass reveals nothing but keratin. One-third of cases of penile horns are associated with underlying malignancies. The standard treatment is electrosurgical excision with the removal of a broad base.

Here is a case report of a 62-year-old female who presented to our hospital with complaints of abdominal pain, unresolving severe anemia, bleeding per rectum with history of multiple blood transfusions at outside hospital. On initial investigations, the findings directed towards case of hemolytic anemia. The cause of hemolytic anemia was still unknown even after extensive clinical and laboratory investigations. Bone marrow biopsy was done, which revealed metastatic adenocarcinoma and diagnosis of cancer-related microangiopathic haemolytic anaemia (CR-MAHA) was established. Endoscopic biopsy was done from gastric growth which revealed gastric adenocarcinoma and final diagnosis of microangiopathic hemolytic anemia secondary to gastric adenocarcinoma was made. The patient’s haematological parameters improved with chemotherapy directed against the gastric adenocarcinoma. Our case supports the findings of various literature which indicates that the gastric cancer-associated MAHA responds well to the treatment with chemotherapy for primary carcinoma.