Villous adenomas are known to occur in gastrointestinal tract; however, they are very rare in female genital tract. The pathogenesis is unclear but their origin from cloacal remnants has been hypothesized. Here we report a rare incidental case of primary villous adenoma with high grade dysplasia arising from vaginal vault in a 28-year-old female who presented with abnormal vaginal bleeding. The importance of reporting this lies in its pre-malignant behaviour and benign looking clinical appearance.

Fungus as a cause of gastric perforation is very rare. Very low pH of stomach usually does not support fungal growth. It is usually associated with immunocompromised state or is seen in debilitated patients like patients receiving steroid therapy, patients with Diabetes Mellitus (DM) and Human Immunodeficiency Virus (HIV) infection, patients undergoing transplant. Prolonged use of strong antacids can also be a predisposing factor for gastric fungal infection; although this theory is controversial, authors could find few studies which were similar to present study. Here, authors are reporting two cases of gastric perforation leading to peritonitis, in otherwise healthy individuals due to prolonged Proton Pump Inhibitors (PPIs) use, due to Candida infection, in the following case report. Both patients (48-year-old male and 65-year-old female) had history of chronic PPI use, had gastric perforation and underwent exploratory laparotomy. On histopathological examination of perforation edge biopsy yeast forms and few pseudohyphae of Candida species were identified. Postoperatively one of the patients survived with systemic antifungal, antibiotic therapy along with replacement of PPI with histamine H2 receptor blockers. The other patient could not survive and died postoperatively due to septicaemia. Fungal aetiology in gastric perforation should prompt further evaluation to look for underlying cause. This case report highlights the effects of unjust and over use of strong antacids for prolonged period.

Fibrocartilaginous dysplasia (FCD) or massive cartilaginous differentiation in fibrous dysplasia are interchangeably used terms. It is a rare variant of fibrous dysplasia (FD) which is benign, lytic, and expansile bone lesion and causes progressive deformity in the bones and may lead to pathological fracture. Radiologically, FCD may confused with cartilaginous benign and malignant bone tumours. FCD usually shows calcification in imaging. Surgical curettage or corrective osteotomy and histopathological examination of these lesions is necessary to differentiate it from other cartilaginous tumours. Here we report case of fibrocartilaginous dysplasia of distal femur in a 4-year-old male child.

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