Skin biopsy findings were significant in all cases. The morphological patterns of cutaneous metastases corresponded with the primary tumors and their evaluation helped localize unknown primary malignancies. In cases with known primaries, cutaneous metastases upstaged the malignancy and affected the prognosis.

Introduction: Parathyroid adenoma with prominent lymphocytic infiltration is rare, with only 12 cases reported in the English scientific literature. All these cases were not related to synchronous autoimmune or IgG4-related disease and presented clinically with primary hyperparathyroidism. Case presentation: A 65-year-old woman presented with hypercalcemia and a neck mass, suggestive of parathyroid adenoma. She underwent parathyroidectomy and histopathological examination of the specimen showed a hypercellular parathyroid nodule comprising mature lymphoid cells admixed with parathyroidal chief cells. A comprehensive immunohistochemistry panel confirmed the benign nature of the lesion. The patient remains asymptomatic a year after the surgery. Discussion: Parathyroid adenoma with prominent lymphocytic may be misdiagnosed as a lymph node at frozen section or cytology smears by an unsuspecting pathologist or cytologist, if the lymphoid component is predominant on the slide examined. Additionally, the morphology could be misinterpreted as a metastasis of parathyroid carcinoma into a peri-thyroidal lymph node. For this distinction, correlation with clinical and radiological findings is crucial and clues to adenoma include presence of a rim of uninvolved parathyroid parenchyma, low mitotic activity (<5%) and positive staining for parafibromin, bcl-2 and MDM2 on immunohistochemistry.

In addition to preservation of the number of corneal endothelial cells with the use of viscoelastic materials and changes in ultrasound power during cataract surgery, activation of the remaining endothelial cells would be benefi cial. Dexamethasone has been shown to increase the Na+,K+-ATPase activity of bovine corneal endothelial cells in vitro. 5 Topical corticosteroid administration has also proved effective for the treatment of corneal edema, possibly as a result of the activation of corneal endothelial cells. 2 The administration of eyedrops containing 0.1% dexamethasone phosphate maintains corneal endothelial pump rates in patients with Fuchs' dystrophy. 4 These experimental and clinical observations suggest that steroids might promote maintenance of corneal transparency through activation of endothelial cells.

Isolated squamous cell carcinoma of cornea, though a rare entity, should be kept in mind in patients with any corneal mass.

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