Paraneoplastic Pemphigus (PNP), a rare autoimmune blistering disease, can be accompanied by both benign and malignant neoplasms. The most frequently reported associated malignancies include lymphomatoid and hematologic malignancies, Castleman's disease, carcinoma, thymoma. In a patient suspected of PNP, with no known history of malignancy, an extensive workup is suggested to look for underlying malignancy, which has to be treated to induce PNP remission. In this clinical case report, cross sectional imaging of a young female diagnosed with PNP, unveiled a pericardial mass lesion extending into transverse pericardial sinus. Excisional biopsy was performed. Histopathology revealed pericardial ectopic thymoma. K E Y W O R D S paraneoplastic pemphigus, paraneoplastic syndromes, pericardial ectopic thymoma A 30-year-old female presented to the dermatology clinic with refractory painful oral ulcers and hemorrhagic crusting for the past 9 months involving inner cheek, gums and angle of the mouth, and a

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Pseudoaneurysms in the neck are challenging surgical cases. They need detailed preoperative evaluation, treatment of etiology, and surgical/interventional management at appropriate time.Here, we describe a case of 45-year-old female who presented to emergency with impending rupture of swelling in the right side of neck. On evaluation, it was found to be a pseudoaneurysm of right common carotid artery (RCCA). She was planned for emergency surgery, but the swelling ruptured before the patient could be taken into the operation room (OR). The challenges faced in managing it are described below.

Transposition of great arteries (TGA) presents in neonates or in infancy. We report a case of TGA with ventricular septal defect (VSD) and pulmonary stenosis (PS) in an adult male patient of 23 years age. Arterial switch operation with VSD closure and neo-aortic valve replacement was done. The patient recovered well in the post-operative period. In adult patients, conversion from atrial to arterial switch has been widely reported, both directly and after prior pulmonary artery banding in two stages, but primary arterial switch for TGA has not been reported previously. In this patient there was a benefit of having a large VSD and severe PS.