A paraganglioma is a rare neuroendocrine neoplasm that may develop at various body sites (including the head, neck, thorax and abdomen). About 97% are benign and cured by surgical removal; the remaining 3% are malignant because they are able to produce distant metastases. When presenting within the abdominal cavity, they may arise as a primary retroperitoneal neoplasm and can mimic vascular malformations or other conditions related to specific retroperitoneal organs such as the pancreas, kidneys, or adrenals. Retroperitoneal paragangliomas are mostly benign with good prognosis; however, they can present with abdominal pain, palpable mass, or hypertensive episodes. Patients should be initially evaluated with catecholamine levels, followed by computed tomography or magnetic resonance imaging to locate the primary lesion. Surgical excision remains the mainstay of treatment, although advanced disease and proximity to vital organs can make excision difficult or impossible. We report a rare case of retroperitoneal mass presented to be a non-functioning Paraganglioma.

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OBJECTIVESThe advances in modern surgery era for assessment of breast lumps has not replaced the triple assessment, which are clinical examination, radiological examination and pathological examination. (1) This study is about to substitute mammogram and ultrasonogram to assess the palpable breast lumps. (2) combined with other two modalities. METHODS Place of StudyDepartment of General Surgery, Chennai Medical College Hospital, Irungalur, Trichy. Method of collection of data: A prospective cross sectional study of 100 female patients with palpable breast lumps attending outpatient department was done and study period is from April 2013 to September 2015. Inclusion CriteriaFemales more than 30 yrs. Females presenting with palpable breast lump. Exclusion CriteriaFemale patient less than 30 yrs. Male patients. Advanced breast cancer patients. RESULTSOut of 100 female patients, 68 patients with 73 breast lumps were inducted into the study. The MTT obviated excision biopsy in 16 patients (22%) and this is the potential advantage of this test. Thus the final study group (n^57) underwent the MTT followed by excision biopsy, the results of which were available for comparison. The average age of women in this study was 41.84+9.1. The mean shifting to 47 years in patients with malignancy, the youngest patient was 30 years and the oldest was 65 years. This conforms with the suitable age for subjecting patients to screening procedure followed worldwide (i.e.) above 40 years; 9 women were nulliparous of which only 3 had malignant lesions. The rest (n-48) were nulliparous. The results do not point to any positive association between parity and malignancy (P>0.05). CONCLUSIONWe conclude that modified triple assessment is a very useful diagnostic tool to evaluate patients with breast lumps and to detect patients with breast cancers with replacing core needle biopsy instead FNAC and Ultrasonogram for Mammogram pertaining to facility available.

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