Primary localized amyloidosis in the head and neck region is a rare entity. The most commonly involved organ is larynx. Primary amyloidosis localized to the sinonasal tract is extremely rare. We report one such case along with a brief review of the associated literature. The aim of reporting this case is to emphasize the fact that sometimes nasal amyloidosis can also present with signs and symptoms of nasal and nasopharyngeal malignancy. The definitive diagnosis in such cases depends upon histopathology and further confirmed by immunohistochemistry. A 55-year old male presented with recurrent episodes of nasal bleed, bilateral nasal obstruction, and bilateral hearing loss from last 7 years. On clinical examination a mass was found in the nasal cavity on both sides reaching up to the nasopharynx. Contrast enhanced CT scan revealed that the mass was extending up to the skull base and destroying bony landmarks of the nasal cavity and paranasal sinuses. Mass was proved to be amyloidosis after histopathological examination. It showed multiple blotches of globular submucosal deposit of amyloid, on staining with Congo red. Immunohistochemistry confirmed AL amyloidosis with expression of mixed kappa and lambda light chain immunoglobulin (j [ k). No evidence of systemic amyloidosis was found after proper work up. It was managed by conservative surgery.

The survival rate of cutaneous melanoma is related to the histological type of tumour and the depth of dermal invasion of the original lesion. 10 In this case, the primary cutaneous melanoma was spindle cell type with a depth of 10 mm. The prognosis is poor 11,12 due to disseminated disease and the poor response to chemotherapeutic regimes. However, the behaviour of melanoma is unpredictable and at times quiescent, resulting in long survival after initial diagnosis and even first onset of metastatic disease as demonstrated in this report. References

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BACKGROUNDThyroid nodule is the most common entity and presentation of underlying thyroid pathology. Term goitre is generalized enlargement of thyroid gland. The management of thyroid swelling depends on clinical examination, battery of tests to reach correct diagnosis. METHODSThis is prospective study of clinical evaluation of thyroid swellings done on 100 patients presented with palpable thyroid