Malignant pleural mesothelioma is usually associated with asbestos exposure. It rarely metastasizes to brain. We are reporting a case of biphasic malignant pleural mesothelioma confirmed with trucut biopsy of pleura in a 40-year-female with classical costal and mediastinal rim like pleural thickening on CT scan thorax. The patient also had brain metastasis on presentation. Due to the incurable nature of her disease, the patient was given palliative chemotherapy but she died soon after presentation.

The etiology of Kawasaki disease (KD) continues to be elusive to the researchers. Although epidemiological studies support infectious origin, familial occurrences across the world suggest possible genetic predisposition. We are reporting two cases of KD diagnosed among cousins. The diagnosis in both these cases was based on clinical criteria. Laboratory data and response to therapeutic measures was also noted. This study reports the occurrence of familial KD in Indian population, which has not been reported in Indian literature before.

Metastasis to skin and subcutaneous tissues is a rare occurrence in colorectal cancer and represents widespread disease. When skin is involved, it is usually postoperatively and at the site of incision. We present here a case of synchronous cutaneous metastasis to forearm in a patient with adenocarcinoma of colon without metastasis to other viscera. Resection of the metastatic lesion and resection of the primary tumor were performed and the patient underwent chemotherapy. Eventually, the patient developed widespread metastasis and died within 2 years of surgery. This case illustrates that cutaneous metastasis can be the initial presenting feature in colonic adenocarcinoma and can occur even in the absence of visceral metastasis.

BACKGROUND: Eosinophilic granuloma is a rare tumor of flat bones usually presenting in children. The clinical manifestations as well as radiological features of eosinophilic granuloma are highly variable and are often a diagnostic dilemma. We present here a case of eosinophilic granuloma localized to the tibial shaft, which was managed successfully by excision and curettage without bone grafting.

CASE REPORT: An eight-year-old girl presented with swelling and pain in the left tibia. On tibial X-ray, a well demarcated 5 to 6 centimeter oval radiolucency within the shaft of upper third of left tibia with sclerosis of medial cortex was seen. Magnetic Resonance Imaging (MRI) showed a 6 centimeter hypointense lesion in the medulla of the medial aspect of tibial shaft on T1W sequence. This lesion was hyperintense on T2 and STIR sequences with surrounding bone marrow edema and mild cortical thinning. In addition, there was no soft tissue involvement outside the bone. Patient was taken to the operation theatre for excision and biopsy. Histopathological examination was consistent with eosinophlic granuloma. Postoperatively, wound and bony defect healed completely, both radiologically and clinically.

CONCLUSION: Eosinophilic granuloma is usually diagnosed on histopathology, and open biopsy along with curettage is the preferred form of treatment. However, recurrence can occur even after treatment.

We report a case of a 68-year-old woman with end stage renal disease in whom the placement of ultrasound-guided left internal jugular vein hemodialysis catheter was extraluminal. Slight flow restriction was noted through the arterial side of the catheter towards the end of the hemodialysis session and subsequent CT scan and venography revealed extraluminal placement of the line with probable clotting of the distal tip. The line was removed carefully and was replaced with a longer catheter bypassing the rent in the lumen of the left brachiocephalic vein. Although dissection of the internal jugular vein during hemodialysis cannulation is a rare complication, physicians who place these catheters should be careful. Higher incidence of complications has been reported with left internal jugular vein and it should not be the first preference. The placement of the catheter and location of its tip should always be confirmed with a radiograph or by fluoroscopy.