Primary neuroendocrine carcinoma of the breast.

Primary neuroendocrine carcinoma of the breast (NECB) is an extremely rare variant of breast cancer having aggressive clinicopathological behaviour and poor prognosis. A 62 years old woman presented with a painless lump in the left breast. Microscopic and immunohistochemical evaluation of the core-tissue biopsy and of the mastectomy specimen revealed moderately-differentiated neuroendocrine carcinoma of the breast.

Induction of labour in postdates pregnant women.

Objective: To differentiate the effect of gestation on the mode of delivery by analysing the difference in the mode of induction, length of labour and the difference in parity or Bishop score and their effect on the mode of delivery of postdates women.

Study Design: A cross-sectional observational study.

Place And Duration Of Study: PAEC General Hospital, Islamabad, from July 2006 to July 2008.

Bleeding disorders in obstetrics and gynaecological practice.

The objective of the study was to determine the frequency, types, presenting symptoms and management options in patients with bleeding disorders in the local obstetric and gynaecological practice. This was a descriptive study of oneyear duration conducted at the Pakistan Atomic Energy Commission General Hospital, Islamabad. Types of bleeding disorders in decreasing order of frequency were HELLP syndrome in 27.

Insulinoma--a deceptive endocrine tumour.

Insulinoma is a deceptive endocrine tumour that can easily mislead even an astute clinician because of its bizarre and nonspecific symptom complex. A 45 year old woman presented with altered behaviour, seizures and spells of coma and was being treated as a case of hysterical neurosis. Biochemical and radiological investigations revealed fasting hypoglycaemia, endogenous hyperinsulinism, and a pancreatic parenchymal lesion.

Hyperreactio luteinalis associated with pregnancy induced hypertension.

This is a unique case of hyperreactio luteinalis associated with partial HELLP syndrome, chronic superimposed hypertension, and intrauterine growth restriction. The cysts were managed conservatively. A caesarean section was performed at 34 weeks due to the deterioration of liver function tests, and intrauterine growth restriction.

Bouveret's syndrome.

Gastric Outlet Obstruction (GOO) due to impaction of a gallstone in the duodenum after migration through a bilioduodenal fistula is known as Bouveret's syndrome. Its clinical symptoms are entirely vague and nonspecific. Because of its rarity, insidiousness and unpredictable symptomatology, Bouveret's syndrome is never thought of in the differential diagnosis as aetiology of gastric outlet obstruction.