We report a case of refractory life-threatening warm autoimmune hemolytic anemia (wAIHA) associated with chronic myelomonocytic leukemia (CMML) for which all conventional treatments had failed. The use of eculizumab allowed controlling hemolysis and resulted in transfusion independence. These data support the use of eculizumab in refractory wAIHA.

Squamous cell carcinoma is one of the most common head and neck types of skin cancer. This main objective of this paper is to present a case of a patient who had a moderately differentiated squamous cell carcinoma of the nose and whose tumor had an aggressive growth.

Parenchymal sparing surgical (PSS) strategy allowed to plan a one-stage systemic extended posterior right sectionectomy with resection of the dorsal subsegment S1 in patient with 11 bilobar CRC metastases. PSS liver surgery has the greatest potential for implementation in modern medicine conditions.

T-cell lymphoblastic lymphoma (T-LBL) is frequently revealed by a mediastinal mass or peripheral lymphadenopathy. Skin lesions in T-LBL usually present as multiple nodules associated with multiple peripheral lymphadenopathy and bone marrow invasion. Our patient is particular by the revealing presentation of the lesions as Cutis verticis gyrate.

Sexual dysfunction (SD) is a common side effect of antipsychotics. The community pharmacist assessed a patient with SD and suggested a change in prescription from risperidone and haloperidol to aripiprazole that improved SD. This is the first report on amelioration of antipsychotic-induced SD by early intervention by community pharmacists.

Histoplasmosis occurs primarily in the lungs but can disseminate in immunocompromised patients. Serology can be negative in patients with local infection, making the diagnosis challenging. Definite diagnosis is by microscopic examination of the tissue sample. We report a rare case of Histoplasma stomatitis whose lesions manifested after initiating antiretroviral therapy.

We present a unique Richter's transformation case in CNS with identical to CLL clonal origin in a patient treated with Venetoclax. With our case we make implications on whether Venetoclax penetrates the blood-brain barrier and we address the debating issue of the appropriate Venetoclax dose in case of drug-drug interactions.

We report the successful surgical closure of right pulmonary artery to left atrium fistula (RPALAF) with secondary atrial septal defect (ASD) in 3.5 years old girl, who had suffered with central cyanosis and exertional dyspnea.

A final Computer-assisted planning with 3D printing jaw reconstruction after two previous unsuccessful surgical reconstructions which leaded to pain, osteomyelitis and severe mandibular bone loss. The conjunction of actions used in this case allowed a successful and predictable outcome.

There are dermatoses that can emerge at the site of healed herpes zoster. Giant Cell Lichenoid dermatitis (GCLD) is a variant of skin graft-versus-host disease that can appear in patients post-transplant. Herein, we present a case of GCLD manifested withib healed varicella zoster site.

Primary renal osteosarcoma is exceedingly rare tumor with poor prognosis. It has tendency to spread to distant sites . we report the case of a 43-year-old female who presented with flank pain, gross hematuria, weakness and weight loss and was treated with diagnosis of primary renal osteogenic sarcoma

Simultaneous Echinococcal Superinfection in a Patient with Polycystic Liver Disease.Cicerone O.*, Lissandrin R.^, Brunetti E.^, Maestri M.**: Fondazione IRCCS Policlinico San Matteo, Chirurgia Generale I, PaviaTropicali, Pavia

Key Clinical Message: In patients presenting with hyperinsulinaemic hypoglycaemia with a non-pancreatic neuroendocrine tumour, the diagnosis of an ectopic insulin-secreting tumour should be considered, and investigated further with confirmatory insulin staining.

Tailgut cysts are rare diseases but require a particular management. We present two cases report of a tailgut cyst two females. treated with transabdominal surgical approach. We review the relevant information present in the medical literature about the incidence, methods of diagnosis, treatment options and management plans.

Oncocytic adenolipoma is a rare tumor composed of adipose tissue and oncocytic epithelial cells in different proportions presenting in the salivary gland. Until now, less than 20 such cases are reported. We report another such rare case presented as huge neck mass.

Endomyocardial fibrosis is a disease that causes restrictive cardiomyopathy, it varies in presentation ranging from asymptomatic to full-blown heart failure. its pathogenesis is poorly understood and it poses a diagnostic and treatment challenge due to its infrequent occurrence.

Indwelling arterial catheters are used routinely for continuous haemodynamic monitoring during major surgery and in critically ill patients. Major complications are rare. We describe two cases of patients in which arterial catheterisation was associated with acute radial arterial thrombosis and radial ischaemic neuropathy. Timely recognition was paramount to successful management.

Traditional palatal and vestibular surgical approaches for removing deeply impacted mesiodens with a crown facing the nasal floor are accompanied by significant complications. Herein, we describe a novel modified intranasal approach to minimize the complications. Also, it can be performed under local anesthesia with proper preoperative workup.