A 35-year-old mother of one child, presented with inability to conceive for two years and a chronic lower abdominal pain. Laparoscopy revealed extensive adhesions in the bilateral adnexal regions and adhesion of uterus to the bowel. Subsequently, she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy.Histopathological examination of endometrium, myometrium, both ovaries and fallopian tubes revealed several granulomata with caseous necrosis. Special stain for acid fast bacilli was negative. However, based on the presence of characteristic caseating granulomata, the diagnosis is most likely tuberculosis.
A 64-year-old male who presented with bleeding per rectum and altered bowel habits for 6 months was found to have numerous polyps in the colon during colonoscopy. He also had two osteomas on the forehead and several epidermal cysts in the scrotal skin. His brother had a history suggestive of a similar disease. The patient underwent total proctocolectomy and ileal pouchanal anastomosis. Pathological examination of the resected specimen revealed an adenocarcinoma in addition to numerous adenomata. The patient was diagnosed to have colonic adenocarcinoma complicating Gardner syndrome.
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