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Adenomas of the extrahepatic biliary tuce are rare and common bile duct adenomas are rare too. They may be pessile or pedunculated our patient was a 60 years old lady who presented with RUQ pain and jaundice so with impression of cholangitic under weat laparotomy, cholecystectomy, CBD explouation and choledochoduodestomy. During CBD exploration a 0.5×0.5 cm of CBD identified that excised. Histopathology confirmed the diagnosis of CBD adenoma and the patient discharged 6 days later with no complication.

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Ehler-Danlos syndrome is rare disorder of collagen metabolism, characterized by skin fragility and hyperlaxity, hypermobility of joint. Type I collagen or III collagen is metabolically disordered. Our case report is 27 years old Turkaman male referred top dermatology clinic 5th Azar Hospital for disability, echymose and papyraceus scar. After clinicopathologic evaluation, the diagnosed case proved to be Ehler-Danlos.

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Hemangiomas are benign tumors, which considered being in distance between hamartomas and true neoplasms. Most of the hemangiomas arise in head and neck region and the others grow is trunk and extremities. Hemangiomas of the uterine cervix are rare. They are usually harmless and appear as dark red or purple mass. Our case is a 35 years old patient suffering from intermittent vaginal bleeding and had a well-defined polypoid mass in vaginal examination. The natural history of cervical hemangioma is regression and involution. Biopsy must be undertaken with circumspection because serious bleeding can occur.

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Cutaneous metastasis from carcinoma of the larynx are very rare. We observed a 75-year-old male patient with squamous cell carcinoma of the larynx who developed a subcutaneous nodule as an abscess presentation in the buttock. It was found to be a metastatic squamous cell carcinoma of the laryngeal cancer, histopathologically. The skin manifestations proceeded laryngeal metastases by 18 months after laryngectomy and radical neck dissection. After 3 months, the patient died. Cutaneous metastasis of laryngeal carcinoma should be considered in all patients with previous laryngeal carcinoma representing with cutaneous lesion.

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Background & Objective: Preeclampsia is a common complications of pregnancy it’s about 5-7% in pregnants and it may complicate mother or fetus which ends with death. The purpose of this study was to determine the value of the protein/creatinine ratio in prediction of 24-hour urine total among women with suspected preeclampsia. Materials & Methods: 60 women who were evaluated for suspected preeclampsia at ?24 weeks of gestation were studied prospectively in Deziani Hospital Gorgan. There was no concurrent or preexisting systemic disease. They were undergoing a 24-hour urine collection for the determination of proteinuria. A single voided urine specimen was obtained after completion of the 24-hour urine collection and analyzed for the P/C ratio. Results: The random urinary protein to creatinine ratios is strongly associated with the 24-hour total protein excretion (P<0.05, R=0.75). The best cut off of 0.5 yields a sensitivity of 47% and a specificity of 100%. Conclusion: The random urinary protein to creatinine ratio could replace the 24-hour urine collection as a simple, faster more useful method for the diagnosis of significant proteinuria.