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The term Noonan syndrome has been applied to phenotypic male and female who have certain anomalies that occur also in female with Turner’s syndrome. These patients have normal karyotype. The disorder is very rare. The most common abnormality are short stature, webbing of the neck, Pectus Carinatum or Pectus excavatum, congenital heart disease. This particular case is a 8-year-old girl-patient who referred to pediatric clinic with short stature. Another abnormality in these patients is abnormal facies (Hypertelorism, hypogonadism, piqure chest and webbing of the neck). The patient had moderate mental retardation. Chromosomal analysis revealed 46xx cytogenetic distinguished Noonan syndrome.

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Vulvar mass is not a common problem in youngester and adults. The common complains are such as, vaginal impairment, infections, trauma, and rape. One of the rare vulvar mass has been presented in this case report. The mass was totally removed and was sent to the pathology department for medical examination. The diagnosis of neurofibromatose was confirmed by the laboratory results.

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This case report is about a 25-year-old patient with microangiopathic in toxemic pregnancy. Clinical manifestations are such as hemorrhage in digestive system and urinary tract accompanied with anemia thrombocytopenia, liver, and kidney, disorder. The clinical diagnosis for this patient was HELLP syndrome, with all of the clinical manifestations of this syndrome the patient was admitted to the 5th Azar Hospital in Gorgan. All of the clinical manifestations and paraclinical observation returned to normal during one and three weeks respectively. The prevalency of this syndrome among the total pregnancies is about 0.2%-0.8% and the risk of recurrence of this disorder is about 3-25%.

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Pseudoxantoma Elasticum is a hereditary disease with prevalency of 1 among 160000 people in which yellowish papules and plaques are symmetrically distributed in abnormally lax skin of the neck, axilla, groin, and cubital and popliteal spaces, other parts of the body are less frequently involved. Patient that has been presented is 30 years old Turkman woman referred to 5th Azar Hospital with skin problems contains skin folds at neck, yellowish papules at ant, abdomen, cubital area and neck. After skin biopsy, histopathological findings confirmed clinical diagnosis of Pseudoxantoma Elasticum.

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Amniotic band syndrome is a collection of congenital abnormalities caused by early amnion rupture. It occurs in approximately 1:1200 to 1:15000 live births. The infant we are reporting was as result of dizygotic twins pregnancy of 34-years old woman in first delivery than born by cesarean section. In clinical examination there were multiple defects such as: Anencephaly, anophthalmia, cleft lip-palate, nose malformation and limb anomalies. Involved infant died an hour after birth, because of severity of anomalies. This case was reported because of rarity and severity signs of this syndrome and its occurrence in one twin from dizygotic twins.

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Peripapilary Toxoplasmosis Chorioretinitis is a rare condition that occurred with papilitis and damage the nerve fiber in the involved zone and visual field defect with central scotoma. Therefore the first complain of these patients are central visual field defect. A 16 years old woman without history of systemic and ocular disease with suddenly central visual field defect and blurred vision was referred to clinic. She was 2+ MG and color vision defect and peripapilary chorioretinitis with papilitis. Elevation of toxo IgG and IgM titer was reported to be higher the normal initially and a week later.

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Perichondritis and chondritis are rare disease of auricle than may be due to burns surgery or trauma and can present with severe pain erythema and edema. Herpes Zoster, that is due to reactivation of virus in nerve root that present with vesicular group in erythematous fild cranial or spinal nerve innervated zone can present with sever pain and some factors include stress-chemotherapy and really surgery can facilate activation of them. We report a case with perichondritis-chondritis and herpes zoster that had reaction to chromic material after tympanomastoidectomy and with medical treatment and debridement with some sequela healed. The importance of this case is multipathological that can mislead the clinication.

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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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A variety of extracranial sites have been described for Meningiomas including the nose, various viscera, skin, eye and extraspinal tissue. Among them cutaneous Meningioma generally occur most frequently on the scalp, forehead or paravertebral areas. We are reporting in this article one case of cutaneous Meningioma in the forehead region with respect by reviewing the literatures is very rare tumor. Our patient is a middle age woman with right forehead mass from two years ago, in the skull X-ray and computerized tomography of our case intracranial lesion is not seen and also there is some thickening involving frontal bone. After the surgical excision of the mass and in the microscopic examination of specimens, histopathologic diagnosis is Meningioma (Meningotheliomatous type) and immunohistochemical study react for epithelial membrane antigen. In the clinical course, extracranial Meningiomas enlarge slowly and are usually cured by simple excision alone but incomplete excision may lead to recurrence, the things have been occurred in our patient.

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Hydatidosis is a parasitic infection mostly in found in the liver and lung due to echinococus species. But occurrence in other locations is possible. Purpose of this report is to describe a case of bilateral Hydatid cyst in ovaries. Clinical findings with this uncommon location are poorly specific and diagnosis required histologic examination after surgical removal. Imaging and serology is useful to differentiate Hydatid cyst from benign and malignant tumors. This obligatory to examine lung and liver as the main sites of cyst when you are being faced with unusual location of Hydatid cyst especially in endemic area such as Iran. Our patients was a 35 years old woman with history of 4-month abdominal pain in left and right lower quadran. Sonography showed two cysts in adenexal lesions after surgical removal, they were sent to pathology lab. Hydatic cyst membrane was seen in histologic examination of two cystic masses.

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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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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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Inguinal hernia is common in midlle age and elderly. It is in two form of direct and indirect. Often the hernia sac consists of omentum and or intestinal segmants, but bladder hernia is very rare. In present patient massive inguinal hernia and urinary retention were associated with ipsilateral nonvisulization and nonfuncting kidney that showed the disease is chronic in nature. The diagnosis is confirm by ultrasonography and retrograde cystography. In cystography, contrast maternal is show in scrotal cavity and commnication of it with bladder. In our case, the diagnosis is made preoperatively with ultrasonograpy and cystography. The patient able to void post-oprative day and scrotal enlargment is compelely reduce. In conclusion it is advised that in patients older than 50 years who have massive inguinoscrotal herina and prostatism cystography to be done mandatory and also preoperative diagnosis is to be made to prevente the injury of bladder and ureter in operating time.

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Kikuchi-Fujimoto disease is a necrotizing Lymphadenitis with benign self-limit process in young women with fever, cervical lymphadenopathy and increased ESR with leukopenia. In this report we introduce 2 females with Kikuchi-Fujimoto disease. The first patient was a 31 years old lady with fever and unilateral cervical lymphadenopathy weight loss from 20 days age. In paraclinical findings ESR=50 mm/hr Hb=10 gr/dl. WBC count was 5300/µl bone marrow aspiration and biopsy with lymph node was done. The histopathologic diagnosis was Kikuchi-Fujimoto (Necrotizing Lymphadenitis). The 2nd patient was a lady with 35 years old and painful neck mass (Behind the sterno-clido mastoid) from 1.5-month age with fever and chill. In paraclinical findings ESR=52 mm/hr WBC 5500/µl, CRP++ lymph node biopsy was done the histopathologic diagnosis was Kikuchi-Fujimoto necrotizing Lymphadenitis. Therefore Kikuchi disease is a important differential diagnosis in young patients especially women with cervical lymphadenopathy and fever (FUO).

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A 13 years old female caucasition admitted in 5 Azar General Hospital with a 3-day history of deteriorating vision. 2 weeks prior to admission she had received a Measles-Rubella vaccination at school (As a mass compain of MR vaccination in Iran). General & neurological examination except lung wheezing & ocular findings were normal. In visual exam she had questionable light perception in right eye & hand motion sensation in left eye. Funduscopy revealed moderate bilateral optic disc hyperemia. Investigations revealed normal full cell blood count, biochemistry profile, clotting studies & sputum. Brain CT scan & MRI were normal except pansinusitis. CSF examination revealed normal constituents. The patient treated with Methyl Prednisolone (1 gr/daily) for 7 days and patient had dramatic response to therapy. After 6 weeks of starting medical treatment ophthalmologic exam revealed 2 meters finger count vision in right eye & 6/10 visual aquity in Left side. This patient is a rare case of bilateral optic neuritis after MR vaccination.

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CCHF is a dreadfull zoonetic disease that is transmitted through tick bites or direct contact of infected animals, tissues or blood secretions. This virus can be seen in domestic animals and ticks. At present, CCHF exists in different areas of the world and can be consideras a health problem. The case in present report was 24 year old men, resident in Ali-Abad a town in Golestan province. He had eaten liver of infected sheep, and was suspected to CCHF according Protocol of WHO criteria to the CCHF. He was treated with Ribavirin and supportive management, and subsequently recovered. This report helps health staff to find out the risk and probable causes of disease thus controlling the spread of the disease.

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A 70- years old female referred with left upper quadrant pain since about 72 hours prior to hospital admission. In physical examination the patient was pale, hypotensive, tachycardiac and a vague left upper quadrant (LUQ) mass palpated. LUQ mass and free intraperitoneal fluid declared by ultrasound investigation there was no history of abdominal trauma and with impression of intraabdominal bleeding of unknown origin the patient underwent laparotomy. A huge fundal gastric mass identified with surrounding rupturea retroperitoneal hematoma and intraperitoneal hemorrhage. No intragatric penetration or hemorrhage was seen, so complete excision of the mass with safe margin was done with subsequent splenectomy. She had an uneventful post operative course and was discharged at the 7th post- op day. A microscopic analysis of the excised tumor demonstrated gastric leiomyoma.

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Hydatidiform mole with a coexistent fetus is a rare occurrence with an incidence of 1 per 22000-100000 pregnancies. It is associated with persistant gestational trophoblastic tumor. Hence an early and correct diagnosis is imperative to plan subsequent management of such patients. We report a case of primigravida who presented with vaginal bleeding and severe nausae and vomiting. Expectant management was carried out for her pregnancy with finally ended in abortion.

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Diagnsis of TAR syndrome usually are made at birth because of the characteristic physical appearace combined with thocmbocytopenia. The Two essential features of TAR syndrome are hypomegakaryocytic thrombocytopenia and bilateral radial aplasia. The rest of the phenotype varies widely and can manifest with abnormalities involving skeletal, skin, gasterointestinal and cardiac systems. Considering to limited cases of syndrome and variability of phenotypic abnormalities exess two essential features, all cases of this syndrome are reportable. We reported a patient with TAR syndrome with any related malformations.