Presence of a hypofunctioning pigmented adenoma are commonly asymptomatic and is usually only found during an autopsy. In contrast, hyperfunctioning pigmented adenoma is a rare clinical entity and in the majority of cases results in Cushing‟s syndrome. In this case study, we report a 66-year-old male who presented instead with the clinical and biochemical features of Conn‟s syndrome. On laparoscopic adrenalectomy, it was found that the tumour had a functioning black adenoma which does not usually present with Conn‟s syndrome but rather to that of a Cushing‟s. The intraoperative changes and histopathological findings are discussed.
Laparoscopy

Chronic granulomatous mastitis is known as a benign and relatively rare disorder that is often difficult to differentiate from breast carcinoma. We highlight the case of a 34-year-old woman who had recurrent episodes of right breast swelling and abscess for 8 years. These were proven to be chronic granulomatous mastitis by tissue biopsies on 3 different occasions. Her condition improved on similar courses of antibiotics and high-dose prednisolone. However, she subsequently developed progressive loss of vision due to an orbital tumour. She then underwent a craniotomy and left orbital decompression with excision of the tumour, which proved to be a metastatic carcinoma. A trucut biopsy of the right breast was then done and showed features consistent with an infiltrating ductal carcinoma. This case illustrates the possibility that chronic granulomatous mastitis could be a precursor for malignancy and the difficulty in differentiating one from the other. The possible mechanisms of development and the implications for future management are also discussed.

Hyalinizing clear cell carcinoma presents as a painless submucosal mass commonly located at the palate and base of tongue. It is a rare tumour and has often been misdiagnosed for other more common tumours with clear cytoplasm, such as acinic cell carcinoma, clear cell oncocytoma or mucoepidermoid carcinoma. HCCC has been reported as a low grade malignant tumour with a high rate of cervical metastases. Due to its rarity, there is no treatment protocol. However, the treatment of choice is wide local excision and the neck disease is treated with neck dissection or radiotherapy or both with no conclusive outcome as incidence is too low or underreported with no long term follow up. Our case highlights the diagnosis difficulties in such rare cases, and the need for longer follow up post excision to determine outcome and recurrence rates.