Dual Pathology Breast Carcinoma: A Report of Two Cases Dual pathology breast carcinoma, whether unifocal, multifocal or multicentric may significantly impact patient prognosis. Certain histological combinations are associated with favourable outcomes, while others may indicate a more aggressive disease. We presented a report of two women with different pathological combinations. The first case had multicentric cancers of the left breast. She underwent neoadjuvant chemotherapy, then nipple-sparing mastectomy with axillary dissection and immediate transverse rectus abdominis myocutaneous (TRAM) breast reconstruction. Histopathological assessment revealed a combination of metaplastic carcinoma and invasive micropapillary carcinoma; both aggressive subtypes. Post adjuvant radiotherapy, she remained disease-free for five years. The second case had a unifocal right breast cancer managed with breast-conserving surgery and sentinel lymph node biopsy. Histopathology revealed a combination of invasive carcinoma of no special type (NST) and invasive papillary carcinoma. These subtypes are associated with a more favourable prognosis. Post radiotherapy and on endocrine therapy, this patient remains well at 2 years follow-up. These cases demonstrate the prognostic variability in dual histopathology breast cancers and highlights the importance of individualised treatment. Both patients remain disease free despite having dual pathology breast carcinoma which seem to suggest a more aggressive disease behaviour.

Wandering spleen is renowned as a surgical enigma due to its diverse presentations. Due to lack of its attaching ligaments which would usually place it at the left hypochondrium region, the spleen ‘wanders’ and may be located anywhere within the abdominal cavity. This condition has been associated with many complications such as splenic torsion, pancreatitis and portal hypertension. We report a case of a wandering spleen presenting as acute appendicitis in an 18-year-old young active sportsman. The patient developed post-operative ileus and later intestinal obstruction which necessitated exploratory laparatomy onto which the final diagnosis of splenic and small bowel infarct due to splenic torsion with small bowel volvulus was made. Splenectomy, small bowel resection and primary anastomosis were performed and the patient made a full recovery.

Chrysomya megacephala (Fabricius) and Chrysomya rufifacies (Macquart) are two important species of blow flies that could be utilised as indicators to estimate the Post Mortem Interval (PMI) of corpses in forensic science. Determination of PMI of corpses is based on the larva size and its development stages. Development studies of eggs, larvae and pupae of Ch. megacephala and Ch. rufifacies at 27ºC, 30ºC and 33ºC were carried out using an insect growth chamber. Data from these studies were used to construct growth curves and Accumulated Degree Hours (ADH) for both species. Ch. megacephala needs 9.15 days to complete one life cycle at 27ºC, 8.54 days at 30ºC and 6.76 days at 33ºC. Development for Ch. rufifacies is slower than Ch. megacephala and takes 9.92 day at 27ºC, 9.13 days at 30ºC and 7.44 days at 33ºC. Eggs of the two species hatch faster at 33ºC compared to the two other temperatures. Low value of ADH shows shorter life cycle of that particular species. This study’s findings are useful in estimating PMI of the corpses found under various environmental temperatures.