BACKGROUNDANDOBJECTIVE: Gastric cancer is the fifth prevalent cancer in worldwide. Among of this, adenocarcinoma is more than 95% of all case and most prevalent. According to gastric adenocarcinoma is resistant to adjuvant therapy, surgical resection is the cardinal strategies of treatment. One of the problems with treating adenocarcinoma of the stomach is that its main causes are malignant or pre-malignant changes in the residual gastric tissue that may be neglected during resection. By recognizing these lesions and resection, they can be expected to reduce the malignancy. Therefore, this study was conducted to investigate the characteristics of non-tumoral gastric tissue in terms of malignant or pre-malignant changes. METHODS: In this retrospective cross-sectional study, 112 patients who had undergone total gastrectomy in the hospitals affiliated to Babol University of Medical Sciences during the period of 2013-2017 were examined and analyzed for age, sex, type and location of tumor. FINDINGS: Of 112 cases that studied, 72 cases (64. 3%) were male and 40 cases (35. 7%) were female. The mean of ages was 64. 7± 8. 6 year. Poorly differentiated pathology in 60. 7% and well differentiated pathology in 39. 3% of patients were seen. In 64 patients (57%), there was synchronous lesions in addition to primary pathology. These synchronous lesions were related statistically significant to pathology, cancer stage and gender. CONCLUSION: Based on the results of this study, it can be concluded that resection should be accompanied by considering simultaneous lesions in addition to primary pathology, which can be a reason for total gastrectomy as a standard treatment for gastric cancer.

A 75-year–old patient was referred with vaginal bleeding. Her physical exam showed two flat dark plaques on the posterior fourchette, mostly on left lateral side of the vulva. A black soft mucosal nodule was present on the left lateral side of upper vagina, and a polypoid ulcerative cervical lesion extended into the right parametrium. Cervical and vaginal biopsies were in favor of malignant melanoma, while vulvar biopsy was in favor of lentigo maligna melanoma. The diagnosis was confirmed using immunohistochemical studies with S100 and HMB 45. The patient was treated by wide local excision of the vulvar lesion followed by high-doses of fractionation radiotherapy of the cervix and upper vagina. Due to advanced and aggressive melanoma of the cervix, in comparison to the len-tigo maligna of the vulva, and the presence of vaginal melanomas on the opposite site of the cervical lesion, it is suggested that the origin of these two lesions are multi focal rather than the direct extension.

Chronic recurrent MultiFocal osteomyelitis (CRMO) is a rare inflammatory bone disease. It is a diagnosis of exclusion based on the clinical, radiological and pathological criteria. The awareness of the corresponding feature can help avoid of unnecessary diagnostic procedures and prolonged antibiotic therapy. We present a case of 4.5 year old girl, diagnosed with CRMO who were followed for 6 months as a case of chronic bacterial osteomyelitis and received long course of antibiotic therapy.

CASE PRESENTATION: A 48-year-old woman presented with floaters, photopsia, blurred vision and ocular pain in both eyes of a few days’ duration prior to referral. She had a history of diabetes mellitus for 10 years and was being treated with glibenclamide and metformin.