Cholestatic hepatitis in a patient with Graves' disease resolved with total thyroidectomy.

Laparotomy was done and the gall bladder was found to be absent. A pancreatic mass of size 5 × 5 cm was found in the head of pancreas (Figure 1B). The mass was enucleated and sent for histopathology. The report described a well circumscribed non-encapsulated neoplasm with extensive areas of fibrosis, necrosis, hemorrhage and inflammatory cell infiltrate. Few areas showed cystic dilated glandular spaces containing papillary processes lined by cuboidal and columnar epithelium containing oval nuclei with coarse chromatin (Figure 2A). Some areas showed solid groups of similar appearing cells (Figure 2B). Based on the above findings a diagnosis of solid pseudo papillary tumor was made. The post operative period was uneventful and the patient is doing fine after 3 months of enucleation.