Rectal gastrointestinal stromal tumor (GIST) in a patient with Crohn's disease: a rare coincidence case report and brief literature review.

Gastrointestinal stromal tumors (GISTs) are the most common type of gastrointestinal mesenchymal tumors. The most common site for developing these neoplasms is the stomach and small intestine. In contrast, anorectal GISTs are very rare. Population-based studies have shown an increased risk of colorectal cancers (CRC) in patients with Crohn's disease (CD). As in sporadic CRC, adenocarcinomas are the most commonly observed tumor. Accordingly, it is expected that rectal mass in CD patients to be an adenocarcinoma. Some reports have presented CD cases with GISTs along the gastrointestinal tract; however, to the best of our knowledge, a rectal GIST has not been reported in CD. Herein, we report a 41-year-old woman with CD who presented with 8 weeks of constipation and was diagnosed with rectal GIST and briefly review existing reports regarding GIST in IBD.

Education case: a case-based approach to overlap syndromes in autoimmune liver disease in patient with ulcerative colitis.

Simultaneous occurrence of immune-based gastrointestinal diseases and autoimmune hepatitis, although not common, is of clinical importance. Some clinical and laboratory findings such as severe pruritus and elevated alkaline phosphatase raise suspicion of a biliary disease which overlaps autoimmune hepatitis. A strong clinical suspicion of overlap syndrome in a patient with autoimmune hepatitis prompts more diagnostic evaluations like MRCP, liver biopsy, and secondary laboratory tests. Patients who fall into the category of overlap syndrome proceed with timely monitoring of known complications including colorectal carcinomas, cholangiocarcinomas, and gallbladder cancers. It is strongly recommended that all simultaneous immune-based involvements be searched prior to labeling a patient as having pure autoimmune hepatitis. The current study attempted to express all challenges about a case with overlap syndrome referred to the gastroenterology ward of Taleghani Hospital and to review the latest articles and related guidelines about the diagnosis, treatment, complications, and surveillance of the mentioned patient with autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and inflammatory bowel disease (IBD).

A Rare Cause of Ascites in a Young Woman Mimicking Peritoneal Carcinomatosis.

Peritoneal granulomatous reaction to foreign body-like materials of a dermoid cyst is a rare condition and has always been challenging in diagnosis for physicians. Macroscopic view of granulomatous peritoneum, which mimics peritoneal carcinomatosis or peritoneal seeding originating from ovarian carcinoma, necessitates a detailed microscopic evaluation of peritoneum, which shows multinucleated giant cells and granuloma formation indicating a foreign body reaction in the peritoneum. To avoid unnecessary radical surgeries and salvage chemotherapies in these patients, a detailed microscopic evaluation of their peritoneum is necessary. The present study introduces a 23-year-old woman with new-onset ascites and an elevation of CA125 level suspicious of ovarian carcinoma but with a peritoneal microscopic finding pathognomonic of foreign body reaction.