Primary signet-ring cell carcinoma of the cecum: A rare case report.

INTRODUCTION AND IMPORTANCE: Primary SRCC is a rare histological colorectal cancer subtype. It is characterized by distinct clinical presentation. CASE PRESENTATION: This case report describes a rare case of a Primary Signet-ring cell carcinoma of the cecum. A 37-year-old man came to the emergency department with bowel obstruction and altered general condition. The abdominal CT scan showed an intestinal occlusion upstream a thickening of the cecum. An exploratory laparotomy found a distention of the bowl with a suspect thickening of the cecum. The patient underwent a right ileo-colectomy and ileocolostomy. Histologic analysis of the operatory specimen confirmed the diagnosis of a primary Signet-ring cell carcinoma of the cecum. The recovery was uneventful, and the patient is in good health after six -months of follow-up. After completing the chemotherapy, the patient is scheduled for a colonoscopy and reversal of colostomy. CLINICAL DISCUSSION: Colorectal primary signet ring cell carcinoma (SRCC) is a rare entity, and it is associated with poor prognosis compared with common colorectal adenocarcinomas. characterized by distinct clinical presentation, with very poor response rates. CONCLUSION: Primary SRCC is an aggressive histological type of colon cancer and it is associated with a poor prognosis. There are no conclusive guidelines for the treatment of this type of tumor.

Massive post-traumatic neglicted diaphragmatic hernia revealed by necrotizing pancreatitis, A case report according scare guidelines.

•Atypical chest presentation of acute pancreatitis consisting of a post-traumatic of less than 10 cases reported in the literature.•We describe a very exceptional complication of diaphragmatic rupture.•We propose to take into consideration diaphragmatic involvement in any patient suffering from abdominal trauma.

Adrenal adenoma as a cause of atypical psychosis: Presentation, diagnosis, surgical technique and outcome (case report with a brief literature review).

INTRODUCTION AND IMPORTANCE: Psychiatric symptoms may be a mode of the revelation of several endocrinopathies, but rarely in primary hyperaldosteronism, which can increase psychiatric comorbidity, as well as cardiovascular risk. CASE PRESENTATION: We report a case of a 26-year-old engineer, who suffered from atypical psychosis before being hospitalized for a state of agitation, he presented with high blood pressure and severe hypokalemia. An etiological assessment revealed a right adrenal adenoma, which was afterward resected, with a very good evolution. CLINICAL DISCUSSION: In this association, a high-level of aldosterone and hypokalemia can be behind these manifestations that present in an atypical form. Treatment is medical by anti-aldosterone or surgical by resection of the adenoma, but the challenge now is to know if we can or not stop psychotropic treatment after the treatment of the adenoma. In our case, the treatment was stopped six months after the resection of the adenoma, with very good outcomes until now. CONCLUSION: Despite the high prevalence of psychiatric illnesses, it is always necessary to look for the organic causes that may be behind these pathologies, especially if they are in atypical forms. LEARNING POINTS.