Large expanding splenic pseudocyst: A case report and review of literature.

INTRODUCTION AND IMPORTANCE: Splenic pseudocysts are extremely uncommon. Most of these cysts are asymptomatic and may result from previous blunt abdominal trauma. We report an interesting uncommon case of large splenic pseudocyst without history of previous abdominal trauma. CASE PRESENTATION: A 56 year old male patient, presented with symptoms of pain in the left side of middle back and discomfort in the left hypochondrium for few months. His physical examination was unremarkable. The abdominal Ultrasound and contrast-enhanced Computed tomography showed a large splenic cyst occupying most of the splenic parenchyma. Echinococcus multilocularis antibody test was negative. The differential diagnosis of this case included non-parasitic splenic cysts. The patient underwent elective exploratory laparoscopy which was converted to laparotomy with total splenectomy. Histopathological examination of the specimen revealed a splenic pseudocyst. CLINICAL DISCUSSION: The splenic cyst in this case was symptomatic due to its large size. It was hard to elicit an etiology as there was no history of abdominal trauma, infection, or degenerative disease. The main factors in selecting either conservative or radical surgical approach for such cases are the cyst location, cyst size, and the residual splenic parenchyma. CONCLUSION: The goal of splenic pseudocysts treatment is to relieve symptoms and avoid complications. Partial splenectomy is the recommended procedure when the size and location of the cyst allow preservation of at least 25% of splenic parenchyma. Otherwise, Total splenectomy is unavoidable.

Unexpected diagnosis of both adenocarcinoma of the colon and metastatic lobular carcinoma of the breast in the gastrointestinal tract.

Breast cancer rarely metastasises to the gastrointestinal tract. Lobular carcinoma more commonly metastasises to the uterus and appendages, peritoneum, and gastrointestinal tract than other types of breast cancer, while ductal carcinoma has a propensity to metastasise to the lungs, liver, and brain. We describe the case of a patient with no known history of breast cancer, whose primary presentation of lobular breast cancer was with malignant small intestinal and colonic strictures, with coexisting previously undiagnosed adenocarcinoma of the colon.

Metastatic breast cancer mimicking cholecystitis. A rare clinical presentation.

We report a case of a 61-year-old lady who presented with central chest and epigastric pain. A clinical diagnosis of cholecystitis was established, and a cholecystectomy was carried out. Microscopic examination of the gallbladder showed chronic cholecystitis and metastatic carcinoma of probable breast lobular carcinoma origin. The report was followed by further clinical and mammographic examination, which showed a focal area of thickening in the left breast. Core biopsy of this lesion confirmed the diagnosis of lobular carcinoma of the breast. Her tumor was treated with surgery followed by chemo/hormone therapy. The patient died 5 years after the cholecystectomy from disseminated breast malignancy.