[Non Hodgkin lymphoma of the sigmoid colon: case report]. / Linfoma no Hodgkin de sigmoides: reporte de un caso.

Non-Hodgkin lymphoma (NHL) occurs in extranodal location in approximately 20% of patients with limited stage, high-grade disease. Colon is infrequently involved as a primary location, accounting for 4% of all extranodal NHL and far less than 1% of all colonic malignancies. Colonic NHL differs significantly in terms of presentation, therapy and outcome relative to other more common gastrointestinal sites, like stomach or small bowel. The most common location is the cecum (60-74% of cases), while the sigmoid is involved in 2.5-14%. Largely related to the lack of specific signs and symptoms, patients frequently present advanced locoregional disease. Moreover, more than half of patients require an emergent surgery, usually due to pain, bleeding, or obstruction. Therapy usually involves resection of the affected colon and regional lymph nodes followed by adjuvant chemotherapy or/and radiotherapy. Utilizing this approach 5 years survival rates range between 27-55%. We present a 59 years old man with weight loss,abdominal pain, palpable mass and intestinal obstruction. A sigmoidectomy was realized with histopathologic report of NHL. Systemic adjuvant chemotherapy and abdominal radiation were administered. After a 6 month follow-up from initial procedure he is now asymptomatic with Karnofsky of 90. Therefore a surgeon should consider the possibility of NHL when evaluating such patients.

[Mixedematous ileus; acute abdomen exacerbate.]. / Ileo mixedematoso;exacerbante de abdomen agudo.

The surgical literature contains few reports about effects of hypothyroidism in patients with acute abdomen; has been reported that a glycoprotein infiltrate the lining of the bowel leading to denervation. We report the case of a woman with acute abdomen secondary to pyosalpynx with uncontrolled hypothyroidism postoperative complications.Hypothyroidism is called "big mimicker"because its clinic spectrum ranges from anasymptomatic subclinical condition to the rare,life-threatening myxedema coma, and thus can bea challenging diagnosis to make. Unrecognized hypothyroidism may lead to unnecessary surgery or even a potentially fatal outcome. A heightened awareness of this not so uncommon entity is mandatory

[Rectal endometriosis: entity difficult to diagnose.]. / Endometriosis rectal:entidad de difícil diagnóstico.

Endometriosis is a gynecologic disorder characterized by the presence of endometrial glands and stroma outside the endometrial cavity and the uterine musculature. Although the ectopic endometriotic implants are most commonly found in the pelvis, the GI tract is the most common site of extrapelvic endometriosis The diagnosis of rectosigmoid is difficult to make on colonoscopy because of the subepithelial location of the endometriotic implants. We present a case report ofa 38-years-old woman referred with a diagnosis of rectal cancer with large intestine symptoms.Rectal endometriosis should be considered in the differential diagnosis of extramucosal rectal masses in premenopausal women, particularly if the patient has gynecological complaints or a history of infertility.