A case of caecal "PECOMA": An uncommon entity.

INTRODUCTION AND IMPORTANCE: World Health Organization (WHO) defines PEComa as a mesenchymal tumor composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. The symptoms and clinical signs of PEComa patients are nonspecific. Hence, diagnosis is usually difficult. Since it's a rare diagnosis, further research might help in understanding the disease better. CASE PRESENTATION: The patient in this study was an asymptomatic patient, who did colonoscopy as part of a regular check-up. A submucosal cecal tumor was detected in colonoscopy, and apart from that, all other investigative parameters were within normal limits. CLINICAL DISCUSSION: Laparoscopic Ileocecectomy was performed, and the histopathology report was suggestive of Pecomatosis (PEComa - Perivascular epithelioid cell tumor). The PEComas, neoplasms with perivascular epithelioid cell differentiation, are mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelioid cells (PEC). The characteristic features of PEC are the positivity of melanocytic markers and smooth muscle markers. CONCLUSION: Perivascular epithelioid tumors are mostly rare in the gastrointestinal tract, and even more unusual to be detected in Cecum. Surgery is the mainstay of the treatment, although, adjuvant therapy has been tried in recent times. The patients have to be kept in close follow-up, as there are reported cases of recurrences and distant metastasis.

Delayed Diagnosis of Ureteral Injury Following Penetrating Abdominal Trauma: A Case Report and Review of the Literature.

BACKGROUND Ureteral injuries are considered to be uncommon in cases of trauma. The possibility of damage to the ureters may not be considered in the setting of acute trauma when life-threatening injuries take clinical management priority. A case of acute ureteral injury is described in a patient with acute penetrating gunshot abdominal injury that had a delay in diagnosis, with a review of the literature. CASE REPORT A 29-year-old woman presented to our hospital with a missed ureteral injury following a self-inflicted gunshot injury to the abdomen. She underwent abdominal computed tomography (CT) imaging and a retrograde pyelogram, which showed complete transection of the left upper ureter with contrast extravasation and the formation of a large urinoma. She underwent a percutaneous nephrostomy and drainage of the urinoma. An end-to-end ureteric anastomosis with excision of the intervening injured ureter, or ureteroureterostomy, was performed three weeks following the diagnosis. CONCLUSIONS Ureteral injuries following trauma are rare, but a delay in diagnosis can be associated with clinical morbidity. A high index of clinical suspicion is important for early identification of ureteral injury in cases of acute abdominal trauma.