A rare case report: Huge ileal leiomyoma: Clinical presentation, management, and implications.

INTRODUCTION AND IMPORTANCE: Leiomyomas, commonly known as fibroids, are benign soft tissue tumors mostly found in the uterus. Although predominantly uterine, they can occur rarely in other areas, notably in the gastrointestinal tract. This article emphasizes an unusual case: an ileal leiomyoma in a 54-year-old patient, showcasing the distinct diagnostic and management challenges it presents. CASE REPORT: A 54-year-old female with no prior medical history presented with a progressively enlarging, painful abdominal mass over six months. Imaging suggested a Gastrointestinal Stromal Tumor (GIST), but guided biopsy yielded an unexpected diagnosis of ileal leiomyoma. Subsequent surgical intervention successfully removed the tumor, leading to an uneventful postoperative recovery. CLINICAL DISCUSSION: This case underscores the diagnostic intricacies and clinical manifestations of ileal leiomyomas. While diagnosis can be challenging, timely histopathological evaluation is crucial. Surgical resection guided by pathological findings played a pivotal role in this patient's care, emphasizing the need for a comprehensive approach to diagnosis and treatment in unique medical cases. CONCLUSION: The rarity of ileal leiomyomas presents a substantial challenge in the medical field, where expertise can be limited. This case emphasizes the pivotal role of histopathological analysis in confirming the diagnosis and guiding effective surgical management.

Diagnostic consideration of lipoma-like lesion: A case report of primary cutaneous Rosai-Dorfman disease.

INTRODUCTION AND IMPORTANCE: Rosai-Dorfman disease (RDD) is a rare disorder characterized by benign histiocytic proliferation. The purely cutaneous variant of Rosai-Dorfman disease is exceptionally uncommon. This abstract centers on an extraordinary case-an instance of primary cutaneous Rosai-Dorfman disease (PCRDD), a rare cutaneous variant within an already infrequent disorder. Successfully managed through surgical intervention, this unique case underscores the pressing need for refined diagnostic and therapeutic strategies. CASE REPORT: We present a noteworthy case of primary cutaneous Rosai-Dorfman disease (PCRDD) in a north African female, deviating from the typical age of onset. The patient exhibited a rare cutaneous variant, emphasizing the need for heightened awareness in diverse demographics. Histological analysis revealed characteristic emperipolesis and immunohistochemical features consistent with RDD. CLINICAL DISCUSSION: PCRDD, although uncommon within the Rosai-Dorfman Disease spectrum, manifests with a later onset and distinctive demographic characteristics. Surgical excision emerges as a viable therapeutic option for managing symptomatic lesions, as demonstrated in our case. The infrequency of PCRDD underscores the importance of tailored diagnostic and therapeutic strategies. Individualized approaches become pivotal in addressing the complexities associated with PCRDD, ensuring careful consideration of its intricacies in the broader context of Rosai-Dorfman disease. CONCLUSION: This case underscores the complexity of RDD, especially in rare cutaneous presentations. Surgical excision, with its reported efficacy, stands as a crucial intervention, offering both symptomatic relief and potential cure, showcasing the significance of individualized care in managing this rare disorder. Continued research remains imperative for advancing RDD understanding and refining clinical approaches.

A rare case report: Gallbladder-associated ectopic liver tissue: Challenges, insights, and surgical considerations.

INTRODUCTION AND IMPORTANCE: Ectopic liver tissue (ELT), a rare anomaly distinct from accessory liver, challenges conventional embryonic morphogenesis. Unlike the latter, ELT lacks a connection to the main liver, showcasing an unusual growth of normal liver tissue beyond its customary location. This peculiarity poses clinical and radiological challenges for surgeons throughout their careers, particularly during laparoscopic or open procedures. Elevated clinical significance arises from ELT's potential to progress into hepatocellular carcinoma, necessitating heightened awareness among surgeons. CASE REPORT: This article presents a compelling case of ELT, discovered incidentally during a planned laparoscopic cholecystectomy. The patient, a 60-year-old female with a history of biliary colic, underwent a meticulous exploration revealing an undistended gallbladder with an unexpected brownish tissue fragment resembling hepatic parenchyma. CLINICAL DISCUSSION: Ectopic liver tissue, dating back to early 20th-century records, challenges precise incidence determination. Theories regarding embryonic development around the fourth week in utero provide insights into ELT's origins and displacement from the hepatic diverticulum. Varied attachment locations and potential manifestations in other intra-abdominal and intra-thoracic sites add layers to the complexity of its diagnosis. Radiological studies, though challenging, offer glimpses of ELT, cautioning against percutaneous biopsies due to associated risks. CONCLUSION: In conclusion, this case of ELT offers valuable insights into its diagnostic challenges and surgical considerations, underscoring the need for continued research and heightened awareness in the medical community. The rarity and varied presentations of ELT warrant ongoing exploration to refine diagnostic approaches and optimize patient outcomes.

Huge mesenteric desmoid-type fibromatosis with unusual presentation: A case report.

Introduction: Desmoid-type fibromatosis, also known as desmoid tumors, are rare fibroblastic neoplasms that account for less than 3% of all soft tissue tumors. Although they are benign neoplasms without metastatic potential, they are known to be locally aggressive and may invade adjacent structures leading to fatal complications. Case presentation: We describe the case of a 26-year-old woman who presenting with the clinical picture of acute peritonitis. Emergency surgery was performed and a large poorly-circumscribed heterogeneous tumor was found, occupying the jejunum mesentery and infiltrating the jejunal wall causing its perforation into the abdominal cavity. En bloc resection of the tumor and the involved jejunum was performed. Histology and immunohistochemistry confirmed it to be mesenteric desmoid-type fibromatosis. The postoperative course was uneventful and the patient had no evidence of recurrence 18 months after tumor resection. Conclusions: Mesenteric desmoid-type fibromatosis is a rare condition with insidious growth and locally aggressive behavior. Serious complications such as bowel perforation are rare but possible, as shown in our presentation. Complete surgical resection is the first-line treatment bur high recurrence rates remain problematic.

Actinomycosis mimicking a pancreatic head neoplasm: A case report.

INTRODUCTION: Actinomycosis is a chronic suppurative disease caused by a filamentous, Gram-positive, facultative anaerobic bacterium Actinomyces. Abdominal actinomycosis accounts for 10 to 20% of reported Actinomyces infections and pancreatic involvement is extremely rare. PRESENTATION OF CASE: We report the case of a 64-year-old man who presented with a 3-week history of abdominal pain, nausea, weight loss, and icterus. Abdominal CT scan revealed a 3.5 cm heterogeneously enhanced mass of the pancreatic head, associated with mild dilation of the main bile duct and the Wirsung duct. The diagnosis of pancreatic head malignancy was highly suspected and surgical management was decided. Intraoperatively, a 3 cm indurated mass of the pancreatic head was found. Whipple's procedure was performed. Histopathological examination revealed pancreatic actinomycosis. DISCUSSION: Pancreatic actinomycosis is extremely rare. To our knowledge, only 18 cases have been reported in the English literature to date. It commonly presents as a slow-growing mass with bile and pancreatic ducts obstruction, which can mimic malignancy. Therefore, it has often been misdiagnosed and over-treated with futile surgery, when medical treatment based on antibiotherapy is the only required treatment. CONCLUSION: We reported a rare observation of surgical management of actinomycosis mimicking a pancreatic head neoplasm. As clinical and radiological findings are nonspecific, the accurate diagnosis can only be made by histology. Through our case, we aim to highlight the importance of preoperative suspicion of pancreatic actinomycosis, given the still relevant morbidity of pancreatic resections.