Submucosal micropapillary adenocarcinoma of the sigmoid colon: A distinct and aggressive subtype of adenocarcinoma.

Colorectal invasive micropapillary carcinoma (MPC) is a rare and distinct variant of adenocarcinoma with high incidence of lymph node metastasis. The differential diagnoses of MPC include extensive lymphovascular invasion, metastatic MPC, and retraction artifacts.

Goblet cell adenocarcinoma of the ascending colon: An underrecognized diagnostic pitfall.

Goblet cell adenocarcinomas (GCA) are infrequent neoplasms of the digestive system that exhibit both mucinous and neuroendocrine differentiation. They predominate in the appendix and rarely involve the colon. Herein, the authors report a case of GCA involving the ascending colon in a 60-year-old woman who presented with severe anemia.

Sarcomatoid carcinoma of the gallbladder: A rare and aggressive form of gallbladder cancer.

Sarcomatoid carcinoma is a rare type of gallbladder cancer with less than 100 cases reported in the literature. Preoperative diagnosis is difficult due to nonspecific clinical and radiological findings. Its prognosis is poor due to rapid progression and a high short-term recurrence rate. The definitive diagnosis relies on histopathological examination.

An unusual simultaneous occurrence of gastric carcinoma with lymphoid stroma, calcified leiomyoma and ectopic pancreas.

Gastric carcinoma with lymphoid stroma is a rare variant of gastric carcinoma accounting for 1%-7% of gastric carcinomas. Its association with gastric leiomyoma and ectopic pancreas is extremely rare. We herein report an unusual simultaneous occurrence of gastric carcinoma with lymphoid stroma, calcified leiomyoma, and ectopic pancreas.

Tuberculous abdominal cocoon: A rare variant of peritonitis.

Cocoon abdomen is an uncommon condition characterized by bowel entrapment in a cocoon-like membrane. Its clinical presentation is usually non-specific. Rarely, it may present with perforation peritonitis. The therapeutic approach depends on the stage of the disease. Surgery is essentially reserved for those with acute surgical complications.

Bifocal intracholecystic tubulopapillary neoplasm: A rare and distinct tumor of the gallbladder.

Intracholecystic papillary-tubular neoplasms are rare precancerous and polypoid lesions of the gallbladder, found in nearly 0.4% of cholecystectomy specimens. They follow the adenoma-carcinoma sequence. About half the cases are associated with invasive carcinoma. Their diagnosis relies on histopathological examination with extensive sampling of the surgical specimen.

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.

Huge Aneurysm of the Proper Hepatic Artery.

Hepatic artery aneurysms are rarely diagnosed. It is mainly because of non specific symptoms. They are generally an incidental findings during imaging studies. They are usually detected in the sixth decade, predominantly in men. We report herein a case of an 80 year-old man with a huge hepatic artery aneurysm revealed by abdominal pain and chronic anemia. It was treated by embolisation. Hepatic artery aneurysms are second among visceral aneurysms. They may cause abdominal pain, jaundice and hemorrhagic events.

Computed Tomographic presentation of obstructive jejunal adenocarcinoma associated with celiac disease and incomplete intestinal malrotation.

INTRODUCTION: Small bowel adenocarcinoma is a rare entity most frequently observed with celiac disease. This is the first case report on the association of celiac disease, small bowel adenocarcinoma and intestinal malrotation. CASE REPORT: A 40 year-old male patient diagnosed with celiac disease since the age of 5 years complained of epigastric pain and vomiting for three days. Computed tomography (CT) showed a significant gastroduodenal dilatation with thickened intestinal wall proximal to the duodenojejunal flexure. The lumen contained a food bezoar in the center. The duodenojejunal angle was abnormally on the right side of the abdomen and the superior mesenteric vein was anterior to the superior mesenteric artery. Endoscopy after aspiration found a hemi-circumferential and irregular mass which bled at the contact of fibroscope. Biopsies showed an adenocarcinoma and small bowel resection was performed. DISCUSSION: Celiac disease is associated with a high risk of small bowel cancer. The association of incomplete intestinal malrotation, duodenojejunal flexure tumor and celiac disease made the surgery challenging. CONCLUSION: Patients with celiac disease should be carefully monitored and endoscopic or radiologic investigations should be carried out in patients with any doubtful symptoms.