A rare case of an inflammatory myofibroblastic tumor of the appendix presenting as acute appendicitis: A case report.

INTRODUCTION AND IMPORTANCE: An inflammatory myofibroblastic tumor is commonly seen in the lungs but rarely in the appendix. It has a distinct inflammatory cell component and myofibroblastic component. The study presents an inflammatory myofibroblastic tumor of the appendix in an elderly who presented with acute appendicitis and was later found to have an appendicular mass intraoperatively. CASE PRESENTATION: Herein, we report a case of inflammatory myofibroblastic tumor of the appendix in a 59 years old female who presented with acute abdomen, features suggestive of acute appendicitis clinically. However, the intra-operative findings showed an appendicular mass involving the base of the appendix for which a right hemicolectomy was done. The histopathological examination of the resected specimen later confirmed it as an inflammatory myofibroblastic tumor of the appendix. CLINICAL DISCUSSION: An inflammatory myofibroblastic tumor is common in the lungs, whereas rare in the appendix. It primarily involves children and young adults. It can present as mimic appendicitis or appendicular mass and should thus be considered in the differentials of these. CONCLUSION: The rare presentation of inflammatory myofibroblastic tumor of the appendix makes it likely to be missed resulting in overzealous resection of the tumor. Thus, it is important to consider it in the differential diagnosis of acute appendicitis and manage it accordingly.

Proximal radioulnar synostosis following Monteggia fracture-dislocation: a case report.

Introduction and importance: Radioulnar synostosis is a rare complication of a forearm fracture that restricts pronation-supination. This study presents a case of proximal radioulnar synostosis in an adult male after Monteggia fracture-dislocation who had a loss of pronation and supination movements. Case presentation: Herein, we report a case of proximal radioulnar synostosis in a 43-year-old man who presented with loss of pronation and supination of the right forearm that restricted his daily activities. He had a history of Monteggia fracture-dislocation 9 months back, which was managed with open reduction and internal fixation with a dynamic compression plate. Plain radiography and computed tomography of the right forearm after 9 months of operation showed an implant in situ with proximal radioulnar synostosis. Implant removal was performed and the excess fibro-osseous connection in the proximal radius and ulna was removed. Clinical discussion: Forearm injuries that affect the interosseous membrane may result in radioulnar synostosis. Trauma and treatment-related factors increase the risk of radioulnar synostosis. The fibro-osseous fusion between the forearm bones restricts the pronation and supination movements. Conclusion: Loss of pronation-supination following forearm fracture should raise suspicion of radioulnar synostosis.