Gastrointestinal stromal tumors (GISTs) occurring outside the gastrointestinal tract are known as extragastrointestinal stromal tumors (EGIST). They share some common histopathologic and molecular characteristics. This report describes two female patients who were suspected of having a mesenteric GIST, but opted for surveillance rather than definitive treatment. Upon reassessment, both patients demonstrated increased tumor mass with no evidence of distant metastasis. The intraoperative findings confirmed the conclusion of clinical and imaging studies performed preoperatively and radical excisions were performed. Histopathological examination (spindle cell neoplasm) and immunohistochemistry (CD117) confirmed EGIST. Both patients underwent Imatinib therapy following surgery with no evidence of disease recurrence or metastasis upon follow up. Although sharing histologic features with GIST, EGIST frequently demonstrates distinct characteristics that facilitate the proper diagnosis and management of EGIST. Since it is a rare and aggressive disease with a poor outcome, early detection and curative surgical resection remains the mainstay of treatment.

Highlights Chronic partial jejunal obstruction leading to various non specific abdominal symptoms since 40 years. The first reported case of Lapsi seed stones causing partial jejunal obstruction. No change in morphological features of Lapsi seed stones when resided for long within human Gastrointestinal tract. First demonstration of radiological features of Lapsi seed stones both in vivo as well as in vitro. When patient not evaluated by non-physician and non-surgeon could delay diagnosis and improper treatment.

Hypertriglyceridemia led acute pancreatitis secreted exudative fluid tacked to the right iliac fossa may cause irritation of retroperitoneum leading to acute periappendicular inflammation and acute appendicitis.

The colonic involvement in acute pancreatitis is quite rare and most commonly occurs in the adjacent colonic part including transverse and splenic flexure colon. This case showed that extrinsic, secondary acute appendicitis could be as a complication of acute pancreatitis.