HighlightsThe origin from perirenal fat is very uncommon.The occurrence of hematogenous metastasis is a rare finding at the time of diagnosis.The undifferentiated and pleomorphic type are neoplasm with high grade of malignancy.In case of diagnostic doubt and in presence of recurrence, magnetic resonance imaging (MRI) may be useful because can identifying in a reliable manner the satellite localizations of the main lesion.The complete surgical (R0) resection represents the only possibility of radical treatment.Following surgical resection, the 50–100% of liposarcomas recur from residual tissue, which is the primary cause of death.Percutaneous biopsy has low accuracy in the diagnosis of retroperitoneal dedifferentiated liposarcoma (DDLS).

It is important to be aware, especially in countries where echinococcosis is endemic, that it is possible to find an echinococcosis cyst in a rare localization.

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The accidental ingestion of a foreign body (FB) is a relatively common condition. In the present study, we report a peculiar case of rectal perforation, the first to our knowledge, caused by the inadvertent ingestion of a blister pill pack. The aim of this report is to illustrate the difficulties of the case from a diagnostic and therapeutic viewpoint as well as its unusual presentation. A 75-year-old woman, mentally impaired, arrived at our emergency department in critical condition. The computed tomography scan revealed a substantial abdominopelvic peritoneal effusion and free perigastric air. The patient was therefore submitted to an urgent exploratory laparotomy; a 2-cm long, full-thickness lesion was identified in the anterior distal part of the intraperitoneal rectum. Hence, we performed a Hartmann’s procedure. Because of her critical condition, the patient was eventually transferred to the Intensive Care Unit, where she died after 10 d, showing no surgical complication. The ingestion of FBs is usually treated with observation or endoscopic removal. Less than 1% of FBs are likely to cause an intestinal perforation. The intestinal perforation resulting from the unintentional ingestion of an FB is often a difficult challenge when it comes to treatment, due to its late diagnosis and the patients’ deteriorated clinical condition.

Rendezvous is a feasible option for treatment of CBDS; it allows one to perform only 1 stage of treatment, even in acute cases such as cholecystitis and pancreatitis. Positioning of the guide wire may allow reduced complications secondary to papilla cannulation but not those of the endoscopic sphincterotomy.