Immunotherapy has improved the results of treatment of patients with metastatic colorectal cancer. According to literature, the most cancericidal effect revealed in a microsatellite instability high (MSI-H) tumors. In our case, PD-1/PD-L1/PD-L2 inhibitors (nivolumab) treatment for locally advanced MSI-H colon carcinoma with liver metastasis in 44-year-old patient resulted in tumor regression, so that R0 surgical procedure became possible. Computed tomography scan and pathology report showed complete response, in primary and metastatic tumors. As a result, this allowed to improve the quality of patient’s life.

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Seborrheic keratosis is the most common benign tumor of the epidermis. Rarely the tumor develops in the perineal area and quite rarely is large. For the Leser-Trelat syndrome these tumors is a marker of a malignant disease even before the symptoms are appeared, as well as a manifestation of the paraneoplastic process. In our case report, a giant perianal seborrheic keratoma was the reason for the clinical examination of the patient and stomach cancer was detected. As a result, we demonstrated a successful experience of surgical treatment of seborrheic keratoma of the perianal area and determined an algorithm for the treatment of stomach cancer.

Resection of “difficult” polyps is associated with high risks of intra- and postoperative complications. About 10 % of polyps are not amenable to endoscopic resection due to technical difficulties. Routinely, for the treatment of big size laterally spread tumors and early tumor of bowel segmental resections is used, which had a significantly higher risks of postoperative complications development. Hybrid laparoendoscopic surgery included a combination of laparoscopic and endoscopic technologies becomes a great opportunity to local bowel resection. This surgical procedure is accompanied by a minimal risk frequency of postoperative complications and the length of stay. In the two clinical cases we demonstrate techniques of hybrid laparoendoscopic surgery for “difficult” endoscopically unresectable polyps of the colon.

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