HighlightsDifferential diagnosis of LPD from leiomyosarcoma or benign metastasizing leiomyoma remains difficult.Ample history of the patient, clinical evaluation, preoperative guided FNA and histopathologic analysis of the FNA tissue and of the tumor resection are essential for differential diagnosis.Prompt diagnosis of LPD is crucial because, although benign in nature, LPD may degenerate into malignancy.

HighlightsBe aware of the rare occasion of PE in patients with intestinal obstruction without other etiological factors.Preoperative diagnosis of PE may be impossible.Management of PE in case of intestinal obstruction requires urgent surgery.

Complete duplication of ureters is a very rare clinical entity that may either be asymptomatic or present with a variety of clinical findings. In the presented case a 51-year-old Caucasian female underwent an intersphincteric resection for low rectal cancer. Intraoperatively, during the standard bilateral recognition and mobilization of the ureters, complete unilateral duplication of the left ureter was incidentally detected, deriving from a single renal parenchyma. Such a congenital abnormality though constitutes a major risk-factor of accidental ureteral injury during operations including pelvis. Conclusively, meticulous exposure of both ureters combined with surgeons’ unceasing awareness constitute the cornerstone of a safe operation.