Scrotal lipomas are benign tumours rarely seen in clinical practice. They can mimic common affections such as an an inguinoscrotal hernia, varicocele, hydrocele or a testicular tumour. Thus, in many cases, physical examination leads to a correct diagnosis, there are situations that require comprehensive imagistic examinations, to establish the preoperatory nature of the scrotal tumour. A case of 64-year-old male, known with arterial hypertension and gonarthrosis, came to the hospital for a painless scrotal tumour with a fast growth rate in dimensions over the last year. Physical examination detected an elastic, painless, irreducible, irregularly shaped mass of a right scrotal region. The scrotal ultrasound revealed a heterogeneous hyperechoic solid mass with 10x8.1x8cm in dimensions, localized in the right scrotal region. The magnetic resonance imaging (MRI) showed a globular shaped right scrotal tumour mass with well-defined margins, poorly vascularized at the lower pole. Surgery was performed, with excision of a mass about 10cm in major diameter from the right scrotal wall. Postoperative evolution was good, and the histological diagnosis of primary scrotal lipoma was made. One-year follow-up revealed no local relapse.

Gallbladder inflammation is most often determined by the presence of gallstones. Acalculous cholecystitisusually occurs in patients with multiple comorbidities or with an immunosuppressed status, and therefore itsevolution is faster and more severe compared to acute calculous cholecystitis. The presence of a fish bone intothe peritoneal cavity, through a gastrointestinal fistula is not very rare, but acute cholecystitis caused by a fishbone is unexpected. Here, we present the case of a 75-year old woman who had eaten fish two months beforeand presented at the Emergency Room with perforated acalculous cholecystitis and a right subphrenic abscess.The laparoscopic approach permitted the evacuation of the subphrenic abscess, bipolar cholecystectomy andremoval of a fish bone from nearby the cystic duct. Postoperative evolution was uneventful, with hospitaldischarge after five days. The patient was in good clinical condition at two months follow-up.

Objective. We present a rare pathology with uncommon onset. Background. Mucinous cystic pancreatic neoplasms (MCNs) are rare tumors, which generally occur in the fifth and sixth decades of women. Although some tumours are frankly malignant, all are in fact considered to be potentially malignant. Case report. We present the case of a 30-year-old patient, with a 16/11 cm tumor located in the pancreas body, which was diagnosed 8 months after birth. The preoperative assessment of the pancreatic lesion suggested the diagnosis of mucosal cyst neoplasm, without being able to determine its benign or malignant nature. Central pancreatectomy was performed with a good postoperative evolution. Histopathologic result was represented by mucinous pancreatic chistadenoma. Two years after surgical intervention, the patient presented no signs of recurrence or pancreatic (exocrine or endocrine) secretion deficiency. Conclusions. Preoperative imaging evaluation could be suggestive for mucinous cystic tumour, but this cannot specify however the nature of the tumor. The postpartum occurrence could establish a possible relationship between hormonal levels encountered during pregnancy and the development of this tumor, taking into considerations the ovarian-type stroma and the presence of hormone (estrogen and progesterone) receptors in this neoplasm. Central pancreatectomy without anastomosis preserves the functions of pancreas, and also decreases morbidity.

We present a clinical case of synchronous colonic lesions, histologically different, associated with streptococcus gallolyticus subsp. gallolyticus (Sgg)/ Streptococcus bovis biotype I, bacteremia and infective endocarditis. A 53-year-old female, without history of CRC in her family, known with total hysterectomy for uterine fibromatosis, presents to Emergency Department for marked asthenia, nausea, weight loss (10 kgs in the last month), febrile episode associated with severe anemia, symptomatology that has increased in the last two weeks. The patient was admitted in the Internal Medicine Department for further investigations, under the suspicion of sepsis of unknown cause. On blood cultures grew Sgg bacteria. Both transthoracic echocardiography and transesophageal echocardiography were performed and diagnosed infective endocarditis with vegetations of the mitral and aortic valves. Antibiotics treatment was initiated, with ceftriaxone and gentamycin, according to antibiogram results. Severe hypochromic, microcytic anemia, and lack of an infective origin site required digestive endoscopic evaluation, and showed gastritis, ulcerovegetative tumor of the ascending colon and polyp in the rectosigmoid. Resection of rectosigmoid polyp was performed through colonoscopy, and, also, right hemicolectomy with ileo-transverse anastomosis for the ascending colon cancer. Post-operative evolution was favorable. Histological result showed mucinous adenocarcinoma of the ascending colon and tubulovillous adenoma, with moderate dysplasia, in the rectosigmoid. At 6-month, endoscopic evaluation showed normal aspect of anastomosis without presence of other colonic lesions.

Pancreatic abscesses are rare and usually occur as a pancreatitis complication. The absence of acute pancreatitis and the clinical presentation that mimics a neoplasm are very unexpected. A 49-year-old man, known with arterial hypertension and chronic infection with virus hepatitis B came to the hospital for weight loss, marked asthenia, nausea/vomiting and jaundice, associated with mild pain in the upper abdomen. At admission, without fever and no medical history of acute pancreatitis. Laboratory values showed an important inflammatory syndrome, near normal pancreatic enzymes and increased tumour markers. Abdominal computed tomography (CT) revealed a heterogeneous fluid collection with gas bubbles inside, localized into the lesser sac that tended to extend peri splenic, towards the anterior and posterior pararenal spaces and the pelvis. Surgery has led to evacuation of peripancreatic and left retrocolic abscesses, associated with debridement and peritoneal drainage. The culture yielded Streptococcus Anginosus. At 7 days post-intervention hemoperitoneum occurred and was required a second intervention for haemostasis. Subsequent favourable clinical and biological evolution, with patient discharge from the clinic 16 days after admission. Repeated CT scans of the abdomen showed resolution of lesions and at colonoscopy it was observed uncomplicated colonic diverticulosis. In this case is highlighted a rare presentation of a peripancreatic pyogenic abscess caused by Streptococcus anginosus, associated with colonic diverticulosis.