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Cutaneous metastases from esophageal adenocarcinoma are exceedingly rare. With the institution of multimodality treatments and surgical resection for esophageal adenocarcinoma, loco-regional disease recurrence has been dramatically reduced. In this report, we present a 59-year-old white male with adenocarcinoma of the distal esophagus that was treated with neoadjuvant chemotherapy and radiation therapy, followed by surgical excision. After a disease free interval of two years the patient presented with cutaneous metastatic disease.

Wandering spleen is a rare condition in which the spleen is attached by a long, vascular pedicle and lacks its usual peritoneal attachments and supporting ligaments. This condition predisposes the spleen to torsion and infarction. We report the case of a 2-year-old boy with a history of intermittent abdominal pain and early satiety who presented with abdominal pain and severe gastric distention. A work-up including computed tomographic and ultrasonographic imaging suggested a wandering spleen. The diagnosis was confirmed during laparoscopy, and splenopexy was performed by anchoring the spleen in a retroperitoneal pocket in the left upper quadrant at the level of the tenth rib. To our knowledge, this is the first reported case of minimally invasive splenopexy for wandering spleen that involves the creation of a retroperitoneal pocket without the use of mesh. The authors believe that this is a safe and effective method that takes advantage of laparoscopy and avoids the risk of infection and complications associated with the use of synthetic material.

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