Background Sacrococcygeal teratomas are tumors originating from pluripotent embryonic germ cell layers located in the fetal coccyx. These tumors are highly vascular if they undergo malignant transformation. Typically, they are found in infants and children and occasionally can be diagnosed prenatally. Adult cases are very rare, and represent tumors present since birth with delayed detection. Case presentation We describe a case of a giant sacrococcygeal teratoma in a 25 years old female college student presenting with right gluteal swelling of 4 months’ duration. In addition to the huge disfiguring mass on the perineal area, she also had lower abdominal pain, urinary complaints, and difficulty with ambulation. Discussion Pre-operative impression was of a sacrococcygeal mass and histopathology following complete surgical excision revealed a sacrococcygeal teratoma. She recovered well after surgery with no radiologic evidence of recurrence at six months. Conclusion Although rare, sacrococcygeal teratoma should be considered as a differential diagnosis for female adults presenting with perineal and/or pelvic masses. Complete surgical excision remains the mainstay of treatment.

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Introduction Bronchial carcinoid tumors are rare, slow growing, malignant neuroendocrine tumors which arise from Enterochromaffin (Kulchitsky) cells. Early diagnosis is extremely important as the main stay of treatment is surgical excision. Presentation of case We present a rare case of bronchial typical carcinoid tumor in a 27-year-old male who presented with a complaint of intermittent dry cough of 2 weeks’ duration associated with shortness of breath and low grade fever. He was initially misdiagnosed as covid-19 pneumonia and was admitted to covid-19 treatment center. Right lung bi-lobectomy with regional lymph node resection was done and he was discharged home in good condition. Discussion Majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain and wheezing. In the era of covid-19 pandemic, lung cancer patients are at higher risk of being affected by covid-19 and, early identification and differential diagnosis is extremely difficult in the absence of comprehensive evaluation and work up as the clinical and imaging findings of covid-19 may resemble lung cancer. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids most lymphadenopathies are caused by a reactive inflammatory reaction. Conclusion Bronchial carcinoids are rare, malignant neuroendocrine tumors with complete surgical resection being the only curative management. During the Covid-19 pandemic crisis, diagnosing rare lung diseases like carcinoid tumor is real challenge especially in resource limited set up and needs high index of suspicion with meticulous diagnostic work up. The outcome of typical carcinoids with lymph node metastasis is excellent with complete resection.

Introduction: Bronchial carcinoid tumors are rare, slow growing, malignant neuroendocrine tumors which arise from Enterochromaffin (Kulchitsky) cells. Early diagnosis is extremely important as the main stay of treatment is surgical excision. Presentation of case: We present a rare case of bronchial typical carcinoid tumor in a 27-year-old male who presented with a complaint of intermittent dry cough of 2 weeks’ duration associated with shortness of breath, low grade intermittent fever and loss of appetite. He was initially misdiagnosed as covid-19 pneumonia and was admitted to covid-19 treatment center. Right lung bi-lobectomy with regional lymph node resection was done and he was discharged home in good condition.Discussion: Majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain, wheezing and hemoptysis. Due to such nonspecific presentation most patients are misdiagnosed or diagnosed late. In the era of covid-19 pandemic, in addition to the wide spread anxiety on the health care workers access to diagnostic work up of patients with rare diseases like bronchial carcinoids is very challenging especially in resource limited areas as invasive diagnostic procedures like bronchoscopy are usually avoided in covid-19 suspected patients during the pandemic. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids most lymphadenopathies are caused by a reactive inflammatory reaction.Conclusion: Bronchial carcinoids are rare, malignant neuroendocrine tumors with complete surgical resection being the only curative management. Although the world is over burdened by Covid-19 pandemic crisis, other lung pathologies are also still present in communities. In such challenging circumstance diagnosing rare pulmonary diseases like bronchial carcinoids need high index of suspicion and meticulous diagnostic work up. The outcome of typical carcinoids with lymph node metastasis is excellent with complete resection but close follow up is mandatory when dealing with larger tumors.