Unusual clinical course Background:Although lipomas are common benign tumors of adipose tissue, diffuse lipomas involving the small bowel, large bowel, and mesentery are rare. Multiple non-encapsulated lipomas characterize diffuse intestinal and mesenteric lipomatosis. Intestinal lipomatosis can be asymptomatic or may result in complications such as intussusception, volvulus, intestinal obstruction, or hemorrhage due to mucosal ulceration. A rare case is presented of intestinal infarction due to diffuse segmental jejunoileal and mesenteric lipomatosis in a 39-year-old woman. Case Report:A 39-year-old woman was admitted to the emergency department with a 12-hour history of diffuse abdominal pain, nausea, vomiting, and absent bowel movements. She had a known history of intestinal lipomatosis, diagnosed two years previously on abdominal computed tomography (CT) imaging. At surgery, segmental jejunoileal and mesenteric lipomatosis was identified associated with acute intestinal infarction. She underwent ileal resection with side-to-side enterocolic anastomosis. Conclusions:Diffuse intestinal and mesenteric lipomatosis is a rare condition that can be associated with complications.To our knowledge, this is the first reported case to present with acute small bowel infarction.

Introducere: Endometrioza parietală (EP) este o patologie rară, care apare frecvent la femeile fertile, după intervenţii chirurgicale sau ginecologice. Simptomatologia cvasipatognomonică constă în durere catamenială asociind sau nu formaţiune palpabilă. Diagnosticul ridică probleme, deoarece adesea se poate confunda cu granulomul de fir, hematomul, hernia şi cancerul. Pacienţi şi metode: Între ianuarie 2007 şi decembrie 2017, 10 paciente cu EP au fost internate în clinica noastră pentru diagnostic şi tratament. Rezultate: Vârsta medie a pacientelor a fost de 35,8 ani. Simptomul principal a fost durerea abdominală (9/10 paciente) şi examenul clinic a relevat prezenţa unei formaţiuni palpabile la toate pacientele. Cinci paciente au fost diagnosticate preoperator cu EP, iar cinci incorect diagnosticate cu tumoră de perete abdominal (4 paciente) şi granulom de fir (1 pacientă). Opt paciente au avut istoric de intervenţii ginecologice (operaţie cezariană, epiziotomie), iar 2 paciente nu au avut operaţii în antecedente. Dimensiunile tumorilor au fost de 1-14 cm. Rezecţia tumorală a necesitat reconstrucţia peretelui abdominal cu plasă de întărire sau substituţie la 5 paciente, iar la restul plasa nu a fost necesară. Concluzii: Studiul nostru confirmă că EP reprezintă o entitate chirurgicală rară şi sugerează necesitatea anamnezei şi examenului

A 72-year-old male with end-stage renal disease underwent a computed tomography scan to assess renal function. An oval-shaped mass, 50 mm × 60 mm in size, was discovered incidentally in his recto-vesical pouch. Because it was suspected to be a teratoma, which could be an impediment for future renal transplantation, surgery was performed. It revealed a giant peritoneal loose body, a rare entity, that has not been reported before in patients with renal chronic insufficiency.

Patient: Male, 48Final Diagnosis: Neuroendocrine tumorSymptoms: Abdominal painMedication: —Clinical Procedure: Excision of the tumorSpecialty: SurgeryObjective:Rare diseaseBackground:Neuroendocrine tumors found in skin or soft tissues usually represent metastasis from other organs and are considered late manifestations of disease. Therefore, primary cutaneous and soft tissue neuroendocrine tumors are extremely rare.Case Report:We report a case of a 48-year-old male with a neuroendocrine tumor occurring in the subcutaneous abdominal fat, which had an echographic appearance of a vascular malformation. The finding was diagnosed as compatible with neuroendocrine tumor based on histopathological and immunohistochemical studies. No other sites of possible internal origin were detected on supplementary investigations.Conclusions:Soft tissue neuroendocrine tumors may have an appearance on imaging studies that challenge physicians to make a correct diagnosis. Despite the rarity of these tumors, they should be included in the differential diagnosis of other soft tissue masses.

Duodenal or pancreatic invasion in locally advanced right colon cancer (LARCC) is a challenging situation that can pose difficulties in its management. When the duodenum alone is invaded, the surgeon may undertake right hemicolectomy (RH) en bloc with the affected patch of duodenum. The duodenal defect can be reconstructed using several techniques. When invasion of the pancreas is present, RH en bloc with duodenopancreatectomy (DP) is the treatment of choice. We present our experience regarding the treatment and prognostic results of this rare colon cancer form. We retrospectively reviewed the data of patients who underwent surgery for right-sided colon cancer with duodenal and/or pancreatic invasion between January 2004 and March 2020. Among the 110 patients with LARCC, pancreas and/or duodenum invasion was encountered in 22 patients, with a mean age of 49.5 years. From the 22 patients, 5 patients underwent palliative procedures, with a maximal survival of 15 months. Three patients underwent RH alone, with lethal outcome in the first year in 66% of the cases. RH en bloc with antrectomy was performed in 2 patients. Eight patients underwent RH with DP, with a 1-year survival of 75% (6/8) and a 5-year survival of 50% (3/6). Thirty-day mortality post-DP was noted in 25% (2/8) of the cases. Four patients underwent RH with limited duodenal resection, with no recurrence of disease at 11 to 39 months postoperatively. Among the duodenal defect restoration, simple duodenal suture was practiced in 2 patients, duodenojejunostomy in one patient and pedicled ileal flap in 1 case. In conclusion, although postoperative mortality can be significant, en bloc resection for LARCC invading the duodenum and/or pancreas offers prolonged survival in a considerable number of patients.