Key Clinical MessageA 74-year-old female patient underwent a Roux-en-Y cystjejunostomy for pancreatic pseudocyst developed several melena episodes and she was surgically reappraised. The main diagnostic concern was a pancreatic cystic neoplasm. A 12 × 8.0 × 5.0 cm retro-gastric lesion was resected and pathology report indicated an unsuspected gastrointestinal stromal tumor (GIST). The report aimed to describe an atypical presentation of GIST.

In spite of the first trials on the effect of cholesterol reduction and its beneficial impact on morbidity and mortality in the elderly many have already proven the antecipated positive results. The high risk attributable to the elderly is a guarantee for an effort in primary prevention, especially when a high level of serum cholesterol is combined with other risk factors linked to coronary artery disease. There are elements of similarity for primary prevention in the elderly over 65 years of age, compared to middle-aged patients. This consideration opened the need for scientific evidence with confirmed levels of evidence. The first studies were WOSCOPS, AFCAPS/TEXCAPS, Heart Protection Study, PROSPER, ALLHAT (Antihipertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial-Lipid Lowering Trial), REVERSAL, Health Study, ASCOT (Anglo Scandinavian Cardiac Outcomes), MIRACL, Post CABG, AVERT, ACCESS, ASSET, ATGOAL, CHALLENGE, CURVES, BELLS, ARBITER, NASDAC, PROVE-IT and DEBATE. Positive evidences were shown from the first to the last trial recalled in this historical beginning.