Reactive arthritis (ReA) with the classic triad of arthritis, conjunctivitis and urethritis, previously termed Reiter’s syndrome, is a systemic illness, usually induced by genitourinary or gastrointestinal infections. However, it can be a rare complication of intravesical Bacillus Calmette-Guérin instillation (iBCG), a therapy prepared from attenuated strains of Mycobacterium bovis, a common and effective treatment for carcinoma in situ of the bladder (CisB). We report a case of a patient with CisB who developed ReA after iBCG. The symptoms resolved completely with corticosteroids. iBCG was stopped with no recurrence of carcinoma within 2 years.

Occam's razor, the principle that a single explanation is the most likely in medicine, assumes that when a patient has multiple symptoms the clinician seeks a single diagnosis rather than diagnosing multiple and different ones. However, as proposed by Hickam’s dictum, sometimes rare different diseases occurred in only one patient. We present a patient with a simultaneous diagnosis of two rare tumours, a cardiac hemangioma (primary cardiac tumour, often misdiagnosed as myxoma) and an appendiceal mucocele (a lesion of the appendix that can be neoplastic or not). A 71-year-old male presented with anorexia, asthenia, fever and weight loss for about one month. During the etiological investigation, a cardiac mass and an appendiceal lesion were detected and both lesions required surgical intervention. Cardiac and abdominal surgeries were uneventful and full recovery was achieved. The histological examination showed a cardiac hemangioma and a neoplastic appendiceal mucocele.

Subcutaneous emphysema is a possible but rare complication after dental procedures. The condition should be distinguished from other situations, such as hematoma, allergic reaction or angioedema, and infection. We describe the case of a 20-year-old puerperal woman, with multiple dental caries, who developed cervicofacial subcutaneous emphysema complicated by pneumomediastinum, following an incomplete extraction of the lower right second molar. This was diagnosed clinically and through imaging tests, and the situation resolved after hospital admission, with antibiotics and close monitoring. The case underlines the need to diagnose and treat this complication early, because of the risk of airway compromise, air embolism, infection, sepsis and death.

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GIST (Gastrointestinal stromal tumors) are rare tumors of mesenchymal origin. The authors present a case of GIST in a 80 years old female with multiple co-morbilities, admitted with epigastric pain, gastrointestinal bleeding and heart failure decompensation.