Gastrointestinal stromal tumors (GISTs) are a common type of soft tissue sarcoma that originates from the interstitial cells of Cajal in the gastrointestinal (GI) tract. These tumors usually affect people above 50 years of age and can be difficult to diagnose, as symptoms can be vague and nonspecific, with some patients remaining asymptomatic. Early diagnosis and treatment are crucial because GISTs can be aggressive and may metastasize.We present a case of a 74-year-old man who presented to our hospital with GI bleeding and anemia. Despite initial investigations, the source of bleeding was not identified until capsule endoscopy and then balloon enteroscopy revealed an ulcerated mass in the jejunum. The tumor was successfully removed using a minimally invasive laparoscopic approach, and the histopathologic report confirmed the diagnosis of GIST. The patient had an uneventful postoperative course. This case highlights the importance of considering GISTs in the differential diagnosis of obscure GI bleeding. A multidisciplinary approach is essential to ensure the best outcomes for these patients. Additionally, the use of minimally invasive surgery should be considered whenever possible to minimize postoperative complications and promote faster recovery.

This report discusses the case of a 20-year-old female patient who presented with acute abdominal pain, nausea, and vomiting. Initial laboratory analyses suggested an inflammatory process, but imaging studies failed to reveal pathologies. The patient underwent a diagnostic laparoscopy, which showed a thickened and multicystic appendix with signs of acute inflammation. Pathology indicated a positive cytology for malignancy, with a grade 1 mixed well-differentiated neuroendocrine tumor (NET) and high-grade mucinous neoplasm identified in the middle and distal thirds of the appendix. Finding both tumors in the same patient is extremely rare and has been reported in a few cases. The case emphasizes the importance of considering appendiceal tumors in the differential diagnosis of acute abdominal pain, even in young patients, and highlights the value of laparoscopy in their diagnosis. The early detection and appropriate management of appendiceal tumors are crucial for improving patient outcomes.

This article discusses acral melanoma, a rare subtype of melanoma often presented at the later stages of the disease and is, thus, associated with poor survival rates, especially in patients with a lower socioeconomic status. Surgical resection is the primary treatment option for localized acral melanoma, while amputation is often necessary for tumors on the digits or the midfoot. Lymphadenectomy may be necessary for patients with regional lymph node involvement; however, the therapeutic role of dissection remains controversial. Here, we present the case of a 68-year-old man with acral melanoma who underwent a Lisfranc amputation and endoscopic groin lymph node dissection for ganglionic metastasis. In Ecuador, this is the first reported case of endoscopic groin lymphadenectomy for regional lymph node metastasis secondary to acral melanoma. The discussion explores the role of sentinel lymph node biopsy and the completion of lymph node dissection in managing regional lymph nodes in melanoma patients. This case study aims to contribute to the growing knowledge on acral melanoma, assess the need for better patient care, and analyze the role of minimally invasive techniques for inguinal lymph node dissections.

The occurrence of synchronous acute cholecystitis and appendicitis is rare. There are few cases reported and small series in the literature. We report the case of a 77-year-old male who presented to the emergency department with right-sided abdominal pain. He was diagnosed preoperatively with acute calculous cholecystitis. During the initial laparoscopy, a complicated appendiceal phlegmon was found and was treated with a one-step laparoscopic approach and subsequent antibiotics. The patient had an uneventful recovery and was discharged on postoperative day (POD) 2. The pathology report confirmed both diagnoses and an incidental low-grade appendiceal mucinous neoplasm. Although uncommon, it is important to be aware of the possibility of both simultaneous pathologies in a patient who presents to the emergency department with abdominal pain.

Although Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, it is rare in the general adult population. When it does become symptomatic, it is usually due to complications such as perforation. We report the case of a 38-year-old man who presented with acute abdominal pain in the right iliac fossa, fever, and tachycardia. Complementary exams at the emergency department showed leukocytosis and elevated C-reactive protein. Acute appendicitis was suspected, so he was taken to the operating room for a diagnostic laparoscopy. During surgical exploration, a perforated Meckel's diverticulum caused by a toothpick was found. Surgery was converted to laparotomy with resection of the small bowel segment containing the diverticulum, followed by a primary anastomosis. The postoperative period was uneventful, and the patient was discharged on day seven. No abnormalities were reported in the histopathology study. In this report, we review and discuss similar cases found in the literature, all of them male with acute abdomen and suspicion of appendicitis. We aim to remark on the importance of keeping in the differential of such patients a perforated Meckel's diverticulum.