Surgical treatment is the dominant choice for the treatment for IPMN. Although minimally invasive, laparoscopic enucleation of BD-IPMN is able to achieve an adequate level of radicality without the accompanying complications and with short postoperative recovery period.

Introduction Osseous metaplasia is a heterotopic formation of bone and its appearance in benign gastrointestinal polyps is exceedingly rare. The mechanism responsible for this type of metaplasia is not fully understood, however it seems to be an innocent rare phenomenon. Case outline We present a case of a 31-year-old male with mesenchimal osseal metaplasia in a large inflamatory polyp measuring 57 × 23 × 20 mm in diameter, located in the anal canal region. Conclusion According to our knowledge, this is the largest gastrointestinal polyp with osseous metaplasia described so far. Although a rare phenomenon, there are certain characteristics of this disease, so we conducted a literature review and summarized these characteristics.

Based on the aforementioned, we consider that the laparoscopic gastric wedge resection is a safe and efficient surgical procedure. This is primary therapy for most common group of patients with resectable gastric GIST.

Introduction: Congenital simple hepatic cysts are extremely rare and are usually asymptomatic. The best therapeutic approach to treating simple liver cysts remains the subject of scientific debate. Case report: We present the case of a giant liver cyst removed with a minimally invasive, laparoscopic approach in a 68-year-old woman, who presented with rapid weight loss. Conclusion: Due to the lack of randomized clinical trials comparing minimally invasive (laparoscopic) and open surgery approaches in liver cyst treatment, we recommend a personalized medical approach, applied after analyzing the characteristics of both the cyst and the patient.

Introduction Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor that occurs in the gastrointestinal tract, most commonly in the stomach or the small intestine. The surgery of the stomach is the dominant way of treatment of these tumors. The synchronous detection of adenocarcinoma and gastric GIST is not a very common condition, which is often diagnosed intraoperatively and has a significant impact on the prognosis of these patients. Outline of cases We herein report two cases of gastric GIST with synchronous adenocarcinoma tumors, which were detected incidentally, intraoperatively, while the patients were undergoing surgery for a primary gastric adenocarcinoma. The first case was of a 76-year-old female patient. The histopathological analysis of the operative specimen firstly showed a poorly differentiated advanced gastric adenocarcinoma. The second tumor, from the gastric serosa, was a spindle cell GIST of low risk. It was diffusely positive for DOG1, CD34, and CD117. Its proliferative index was established using the Ki67 antibody. The number of mitoses was one per 5 mm 2. The second case was of a 65-year-old male patient. The histopathological analysis revealed an early, well-differentiated, intestinal type adenocarcinoma of the gastric mucosa. The synchronous tumor from the serosa of the stomach was a spindle cell gastrointestinal stromal tumor (CD34, DOG1, and CD117 diffusely positive) of low risk. The proliferative index of this tumor, labeled with the Ki67 antibody, was very low. Necrosis was not present, nor was mitosis. Conclusion Synchronous adenocarcinomas and GIST of the stomach are not very commonly associated, and are usually detected intraoperatively and after an immunohistochemical analysis. Recognition of this condition has a very important role in a differential diagnosis and the exclusion of metastases of malignant tumor deposits. Based on the tumor severity, the radicalness of the surgical intervention is determined, which affects the outcome of these patients.