Surgical Case Library

Small Intestine

Thrombosis of the celiacomesenteric trunk

The majority of the blood supply of the gastrointestinal tract , is provided by the anterior branches of the a...

Celiacomesenteric trunk thrombosis is an extremely rare vascular anomaly, with very few cases reported in the literature.

Colorectal

Ulcerative Colitis and Descending Colon adenocarcinoma with metastasis to the appendix

It is widely accepted that patients with ulcerative colitis have an increased risk of developing colorectal ca...

Metastatic spread to the appendix in the context of descending colon adenocarcinoma and ulcerative colitis is extremely uncommon, with few reported cases in the literature.

Vascular & Trauma

Traumatic Renal Rupture

While renal injuries are not uncommon in blunt trauma, complete bisection requiring nephrectomy is rare in pediatric patients.

Colorectal

Toxic megacolon associated Clostridium difficile colitis

Clostridium difficile (C. difficile) is a gram positive, anaerobic, spore forming bacterium spread by the feca...

Toxic megacolon secondary to C. difficile infection is a rare but severe complication, occurring in approximately 0.4%–3% of cases.

Endocrine

synchronous papillary and follicular thyroid carcinomas

Although composite thyroid carcinomas have been reported in the literature, the simultaneous occurrence of mul...

Simultaneous occurrence of papillary and follicular thyroid carcinomas in the same lobe is extremely rare and sparsely reported in the literature.

Colorectal

Synchronous mucocele appendix-sigmoid carcinoma

Appendiceal mucocele (AM) is defined as a gross dilatation of the vermiform appendix, caused by the accumulati...

The synchronous occurrence of appendiceal mucinous cystadenoma and colon adenocarcinoma is exceptionally rare, with few reported cases in the literature.

Stomach & Esophagus

Synchronous gastric adenocarcinoma and nec

Gastric neuroendocrine carcinoma (NEC) is a rare disease that accounts for 0.1-0.6% of all gastric cancers. It...

Synchronous gastric adenocarcinoma and NEC is an exceptionally rare entity that can be misinterpreted as double MANECs.

Colorectal

Synchronous colonic and adrenal tumors

Synchronous colonic adenocarcinoma and non-functional adrenocortical adenoma with extensive degeneration is an exceptionally rare clinical scenario.

Colorectal

Synchronous Ovarian Carcinoma with Colonic and Ileal Metastases

Epithelial cancers represent 90.0% of all malignant ovarian tumours. Primary ovarian cancers tend to spread, a...

Synchronous ileocolic metastases from primary ovarian carcinoma are exceedingly rare, with few cases reported in the literature.

Breast

Synchronous Noninvasive Ductal Breast adenocarcinoma and Follicular lymphoma.

The incidence of breast cancer (BC) is extremely high and malignant lymphoma (ML) is a common malignant diseas...

This is only the seventh reported case in the literature of synchronous ductal breast carcinoma and follicular lymphoma.

Colorectal

Wegener's granulomatosis presenting as a perirectal abscess

Perirectal abscess as an initial manifestation of Wegener’s granulomatosis is extremely rare.

Hepatobiliary & Pancreas

Total Pancreatectomy and Cardiac arrest episode.

This report describes a rare case of unexplained cardiac arrest following total pancreatectomy with no similar cases identified in the literature.

Colorectal

Synchronous Colonic Adenocarcinomas and Colonic Hydatidosis

We report the case of a 68-year-old gentleman , with a previous history of liver hydatidosis who...

The coexistence of synchronous colonic adenocarcinomas with colonic hydatidosis is extremely rare, with minimal precedent in the literature.

Small Intestine

Stromal Endometriosis of the Intestine

Endometriosis is the presence of heterotopic endometrium outside the uterus. Small bowel endometriosis occurs ...

Symptomatic small bowel endometriosis causing acute obstruction is rare, comprising less than 1% of intestinal endometriosis cases.

Colorectal

Steroid induced sigmoid perforation

Corticosteroids and non-steroidal anti-inflammatory drugs are widely used for the treatment of nephropathies ,...

Steroid-induced sigmoid diverticular abscess perforation is a rare complication, particularly in patients with nephrotic syndrome.

Small Intestine

Spontaneous mesenteric haematoma

Spontaneous mesenteric haematomas are rare. It was first described in 1909 and for the remainder of the 20th c...

Spontaneous mesenteric hematoma is a rare clinical entity, with only a limited number of cases reported in the literature.

Stomach & Esophagus

spontaneous malignant metastatic gastric perforation

Spontaneous malignant gastric perforation due to metastatic colon cancer is exceedingly rare, especially post-colectomy and in the absence of chemotherapy.

Colorectal

Spontaneous perforation of Sigmoid Colon

Spontaneous sigmoid colon perforation is a rare and potentially life-threatening condition, with poorly understood pathophysiology and high morbidity if not managed promptly.

Stomach & Esophagus

Spontaneous Gastric Fistula - Bone Marrow Transplantation .

This case is based upon a rare complication of non-Hodgkin's lymphoma. Different disciplines within the medic...

This is a very rare presentation, with no previously reported cases of spontaneous gastric fistula following bone marrow transplantation for non-Hodgkin's lymphoma.

Colorectal

Spontaneous Extraperitoneal Rectal Rupture

Though ruptures and "spontaneous" perforations of the rectum and sigmoid are sometimes confused they are very ...

Spontaneous extraperitoneal rectal rupture is exceedingly rare, with no similar cases traced in prior English literature.

Hepatobiliary & Pancreas

Spontaneous Perforation of Common Bile Duct

Spontaneous perforation of the wall of the extrahepatic or intrahepatic bile duct with biliary peritonitis is ...

Spontaneous extrahepatic bile duct perforation in an elderly adult with an atypical site is extremely rare.

Endocrine

Spontaneous Adrenal Haemorrhage

Adrenal hemorrhage (AH) is a rare but life-threatening condition especially when it occurs bilaterally . Aetio...

This is the first reported case of a massive spontaneous adrenal hemorrhage due to adrenal chloroma in a young adult, surgically managed.

Stomach & Esophagus

Splenic abscess - colosplenic fistula

The spleen is one of the usually forgotten organs to be considered in the work-up of a differential diagnosis ...

Colosplenic fistula with splenic abscess as the first presentation of colon cancer is an exceedingly rare entity with few cases reported in the literature.

Colorectal

Solitary Lymphatic cyst left colonic flexure mimicking tumor

Lymphatic cysts ( cystic lymphangiomata , lymphangiomatous , lymphahgiectatic or chylous cysts ) of the abdome...

Solitary mural lymphatic cysts of the colon are exceedingly rare, with only a few cases reported in the literature.

Small Intestine

Small bowel vascular tumor presenting with intermittent bleeding and intussusception.

The small intestine is approximately 5-6 m long and occupies a large area in the abdominal cavity. These facto...

Small bowel vascular tumors are rare causes of gastrointestinal bleeding and intussusception in young adults.

Small Intestine

Small bowel spontaneous perforation in a HIV positive patient.

Non-traumatic small bowel perforation is uncommon but can be fatal. Typhoid fever and tuberculosis are the com...

Perforation of the small intestine due to CMV infection in an HIV-positive patient is extremely rare, with few reported cases in the literature.

Endocrine

Riedel's thyroiditis

Riedel thyroiditis (RT) is a rare fibro sclerotic condition affecting the thyroid gland, characterized by thyr...

Riedel's thyroiditis is a rare fibroinflammatory disease, representing less than 0.1% of all thyroidectomies.

Skin & Soft Tissue

Rapidly progressive metastatic epithelioid angiosarcoma of the small and large bowel.

Angiosarcoma is a rare high-grade neoplasm that frequently involves the skin and subcutaneous tissue. Rarely, ...

Intestinal angiosarcoma, particularly of the epithelioid subtype, is exceedingly rare and presents significant diagnostic challenges.

Colorectal

Quintuple Synchronous rectal adenocarcinomas

The colon is the organ most frequently involved in synchronous malignancy, especially in patients of advanced ...

Synchronous quintuple rectal adenocarcinomas are extremely rare, with this being the first reported case in Greece.

Small Intestine

Primary Mesenteric Neuroendocrine tumor

Carcinoid tumours are rare, slow-growing neoplasms that display neuroendocrine properties. The term carcinoid ...

Primary neuroendocrine tumors arising in the mesentery are extremely rare, with most mesenteric neuroendocrine tumors representing metastases from small bowel primaries.

Endocrine

Primary Adrenal Leiomyosarcoma

Primary adrenal leiomyosarcoma is exceptionally rare and represents 0.10.2 % of intra-abdominal soft tissue ma...

Primary adrenal leiomyosarcoma is exceptionally rare, with fewer than 30 reported cases in the English literature.

Hepatobiliary & Pancreas

PRES-Pancreatitis

PRES following necrotic pancreatitis surgery is extremely rare and has been reported primarily in critically ill patients with significant comorbidities.

Retroperitoneal & Pelvic

Presacral cystic schwannoma

Presacral schwannomas are rare, accounting for few hospital admissions and can grow to large sizes due to minimal early symptoms and limited bone involvement.

Small Intestine

Portomesenteric Axis Thrombosis following Sleeve Gastrectomy

Portal vein thrombosis (PVT) following sleeve gastrectomy is rare. There are limited documented cases within t...

Portomesenteric thrombosis after laparoscopic sleeve gastrectomy is extremely rare, with limited cases documented in the current literature.

Stomach & Esophagus

Pneumobilia with gastric outlet obstruction

Spontaneous biliary enteric fistula caused by peptic ulcer disease (PUD) is a rare phenomenon. They often pres...

Spontaneous cholecysto-duodenal fistula secondary to peptic ulcer disease with concomitant gastric outlet obstruction is extremely rare today.

Small Intestine

Pneumatosis Cystoides Intestinalis

Pneumatosis cystoides intestinalis (PCI), defined as the presence of gas inside the intestinal wall, may be lo...

Pneumatosis cystoides intestinalis is a rare entity and often presents as a secondary finding in association with various GI or systemic conditions.

Skin & Soft Tissue

Pseudomyxoma Peritonei: Case Report and review of the literature

Pseudomyxoma peritonei is a rare entity, with an estimated incidence of 1–2 per million annually.

Colorectal

Perforated diverticulum of the ascending colon mimicking aggressive fibrosis - desmoid tumor

Diverticular disease of the colon is frequent. It is encountered usually in the sigmoid colon but all parts of...

Spontaneous perforation of an ascending colon diverticulum presenting as a rapidly growing abdominal mass without systemic signs of sepsis is extremely rare and has not been previously described in the literature.

Stomach & Esophagus

Perforated Early Gastric Carcinoma: Uncommon and easily missed

Gastric carcinoma rarely presents with perforation. The reported incidence of perforation of gastric cancer is...

Perforated early gastric cancer (pT1bN0) is extremely rare and, to date, has not been previously reported in the English-language literature.

Endocrine

Pendred Syndrome associated with Retrosternal Goiter

Pendred syndrome is a recessively inherited disorder characterized by dyshormonogenic goitre associated with s...

Adult presentation of Pendred syndrome with retrosternal extension is rare.

Rare Syndromes & Systemic

Paraplegia: An Unusual Presentation of Follicular Lymphoma

Follicular lymphoma (FL) is the commonest indolent Non-Hodgkin s lymphoma It usually presents with advanced st...

This is a rare presentation of follicular lymphoma manifesting initially as rapid-onset paraplegia due to spinal cord compression.

Rare Syndromes & Systemic

Paraganglioma of the root of the mesentery.

This is the first reported case of a paraganglioma arising at the root of the mesentery.

Endocrine

Papillary Thyroid Carcinoma following Postpartum Thyroiditis

Postpartum thyroiditis is the term used for patients who develop painless thyroiditis in the postpartum period...

This case highlights the extremely rare occurrence of papillary thyroid carcinoma presenting during the thyrotoxic phase of postpartum thyroiditis.

Hernia & Abdominal Wall

Non-steroidal anti-inflammatory drug-induced diaphragm disease: an uncommon cause of small bowel obstruction

NSAID-induced diaphragm disease is a very uncommon cause of small bowel obstruction and often mimics other gastrointestinal pathologies.

Rare Syndromes & Systemic

Non-Hodgkin's Lymphoma in a Psoriatic patient treated with Humira

Lymphomas may be induced by the systemic immunosuppressive therapies used to treat psoriasis, such as ciclospo...

T cell/histiocyte-rich large B cell lymphoma in psoriatic patients treated with adalimumab is a rare and previously unreported presentation.

Skin & Soft Tissue

Non AIDS Kaposi's Sarcoma Leading to Lower Extremities Wounds

Classic, non-HIV-associated Kaposi sarcoma is uncommon, particularly in non-immunocompromised patients.

Hepatobiliary & Pancreas

NeuroEndocrine Carcinoma of Ampulla of Vater

Neuroendocrine carcinoma (NEC) of the duodenal ampulla of Vater is one of the types of neuroendocrine tumours ...

Large-cell neuroendocrine carcinoma of the ampulla of Vater is exceptionally rare, representing less than 0.3% of gastrointestinal neuroendocrine tumours.

Hepatobiliary & Pancreas

Migrated intragastric abdominal drain - Whipple's operation

The use of surgical drains is the subject of much debate but they continue to be commonly used. Drains are emp...

Intragastric migration of an abdominal drain after pancreatogastric anastomosis is extremely rare, with very few cases reported in the literature.

Colorectal

Metachronous Primary jejunal adenocarcinoma following twice resected rectal carcinoma

The annual incidence of SBA (Small Bowel Adenocarcinoma) in the USA is approximately 3.9 cases per million per...

Metachronous primary jejunal adenocarcinoma after twice resected rectal carcinoma is an exceptionally rare clinical occurrence.

Small Intestine

Mesenteric Panniculitis as an incidental finding.

Mesenteric panniculitis (MP) is a rare, idiopathic disorder characterized by chronic inflammation of the mesen...

Mesenteric panniculitis is a rare, often underdiagnosed entity with a reported prevalence ranging from 0.16% to 7.8%.

Endocrine

Encapsulated Medullary thyroid Microcarcinoma

<p><strong>Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor that arises from parafollicular ca...

Medullary thyroid microcarcinoma is a rare entity with limited data on natural history and optimal management strategies.

Rare Syndromes & Systemic

Marfan syndrome and acute abdomen

<p><strong>Marfan syndrome (MFS) is an autosomal dominant condition of abnormal connective tissue. The gene th...

Acute appendicitis in a patient with Marfan syndrome is rare, with limited reports in the literature.

Colorectal

Large cell neuroendocrine-adenocarcinoma mixed tumour of colon: Collision tumour with peculiar behaviour

Mixed tumours containing glandular and neuroendocrine components are infrequent.The first case was noted by Co...

This represents the fourth reported case in English literature of a metastatic collision tumor of the colon with both components, and the third case localized to the transverse colon.

Skin & Soft Tissue

Low grade fibromyxoid sarcoma medial vastus left thigh mimicking lipoma.

<p><strong>Soft tissue tumours are uncommon tumours accounting for only approximately 1% of cancers in adults,...

LGFMS is a rare spindle cell tumour, with just over 150 cases reported in the literature.

Spleen

Littoral Cell Angioma of the Spleen

<p><strong><u>Primary vessel tumours are the most common type of non-lymphomatous tumour of the spleen, most o...

Littoral cell angioma is an extremely rare benign vascular tumor of the spleen, with only a few cases reported in the literature.

Small Intestine

Jejunogastric intussusception

<p>Intussusception represents 90% of patients in children and adult intussusception occur only 5% of all intus...

Jejunogastric intussusception is a rare complication, occurring in less than 0.1% of patients after gastric resection, with fewer than 200 cases reported in the literature.

Colorectal

Isolated Non Solitary Rectal Bleeding Ulcers

<p>Isolated or solitary ulcers of the large intestine are not associated with an underlying colitis and may be...

SRUS is a rare colorectal condition with an estimated incidence of 1 in 100,000 per year.

Small Intestine

Isolated Varicosis of the small Intestine without Portal Hypertension

<p><strong>Varicosis of the small bowel</strong> (also called <em>small bowel varices</em>) refers to abnormal...

This is a very rare case of ileal varices unassociated with portal hypertension, with most cases reported in the literature eventually manifesting portal hypertension.

Small Intestine

Ischemic Intestinal involvement in a patient with Buerger's Disease

<p>Buerger's disease or thromboangiitis obliterans is characterized by occlusive segmental and often multiple ...

Intestinal involvement in Buerger's disease is extremely rare, particularly affecting both small and large bowel.

Skin & Soft Tissue

Intramuscular Myxoma

<p>Intramuscular myxoma is a rare benign soft tissue tumor involving the musculoskeletal system. The incidence...

Intramuscular myxoma is a rare benign tumor with an estimated incidence of 0.1–0.13 per 100,000 population.

Small Intestine

Intestinal perforation caused by a quail bone

<p>The majority of ingested foreign bodies (IFB) are excreted from the digestive tract without any complicatio...

Intestinal perforation due to ingested bone fragments is a rare complication, occurring in less than 1% of cases involving ingested foreign bodies.

Small Intestine

Ileal ulcers due to NSAIDs ingastion causing massive bleeding.

<p>It has been demonstrated that low-dose aspirin (LDA) and non-steroidal anti-inflammatory drugs (NSAIDs) inc...

Massive ileal bleeding due to NSAID-induced ulcers is uncommon and often under-recognized.

Small Intestine

Ileal Maltoma

<p>The gastrointestinal tract is involved by 30-40 % of all extranodal non-Hodgkin lymphomas. The majority (60...

Primary ileal MALT lymphoma is rare, with few cases described in the literature.

Small Intestine

Ileal Lymphoid Nodular Hyperplasia

Primary lymphomas of the small intestine are rare and mostly of B-cell and non-Hodgkin types. The problem is t...

Pseudo-tumoral nodular lymphoid hyperplasia of the ileum is rare in adults, with only twelve cases reported in patients over 25 years.

Colorectal

Idiopathic rectal varices

<p>Colonic varices (CV) and lower gastrointestinal bleeding related to these lesions are relatively rare, and ...

Idiopathic rectal (or colonic) varices are exceedingly rare, with fewer than 50 cases reported in the literature.

Skin & Soft Tissue

Huge Hibernoma mimicking liposarcoma

<p>Hibernoma is a rare benign adipocytic tumor that differentiates similar to brown fat, hence an origin from ...

Hibernoma is a rare benign adipocytic tumor accounting for less than 2% of benign lipomatous neoplasms.

Rare Syndromes & Systemic

HOS and Crohn's disease

This is the first reported case of concomitant Holt-Oram syndrome and Crohn's disease.

Hepatobiliary & Pancreas

Hilar inflammatory myofibroblastic tumor

<p>Inflammatory myofibroblastic tumors (IMT) are rare lesions with the gross appearance of a malignancy, but t...

Hilar inflammatory myofibroblastic tumors are exceptionally rare, with very few reported cases in the literature.

Skin & Soft Tissue

Hidranitis Suppurativa : Medical or Surgical Treatment

<p><strong>Pyoderma fistulans sinifica</strong> (fox den disease) appears to be the same entity as Hurley Stag...

While hidradenitis suppurativa is not rare, its severe surgical stage and association with multiple systemic diseases are noteworthy.

Colorectal

Giant Rectal Villous Adenoma recurrence

<p>Colorectal cancer (CRC) is one of the main causes of death by cancer in the world and approximately 90% of ...

Giant circumferential rectal villous adenomas with recurrent presentation and severe electrolyte disturbances are rare.

Hernia & Abdominal Wall

Giant Inguinoscrotal Hernia

Giant inguinoscrotal hernias extending below the midpoint of the inner thigh in standing position are rare.

Small Intestine

Giant Mesenteric Cyst

<p>Mesenteric cysts are rare, usually benign tumours, with an incidence of 1/105,000 250,000 in the admitted s...

Mesenteric cysts are rare with an incidence of approximately 1 in 105,000 to 250,000 surgical admissions, and giant cysts of this size are extremely uncommon.

Breast

Gestational Gigantomastia complicating Pregnancy

<p>Gigantomastia in pregnancy, also known as gestational Gigantomastia (GG) and gravid macromastia, is a rare ...

Gestational gigantomastia is extremely rare, with an incidence between 1 in 28,000 and 1 in 100,000 pregnancies reported historically.

Small Intestine

Gastrostomy foley tube Dislodgment causing jejunal Obstruction

<p>Percutaneous gastrostomy is the preferred root for long term feeding of patients who cannot be fed orally. ...

Jejunal obstruction from Foley catheter balloon migration is extremely rare and not previously reported in literature according to the author's thorough search.

Stomach & Esophagus

Gastrointestinal bleeding from Dieulafoy's lesion .

Dieulafoy lesions represent approximately 4% of upper gastrointestinal hemorrhages and are infrequent but can cause life-threatening bleeding.

Stomach & Esophagus

Gastrobronchial fistula following removal of adjustable gastric banding

Gastrobronchial fistula is a very rare complication after bariatric surgery, and its true incidence remains unknown due to the limited number of reported cases.

Hepatobiliary & Pancreas

Gallbladder Agenesis

<p><strong><u>The absence of the gallbladder, also known as gallbladder agenesis (GA), is an extremely rare an...

Gallbladder agenesis is an extremely rare anatomic anomaly with an incidence of less than 1 per 6500 live births.

Hepatobiliary & Pancreas

Gallbladder Diverticulosis

The literature indicates that gallbladder diverticulosis is a very rare disease.

Small Intestine

Extraovarian Primary Peritoneal Carcinomatosis

Extraovarian Primary Peritoneal Carcinomatosis is a very rare malignancy with an age-adjusted incidence rate of 6.78 per million.

Hepatobiliary & Pancreas

Extraluminal Perirectal Pseudomucocele following Hartmann's operation

<p>Hartmann's procedure is often selected in situations in which the construction of a colorectal anastomosis ...

This is the first reported case of extraluminal perirectal pseudomucocele following Hartmann’s operation for rectal adenocarcinoma.

Endocrine

Ectopic parathyroid adenoma in the carotid sheath

Ectopic parathyroid adenomas located in the carotid sheath are rare, reported in less than 1% of primary hyperparathyroidism cases.

Stomach & Esophagus

Late Duodenal stump recurrence following subtotal gastrectomy

This is only the fifth reported case of duodenal stump recurrence after gastrectomy for gastric cancer and is unique as the only case occurring in the first part of the duodenum.

Skin & Soft Tissue

Duodenal metastasis of aggresive Melanoma

<p>Gastrointestinal (GI) malignant melanoma is an unusual clinical entity. Patients often present the similar ...

Primary malignant melanoma originating in the duodenum is extremely rare and very controversial.

Hepatobiliary & Pancreas

Dumbbell cholecystitis

Gallbladder strictures are rare clinical entities with limited available literature, often posing diagnostic challenges due to similarity with choledochal cysts.

Rare Syndromes & Systemic

Distal Intestinal Obstruction Syndrome in adults with cystic fibrosis

DIOS is a recognized but relatively uncommon cause of intestinal obstruction in adult cystic fibrosis patients, with limited reports describing surgical management and outcomes.

Colorectal

Disseminated Carcinomatosis of the Bone Marrow Originating from ascending Colon Cancer

<p>Disseminated carcinomatosis of the bone marrow (DCBM) is often associated with disseminated intravascular c...

DCBM originating from colorectal cancer is relatively rare, with only 27 cases reported in Japan from 1984 to 2013. The majority of DCBM cases originate from gastric cancer.

Endocrine

Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma

<p>The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC), first described by Vickery et al. ...

Diffuse sclerosing variant of papillary thyroid carcinoma is a rare histological subtype of papillary thyroid carcinoma, accounting for a small percentage of PTC cases but notable for its aggressive clinical behavior.

Hernia & Abdominal Wall

Diaphragmatic eventration presenting as a recurrent diaphragmatic hernia

<p>Diaphragmatic eventration is the partial or total replacement of the diaphragm muscle with fibroelastic tis...

Diaphragmatic eventration is a rare condition, affecting approximately 0.05% of the general population and usually discovered incidentally.

Rare Syndromes & Systemic

Dermatopathic Lymphadenopathy

Dermatopathic lymphadenitis (DLN) is a well-described histopathological entity characterized by the expansion ...

Dermatopathic lymphadenopathy is a rare and challenging entity, especially when it occurs without an associated skin disease.

Skin & Soft Tissue

Dermatofibrosarcoma Protuberans

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing fibrohistiocytic neoplasm considered of low to ...

DFSP is a rare tumor accounting for less than 0.1% of malignancies and about 1% of soft tissue sarcomas, with an incidence of 0.8–4.5 cases per million annually.

Endocrine

Cystic Phaeochromocytomas

Cystic Phaeochromocytomas: a distinctive subgroup with special clinical, imaging and histological features tha...

Cystic phaeochromocytomas comprised 20% of phaeochromocytomas in this series, suggesting that this entity might be more prevalent than currently appreciated but remains under-recognized due to atypical presentation.

Endocrine

Concurrent Papillary Thyroid Carcinoma and Parathyroid Adenoma

Primary hyperparathyroidism is present in up to 0.1% of the general population, and it is clinically recognize...

The concurrent diagnosis of papillary thyroid carcinoma and parathyroid adenoma is rare, with very few similar cases reported in the literature.

Colorectal

Coexistent Hairy cell leukemia-T cell lymphoma-adenoca colon

Coexistent Hairy cell leukemia, T cell Lymphoma and Colonic Adenocarcinoma. A case report and review of the li...

The coexistence of hairy cell leukemia, hepatosplenic T-cell lymphoma, and rectal adenocarcinoma has not been previously reported in the literature and is highly unlikely to have occurred by chance.

Rare Syndromes & Systemic

CIRCI - surgical patients.

Dysfunction of the hypothalamo-pituitary adrenal axis has become a central feature in descriptions of the path...

Head & Neck

Chronic Sialadenitis and Hodgkin's Lymphoma

Lymphoid infiltrates of the salivary gland can be either reactive or neoplastic. The reactive lesion, lymphoep...

Primary Hodgkin’s lymphoma of the parotid gland is a very rare occurrence, especially in a patient with previous non-Hodgkin’s lymphoma treated 20 years prior.

Colorectal

Cecal adenocarcinoma perforation due to left colon diverticular stenosis

Cecal adenocarcinoma perforation due to left colon diverticular stenosis: an unusual presentation against Lapl...

Spontaneous perforation of the cecum due to distal diverticular disease stenosis is an extremely rare clinical entity, with this case being a unique presentation not previously reported in the literature.

Appendix

Carcinoid tumor of the appendix

Acute appendicitis is the most common abdominal emergency encountered by the general surgeon.Subsequent to dia...

Primary carcinoid tumors of the appendix are rare neuroendocrine neoplasms, accounting for more than 50% of all appendiceal neoplasms but occurring in approximately 0.5% of all surgically removed appendices.

Rare Syndromes & Systemic

Calciphylaxis in a pre dialysis patient

In addition to accelerated atherosclerosis, patients with end-stage renal disease are subject to diffuse media...

Calciphylaxis is a rare and severe complication typically seen in end-stage renal disease, and its occurrence in pre-dialysis patients is less common but important for clinicians to recognize.

Colorectal

Caecal NECs

Poorly differentiated neuroendocrine carcinomas (NECs) arising from the gastrointestinal (GI) tract are rare a...

Poorly differentiated neuroendocrine carcinomas of the cecum are rare tumors with an annual incidence of approximately 1,000 GI NEC cases, representing a small fraction of gastrointestinal malignancies.

Hepatobiliary & Pancreas

Bile cast nephropathy in patients with ostructing jaundice due to pancreatic carcinoma

Carcinomas located in the head of pancreas are increasing in frequency in the last decade in Greece. Patients ...

Bile cast nephropathy is an uncommon and often overlooked cause of renal failure in patients with obstructive jaundice due to pancreatic carcinoma.

Retroperitoneal & Pelvic

Bilateral Long Ureteral Strictures- RT

A 63 years old lady, suffering from low rectal carcinoma 3 cm from the anal verge was admitted in our Departme...

This case represents an exceptionally rare early complication of short-course preoperative pelvic radiotherapy for rectal carcinoma presenting as bilateral long ureteral strictures, with no similar cases found in the literature upon review.

Retroperitoneal & Pelvic

Bilateral Giant Ovarian Cystadenomas.

The giant ovarian cyst is rarely found nowadays because of the improved imaging modalities and minimally invas...

Giant bilateral ovarian serous cystadenomas are rare, especially in adolescents, and often benign. They are infrequently encountered in modern clinical practice due to earlier detection via advanced imaging and minimally invasive techniques.

Colorectal

Beçhet Disease - Toxic Megacolon

The gastrointestinal symptoms of Behçet's disease are ancillary manifestations of this disorder reflected prin...

Toxic megacolon as a complication of intestinal Beçhet's disease is rare, often misdiagnosed as inflammatory bowel disease, and is highlighted as an uncommon presentation in this report.

Breast

Axillary Ectopic Breast Tissue with Gynecomastia

While malignancy must be included in the differential diagnosis of axillary masses, there are a variety of ben...

Gynecomastia-like hyperplasia in ectopic axillary breast tissue of a female patient is an extremely rare entity, with this case representing a unique reported example.

Colorectal

Anterior anal sphincter repair

All patients that had undergone ASR at G. Papanikolaou Hospital, were identified from hospital records. The se...

Hepatobiliary & Pancreas

Ampullectomy for Tumors of Ampulla of Vater

Ampullectomy for tumors of ampulla of Vater: is it efficient h2.western { font-style: italic; font-weight: bol...

Mass lesions of the ampulla of Vater represent less than 10% of pancreatic and periampullary tumors, with a diverse histological presentation including adenocarcinomas, neuroendocrine tumors, and others.

Skin & Soft Tissue

Amelanotic malignant melanoma presenting as a keloid

Malignant melanoma (MM), which occurs mainly in the skin, is a highly malignant tumor derived from melanocytes...

Amelanotic malignant melanoma presenting as a keloid is a rare presentation and easily misdiagnosed or missed without histopathological analysis.

Colorectal

Adult Type Hirschprung's Disease

Hirschprung s disease is well known. The basic pathogenesis is lack of parasympathetic ganglia in the large bo...

Hirschsprung's disease is predominantly diagnosed in infancy; adult presentation is rare and represents a unique diagnostic and therapeutic challenge.

Small Intestine

Acute intussusception - polyp with malignant transformation in Peutz Jeghers

Peutz-Jeghers syndrome is a rare autosomal dominant inherited disease characterized by mucocutaneous pigmentat...

Coexistence of adult intussusception caused by Peutz-Jeghers syndrome and malignant polyps is rarely reported in the literature.

Colorectal

Acute myocardial infarction and ischaemic colitis

The effects of acute ischaemia on the ischaemic vascular bed, include decreases in vascular tone and the sensi...

The simultaneous occurrence of acute myocardial infarction and ischaemic colitis as a direct consequence is rare; it is often uncertain whether the association is direct or incidental.

Retroperitoneal & Pelvic

Acquired cystic kidney disease RCC.

Renal tubular cystic changes may develop in end-stage renal disease (ESRD), and this condition is termed acqui...

ACKD-associated RCC is a rare subtype occurring exclusively in patients with ESRD and acquired cystic kidney disease, with an incidence less than 10% but a risk over 100 times higher than the general population.

Hernia & Abdominal Wall

Abdominal separation

Acute abdominal pain, a common chief complaint encountered in emergency department, accounts for about 5% of a...

Abdominal separation causing strangulated internal hernia and intestinal malrotation in adults is extremely rare and has not been widely reported in the literature.

Hernia & Abdominal Wall

Abdominal cocoon syndrome

Encapsulating peritoneal sclerosis (EPS), also known as abdominal cocoon syndrome (AC) or sclerosing encapsula...

Abdominal cocoon syndrome is a rare cause of small bowel obstruction, accounting for approximately 6% of rare bowel obstruction etiologies, and is often diagnosed by exclusion or intraoperatively.

Colorectal

Rectal perforation following Longo Hemorrhoidectomy

Conventional excisional haemorrhoidectomy has proven to be very effective as a long-term alternative for haemo...

Rectal perforation following Longo haemorrhoidectomy is a rare but significant complication documented in the literature.

Colorectal

Right colon cancer-sister mary's nodule .

Mary Josephs nodule caused by transverse colon cancer: Case Report and Review of the Literature. Penopoulos Co...

Umbilical metastasis from colon cancer causing Sister Mary Joseph's nodule is uncommon, highlighting its significance as a rare clinical finding.

Colorectal

R Colon carcinoma -Metachronous ovarian metastasis

Metachronous Ovarian Metastases in a Patient with Primary Colorectal Cancer. A Case Report and Review of the L...

Metachronous ovarian metastasis from colorectal carcinoma is a rare occurrence and is an unusual metastatic site compared to liver and lungs, warranting increased awareness during surveillance.

Small Intestine

Primary multiple mesenteric mesocolic liposarcomas

Liposarcomas are the second most common type of soft tissue sarcomas. They are commonly known to occur in the ...

The simultaneous occurrence of primary multiple mesenteric, mesocolic, and retroperitoneal liposarcomas, especially involving the transverse mesocolon, is an extremely rare and unique presentation not previously reported in the literature.

Rare Syndromes & Systemic

Acute Postoperative TTP-UC

We report a case of a 43 years old lady, who was treated surgically for resistant to medical therapy ulcerativ...

This case represents the first reported instance of postoperative TTP following total colectomy for ulcerative colitis.

Stomach & Esophagus

Paraesophageal hernia and gastric volvulus

Gastric volvulus is characterized by a rotation of the stomach along its axis in variable degrees and may pres...

Mesentero-axial gastric volvulus associated with a diaphragmatic hernia is an uncommon etiology of vomiting and upper gastrointestinal bleeding.

Hernia & Abdominal Wall

Unusual presentation Midgut malrotation-abdominal trauma.

A 22 years old gentleman was admitted as an acute following a road traffic accident. On examination, he was co...

This case represents the first reported adult midgut malrotation presenting as acute abdomen following blunt abdominal trauma with incidental anterior nutcracker syndrome.

Vascular & Trauma

Riolan Arch Pseudoaneurysm -AAA Repair

The Riolan arterial arch was proposed by the French anatomist Jean Riolan in 1965. It is formed by the anastom...

Riolan arterial arch pseudoaneurysm rupture after endovascular AAA repair is an extremely uncommon vascular complication, with very few cases reported in the literature.

Colorectal

Tonsillar metastasis colonic adenocarcinoma

Metastatic palatine tonsil tumor is uncommon despite the palatine tonsil is rich in vasculature. It was report...

Metastatic palatine tonsil tumors are extremely rare, with about 100 reported cases in English literature, and only seven cases previously reported from colorectal carcinoma.

Stomach & Esophagus

Cervical fusion-esophageal perforation

Abstract. Esophageal injury after anterior cervical discectomy and fusion (ACDF) is a rare complication that c...

Esophageal injuries following anterior cervical discectomy and fusion are rare complications with limited reported cases, emphasizing the need for awareness and specialized repair techniques.

Endocrine

Cystic parathyroid adenomas

Primary hyperparathyroidism (PHPT) is the most common disease in parathyroid glands and is accompanied by exce...

Cystic parathyroid adenomas are very rare, with fewer than 300 cases reported in the literature to date, which limits the understanding of their clinical behavior and optimal management strategies.

Colorectal

Colorectal Stricture in Ulcerative Colitis

The management of ulcerative colitis (UC) patients with colorectal stricture remains a difficult task in clini...

Colorectal strictures in ulcerative colitis occur in 1.7% to 12.2% of patients, with malignancy reported in 0% to 33% of cases, making this a relatively uncommon but clinically important complication.

Colorectal

Synchronous Rectal and ovarian tumors

Synchronous Ovarian Psammocarcinoma and perforated Rectal carcinoma. Case report and review of the literature....

Psammocarcinoma of the ovary is extremely rare, with only 34 cases reported to date. The coexistence of synchronous rectal carcinoma with ovarian psammocarcinoma is exceptionally uncommon.

Hernia & Abdominal Wall

Spiegelian Hernia

B Surgical Department, G. Papanikolaou Regional General Hospital, Exohi, Thessaloniki, GREECE. Image in medici...

Spiegelian hernia is a rare cause of acute intestinal obstruction and represents an uncommon type of ventral abdominal hernia.

Endocrine

Chronic parathyroiditis manifesting from hypocalcemia to severe hypercalcemia

A 64-years-old woman who presented with hypocalcemia compatible with idiopathic hypoparathyroidism gradually c...

The transition from hypoparathyroidism to hyperparathyroidism associated with chronic parathyroiditis is a rare clinical entity.

Rare Syndromes & Systemic

ANCA vasculitis and Sjogren's syndrome

Mesenteric inflammatory venoocclusive disease is an uncommon cause of intestinal ischemia. Certain diseases, s...

Mesenteric inflammatory veno-occlusive disease is an uncommon and underrecognized cause of intestinal ischemia, especially in patients with primary Sjögren's syndrome without concurrent systemic vasculitis.

Small Intestine

Ileal pouch carcinoma .

Cancer arising in the remnant mucosa following ileoanal anastomosis for Adenomatous Polyposis Coli (APC) Cance...

Ileal pouch-related adenocarcinoma is a rare occurrence with limited existing treatment guidelines, posing challenges in management.

Stomach & Esophagus

gastrocolic fistula in Crohn's disease

resonance enterography findings of a gastrocolic fistula in Crohns. Penopoulos Consultant General Surgeon. dis...

Gastrocolic fistulas are rare complications of Crohn’s disease; although fistulas are common in Crohn’s, the formation of a fistulous tract between the stomach and colon is uncommon.

Skin & Soft Tissue

Giant vulvar lipoma

lipoma is a slow-growing, benign tumor comprised of mature adipocytes encased in a thin, fibrous, well-circums...

Vulvar lipomas are uncommon and giant vulvar lipomas with fat necrosis causing nodularity have not been previously reported in the literature.

Stomach & Esophagus

Gastric Carcinoma - Acquired Thrombotic Thrombocytopenic Purpura

Brain, Dacie and Hourihane popularized the term Microangiopathic hemolytic anemia to designate anemias referri...

MAHA-related signet ring cell carcinoma of unknown origin presenting as refractory acquired TTP is very infrequent and rarely documented.

Hepatobiliary & Pancreas

gallbladder carcinoma presenting as a primary ovarian tumor

Ovary is a relatively frequent site of metastasis from various organs especially pancreas and gastrointestinal...

Primary signet ring cell carcinoma of the gallbladder is extremely rare, accounting for approximately 3% of malignant gallbladder tumors. Metastatic involvement of the ovary from gallbladder carcinoma is also rare with few reports in the literature.

Vascular & Trauma

finger varicosities

Palmar and finger varicosities are quite frequent in elderly people but they are rarely reported in the litera...

Although palmar and finger varicosities are quite frequent in elderly people, they are rarely reported in the literature.

Vascular & Trauma

Femoral Hernia-Prevascular .

A 49-years-old lady, was presented to the emergency department, with a painful irreducible left groin swelling...

Prevascular femoral hernia is an uncommon femoral hernia variant, reported to represent 16% of all femoral hernias. The described case highlights an unusual presentation with the hernia sac split by the inferior epigastric vessels, which is rarely documented.

Vascular & Trauma

Thoracic Aorta Stent

Esophageal perforation secondary to thoracic aortic rupture is rare. Endovascular treatment is generally consi...

Esophageal perforation secondary to thoracic aortic rupture and TEVAR is a rare but serious complication that can be fatal without early detection and intervention.

Hernia & Abdominal Wall

Diaphragm Eventration-Plication .

Diaphragmatic eventration is defined as long-term or constant elevation of a hemidiaphragm without presence of...

Endocrine

De Quervain thyroiditis-parathyroid adenoma

Subacute granulomatous thyroiditis / de Quervains thyroiditis is a painful inflammatory condition of the thyro...

Synchronous De Quervain’s thyroiditis and parathyroid adenoma presenting diagnostic and treatment dilemmas is very rare, with no previous cases identified in literature review.

Stomach & Esophagus

Completion gastrectomy for postsurgical gastroparesis syndrome

Abstract Postsurgical gastroparesis syndrome (PGS) is a complex disorder characterized by postprandial nausea,...

Postsurgical gastroparesis syndrome is a rare and complex disorder that may require radical surgical intervention when medical therapy fails.

Hepatobiliary & Pancreas

Huge pancreatic undifferentiated carcinoma with osteoclast-like giant cells

Anaplastic carcinoma of the pancreas is rarely observed and accounts for less than 10% of all types of pancrea...

PUC-OGC accounts for less than 1% of all malignant pancreatic neoplasms worldwide and is an extremely rare subtype of anaplastic pancreatic carcinoma.

Colorectal

ColoColonic intussusception-Sarcoma

Intussusception is a process in which a segment of bowel telescopes into an adjoining segment, leading to bowe...

Primary colorectal sarcomas are a rare entity with anecdotal poor outcomes; adult colo-colonic intussusception secondary to sarcoma is an unusual diagnosis.

Colorectal

Coexistance of ccl and colon adenocarcinoma

B Surgical Department, G. Papanikolaou Regional General Hospital, Exohi, Thessaloniki, GREECE....

The incidental detection of B-CLL/SLL based on histological evaluation of lymph nodes resected for colorectal adenocarcinoma is a rare entity, and synchronous diagnosis of these two malignancies is most likely coincidental though some epidemiological association exists.

Head & Neck

Branchial Cleft Cyst

Branchial cleft cysts (BCCs), also called lateral cervical cysts, occur mostly in the lateral cervical area an...

Branchial cleft cysts in adults are uncommon congenital anomalies that typically present in the second to third decades of life; occurrence with associated Hashimoto's thyroiditis is rarely reported.

Small Intestine

Neurofibromatosis - multiple Jejunal GIST Tumors

Type 1 neurofibromatosis (NF1, von Recklinghausen s disease), an autosomal dominantly inherited disorder, usua...

Multiple jejunal GISTs causing fulminant bleeding in NF1 patients are very uncommon, with only occasional reports in the literature.

Appendix

Test case

fewer than 5 cases

Appendix

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Vascular & Trauma

Postoperative Thrombotic Thrombocytopenic Purpura After Total Orthoproctocolectomy

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disease characterized by acute episodes ...

Postoperative TTP is newly recognized and has been reported in 29 cases so far, mostly after cardiac and vascular surgeries, with very few cases after orthopedic and gastrointestinal operations.

Hepatobiliary & Pancreas

Liver Abscesses

Pyogenic hepatic abscesses constitute a significant clinical problem. Unfortunately, little is known about the...

The development of pyogenic liver abscesses after pancreatoduodenectomy is an uncommon postoperative complication with limited data available on its incidence and management.

Hepatobiliary & Pancreas

Subhepatic Appendicitis

Acute appendicitis is a common acute surgical condition. The normal anatomy of the appendix and its classic ma...

Subhepatic appendicitis is very rare, reported with an incidence of 0.08%. Its cause is attributed to abnormal cecal rotation rather than failure of cecal descent.

Rare Syndromes & Systemic

Brenner Tumor of the Ovary: An Incidental Finding

Brenner tumor was first described in 1907 by Fritz Brenner, who hypothesized that it originated from the granu...

Extragonadal Brenner tumors are extremely rare, with only 16 cases reported outside the ovary to date.

Surgical Complications

Novel Management of Chylous Ascites Following Laparoscopic Nissen Fundoplication

Chylous ascites is a rare and challenging complication that may be caused by abdominal injuries, neoplasms, in...

Chylous ascites as a complication of laparoscopic Nissen fundoplication is very rarely reported in the international literature.

Retroperitoneal & Pelvic

URETERAL METASTASIS

The renal parenchyma reacts in a limited number of ways to the countless harmful factors. The clinical manifes...

Metastasis to the ureter from colon adenocarcinoma is extremely rare and typically reported as incidental autopsy findings.

Vascular & Trauma

Spontaneous Rupture of the Urinary Bladder

Ruptures of the urinary bladder classically occur as a consequence of blunt or penetrating trauma or due to ia...

This is a rare case of spontaneous bladder rupture in a woman without identifiable risk factors or prior trauma.

Skin & Soft Tissue

Peristomal Gangrenous Pyoderma

Pyoderma gangrenosum (PG) is a rare dermatological condition, first described by the French dermatologist Broc...

Peristomal gangrenous pyoderma is an uncommon subtype, accounting for approximately 15% of all gangrenous pyoderma cases and is rarely reported in the literature.

Skin & Soft Tissue

PERIORAL GANGRENOUS PYODERMA

Pyoderma gangrenosum (PG) is a rare dermatological condition, first described by the French dermatologist Broc...

Perioral gangrenous pyoderma is a very rare subtype, representing approximately 15% of all gangrenous pyoderma cases, with limited literature and few reported cases.

Endocrine

Thymic Neuroendocrine Carcinoma

Neuroendocrine tumors are neoplasms that originate from endocrine and neural cells. As they are rare tumors, t...

Thymic neuroendocrine carcinoma represents 2–4% of anterior mediastinal neoplasms and about 6% of carcinoid tumors, making it an exceptionally rare malignancy.

Rare Syndromes & Systemic

Rhabdomyolysis

Rhabdomyolysis occurs following the development of traumatic compartment syndrome and presents with high morbi...

Rare Syndromes & Systemic

Spontaneous Sternal Fracture

Osteolytic bone disease constitutes a common finding in multiple myeloma and poses a risk for the development ...

Spontaneous sternal fractures in the context of multiple myeloma are uncommon clinical presentations.

Retroperitoneal & Pelvic

Primary Retroperitoneal Carcinoma from Transitional Cells

Primary retroperitoneal transitional cell carcinomas constitute very rare neoplasms and demonstrate very poor ...

Only 3 cases of primary retroperitoneal transitional cell carcinoma have been reported in the last 60 years, all previously fatal within 8-24 months.

Small Intestine

Peritoneal Carcinomatosis

The peritoneal stromal tissue, which provides a rich source of growth factors and chemokines (chemoattractant ...

Skin & Soft Tissue

Primary Melanoma of the Nose

Primary malignant melanoma of the nose and the mucosa of the paranasal sinuses is rare, accounting for less th...

Primary mucosal melanoma of the nasal and paranasal cavities is extremely rare, with limited cases reported in the literature.

Hepatobiliary & Pancreas

Metastasis of Pancreatic Cancer to the Microenvironment of Lung Cancer

The suppression and control of cancer metastases is one of the most important issues related to oncological ca...

This is a unique case of pancreatic adenocarcinoma metastasizing into an independent primary lung squamous cell carcinoma, which is a rare and poorly documented phenomenon.

Colorectal

Cancer Esophagus-STENT: Post-emetic Expulsion of an Esophageal Metal Stent

Esophageal cancer is the 7th leading cause of death worldwide. More than 50% of esophageal cancers are inopera...

This case reports a rare late complication of oral expulsion of an intact esophageal metal stent following chemotherapy-induced partial tumor response.

Spleen

Marginal Zone Lymphoma of the Spleen

Lymphoma is a malignant tumor that originates from the lymphatic hematopoietic system. According to the differ...

Primary marginal zone lymphoma of the spleen is an exceptionally rare and indolent lymphoma subtype, comprising 1–2% of non-Hodgkin lymphomas.

Hepatobiliary & Pancreas

Hepatic Lymphorrhea After Total Pancreatectomy

During abdominal operations, particularly after extended lymphadenectomy for gastric or pancreatic cancer, any...

Hepatic lymphorrhea following total pancreatectomy and extensive lymphadenectomy is rarely reported and represents a challenging clinical entity.

Endocrine

Ectopic Parathyroid Adenoma within the Carotid Sheath

Ectopic parathyroid adenoma constitutes an uncommon cause of primary hyperparathyroidism. Besides the commonly...

Spleen

Spleno-Renal Shunt for the Management of Idiopathic Portal Hypertension

Idiopathic portal hypertension (IPH), also known as non-cirrhotic portal hypertension (NCPH) or nodular regene...

Idiopathic portal hypertension without underlying cirrhosis is a rare clinical entity requiring specialized surgical management.

Hepatobiliary & Pancreas

Dilemmas in the Management of Cholecystocolic Fistula

Cholecystocolic fistula constitutes a rare condition, encountered in approximately one case per 10,000 cholecy...

Cholecystocolic fistula is an uncommon surgical entity, representing 6.3–26.5% of all cholecystoenteric fistulas, with only isolated cases reported rather than large series.

Colorectal

Necrotizing Typhlitis

Typhlitis describes the presence of enterocolitis in the ileocecal region, a condition encountered most freque...

Neutropenic enterocolitis is a rare but increasingly recognized life-threatening condition, frequently underdiagnosed, with rising incidence due to aggressive chemotherapy regimens and novel therapies.

Small Intestine

Anomalous Rotation of the Midgut

Anomalous rotation of the midgut constitutes a congenital anatomical anomaly that occurs during embryonic deve...

The true prevalence of anomalous midgut rotation in adults is difficult to estimate as many patients remain asymptomatic and undiagnosed. Literature review by von Flue et al. revealed only 40 reported cases between 1923 and 1992.

Hepatobiliary & Pancreas

Luschka Duct

Subcystic biliary ducts (frequently erroneously called Luschka ducts) gained significant clinical recognition ...

Bile leaks from injured Luschka ducts are an uncommon but recognized complication after laparoscopic cholecystectomy, with an incidence of approximately 0.06% in this series.

Endocrine

Internal Spread of Papillary Thyroid Carcinoma

Internal dissemination of papillary thyroid carcinoma is a recognized but uncommon pattern of tumor spread that may mimic multifocal disease.

Colorectal

Kraske Surgery

The presacral space constitutes a peculiar anatomical region between the posterior wall of the rectum and the ...

The Kraske procedure is specialized and less commonly performed, reserved for select cases of low rectal tumors with ambiguous histology.

Colorectal

Diverticulitis of End Colostomy

The prevalence of colonic diverticulosis is directly correlated with age and may reach 60% of the general popu...

Diverticulitis occurring at the distal segment of an end colostomy is an extremely rare condition.

Stomach & Esophagus

Cholecystogastric Fistula

Gallstone ileus constitutes a rare complication of cholelithiasis, occurring in 0.3–0.5% of patients with this...

Gallstone ileus occurs in 0.3–0.5% of patients with gallstones and cholecystitis and represents a rare form of bowel obstruction.

Hepatobiliary & Pancreas

Left-Sided Gallbladder

Left-sided gallbladder (LSG) constitutes a rare anomaly, encountered at frequencies ranging from 0.2–1.1%. Nor...

The true left-sided gallbladder is an extremely rare anatomical variation and is usually discovered incidentally during surgery.

Endocrine

Functional Parathyroid Cysts

Parathyroid cysts are traditionally classified as functional or non-functional and represent approximately 5% ...

Functional parathyroid cysts represent less than 1% of primary hyperparathyroidism cases and are particularly rare in women.

Hepatobiliary & Pancreas

CYSTIC DILATION OF BILIARY TRACTS

The presence of biliary duct cysts is uncommon in the Western world, and most reports originate from Asian cou...

Cystic dilations of the biliary ducts are rare pathologic entities with most cases reported from Asian countries; the presented condition—solitary cystic dilation of an intrahepatic bile duct—is particularly rare.

Endocrine

Secondary Papillary Thyroid Carcinoma Following Allogeneic Bone Marrow Transplantation

The development of secondary malignancies is a rare but clearly defined late complication following autologous...

Secondary papillary thyroid carcinoma as a late complication post-allogeneic bone marrow transplantation is rare but recognized.

Appendix

Mucocoele of the Appendiceal Vermiform Process

Appendectomy constitutes a common surgical procedure performed worldwide for the management of a common pathol...

Appendiceal mucocoeles are rare, occurring in only 0.2 – 0.7% of appendectomy specimens.

Hernia & Abdominal Wall

Retrosternal Goiter

Retrosternal goiter refers to cases where the thyroid gland grows along with the sternum, from the neck to the...

Retrosternal goiter extending beyond the aortic arch into the posterior mediastinum is less common and often requires more extensive surgical approaches.

Vascular & Trauma

Traumatic Displacement of the Testis

Traumatic displacement of the testis constitutes a rare clinical entity and occurs when a direct blunt trauma ...

Traumatic displacement of the testis is a rare condition.

Skin & Soft Tissue

Giant Cutaneous Papilloma of the Lumbar Region

Acrochordons/papillomas constitute common benign neoplasms encountered in daily clinical practice. The term gi...

Giant and solitary cutaneous papillomas in the lumbar area are a rare clinical entity with few reports in the international literature.

Breast

A Parathyroid Adenoma Arising Within the Sternocleidomastoid Muscle: A Rare Complication of Autotransplantation

Multiple endocrine neoplasia syndrome type 2A (MEN 2A) constitutes an autosomal dominant disease characterized...

This is a rare case of parathyroid adenoma arising within the sternocleidomastoid muscle following autotransplantation after total parathyroidectomy in a MEN 2A patient.

Endocrine

Giant Parathyroid Adenoma

The normal weight of a parathyroid gland ranges between 50 and 70 mg. Parathyroid adenomas are usually small, ...

Presentation of a non-ectopic giant parathyroid adenoma with a palpable neck mass is unusual, as such large adenomas are rare and can mimic thyroid origin.

Head & Neck

Sebaceous Glands of the Exocervix

The presence of sebaceous glands constitutes an extremely rare finding in the female genital tract. Apart from...

Sebaceous glands in the exocervix constitute an extremely rare and unusual histological finding in gynecologic pathology.

Rare Syndromes & Systemic

Primary Testicular Lymphoma

Primary testicular lymphoma (PTL) accounts for 1–2% of lymphomas, 4% of extranodal non-Hodgkin lymphomas, and ...

Primary testicular lymphoma represents 1-2% of non-Hodgkin's lymphomas, 4% of extranodal non-Hodgkin's lymphomas, and approximately 1-10% of testicular neoplasms.

Spleen

Wandering Spleen

Wandering spleen and gastric volvulus constitute two rare pathological conditions described in both children a...

The coexistence of wandering spleen and gastric volvulus in a patient with a previously repaired Morgagni hernia is very rare.

Spleen

Primary Angiosarcoma of the Spleen

Primary splenic malignancies are categorized into vascular and lymphoid, with the former originating from the ...

Fewer than 200 cases worldwide

Vascular & Trauma

Nodular Polyarteritis

Mesenteric vasculitis due to polyarteritis nodosa constitutes an atypical but potentially life-threatening cau...

Nodular polyarteritis causing mesenteric ischemia is a rare etiologic factor for acute abdomen.

Skin & Soft Tissue

SQUAMOUS CELL CARCINOMA ARISING FROM GIANT CONDYLOMA

Giant condyloma acuminatum (GCA), originally described by Buschke and Loewenstein in 1925 as a penile lesion, ...

Giant condyloma of the anorectal region with malignant transformation is a rare entity, complicating standardized management approaches.

Hepatobiliary & Pancreas

Echinococcus of Liver and Lung

Hydatidosis is a parasitic infection caused by the encysted larvae of Echinococcus granulosus and is called hy...

Dual echinococcosis involving both liver and right lung in a pediatric patient is a rare presentation requiring multidisciplinary expertise.

Head & Neck

Adenosquamous Carcinoma Arising in a Thyroglossal Duct Cyst

Fewer than 20 cases in world literature

Small Intestine

Superior Mesenteric Artery Syndrome

Superior mesenteric artery syndrome (Wilkie syndrome) is one of the rarest causes of small bowel obstruction. ...

Superior mesenteric artery syndrome is a very rare surgical entity and one of the rarest causes of small bowel obstruction.

Infections & Sepsis

Abscess of the Round Ligament of the Liver Due to Acute Obstructive Suppurative Cholangitis and Septic Thrombosis of the Left Branch of the Portal Vein

The round ligament of the liver is a remnant of the embryonic umbilical vein. After birth, the embryonic umbil...

Abscess of the round ligament of the liver is a very rare condition with fewer than 10 cases reported in English literature.

Head & Neck

THYROGLOSSAL DUCT CYST

The thyroglossal duct cyst is a widely recognized congenital anomaly, which is encountered in 7% of the genera...

Thyroglossal duct cyst is a relatively common congenital anomaly, seen in approximately 7% of the population; however, symptomatic cysts requiring surgery are less frequent, often presenting in young adults.

Hepatobiliary & Pancreas

Retroperitoneal Hydatid (Echinococcal) Cyst

Primary retroperitoneal transitional cell carcinomas are very rare neoplasms and carry a very poor prognosis. ...

Retroperitoneal echinococcal cysts without hepatic involvement are rare, representing 14-19% of abdominal echinococcal cyst cases.

Colorectal

Pseudodiverticulum Perforation: Pseudo-Pneumoperitoneum Due to Pseudo-Obstruction of a Dilated J-Shaped Neoleimph Intestine Mimicking Hollow Viscus Perforation

Restorative proctocolectomy with ileal pouch-anal anastomosis constitutes the surgical treatment of choice in ...

This is a rare case of pseudo-pneumoperitoneum caused by chronic inflammation and pseudo-obstruction of an ileal pouch mimicking bowel perforation.

Colorectal

Cecal Volvulus

Cecal volvulus is caused by an axial rotation of the cecum, ascending colon, and terminal ileum around the mes...

Cecal volvulus is an uncommon clinical condition with an annual incidence of 2.8–7.8 cases per million in the general population.

Colorectal

MALT Lymphoma of the Cecum

MALT lymphomas of the large intestine are very rare, accounting for only 2.5% of all MALT lymphomas, and those forming large masses even more so.

Skin & Soft Tissue

Giant Vulvar Epidermoid Cyst in an Adolescent Female

Vulvar epidermoid cysts are rarely encountered. Their development is due to the invagination of superficial sq...

Giant vulvar epidermoid cysts are extremely rare in adolescent females, with most reported cases occurring in adult women, often related to trauma or female circumcision—a history absent in this patient.

Rare Syndromes & Systemic

Sweet's Syndrome

Sweet syndrome, or acute neutrophilic dermatosis, is an uncommon dermatological disorder that may constitute a...

This case represents the first reported association of Sweet’s syndrome with cancer of the rectosigmoid junction in the literature.

Endocrine

Total Parathyroidectomy

Colorectal

Bilateral Diverticulosis

Diverticular disease is one of the most common disorders of the gastrointestinal tract. Approximately 28-45% o...

Bilateral diffuse diverticulosis with chronic recurrent massive bleeding necessitating subtotal colectomy is an uncommon presentation with important clinical implications.

Spleen

Splenic Cyst

Non-parasitic cysts of the spleen constitute a rare condition with an undefined incidence. They represent 10% ...

Non-parasitic splenic cysts are a very rare condition with undefined incidence.

Stomach & Esophagus

ESOPHAGEAL BURNS

The potentially devastating presentation and lifelong management of complications caused by the ingestion of c...

Hepatobiliary & Pancreas

PSEUDO-TUMOR OF THE PANCREAS

Various non-neoplastic conditions of the pancreas may develop solid, tumor-like masses that mimic pancreatic c...

Pseudo-tumors of the pancreas are uncommon but important to recognize to prevent misdiagnosis and overtreatment.

Hepatobiliary & Pancreas

Whipple Procedure and AAA

The management approach for coexisting abdominal aortic aneurysm and intra-abdominal malignancy is controversi...

Reports describing combined management of abdominal aortic aneurysm and pancreatic head cancer are extremely rare.

Stomach & Esophagus

Multiple Stromal Tumors of the Stomach

The stomach is divided into the cardia, fundus, body, antrum, and pylorus. According to the World Health Organ...

Multiple sporadic stromal tumors of the stomach with different KIT gene mutations are uncommon, representing a field effect phenomenon rather than metastatic disease.

Stomach & Esophagus

Inflammatory Fibrous Duodenal Polyp

Inflammatory fibroid polyp (IFP) constitutes a benign lesion that can be found throughout the length of the ga...

Inflammatory fibrous polyps of the duodenum are extremely rare, with very few pediatric cases reported worldwide.

Hepatobiliary & Pancreas

Hemorrhage of Simple Hepatic Cyst

Hemorrhagic rupture of a simple hepatic cyst constitutes a rare but potentially life-threatening complication....

Hemorrhagic rupture of simple hepatic cysts is extremely rare with limited cases described in the international literature, resulting in scarce knowledge about etiology and management.

Hernia & Abdominal Wall

Bochdalek Hernia

Bochdalek hernia (BH) is a form of congenital diaphragmatic hernia in a posterior position, caused by a defect...

Fewer than 20 adult cases of right-sided Bochdalek hernia are reported in the English literature, making this a rare clinical entity.

Skin & Soft Tissue

Gluteal Muscle Lymphoma Mimicking Soft Tissue Sarcoma: Report of a Unique Case and Literature Review

Malignant lymphomas constitute a heterogeneous group of malignancies of B or T cells, usually originating from...

Primary lymphoma of the gluteal muscle is an exceptionally rare extranodal presentation, with very few cases reported in the literature.

Stomach & Esophagus

AORTO-DUODENAL FISTULA

Primary aortoenteric fistula (PAEF) is a rare, life-threatening condition that develops between the native abd...

Primary aortoenteric fistula is a very rare cause of gastrointestinal bleeding, less common than secondary fistulas that occur after prior aortic aneurysm repair.

Colorectal

Recurrent Epiploic Appendagitis Mimicking Appendicitis and Diverticulitis

Recurrent epiploic appendagitis is a rare clinical condition but should be taken into account in differential diagnosis of acute localized abdominal pain.

Stomach & Esophagus

Delayed Presentation of Esophageal Pseudodiverticulum after Sternocleidomastoid Muscle Repair of Traumatic Rupture Following Anterior Cervical Fusion

Anterior fixation of the cervical spine has become a favored method of stabilization. Since its initial applic...

The delayed formation of an esophageal pseudodiverticulum eight months after iatrogenic esophageal rupture during anterior cervical fusion is a rare and noteworthy complication.

Vascular & Trauma

Pseudoaneurysm of the Arc of Riolan

The arterial arc of Riolan was proposed and named after the French anatomist Jean Riolan in 1965. It is formed...

Pseudoaneurysm formation and rupture of the arc of Riolan following endovascular repair of an abdominal aortic aneurysm is an extremely rare clinical occurrence.

Colorectal

Chronic Diverticulitis Causing Salpingo-Ovarian Abscess and Utero-Colonic Fistula: A Unique Case Report and Literature Review

Utero-colic fistulas constitute a rare complication of sigmoid diverticulitis. Although sigmoid diverticulosis...

Utero-colonic fistulas caused by sigmoid diverticulitis are exceedingly rare due to the uterus’s thick myometrial wall providing resistance.

Stomach & Esophagus

Chronic Gastric Volvulus

Gastric volvulus is recognized as a life-threatening condition requiring prompt diagnosis and management. It i...

Chronic gastric volvulus is a rare condition, especially when associated with atrial fibrillation and thoracic pain episodes.

Retroperitoneal & Pelvic

Recurrence of Sacral Chordoma: Unique Case Report and Literature Review

Chordoma is a rare, primary, malignant tumor described by Virchow in 1846, accounting for 1-4% of all malignan...

Chordoma is an extremely rare malignant tumor with an incidence of approximately 0.1 per 100,000 per year, making it a rare cause of sacral tumors.

Appendix

Surgical Management of Neuroendocrine Tumors of the Appendix

Neuroendocrine neoplasms of the appendix, formerly known as carcinoids, constitute the most prevalent tumors o...

Neuroendocrine tumors of the appendix are rare, with an incidence ranging from 0.15 to 0.6 per 100,000 per year.

Small Intestine

Small Intestine Obstruction by Phytobezoar

Phytobezoars constitute undigested vegetable masses in the gastrointestinal tract and represent a rare cause o...

Phytobezoars causing small bowel obstruction are uncommon, representing about 1.5% of small bowel obstructions and are rarely diagnosed preoperatively.

Colorectal

Inflammatory Cloacogenic Polyp of the Anus: A Unique Case Report and Literature Review

The inflammatory cloacogenic polyp constitutes a rare lesion that arises in the transitional zone of the anus....

Inflammatory cloacogenic polyps are rare lesions with limited literature, predominantly affecting adults between 40 and 60 years old but can also appear in children and adolescents.

Small Intestine

Inflammatory Occlusive Disease of the Mesenteric Veins in a Patient with Primary Sjögren's Syndrome and Ischemic Colitis: A Case Report and Literature Review

Inflammatory occlusive disease of the mesenteric veins is an unusual and under-recognized cause of intestinal ischemia, often diagnosed only after surgery and histology.

Stomach & Esophagus

Hypoganglionosis of the Stomach Resulting in Persistent Gastroparesis: A Unique Case Report

Gastric emptying of solids and liquids into the duodenum constitutes a complex process that relies on both int...

Hypoganglionosis of the stomach is an extremely rare pathological entity and differs from the more commonly known Hirschsprung disease of the colon.

Infections & Sepsis

Segmental Lateral Overgrowth (Isolated Hemihyperplasia / Hemihypertrophy) in a Patient with Abscessed Pilonidal Cyst

DEFINITION/DESCRIPTION: Significant increase in the length and/or circumference of most or all parts of one si...

Isolated segmental lateral overgrowth is rare, occurring in approximately 1 in 13,200 live births.

Appendix

Ovarian Teratoma Mimicking Acute Suppurative Appendicitis: A Unique Case Report and Literature Review

Acute appendicitis is one of the most common causes of right iliac fossa pain among the younger population. Th...

Ovarian teratoma is an uncommon cause of right lower quadrant pain mimicking acute appendicitis.

Retroperitoneal & Pelvic

Torsion of Ectopic Undescended Testis

Cryptorchidism is the most common congenital disorder of the male genitalia in male infants. It is diagnosed i...

Intramural (between muscle layers) ectopic testicular torsion is an extremely rare condition.

Rare Syndromes & Systemic

Ogilvie Syndrome - Chilaiditi Syndrome

Chilaiditi syndrome is a rare medical condition characterized by the radiological anomaly of interposition of ...

Both syndromes are rare medical conditions; the Chilaiditi sign is found in 0.025 - 0.28% of chest and abdominal radiographs.

Hepatobiliary & Pancreas

Right Hepatic Artery Syndrome

Obstructive jaundice as a result of vascular compression is extremely rare. Luttwak and Schwartz were the firs...

This is a rare case of asymptomatic common hepatic duct dilation caused by compression from the right hepatic artery.

Rare Syndromes & Systemic

Boerhaave Syndrome

Spontaneous esophageal perforation (Boerhaave syndrome) constitutes a challenging diagnostic and therapeutic p...

Boerhaave syndrome is a rare spontaneous esophageal rupture without preceding instrumentation, surgery, or trauma.

Endocrine

Synchronous Primary Thyroid and Kidney Cancers

Thyroid cancer accounts for approximately 1% of all cancers. Papillary carcinoma is the most common histologic...

The coexistence of papillary and follicular thyroid carcinomas together with primary clear cell renal carcinoma in the same patient is an exceptionally rare sporadic case.

Breast

Synchronous Bilateral Breast Cancers

The presence of synchronous bilateral breast cancers is not a rare condition. The improvement in survival time...

Secretory breast carcinoma is a rare type, accounting for less than 0.15% of all invasive breast cancers.

Endocrine

Contemporary Malignant Thyroid Neoplasms – Papillary and Medullary – with High Risk of Diagnostic Failure

In recent years, a global increase in well-differentiated thyroid cancers has been observed, without a concurr...

Synchronous (mixed) papillary and medullary thyroid carcinomas are uncommon, with about 340 cases reported internationally since 1981.

Small Intestine

Simultaneous Thrombosis of the Celiac Artery (Haller's Tripod) and Superior Mesenteric Artery: Report of a Unique Case and Literature Review

The majority of the arterial blood supply to the gastrointestinal tract originates from the anterior branches ...

Simultaneous occlusion of both the celiac artery and superior mesenteric artery is extremely rare and rarely reported in the literature.

Hepatobiliary & Pancreas

Congenital Absence of the Cystic Duct: A Rare Anomaly

The extrahepatic biliary ducts constitute a common site of anatomical variations, encountered in up to 47% of ...

Congenital absence of the cystic duct is a very rare biliary anomaly encountered in surgical practice.

Rare Syndromes & Systemic

STROMAL ENDOMETRIOSIS OF THE SMALL INTESTINE: A DECEPTIVE PRESENTATION AND LITERATURE REVIEW

Endometriosis represents the presence of ectopic endometrium at sites outside the uterus. The presence of endo...

Endometriosis involving the small intestine is an uncommon occurrence, representing 1-10% of patients with endometriosis, and bowel obstruction due to stromal endometriosis is described in less than 1% of cases.

Colorectal

Stenoses in Patients with Ulcerative Colitis: Clinical Significance and Risk Factors

The development of colorectal strictures, regardless of whether they are benign or malignant, is not uncommon ...

Recto-colonic stenoses occur in up to 12% of ulcerative colitis patients but malignant transformation within these strictures is relatively uncommon, ranging from 0% to 33%.

Spleen

SPLENECTOMY - SPLENOMEGALY + FEVER

Evaluation of the value of splenectomy in the diagnostic workup of fever of unknown origin in patients whose s...

Fever and isolated splenomegaly as the sole presenting signs pose diagnostic challenges; splenectomy is a valuable diagnostic approach in such rare clinical presentations.

Spleen

Splenectomy and Autotransplantation of the Spleen

Splenectomized patients have disturbances in the function of both B and T lymphocytes as well as reduced blood...

Autotransplantation of the spleen after splenectomy is an uncommon and innovative surgical technique aiming to restore immunological function.

Small Intestine

Progressive Sclerosing Encapsulating Peritonitis: A Unique Case Report and Literature Review

Sclerosing encapsulating peritonitis constitutes a rare, chronic, inflammatory condition of the peritoneum of ...

Progressive Sclerosing Encapsulating Peritonitis is an extremely rare condition with less than 120 cases reported worldwide, making clinical awareness and diagnosis challenging.

Endocrine

Silent Pheochromocytoma

Pheochromocytoma is a rare catecholamine-producing tumor, encountered with a frequency of 0.005–0.1% in the ge...

Silent pheochromocytomas represent a distinct subgroup of adrenal tumors rarely diagnosed preoperatively due to absence of typical clinical features and normal catecholamine levels.

Breast

Breast Sarcoidosis Mimicking Lymphoma Relapse

Breast sarcoidosis is a very rare entity, occurring in less than 1% of sarcoidosis cases, and its presentation mimicking lymphoma relapse after several years is exceptionally uncommon.

Spleen

RUPTURE OF SPLENIC ARTERY ANEURYSM

Splenic artery aneurysms (SAAs) are estimated to constitute more than half of all visceral artery aneurysms. S...

Although rare, splenic artery aneurysms are clinically significant due to their potential life-threatening complications such as spontaneous rupture and hemorrhagic shock.

Hepatobiliary & Pancreas

Rupture of Pseudoaneurysm of the Common Hepatic Artery following Acute Idiopathic Pancreatitis: Report of 2 Cases and Literature Review

The development of a pseudoaneurysm of the common hepatic artery is a rare morbid entity, and when it ruptures...

Pseudoaneurysm rupture of the common hepatic artery following idiopathic acute pancreatitis is extremely rare.

Spleen

Splenectomy for the Management of Primary Myelofibrosis

Philadelphia chromosome-negative myeloproliferative neoplasms include essential thrombocythemia, polycythemia ...

Primary myelofibrosis with severe symptomatic splenomegaly suitable for splenectomy is relatively rare.

Vascular & Trauma

Primary Retroperitoneal Angiosarcoma

Primary retroperitoneal sarcoma is a malignant tumor arising from the mesenchymal cells of the retroperitoneal...

Primary retroperitoneal angiosarcomas are extremely rare, constituting a small fraction of retroperitoneal sarcomas, which themselves occur with a frequency of 0.0027%.

Hepatobiliary & Pancreas

Primary Gastrointestinal Stromal Tumor (GIST) of the Liver

Gastrointestinal stromal tumor is the most common type of mesenchymal tumor, predominantly encountered in the ...

Primary stromal tumors of the liver are exceedingly rare with only 23 cases reported in the literature from 2003 to 2019.

Skin & Soft Tissue

Primary Leiomyosarcoma of the Great Saphenous Vein

Smooth muscle sarcomas (SMS) arising from the vessel wall are extremely rare. They represent less than 2% of a...

Sarcomas originating from smooth muscle cells of vessel walls are very rare, representing less than 2% of all leiomyosarcomas, with venous involvement being five times more common than arterial, and involvement of the great saphenous vein being particularly uncommon.

Stomach & Esophagus

Primary Adenosquamous Carcinoma of the Esophagus: Analysis of 9 Cases and Literature Review

Esophageal cancer is the 6th cause of death in men and the 9th in women among cancers worldwide. More than 90%...

Adenosquamous carcinoma of the esophagus is extremely rare, accounting for only 0.74% of esophageal cancers.

Retroperitoneal & Pelvic

Premature Metastasis of Renal Cell Carcinoma

Clear cell renal cell carcinoma is the most common type of renal malignancy and is encountered in 80-90% of al...

Skin metastases from renal cell carcinoma are rare and usually represent late manifestations; here, premature skin metastasis preceding detectable primary tumor is presented.

Hepatobiliary & Pancreas

Surgical Management of Polypoid Lesions of the Gallbladder

Polypoid lesions of the gallbladder are divided into benign and malignant. Malignant polypoid lesions include ...

Gallbladder adenomas and polypoid adenocarcinomas are relatively rare findings, with malignancy present in less than 3% of operated cases in this study.

Hepatobiliary & Pancreas

Polycystic Kidney and Liver Disease

Few cases have been reported internationally combining gastric cancer with Potter type III polycystic kidney and liver disease. This case represents a unique contribution to the literature.

Colorectal

Multiple Myeloma and Cecal Carcinoma

This is a unique reported case of invasive cecal adenocarcinoma developing after autologous stem cell transplantation for multiple myeloma.

Rare Syndromes & Systemic

Pneumorrhachis

The occurrence of pneumorrhachis is a relatively rare phenomenon and takes place when air enters the spinal ca...

Pneumorrhachis is an exceedingly rare phenomenon with limited understanding regarding its evaluation and management.

Vascular & Trauma

Pulmonary Tumor Thrombotic Microangiopathy Following Gastrectomy for Gastric Adenocarcinoma

Pulmonary tumor thrombotic microangiopathy (PTTM) constitutes a rare complication of malignancies, whose main ...

PTTM is extremely rare with limited cases reported globally, most diagnosed post-mortem, highlighting the diagnostic challenge.

Vascular & Trauma

Late Metastases of Cholangiocarcinoma

Cholangiocarcinoma is a type of malignant tumor arising from the epithelium of the biliary ducts. According to...

Umbilical metastases from cholangiocarcinoma without local recurrence are very rare and this is a unique reported case with muscle and umbilical metastases three years after R0 resection.

Hernia & Abdominal Wall

Lumbar Hernia: A Rare Entity

V. M. PENOPOULOS, GENERAL SURGEON. D. SGOURIDI, GENERAL SURGEON. M. NTAVLIS, ANAESTHESIOLOGIST. INTERBALKAN ME...

Lumbar hernia represents a very rare surgical condition with limited cases reported in the literature.

Retroperitoneal & Pelvic

Borderline Ovarian Tumor

Fewer than 25 cases of borderline clear cell ovarian tumors have been reported in the international literature with detailed management and follow-up information.

Retroperitoneal & Pelvic

Retrorectal Sarcoma

Retrorectal tumors are extremely rare, with a reported incidence of one case per 40,000 hospital admissions. M...

This case represents a unique and extremely rare occurrence of retrorectal spindle cell sarcoma, a rare malignant mesenchymal tumor subtype characterized histologically by spindle-shaped cells.

Retroperitoneal & Pelvic

Retro-rectal Schwannoma

Primary sacral and presacral lesions are considered very rare and occur with an incidence of 0.01 cases per 10...

Retro-rectal schwannomas constitute only 1-5% of schwannomas and 0.5-5% of all retro-rectal tumors. The ancient degenerative variant is especially rare and infrequently involves bone, with the sacrum and mandible being the most common osseous sites. Fewer than 80 intraosseous schwannomas are reported in the literature, with only 21 at the sacrum.

Retroperitoneal & Pelvic

Retrorectal Epidermoid Cyst

Epidermoid cysts are developmental cysts of the retrorectal space. They are typically benign, unilocular lesio...

Retrorectal epidermoid cysts are uncommon developmental cysts that may be misdiagnosed due to their non-specific presentation and constitute a rare entity in the retrorectal space.

Small Intestine

Retroperitoneal Leiomyoma

Primary retroperitoneal transitional cell carcinomas are very rare neoplasms and carry a very poor prognosis. ...

Retroperitoneal location of leiomyomas without coexistence with uterine fibroids is extremely rare (0.5-1.2%). Mitotically active leiomyomas are seldom found in postmenopausal women unless exposed to exogenous hormones. The pathogenesis of primary retroperitoneal leiomyomas is not fully clarified.

Colorectal

Total Aganglionosis of the Colon - Hirschsprung Disease

Hirschsprung's disease is a congenital anomaly of the gastrointestinal tract that affects the development, and...

Total aganglionosis of the colon is a rare subtype of Hirschsprung disease, accounting for less than 8% of cases, and extension into small bowel is even rarer.

Retroperitoneal & Pelvic

Renal Oncocytoma

This neoplasm was first described in 1942 by Zippel and later by Klein and Valensi in 1976. Oncocytoma account...

Renal oncocytoma is a rare benign tumor constituting 5–9% of epithelial renal tumors, with a low incidence of invasive histologic features and excellent prognosis despite such findings.

Colorectal

Neuroendocrine Tumor of the Right Hemicolon

Neuroendocrine tumors (NETs) constitute a group of tumors with different biological behaviors, which can be fo...

Neuroendocrine tumors of the colon are extremely rare, originating from enterochromaffin cells, and their management is not well defined due to low case numbers.

Endocrine

VATER PAPILLA NEUROENDOCRINE TUMOR

Neuroendocrine neoplasms arise from cells of the diffuse neuroendocrine system. They are typically/classically...

Neuroendocrine tumors of the Vater papilla are exceedingly rare with few cases reported, and exact epidemiological data remain limited.

Spleen

NET and Littoral Cell Hemangioma of the Spleen

Littoral cell angioma is a primary vascular tumor of the spleen, first described by Falk et al. in 1991. It is...

Littoral cell hemangioma of the spleen is a very rare vascular tumor with about 150 cases reported worldwide.

Endocrine

Neuroendocrine Tumors of the Small Intestine

Neoplasms of the small bowel are rare. The clinical symptomatology is non-specific, tumor-related symptoms app...

Neuroendocrine tumors of the small intestine are rare but are among the most frequent small intestine malignancies in the USA.

Retroperitoneal & Pelvic

MUSCLE METASTASES - RENAL CELL CARCINOMA

Skeletal muscles represent a rare site for the occurrence of metastases from renal cancers. We report the case...

Metastases to skeletal muscles from primary renal cell carcinoma are exceptionally uncommon, particularly after a long postoperative disease-free interval.

Hepatobiliary & Pancreas

Solitary Fibrous Tumor of the Liver

Solitary fibrous tumor of the liver is a rare spindle-cell neoplasm, arising from the mesenchyme. It was first...

Primary solitary fibrous tumor of the liver is extremely rare, with few reported cases in the literature.

Hernia & Abdominal Wall

Non-Traumatic Trans-Diaphragmatic Intercostal Hernia

Trans-diaphragmatic intercostal hernia is a rare clinical entity, with only a few cases reported. It occurs wh...

Trans-diaphragmatic intercostal hernia is a very rare clinical entity with only a few cases reported, mostly post-traumatic; non-traumatic cases are even rarer.

Colorectal

Non-Obstructive Ischemic Colitis

Idiopathic inflammatory venoocclusive disease of the mesentery is an unusual cause of intestinal ischemia, cha...

This case illustrates a unique presentation of idiopathic inflammatory phlebo-occlusive mesenteric disease causing fulminant ischemic colitis in a young adult, a condition rarely reported in literature.

Small Intestine

Delayed Metastasis to Ileostomy

An ileostomy is the surgical creation of an opening—either end or through a loop of ileum—and fixation of it t...

Metastases to ileostomies are extremely rare with fewer than 0.1% incidence reported in literature over the past five decades. Very few cases have been published in the last 30 years.

Endocrine

Transformation of Adrenal Incidentaloma into Carcinoma

Recently, new European guidelines have been issued regarding the management of adrenal incidentalomas. One of ...

Only two other cases of adrenocortical carcinoma developing from previously long-standing non-functional adrenal incidentalomas have been reported, making this an extremely rare event. It remains unclear whether this represents a coincidental finding or a yet unknown oncological process.

Retroperitoneal & Pelvic

Spermatic Cord Metastasis

The patient underwent ultra-low anterior resection of the rectum with total mesorectal excision, combined with...

Metastasis of rectal mucinous adenocarcinoma to the spermatic cord is extremely rare, possibly due to the lower temperature of the scrotum creating an unfavorable environment for metastatic cell implantation.

Colorectal

Metastasis of Sigmoid Colon Cancer to the Right Palatine Tonsil

The identification of metastatic lesions in the palatine tonsils is rare, despite the rich vascular supply of ...

Metastatic cancer in the palatine tonsil is an extremely rare clinical finding with only about 100 cases reported in English literature, and generally carries a poor prognosis.

Retroperitoneal & Pelvic

Mediastinal Pelvic Cyst

Benign multicystic mesothelioma of the peritoneum is an extremely rare peritoneal tumor, most commonly affecti...

Benign multicystic peritoneal mesothelioma is an extremely rare tumor with an incidence of 0.2 to 2 cases per 1,000,000 women, often complicated by diagnostic challenges due to its mimicking of ovarian carcinoma.

Colorectal

Partial Ischemic Necrosis of the Cecum

Ischemic colitis of the right hemicolon is clearly less frequent than its localization in the left hemicolon. ...

Isolated cecal necrosis is an exceedingly rare variant of ischemic colitis, infrequently reported and most commonly seen in elderly patients with multiple comorbidities causing systemic low flow states.

Colorectal

COLON MELANOSIS - PSEUDO-OBSTRUCTION

The use of laxatives is inextricably linked with constipation. Melanosis coli is a brown discoloration of the ...

Severe pseudo-obstruction caused by melanosis coli presenting as a jet black colon with mesenteric lymph node pigmentation is an extremely rare clinical scenario seldom described in international literature.

Colorectal

Lipoma of the Ileocecal Valve

Lipomas of the colon are rare benign tumors that constitute the most common non-epithelial (mesenchymal) neopl...

Lipomas of the colon, particularly those causing obstruction at the ileocecal valve, are rare entities with limited cases reported in the literature.

Skin & Soft Tissue

Leiomyosarcoma of the Left Shoulder

Leiomyosarcomas constitute a rare subgroup of malignant neoplasms originating from smooth muscle cells. They s...

Superficial or subcutaneous leiomyosarcomas larger than 5 cm are extraordinarily rare, with only eight cases reported in English literature. Overall incidence in the US is less than one per 200,000 population.

Endocrine

Cystic Parathyroid Adenoma

Primary hyperparathyroidism is defined as the excessive secretion of parathyroid hormone by the parathyroid gl...

Cystic parathyroid adenomas causing primary hyperparathyroidism are rare, representing less than 2% of cases.

Colorectal

Varices of the Anorectal Region

Variceal bleeding is a common and life-threatening manifestation of portal hypertension and remains the leadin...

Ectopic varices including anorectal varices represent 2-5% of all variceal hemorrhages but account for 20-30% of bleeding in patients with extrahepatic portal hypertension. Acute bleeding from anorectal varices is uncommon but can be catastrophic.

Vascular & Trauma

VARICOSE VEINS OF THE URETERS

Varices of the ureters are considered to represent a relatively rare morbid condition. The rapid evolution of ...

Only 14 cases of ureteral varices have been reported in Europe and America, with no cases described in Japan before this report.

Endocrine

Thyroid Varices

Bleeding from distal esophageal varices is a common complication of portal hypertension. Portal vein blood is ...

This is a rare case of hematemesis from downhill esophageal varices caused by a large goiter without obstruction of the superior vena cava, treated successfully with total thyroidectomy.

Endocrine

SUBMERGED PARATHYROID ADENOMA

Submerged or excessively descended upper parathyroid adenomas mimicking lower parathyroid adenomas are rare clinical entities that may complicate diagnosis and surgical treatment of primary hyperparathyroidism.

Skin & Soft Tissue

Sebaceous Gland Carcinoma

Sebaceous gland carcinoma occurs/presents primarily in the periocular region. Extra-ocular localizations accou...

Sebaceous gland carcinoma is a rare malignancy, especially in extra-ocular sites. Its association with Muir-Torre syndrome highlights the importance of genetic evaluation in these uncommon cases.

Endocrine

Parathyroid Gland Cancer

Parathyroid carcinoma is an extremely rare malignant endocrine neoplasm, with an increasing incidence ranging ...

This report describes a uniquely rare case of asymptomatic parathyroid carcinoma with normal calcium levels. According to the literature review, only one other similar case has been reported.

Endocrine

Hürthle Cell Carcinoma of the Thyroid

Hürthle cell carcinoma represents about 3% of thyroid cancers, making it a relatively rare thyroid malignancy.

Endocrine

Poorly Differentiated Thyroid Carcinoma

Poorly differentiated thyroid carcinomas (PDTC) constitute a rare type of thyroid cancer, with a reported inci...

Poorly differentiated thyroid carcinomas are uncommon, representing between 2% and 15% of thyroid cancers worldwide.

Colorectal

Ischemic Colitis - Spina Bifida

Bowel dysfunction is described in 0.7-29.6% of children and adolescents, associated with functional disorders ...

Ischemic colitis typically affects older adults; its presentation in a 14-year-old with spina bifida is rare and noteworthy.

Colorectal

GIANT FIBROMA OF THE ANUS

Fibromas are benign mesenchymal tumors, which are characterized by smooth nodules composed of fibrous or conne...

This case represents a unique reported instance of a giant anal fibroma coexisting with Crohn's disease, with no prior similar cases found in the English literature, making the association and pathogenesis unclear.

Skin & Soft Tissue

Proximal-Type Epithelioid Sarcoma

Epithelioid sarcoma was first described in 1970 by Enzinger as a rare soft tissue sarcoma which characteristic...

Proximal-type epithelioid sarcoma is an extremely rare histological variant with very few reported cases in the literature, especially presenting with widespread metastases and rapid clinical decline.

Skin & Soft Tissue

Epidermoid Cyst of the Anus

Epidermoid cysts of the vulva are rarely encountered. Their development is due to the infolding of superficial...

Epidermoid cysts at the anal verge of this size are uncommon in the absence of previous trauma or surgery, making this a unique and educational case.

Hernia & Abdominal Wall

ENDOMETRIOSIS OF THE ABDOMINAL WALL

Endometriosis of the abdominal wall is a rare clinical entity, especially when occurring outside of the peritoneal cavity, making it a diagnostic and therapeutic challenge.

Colorectal

INTERMEDIATE COLITIS

The distinction between ulcerative colitis and Crohn's disease is typically based on the assessment of multipl...

Intermediate colitis is a relatively rare condition encountered in inflammatory bowel disease surgery, representing cases with overlapping features of ulcerative colitis and Crohn's disease.

Stomach & Esophagus

GASTRIC EMPHYSEMA FROM SUDDEN VOMITING: A DILEMMA FOR THE YOUNG SURGEON

Gastric pneumatosis refers to the presence of air within the wall of the stomach. It is classified into two ty...

Gas within the gastric wall spreading into the portal venous system after repeated vomiting is a rare clinical finding that poses a diagnostic and therapeutic dilemma, especially for young surgeons.

Endocrine

Ectopic Thyroid

Ectopic thyroid is an embryological abnormality of thyroid migration characterized by the presence of thyroid ...

Ectopic thyroid gland is a rare condition with an incidence of about 1 in 4,000 to 10,000 individuals, with lateral cervical ectopic thyroids constituting approximately 1-3% of ectopic thyroids.

Hepatobiliary & Pancreas

Extended Right Hepatic Trisegmentectomy

The performance of hepatectomies has increased in recent decades, not only because of the demonstrated improve...

Colorectal

Appendiceal Diverticulitis

Appendiceal diverticulosis was first described by Kelynack in 1893. Appendiceal diverticulitis is a rare patho...

Appendiceal diverticulitis is a rare cause of appendicitis-like symptoms with a reported incidence ranging from 0.004% to 2.1%.

Rare Syndromes & Systemic

Intussusception - Peutz-Jeghers Syndrome

Peutz-Jeghers syndrome is a rare inherited disease with autosomal dominant transmission, characterized by muco...

The coexistence of adult intussusception with malignant polyps in a patient with Peutz-Jeghers syndrome is very rare and scarcely described in the literature.

Endocrine

Double Parathyroid Adenomas

Primary hyperparathyroidism is one of the most frequently encountered pathologies in endocrinology, with an in...

This is the second reported case internationally of hypercalcemic crisis caused by double parathyroid adenomas composed of clear cells since the first description in 1934 and very limited published cases.

Colorectal

Cecal Perforation Due to Impacted Coprolith: Report of a Unique Case and Literature Review

Impaction of a fecalith causing perforation of the cecum is a rare cause of acute abdominal pain in adults. Ce...

Cecal perforation due to impacted coprolith is a rare cause of acute abdomen, especially in young adults, with few cases reported in the literature.

Retroperitoneal & Pelvic

Vaginal Erosion - Mesh

Suspension of the vaginal apex/vaginal vault is an essential component of reconstructive surgery for the manag...

Vaginal erosion from mesh is a known but relatively rare late complication, with long-term incidence up to 10% and often requiring surgical correction.

Breast

Diabetic Mastopathy in Patients with Type II Diabetes

Diabetic mastopathy was first described by Soler and Khardori in 1984, as a constellation of clinical, radiolo...

Diabetic mastopathy is an uncommon benign condition occurring in less than 1% of all benign breast lesions. Its occurrence in type II diabetes patients is particularly rare and noteworthy.

Colorectal

Giant Megacolon Causing Acute Pseudoobstruction of the Colon

Acute pseudo-obstruction of the colon, also known as Ogilvie's syndrome, is a condition characterized by massi...

This case presents a rare instance of giant megacolon causing acute pseudoobstruction in a middle-aged patient successfully treated surgically after failure of conservative management.

Rare Syndromes & Systemic

Giant Villous Adenoma - McKittrick-Wheelock Syndrome

Adenomatous polyps of the sigmoid and rectum are usually characterized by the absence of symptoms, although th...

McKittrick-Wheelock syndrome caused by giant villous adenoma is an uncommon clinical entity with few reported cases.

Stomach & Esophagus

GASTROPARESIS AFTER GASTRECTOMY + RADIOTHERAPY

Gastroparesis is a syndrome caused by gastric stasis that is not related to mechanical obstruction. The predom...

Gastroparesis occurring postoperatively in association with radiotherapy and autonomic nerve damage is a rare and seldom reported complication.

Stomach & Esophagus

Gastrocolic Fistula in Crohn's Disease

Crohn's disease is a chronic inflammatory disease of unknown etiology, characterized by periods of remission a...

Gastrointestinal fistulas, including gastrocolic fistulas, represent rare manifestations of Crohn's disease and can be challenging to diagnose, contributing to increased morbidity and mortality if not detected early.

Colorectal

Deep Cystic Colitis

Colitis cystica profunda is a rare and unusual benign lesion of the colon and rectum, characterized by the pre...

Deep cystic colitis is a rare and unusual benign lesion of the large bowel presenting as mucus-containing cysts, historically first described by Stark and named by Virchow. It is an unexpected surgical finding due to its rarity and similarity to malignant lesions.

Stomach & Esophagus

Achalasia of the Esophagus in Elderly Patients

Achalasia of the esophagus is a rare disorder caused by obstruction at the gastroesophageal junction, secondar...

Achalasia is a rare disease with a reported incidence of 0.3 to 1.63 per 100,000 individuals.

Spleen

Spontaneous Splenic Rupture — Lymphoma

Spontaneous splenic rupture was first described by Rokitansky in 1861 and by Atkinson in 1874 and is implicate...

Spontaneous rupture of the spleen represents about 1% of all splenic ruptures, with lymphoma as an uncommon cause. This is a unique case presentation with literature review.

Hernia & Abdominal Wall

Idiopathic Spontaneous Intraperitoneal Hemorrhage

Idiopathic spontaneous intraperitoneal hemorrhage is a rare and often fatal condition, historically referred t...

Idiopathic spontaneous intraperitoneal hemorrhage is an exceptionally rare condition accounting for a small proportion of hemoperitoneum cases.

Endocrine

Atypical Parathyroid Adenoma

Primary hyperparathyroidism is one of the most common causes of hypercalcemia. It is an endocrine disorder mos...

Atypical parathyroid adenomas are extremely rare tumors, accounting for approximately 1.2–1.3% of primary hyperparathyroidism cases, and their exact incidence and clinical behavior remain largely unknown.

Small Intestine

Small Bowel Obstruction Due to Metastatic Urothelial Bladder Carcinoma

Urothelial carcinoma of the urinary bladder is among the most common malignancies of the genitourinary system ...

Small bowel metastasis from primary urothelial carcinoma of the bladder is an exceptionally rare clinical entity.

Colorectal

Bilateral Mucotome and Removal of Staples

We present the case of a 50-year-old female patient who underwent a Longo procedure for prolapsing hemorrhoids...

Although most surgeons inform patients that the staples fall off within weeks to months, it is unusual but important to recognize that staples may persist for many years and cause complications.

Hernia & Abdominal Wall

Streptococcus Oralis - Intra-abdominal Abscesses

V.M. Penopoulos, General Surgeon. D. Sgouridi, General Surgeon. M. Davlis, Anesthesiologist. Interbalkan Medic...

Intra-abdominal abscesses due to bacteremia reaching the peritoneal cavity from Streptococcus Oralis are extremely rare, especially in previously healthy individuals without immunocompromised states.

Colorectal

Endorectal Mesh Migration After Rectopexy

Complete rectal prolapse is the circumferential, full-thickness descent of the rectal wall through the anus. T...

Reports of rectal mesh migration after posterior mesh rectopexy are extremely rare in the literature.

Breast

Male Breast Cancer

Male breast cancer is a relatively rare disease, accounting for less than 1% of all male cancer cases. Due to ...

Male breast cancer is a relatively rare condition constituting less than 1% of all male cancers and about 1% of breast cancer cases globally.

Endocrine

Chronic Parathyroiditis

Vasileios Penopoulos, General Surgeon. Despoina Sgouridi, General Surgeon. 2nd Surgical Clinic, G.N.T. G. Papa...

This case is unique as it demonstrates the progression from hypoparathyroidism to hyperparathyroidism related to chronic parathyroiditis, a rare clinical entity.

Infections & Sepsis

Clostridium difficile Enteritis After Total Colectomy

C. difficile infection is related/associated with pseudomembranous colitis caused by antibiotic intake. The in...

Isolated Clostridium difficile enteritis after total colectomy with pouch formation is rare but often severe and life-threatening.

Hernia & Abdominal Wall

Bilateral Hematomas of Abdominal Muscles - Heparin

Antiplatelet agents have been widely used during hemodialysis in uremic patients. The most commonly used medic...

To the best of our knowledge, similar cases of bilateral rectus sheath hematomas causing bladder irritation symptoms have not been previously reported in international literature.

Spleen

Left Portal Hypertension - Splenectomy

The development of left portal hypertension constitutes a rare clinical condition, which is very often associa...

Left-sided portal hypertension due to splenic vein thrombosis from pancreatitis is uncommon and poses significant management challenges.