Surgical Case Library

Vascular

Thrombosis of the Celiacomesenteric Trunk.

<p style="text-align: justify;">The majority of the blood supply of the gastrointestinal tract , is provided b...

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.

<p style="text-align: justify;">It is widely accepted that patients with ulcerative colitis have an increased ...

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.

Infections & Sepsis

Toxic Megacolon associated Clostridium Difficile Colitis.

<p style="text-align: justify;">Clostridium difficile (C. difficile) is a gram positive, anaerobic, spore form...

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.

<p style="text-align: justify;"><strong>Although composite thyroid carcinomas have been reported in the litera...

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

Synchronous pathologies

Synchronous Occurrence of Appendiceal Mucinous Neoplasm and Colonic Adenocarcinoma.

<p style="text-align: justify;"><strong>Appendiceal mucocele (AM) is defined as a gross dilatation of the verm...

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 Neuroendocrine Carcinoma mimicking Double MANECs.

<p style="text-align: justify;"><strong>Gastric neuroendocrine carcinoma (NEC) is a rare disease that accounts...

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

Synchronous pathologies

Synchronous Colonic and Adrenal Tumors.

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

Female genitalia

Primary Ovarian Adenocarcinoma with synchronous Colonic and Ileal Metastases.

<p style="text-align: justify;">Epithelial cancers represent 90.0% of all malignant ovarian tumours. Primary o...

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.

<p style="text-align: justify;">The incidence of breast cancer (BC) is extremely high and malignant lymphoma (...

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

Autoimmune diseases

Wegener's Granulomatosis presenting as a Perirectal Abscess.

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

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.

<p style="text-align: justify;"><strong><u>Synchronous colorectal cancer refers to more than 1 primary colorec...

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

Small Intestine

Intestinal Stromal Endometriosis.

<p style="text-align: justify;">Endometriosis is the presence of heterotopic endometrium outside the uterus. S...

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

Colorectal

Steroid induced Sigmoid Diverticular Abscess Perforation.

<p style="text-align: justify;">Corticosteroids and non-steroidal anti-inflammatory drugs are widely used for ...

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

Mesentery

Spontaneous Mesenteric Haematoma.

<p style="text-align: justify;"><strong>Spontaneous mesenteric haematomas are rare. It was first described in ...

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.

<p style="text-align: justify;"><strong><u>Spontaneous perforation of colon is a rare disease and its physiopa...

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

Bone marrow transplantation

Spontaneous Gastric Fistula - Bone Marrow Transplantation .

<p style="text-align: justify;">This case is based upon a rare complication of non-Hodgkin's lymphoma.</p><p s...

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.

<p style="text-align: justify;"><strong><u>Though "ruptures" and "spontaneous" perforations of the rectum and ...

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

Hepatobiliary

Spontaneous Perforation of Common Bile Duct.

<p style="text-align: justify;"><strong><u>Spontaneous perforation of the wall of the extrahepatic or intrahep...

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

Endocrine

Spontaneous Adrenal Haemorrhage.

<p style="text-align: justify;"><strong><u>Adrenal hemorrhage (AH) is a rare but life-threatening condition es...

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

Colorectal

Colosplenic Fistula as the presenting manifestation of Colonic Carcinoma.

<p style="text-align: justify;"><strong><u>The spleen is one of the usually forgotten organs to be considered ...

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 of the splenic colonic flexure mimicking tumor.

<p style="text-align: justify;"><strong>Lymphatic cysts ( cystic lymphangiomata , lymphangiomatous , lymphahgi...

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.

<p style="text-align: justify;"><strong><u>The small intestine is approximately 5-6 m long and occupies a larg...

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

Infections & Sepsis

Small Bowel Spontaneous Perforation in a HIV positive patient.

<p style="text-align: justify;"><strong><u>Non-traumatic small bowel perforation is uncommon but can be fatal....

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.

<p style="text-align: justify;"><strong>Riedel thyroiditis (RT) is a rare fibro sclerotic condition affecting ...

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

Small Intestine

Rapidly Progressive Metastatic Epithelioid Angiosarcoma of the Small and Large Bowel.

<p style="text-align: justify;">Angiosarcoma is a rare high-grade neoplasm that frequently involves the skin a...

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

Colorectal

Quadruple Synchronous Rectal Adenocarcinomas.

<p style="text-align: justify;">The colon is the organ most frequently involved in synchronous malignancies, e...

Synchronous Quadruple Rectal Adenocarcinomas are extremely rare, with this being the first reported case in Greece.

Mesentery

Primary Mesenteric Neuroendocrine Tumor.

<p style="text-align: justify;">Carcinoid tumours are rare, slow-growing neoplasms that display neuroendocrine...

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.

<p style="text-align: justify;"><strong><u>Primary adrenal leiomyosarcoma is exceptionally rare and represents...

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

Pancreas

Posterior Reversible Encephalopathy Syndrome following Surgery for Necrotic Pancreatitis.

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

Peripheral nerve tumors

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.

Vascular

Portomesenteric Axis Thrombosis following Sleeve Gastrectomy.

<p style="text-align: justify;"><strong>Portal vein thrombosis (PVT) following sleeve gastrectomy is rare. </s...

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

Stomach & Esophagus

Gastric Outlet obstruction induced Pneumobilia.

<p style="text-align: justify;"><strong><u>Spontaneous biliary enteric fistula caused by peptic ulcer disease ...

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

Small Intestine

Pneumatosis Cystoides Intestinalis.

<p style="text-align: justify;"><strong><u>Pneumatosis cystoides intestinalis (PCI), defined as the presence o...

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

Appendix

Pseudomyxoma Peritonei.

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

Colorectal

Perforated Diverticulum of the Ascending Colon mimicking Desmoid Tumor.

<p style="text-align: justify;">Diverticular disease of the colon is frequent. It is encountered usually in th...

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.

<p style="text-align: justify;"><strong>Gastric carcinoma rarely presents with perforation.</strong> The repor...

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.

<p style="text-align: justify;"><strong>Pendred syndrome is a recessively inherited disorder characterized by ...

Adult presentation of Pendred syndrome with retrosternal extension is rare.

Hematological malignancy

Paraplegia: An unusual presentation of Follicular Lymphoma.

<p style="text-align: justify;"><strong>Follicular lymphoma (FL) is the commonest indolent Non-Hodgkin s lymph...

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

Mesentery

Paraganglioma at 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.

<p style="text-align: justify;"><strong>Postpartum thyroiditis is the term used for patients who develop painl...

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

Small Intestine

Non-steroidal anti-inflammatory drug-induced Diaphragm Disease presenting as Small Bowel Obstruction.

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

Rheumatology

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

<p style="text-align: justify;"><strong>Lymphomas may be induced by the systemic immunosuppressive therapies u...

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

Sarcoma

Non AIDS Kaposi's Sarcoma leading to Lower Extremities Wounds.

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

Duodenum

NeuroEndocrine Carcinoma of Ampulla of Vater.

<p style="text-align: justify;"><strong>Neuroendocrine carcinoma (NEC) of the duodenal ampulla of Vater is one...

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

Rare events

Migrated Abdominal Drain Intragastrically following modified Whipple's Operation.

<p style="text-align: justify;"><strong>The use of surgical drains is the subject of much debate but they cont...

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

Small Intestine

Primary Jejunal Adenocarcinoma unrelated to previously resected twice Rectal Carcinomas.

<p style="text-align: justify;">The annual incidence of SBA (Small Bowel Adenocarcinoma) in the USA is approxi...

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

Mesentery

Mesenteric Panniculitis as an incidental finding.

<p style="text-align: justify;"><strong>Mesenteric panniculitis (MP) is a rare, idiopathic disorder characteri...

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 style="text-align: justify;"><strong>Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor that ...

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 style="text-align: justify;"><strong>Marfan syndrome (MFS) is an autosomal dominant condition of abnormal c...

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.

<p style="text-align: justify;"><strong>Mixed tumours containing glandular and neuroendocrine components are i...

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.

Sarcoma

Low grade Fibromyxoid Sarcoma Medial Vastus Left Thigh mimicking Lipoma.

<p style="text-align: justify;"><strong>Soft tissue tumours are uncommon tumours accounting for only approxima...

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

Spleen

Littoral Cell Angioma of the Spleen.

<p style="text-align: justify;"><strong><u>Primary vessel tumours are the most common type of non-lymphomatous...

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 style="text-align: justify;">Intussusception represents 90% of patients in children and adult intussuscepti...

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 style="text-align: justify;"><strong><u>Isolated or solitary ulcers of the large intestine </u></strong>are...

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

Vascular

Isolated Varicosis of the Small Intestine without Portal Hypertension.

<p style="text-align: justify;"><strong>Varicosis of the small bowel</strong> (also called <strong><em>small b...

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

Vascular

Ischemic Intestinal involvement in a patient with Buerger's Disease

<p style="text-align: justify;"><strong><u>Buerger's disease or thromboangiitis obliterans is characterized by...

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

Skin & Soft Tissue

Intramuscular Myxoma.

<p style="text-align: justify;"><strong>Intramuscular myxoma is a rare benign soft tissue tumor involving the ...

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

Foreign bodies

Intestinal Perforation caused by a Quail Bone.

<p style="text-align: justify;"><strong><u>The majority of ingested foreign bodies (IFB) are excreted from the...

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 style="text-align: justify;"><strong><u>It has been demonstrated that low-dose aspirin (LDA) and non-steroi...

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

Hematological malignancy

Ileal Maltoma.

<p style="text-align: justify;">The gastrointestinal tract is involved by 30-40 % of all extranodal non-Hodgki...

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

Small Intestine

Ileal Lymphoid Nodular Hyperplasia

<p style="text-align: justify;"><strong>Primary lymphomas of the small intestine are rare and mostly of B-cell...

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 style="text-align: justify;">Colonic varices (CV) and lower gastrointestinal bleeding related to these lesi...

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 style="text-align: justify;"><strong>Hibernoma is a rare benign adipocytic tumor that differentiates simila...

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

Rare Syndromes & Systemic

Holt Oram Syndrome and Crohn's Disease.

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

Hepatobiliary

Hilar Inflammatory Myofibroblastic Tumor following Laparoscopic Cholecystectomy.

<p style="text-align: justify;"><strong>Inflammatory myofibroblastic tumors (IMT) are rare lesions with the gr...

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

Skin & Soft Tissue

Hidradenitis Suppurativa - Medical or Surgical Treatment?

<p style="text-align: justify;"><strong>Hidradenitis suppurativa</strong> (HS), a pathologic <strong>follicula...

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 style="text-align: justify;"><strong>Colorectal cancer (CRC) is one of the main causes of death by cancer i...

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.

Mesentery

Giant Mesenteric Cyst.

<p style="text-align: justify;"><strong>Mesenteric cysts are rare, usually benign tumours, with an incidence o...

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 style="text-align: justify;"><strong>Gigantomastia in pregnancy, also known as gestational Gigantomastia (G...

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

Stomach

Gastrostomy Foley Tube dislodgment causing Jejunal Obstruction.

<p style="text-align: justify;"><strong>Percutaneous gastrostomy is the preferred root for long term feeding o...

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

Stomach

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

Gallbladder Agenesis.

<p style="text-align: justify;"><strong><u>The absence of the gallbladder, also known as gallbladder agenesis ...

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

Hepatobiliary

Gallbladder Diverticulosis.

<p style="text-align: justify;"><strong>Gallbladder diverticulosis</strong> refers to the presence of small ou...

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

Peritoneum

Extraovarian Primary Peritoneal Carcinomatosis.

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

Colorectal

Extraluminal Perirectal Pseudomucocele following Hartmann's operation.

<p style="text-align: justify;"><strong>Hartmann's procedure is often selected in situations in which the cons...

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

Duodenum

Late Duodenal Stump recurrence following previous 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.

Duodenum

Duodenal Metastasis of Aggresive Melanoma.

<p style="text-align: justify;"><strong><u>Gastrointestinal (GI) malignant melanoma is an unusual clinical ent...

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

Hepatobiliary

Dumbbell Cholecystitis.

<p style="text-align: justify;">Dumbbell cholecystitis is an uncommon morphological variant of gallbladder inf...

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

Small Intestine

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

Bone Marrow Disseminated Carcinomatosis originating from Ascending Colon Carcinoma.

<p style="text-align: justify;"><strong>Disseminated carcinomatosis of the bone marrow (DCBM) is often associa...

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 style="text-align: justify;"><strong><u>The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-...

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.

Diaphragm

Diaphragmatic Eventration presenting as a "Recurrent Diaphragmatic Hernia".

<p style="text-align: justify;"><strong>Diaphragmatic eventration is the partial or total replacement of the d...

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

Rare Syndromes & Systemic

Dermatopathic Lymphadenopathy in the absence of clinical Skin Disease.

<p style="text-align: justify;"><strong>Dermatopathic lymphadenitis (DLN) is a well-described histopathologica...

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

Skin & Soft Tissue

Dermatofibrosarcoma Protuberans.

<p style="text-align: justify;"><strong>Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing fibrohi...

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 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.

<p style="text-align: justify;">Primary hyperparathyroidism is present in up to 0.1% of the general population...

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

Hematological malignancy

Coexistence of Hairy Cell Leukemia, T cell lymphoma and Colonic Adenocarcinoma.

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.

Endocrine

Critical Ilness Related Corticosteroid Insufficiency in Surgical Patients.

<p style="text-align: justify;"><strong>Dysfunction of the hypothalamo-pituitary adrenal axis has become a cen...

Hematological malignancy

Chronic Sialadenitis and Hodgkin's Parotid Lymphoma.

<p style="text-align: justify;"><strong>Lymphoid infiltrates of the salivary gland</strong> can be either <str...

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

Perforation of Cecal Adenocarcinoma due to Left Colon Diverticular Stenosis.

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.

<p style="text-align: justify;">Acute appendicitis is the most common abdominal emergency encountered by the g...

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.

<p style="text-align: justify;">In addition to accelerated atherosclerosis, patients with end-stage renal dise...

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.

<p style="text-align: justify;"><strong><u>Poorly differentiated neuroendocrine carcinomas (NECs) arising from...

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 Obstructing Jaundice.

<p style="text-align: justify;">Carcinomas located in the head of pancreas are increasing in frequency in the ...

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

Urinary system

Bilateral Long Ureteral Strictures following Short Term Preoperative Radiotherapy for Rectal Carcinoma.

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.

Ovarian tumor

Bilateral Giant Ovarian Cystadenomas.

<p style="text-align: justify;">The giant ovarian cyst is rarely found nowadays because of the improved imagin...

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.

Autoimmune diseases

Beçhet's Disease : A rare cause of Toxic Megacolon.

<p style="text-align: justify;">The gastrointestinal symptoms of Behçet's disease are ancillary manifestations...

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.

<p style="text-align: justify;">While&nbsp; malignancy&nbsp; must&nbsp; be&nbsp; included&nbsp; in&nbsp; the&n...

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.

Anus

Anterior Anal Sphincter Repair.

Duodenum

Ampullectomy for Tumors of Ampulla of Vater.

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.

<p style="text-align: justify;"><strong>Malignant melanoma (MM), which occurs mainly in the skin, is a highly ...

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.

<p style="text-align: justify;">Hirschprung s disease is well known. <strong>The basic pathogenesis is lack of...

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

Rare Syndromes & Systemic

Acute intussusception due to polyp with Malignant Transformation in a patient with Peutz Jeghers Syndrome.

<p style="text-align: justify;"><strong>Peutz-Jeghers syndrome is a rare autosomal dominant inherited disease ...

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

Colorectal

Ischaemic Colitis following Acute Myocardial Infarction.

<p style="text-align: justify;">The effects of acute ischaemia on the ischaemic vascular bed, include decrease...

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.

Urinary system

Acquired Cystic Kidney Disease-associated Renal Cell Carcinoma.

<p style="text-align: justify;"><strong><u>Renal tubular cystic changes may develop in end-stage renal disease...

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.

Congenital anatomical anomalies

Abdominal Separation.

<p style="text-align: justify;"><strong>Acute abdominal pain, a common chief complaint encountered in emergenc...

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

Rare Syndromes & Systemic

Abdominal Cocoon Syndrome.

<p style="text-align: justify;"><strong>Encapsulating peritoneal sclerosis (EPS), also known as abdominal coco...

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 Stapled Hemorrhoidopexy.

<p style="text-align: justify;">Conventional excisional haemorrhoidectomy has proven to be very effective as a...

Rectal perforation following Stapled haemorrhoidopexy is a rare but significant complication documented in the literature.

Colorectal

Sister Mary Joseph's nodule caused by Transverse Colon Carcinoma..

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

Colorectal

Metachronous Ovarian Metastasis in a patient with Primary Colorectal Cancer.

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.

Mesentery

Primary multiple Mesenteric - Mesocolic - Retroperitoneal Liposarcomas.

<p style="text-align: justify;">Liposarcomas are the second most common type of soft tissue sarcomas. They are...

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.

Post-operative TTP

Acute Postoperative Thrombotic Thrombocytopenic Purpura following Total Colectomy for Ulcerative Colitis.

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

Stomach

Acute Mesentero - Axial Gastric Volvulus in a patient with Diaphragmatic Hernia.

<p style="text-align: justify;"><strong>Gastric volvulus is characterized by a rotation of the stomach along i...

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

Congenital anatomical anomalies

Unusual presentation of Midgut Malrotation in Adulthood after Blunt Abdominal Trauma.

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

Metastatic disease

Sigmoid Colon Adenocarcinoma with metachronous Tonsillar Metastasis.

<p style="text-align: justify;">Metastatic palatine tonsil tumor is uncommon despite the palatine tonsil is ri...

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

Esophagus

The use of Sternocleidomastoid Muscle Flap for Esophageal Fistula Repair.

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.

<p style="text-align: justify;">Primary hyperparathyroidism (PHPT) is the most common disease in parathyroid g...

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

<p><strong>Colorectal strictures, either benign or malignant, are not uncommon in ulcerative colitis.</strong>...

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 Ovarian Psammocarcinoma and perforated Rectal Carcinoma.

<p style="text-align: justify;"><strong>The incidence of multiple primary cancers in the same patient is about...

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.

<p style="text-align: justify;"><strong>Spigelian hernia is a rare type of ventral abdominal wall hernia occur...

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.

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

Rare Syndromes & Systemic

Mesenteric inflammatory veno-occlusive disease in a patient with primary Sjogren's syndrome

<p style="text-align: justify;">Mesenteric inflammatory venoocclusive disease is an uncommon cause of intestin...

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 .

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.

<p><strong>Crohn’s disease (CD) is characterized by patches of inflammation, which may affect the whole gastro...

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.

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

Stomach & Esophagus

A Signet Ring Cell Gastric Carcinoma presented as Refractory Acquired Thrombotic Thrombocytopenic Purpura.

<p><strong><u>Brain, Dacie and Hourihane popularized the term Microangiopathic hemolytic anemia to designate a...

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

Hepatobiliary & Pancreas

Occult Gallbladder Carcinoma presenting as a Primary Ovarian Tumor.

<p>Ovary is a relatively frequent site of metastasis from various organs especially pancreas and gastrointesti...

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.

<p>Palmar and finger varicosities are quite frequent in elderly people but they are rarely reported in the lit...

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

Hernia & Abdominal Wall

Prevascular Femoral Hernia .

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.

Stomach & Esophagus

Esophageal Perforation afterTEVAR for Thoracic Aorta Rupture.

<p><strong><u>Esophageal perforation secondary to thoracic aorta rupture is rare. </u></strong>Endovascular tr...

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

Rare Surgical Techniques

Adult Diaphragmatic Eventration : Is Plication necessary.

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

Endocrine

Synchronous De Quervain's thyroiditis and Parathyroid Adenoma.

<p><strong>Subacute granulomatous thyroiditis / de Quervains thyroiditis</strong> <strong>is a painful inflamm...

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 Post-Gastrectomy Gastroparesis Syndrome (PGGS).

<p><strong><u>Gastroparesis is a disorder characterized by delayed gastric emptying in the absence of mechanic...

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.

<p><strong>Anaplastic carcinoma of the pancreas is rarely observed and accounts for less than 10% of all types...

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

Colorectal

Adult Colo-colic Intussusception secondary to Undifferentiated Sarcoma.

<p><strong>Intussusception is a process in which a segment of bowel telescopes into an adjoining segment, lead...

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

Colorectal

Simultaneous detection of B-Cell CLL and Colonic Adenocarcinoma.

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

Second Branchial Cleft Cyst in an adult patient.

<p><strong>Branchial cleft cysts (BCCs)</strong>, also called lateral cervical cysts, occur mostly in the late...

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

Fluminant Bleeding in a Neurofibromatosis patient with multiple Jejunal GIST Tumors.

<p><strong>Type 1 neurofibromatosis (NF1, von Recklinghausen s disease), an autosomal dominantly inherited dis...

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

Stomach & Esophagus

Solitary Esophagial Fibroma presenting with progressive Dysphagia.

<p><strong><u>Solitary fibrous tumors are uncommon spindle-cell neoplasms of mesenchymal origin, initially des...

Fewer than 5 cases

Post-operative TTP

Postoperative Thrombotic Thrombocytopenic Purpura following Restorative Proctocolectomy.

<p style="text-align: justify;"><strong><u>Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threateni...

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.

Liver

Liver Abscesses following Pancreaticoduodenectomy.

<p style="text-align: justify;">Pyogenic hepatic abscesses constitute a significant clinical problem. Unfortun...

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

Appendix

Subhepatic Appendicitis.

<p style="text-align: justify;">Acute appendicitis is a common acute surgical condition. The normal anatomy of...

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.

Ovarian tumor

Brenner Tumor of the Ovary - An Incidental Finding.

<p style="text-align: justify;">Brenner tumor was first described in 1907 by Fritz Brenner, who hypothesized t...

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

Invasive procedure

Novel Management of Chylous Ascites following Laparoscopic Nissen Fundoplication.

<p style="text-align: justify;">Chylous ascites is a rare and challenging complication that may be caused by a...

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

Urinary system

Distant Metachronous Ureteral Metastasis.

<p style="text-align: justify;">The renal parenchyma reacts in a limited number of ways to the countless harmf...

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

Urinary system

Spontaneous Rupture of the Urinary Bladder.

<p style="text-align: justify;"><strong>Ruptures of the urinary bladder</strong> classically occur as a conseq...

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

Dermatology

Peristomal Pyoderma Gangrenosum.

<p style="text-align: justify;"><strong><u>Pyoderma gangrenosum (PG) is a rare dermatological condition first ...

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

Endocrine

Thymic Neuroendocrine Carcinoma.

<p style="text-align: justify;">Neuroendocrine tumors are neoplasms arising from endocrine and neural cells. A...

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.

<p style="text-align: justify;">Rhabdomyolysis occurs following the development of traumatic compartment syndr...

Hematological malignancy

Spontaneous Sternal Fracture.

<p style="text-align: justify;">Osteolytic bone disease constitutes a common finding in multiple myeloma and p...

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

Retroperitoneal & Pelvic

Primary Retroperitoneal Carcinoma from Transitional Cells.

<p style="text-align: justify;">Primary retroperitoneal transitional cell carcinomas constitute very rare neop...

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

Peritoneum

Peritoneal Carcinomatosis due to Gastrointestinal Malignancies.

<p style="text-align: justify;"><strong><u>The peritoneal stromal tissue, which provides a rich source of grow...

Head & Neck

Primary Melanoma of the Nose.

<p style="text-align: justify;"><strong><u>Primary malignant melanoma of the nose and the mucosa of the parana...

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

Metastatic disease

Metastasis of Pancreatic Cancer to the Microenvironment of Lung Cancer.

<p style="text-align: justify;">The suppression and control of cancer metastases is one of the most important ...

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.

Stomach & Esophagus

Post-emetic Expulsion of Esophageal Metal Stent.

<p style="text-align: justify;">Esophageal cancer is the 7th leading cause of death worldwide. <strong>More th...

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

Hematological malignancy

Marginal Zone Lymphoma of the Spleen.

<p style="text-align: justify;">Lymphoma is a malignant tumor that originates from the lymphatic hematopoietic...

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

Lymphatic system

Hepatic Lymphorrhea following Total Pancreatectomy.

<p style="text-align: justify;">During abdominal operations, particularly after extended lymphadenectomy for g...

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.

<p style="text-align: justify;">Ectopic parathyroid adenoma constitutes an uncommon cause of primary hyperpara...

Vascular

Spleno-Renal Shunt to tackle Idiopathic Portal Hypertension.

<p style="text-align: justify;"><strong><u>Idiopathic portal hypertension (IPH), also known as non-cirrhotic p...

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

Hepatobiliary

Cholecystocolic Fistula.

<p style="text-align: justify;"><strong>Cholecystocolic fistula constitutes a rare condition, encountered in a...

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

Synchronous Necrotizing Typhlitis and Ano-Rectal "Typhlitis" in an Immunocompromised patient.

<p style="text-align: justify;"><strong><u>Typhlitis describes the presence of enterocolitis in the ileocecal ...

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

Congenital anatomical anomalies

Incidental discovery of Midgut Malrotation during Exploratory Laparotomy.

<p style="text-align: justify;"><strong>Anomalous rotation of the midgut constitutes a congenital anatomical a...

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

Luschka's Duct Injuries.

<p style="text-align: justify;"><strong><u>Subcystic biliary ducts (frequently erroneously called Luschka duct...

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 Procedure to cope with Low Rectal Adenomas of doubtful malignancy.

<p style="text-align: justify;">The presacral space constitutes a peculiar anatomical region between the poste...

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.

<p style="text-align: justify;">The prevalence of colonic diverticulosis is directly correlated with age and m...

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

Hepatobiliary

Cholecystogastric Fistula.

<p style="text-align: justify;">Gallstone ileus constitutes a rare complication of cholelithiasis, occurring i...

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

Congenital anatomical anomalies

Left-Sided Gallbladder.

<p style="text-align: justify;"><strong>Left-sided gallbladder (LSG) constitutes a rare anomaly, encountered a...

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

Endocrine

Functional Parathyroid Cyst.

<p style="text-align: justify;"><strong><u>Parathyroid cysts are traditionally classified as functional or non...

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

Hepatobiliary

Solitary Cystic Dilatation of Intrahepatic Biliary Duct.

<p style="text-align: justify;">The presence of biliary duct cysts is uncommon in the Western world, and most ...

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.

<p style="text-align: justify;"><strong>The development of secondary malignancies is a rare but clearly define...

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

Appendix

Mucocoele of the Vermiform Appendix.

<p style="text-align: justify;">Appendectomy constitutes a common surgical procedure performed worldwide for t...

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

Endocrine

Retrosternal Goiter.

<p style="text-align: justify;"><strong><u>Retrosternal goiter refers to cases where the thyroid gland grows a...

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

Trauma

Traumatic Displacement of the Testis.

<p style="text-align: justify;"><strong><u>Traumatic displacement of the testis constitutes a rare clinical en...

Traumatic displacement of the testis is a rare condition.

Skin & Soft Tissue

Giant Cutaneous Papilloma on the Lumbar Region.

<p style="text-align: justify;">Acrochordons/papillomas constitute common benign neoplasms encountered in dail...

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

Endocrine

Parathyroid Adenoma arising within the Sternocleidomastoid Muscle.

<p style="text-align: justify;"><strong><u>Multiple endocrine neoplasia syndrome type 2A (MEN 2A) constitutes ...

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.

<p style="text-align: justify;"><strong><u>The normal weight of a parathyroid gland ranges between 50 and 70 m...

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.

Female genitalia

Sebaceous Glands of the Exocervix.

<p style="text-align: justify;"><strong>The presence of sebaceous glands constitutes an extremely rare finding...

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

Hematological malignancy

Primary Testicular Lymphoma.

<p style="text-align: justify;">Primary testicular lymphoma (PTL) accounts for 1–2% of <strong>Non-Hodgkin's <...

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.

<p style="text-align: justify;"><strong><u>Wandering spleen and gastric volvulus constitute two rare pathologi...

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 presenting as Idiopathic Thrombocytopenic Purpura.

<p style="text-align: justify;">Primary splenic malignancies are categorized into <strong>vascular </strong>an...

Fewer than 200 cases worldwide

Rheumatology

Polyarteritis Nodosa presenting as Acute Abdomen.

<p style="text-align: justify;"><strong><u>Mesenteric vasculitis due to polyarteritis nodosa constitutes an at...

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

Colorectal

Squamous Cell Carcinoma arising from a Giant Condyloma Acuminatum ( Buschke-Lowenstein tumor ).

<p style="text-align: justify;">Giant condyloma acuminatum (GCA), originally described by Buschke and Loewenst...

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

Parasitic disease

Simultaneous Management of Hepatic and Pulmonary Hydatidosis.

<p style="text-align: justify;">Hydatidosis is a parasitic infection caused by the encysted larvae of Echinoco...

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

Vascular

Superior Mesenteric Artery Syndrome ( Wiklie Syndrome ).

<p style="text-align: justify;"><strong>Superior mesenteric artery syndrome (Wilkie syndrome) is one of the ra...

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

<p style="text-align: justify;">The round ligament of the liver is a remnant of the embryonic umbilical vein. ...

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.

<p style="text-align: justify;">The thyroglossal duct cyst is a widely recognized congenital anomaly, which is...

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.

Retroperitoneal & Pelvic

Sizeable Solitary Retroperitoneal Hydatid (Echinococcal) Cyst.

<p style="text-align: justify;">Hydatid disease, which causes unilocular cystic lesions, is an infectious dise...

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

Small Intestine

Pseudo-Pneumoperitoneum due to chronically inflammed and distended ileal pouch.

<p style="text-align: justify;"><strong>Restorative proctocolectomy with ileal pouch-anal anastomosis constitu...

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.

<p style="text-align: justify;"><strong>Cecal volvulus is caused by an axial rotation of the cecum, ascending ...

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( Mucosa Associated Lymphoid Tissue ) 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.

<p style="text-align: justify;">Vulvar epidermoid cysts are rarely encountered. Their development is due to th...

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 in a patient with Recto-colic Carcinoma.

<p style="text-align: justify;"><strong>Sweet syndrome, or acute neutrophilic dermatosis, is an uncommon derma...

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

Endocrine

Total Parathyroidectomy with or without autotransplantation in the sternocleidomastoid muscle.

Colorectal

Chronically Bleeding Bilateral Diverticulosis.

<p style="text-align: justify;"><strong>Diverticular disease is one of the most common disorders of the gastro...

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

Spleen

Giant Non Parasitic Splenic Cyst.

<p style="text-align: justify;"><strong>Non-parasitic cysts of the spleen constitute a rare condition with an ...

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

Stomach & Esophagus

Esophageal Burns following ingestion of Caustic Substances.

<p style="text-align: justify;"><strong>The potentially devastating presentation and lifelong management of co...

Pancreas

Pseudo-Tumor of the Pancreas.

<p style="text-align: justify;">Various non-neoplastic conditions of the pancreas may develop solid, tumor-lik...

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

Pancreas

Modified Whipple's Procedure in a patient with Stented Abdominal Aortic Aneurysm.

<p style="text-align: justify;"><strong><u>The management approach for coexisting abdominal aortic aneurysm an...

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

Stomach & Esophagus

Multiple Stromal Tumors of the Stomach.

<p style="text-align: justify;">The stomach is divided into the cardia, fundus, body, antrum, and pylorus. Acc...

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

Duodenum

Inflammatory Fibrous Duodenal Polyp.

<p style="text-align: justify;">Inflammatory fibroid polyp (IFP) constitutes a benign lesion that can be found...

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

Hepatobiliary

HAemorrhage of A Simple Hepatic Cyst.

<p style="text-align: justify;"><strong>Hemorrhagic rupture of a simple hepatic cyst constitutes a rare but po...

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.

Diaphragm

Adults' Bochdalek's Hernia presenting with Hematemesis and Pancreatitis.

<p style="text-align: justify;"><strong><u>Bochdalek hernia (BH) is a form of congenital diaphragmatic hernia ...

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.

<p style="text-align: justify;"><strong><u>Malignant lymphomas constitute a heterogeneous group of malignancie...

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

Vascular

Primary Aorto -Duodenal Fistula.

<p style="text-align: justify;">Primary aortoenteric fistula (PAEF) is a rare, life-threatening condition that...

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.

Esophagus

Delayed Presentation of Esophageal Pseudodiverticulum following Sternocleidomastoid Muscle Repair of Esophageal Fistula.

<p style="text-align: justify;"><strong>Anterior fixation of the cervical spine has become a favored method of...

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

Vascular

Rupture of Riolan's Arc Pseudoaneurysm following endovascular repair of AAA.

<p style="text-align: justify;"><strong><u>The arterial arc of Riolan was proposed and named after the French ...

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.

<p style="text-align: justify;"><strong><u>Utero-colic fistulas constitute a rare complication of sigmoid dive...

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.

<p style="text-align: justify;"><strong><u>Gastric volvulus is recognized as a life-threatening condition requ...

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

Sarcoma

Recurrence of Sacral Chordoma.

<p style="text-align: justify;"><strong>Chordoma is a rare, primary, malignant tumor described by Virchow in 1...

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.

<p style="text-align: justify;"><strong><u>Neuroendocrine neoplasms of the appendix, formerly known as "carcin...

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 Bowel Obstruction by Phytobezoar in a patient with "virgin" Abdomen.

<p style="text-align: justify;">Phytobezoars constitute undigested vegetable masses in the gastrointestinal tr...

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

Anus

Inflammatory Cloacogenic Polyp of the Anus.

<p style="text-align: justify;"><strong><u>The inflammatory cloacogenic polyp constitutes a rare lesion that a...

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.

Vascular

Mesenteric Inflammatory Veno Occlusive Disease in a Patient with Primary Sjögren's Syndrome.

<p style="text-align: justify;"><strong>Inflammatory veno-occlusive disease of the mesentery is a rare cause o...

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.

<p style="text-align: justify;">Gastric emptying of solids and liquids into the duodenum constitutes a complex...

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

Rare Syndromes & Systemic

Segmental Lateral Overgrowth in a patient with Abscessed Pilonidal Cyst.

<p><strong>DEFINITION/DESCRIPTION.</strong></p><p style="text-align: justify;"><strong><u>Significant increase...

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

Ovarian tumor

Ovarian Teratoma mimicking Acute Suppurative Appendicitis.

<p style="text-align: justify;">Acute appendicitis is one of the most common causes of right iliac fossa pain ...

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

External genitalia

Torsion of Ectopic Undescended Testis.

<p style="text-align: justify;"><strong><u>Cryptorchidism is the most common congenital disorder of the male g...

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

Rare Syndromes & Systemic

Ogilvie Syndrome - Chilaiditi Syndrome. An odd connection.

<p style="text-align: justify;"><strong>Chilaiditi syndrome is a rare medical condition characterized by the r...

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

Vascular

Right Hepatic Artery Syndrome.

<p style="text-align: justify;"><strong>Obstructive jaundice as a result of vascular compression is extremely ...

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

Rare Syndromes & Systemic

Boerhaave Syndrome.

<p style="text-align: justify;"><strong>Spontaneous esophageal perforation (Boerhaave syndrome) constitutes a ...

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

Endocrine

Synchronous Primary Thyroid and Kidney Cancers.

<p style="text-align: justify;">Thyroid cancer accounts for approximately 1% of all cancers. <strong>Papillary...

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.

<p style="text-align: justify;">The presence of synchronous bilateral breast cancers is not a rare condition. ...

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.

<p style="text-align: justify;"><strong>In recent years, a global increase in well-differentiated thyroid canc...

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

Vascular

Simultaneous Thrombosis of the Celiac Artery (Haller's Tripod) and Superior Mesenteric Artery.

<p style="text-align: justify;">The majority of the arterial blood supply to the gastrointestinal tract origin...

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

Hepatobiliary

Congenital Absence of the Cystic Duct.

<p style="text-align: justify;"><strong><u>The extrahepatic biliary ducts constitute a common site of anatomic...

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

Small Intestine

Stromal Endometriosis of the Small Intestine.

<p style="text-align: justify;"><strong><u>Endometriosis represents the presence of ectopic endometrium at sit...

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.

<p style="text-align: justify;"><strong><u>The development of colorectal strictures, regardless of whether the...

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 for the Treatment of Splenomegaly and Fever of unknowh origin.

<p style="text-align: justify;"><strong><u>When splenomegaly constitutes the only finding in patients with fev...

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

Spleen

Autotransplantation of the Spleen when Splenectomy becomes inevitable.

<p style="text-align: justify;">The fragile structure of the spleen often leads to injury following abdominal ...

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

Small Intestine

Progressive Sclerosing Encapsulating Peritonitis.

<p style="text-align: justify;"><strong>Sclerosing encapsulating peritonitis constitutes a rare, chronic, infl...

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.

<p style="text-align: justify;">Pheochromocytoma is a rare catecholamine-producing tumor, encountered with a f...

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.

<p style="text-align: justify;"><strong>Sarcoidosis is a benign systemic granulomatous disorder of unknown eti...

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.

Vascular

Spontaneous Idiopathic Rupture of Splenic Artery Aneurysm.

<p style="text-align: justify;"><strong><u>Splenic artery aneurysms (SAAs) are estimated to constitute more th...

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

Vascular

Rupture of Common Hepatic Artery Pseudoameurysm following Acute Idiopathic Pancreatitis.

<p style="text-align: justify;"><strong>The development of a pseudoaneurysm of the common hepatic artery is a ...

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

Hematological malignancy

Splenectomy for the Management of Primary Myelofibrosis.

<p style="text-align: justify;"><strong>Philadelphia chromosome-negative myeloproliferative neoplasms include ...

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

Sarcoma

Primary Retroperitoneal Angiosarcoma.

<p style="text-align: justify;"><strong>Primary retroperitoneal sarcoma is a malignant tumor arising from the ...

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

Liver

Primary Gastrointestinal Stromal Tumor (GIST) of the Liver.

<p style="text-align: justify;"><strong><u>Gastrointestinal stromal tumor is the most common type of mesenchym...

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

Vascular

Primary Leiomyosarcoma of the Great Saphenous Vein.

<p style="text-align: justify;"><strong>Smooth muscle sarcomas (SMS) arising from the vessel wall are extremel...

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.

Esophagus

Primary Adenosquamous Carcinoma of the Esophagus.

<p style="text-align: justify;">Esophageal cancer is the 6th cause of death in men and the 9th in women among ...

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

Urinary system

Premature Metastasis of Renal Cell Carcinoma.

<p style="text-align: justify;">Clear cell renal cell carcinoma is the most common type of renal malignancy an...

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

Hepatobiliary

Surgical Management of Polypoid Lesions of the Gallbladder.

<p style="text-align: justify;">Polypoid lesions of the gallbladder are divided into <strong>benign</strong> a...

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

Genetically inherited cystic diseases

Left Total Nephrectomy and excision of an infected Hepatic Cyst in a patient with Polycystic Liver-Kidney Disease and Gastric Adenocarcinoma.Potter type III. .

<p style="text-align: justify;"><strong>Autosomal Dominant Polycystic Kidney Disease</strong> is the most comm...

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

Cecal Carcinoma following autologous transplantation for Multiple Myeloma.

<p style="text-align: justify;"><strong>Multiple Myeloma is a malignancy of plasma cells characterized by the ...

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

Colorectal

Pneumorrhachis following Rectal Injury.

<p style="text-align: justify;"><strong><u>The occurrence of pneumorrhachis is a relatively rare phenomenon an...

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

Rare Syndromes & Systemic

Pulmonary Tumor Thrombotic Microangiopathy Following Gastrectomy for Gastric Adenocarcinoma.

<p style="text-align: justify;"><strong><u>Pulmonary tumor thrombotic microangiopathy (PTTM) constitutes a rar...

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

Metastatic disease

Late Metastases to Skeletal Muscles and Umbilicus following R0 resection of Type I Cholangiocarcinoma.

<p style="text-align: justify;"><strong><u>Cholangiocarcinoma is a type of malignant tumor arising from the ep...

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.

<p style="text-align: justify;"><strong><u>A lumbar hernia is defined as the protrusion of extraperitoneal or ...

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

Ovarian tumor

Borderline Ovarian Tumor.

<p style="text-align: justify;">The ovarian clear cell borderline tumor is a rare neoplasm, accounting for les...

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

Sarcoma

Retrorectal Sarcoma.

<p style="text-align: justify;"><strong><u>Retrorectal tumors are extremely rare, with a reported incidence of...

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.

Peripheral nerve tumors

Retro-Rectal Schwannoma ("Ancient Degenerative Variant").

<p style="text-align: justify;"><strong><u>Primary sacral and presacral lesions are considered very rare and o...

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.

Developmental abnormalities

Retrorectal Epidermoid Cyst.

<p style="text-align: justify;"><strong>Epidermoid cysts are developmental cysts of the retrorectal space. The...

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.

Retroperitoneal & Pelvic

Retroperitoneal Leiomyoma.

<p style="text-align: justify;"><strong><u>Leiomyomas, are benign tumors composed of smooth muscle fibers and ...

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.

Congenital anomaly

Total Aganglionosis of the Colon with extension to the Terminal Ileum - Adult Hirschsprung’s Disease.

<p style="text-align: justify;"><strong><u>Hirschsprung's disease is a congenital anomaly of the gastrointesti...

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.

Urinary system

Renal Oncocytoma.

<p style="text-align: justify;"><strong>This neoplasm was first described in 1942 by Zippel and later by Klein...

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

Well Differentiated Grade - 3 Neuroendocrine Tumor of the Cecum.

<p style="text-align: justify;"><strong>Neuroendocrine tumors (NETs) constitute a group of tumors with differe...

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

Metastatic disease

Metachronous presentation of NET in a splenectomized patient for Littoral Cell Hemangioma of the Spleen.

<p style="text-align: justify;"><strong>Littoral cell angioma is a primary vascular tumor of the spleen, first...

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

Small Intestine

Resection of Small Intestinal Neuroendocrine Tumors should be combined with Radical Regional Lymphadenectomy to improve survival.

<p style="text-align: justify;"><strong><u>Neoplasms of the small bowel are rare</u></strong>. The clinical sy...

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

Metastatic disease

Multiple Muscular Metastases (Psoas Muscle) from Clear Cell Renal Carcinoma following Radical Nephroureterectomy.

<p style="text-align: justify;"><strong><u>Skeletal muscles represent a rare site for the occurrence of metast...

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

Liver

Solitary Fibrous Tumor of the Liver.

<p style="text-align: justify;"><strong>Solitary fibrous tumor of the liver is a rare spindle-cell neoplasm, a...

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.

<p style="text-align: justify;"><strong>Trans-diaphragmatic intercostal hernia is a rare clinical entity, with...

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.

<p style="text-align: justify;"><strong><u>Idiopathic inflammatory venoocclusive disease of the mesentery is a...

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.

Metastatic disease

Metachronous Metastasis to Ileostomy.

<p style="text-align: justify;">An ileostomy is the surgical creation of an opening - either end or through a ...

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.

<p style="text-align: justify;"><strong>Adrenal incidentaloma refers to an unsuspected adrenal lesion detected...

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.

External genitalia

Spermatic Cord Metastasis.

<p style="text-align: justify;"><strong>Rectal carcinoma commonly metastasizes to the liver, lungs, peritoneum...

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.

Retroperitoneal & Pelvic

Mesothelial Pelvic Cyst.

<p><strong><u>Benign multicystic mesothelioma of the peritoneum is an extremely rare peritoneal tumor, most co...

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.

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

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

Pseudo-obstruction of a pitch-black Colon.

<p>The use of laxatives is inextricably linked with constipation. Melanosis coli is a brown discoloration of t...

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

Obstruction of the Ileocecal Valve due to a large Cecal Lipoma in a patient with Sigmoid Colon Cancer.

<p>Lipomas of the colon are rare benign tumors that constitute the most common non-epithelial (mesenchymal) ne...

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

Superficial/Subcutaneous Leiomyosarcoma of the Left Shoulder.

<p>Leiomyosarcomas constitute a rare subgroup of malignant neoplasms originating from smooth muscle cells. The...

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 functioning Parathyroid Adenoma in a patient with Primary Hyperparathyroidism and Negative Sestamibi Scan.

<p>Primary hyperparathyroidism is defined as the excessive secretion of parathyroid hormone by the parathyroid...

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

Colorectal

Management of Βleeding Varices of the Αnorectal region in a patient with Portal Hypertension due to Liver Cirrhosis.

<p><strong><u>Variceal bleeding is a common and life-threatening manifestation of portal hypertension and rema...

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

Ureteral Varices.

<p><strong>Ureteral varices are an exceptionally rare vascular abnormality characterized by dilated venous cha...

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.

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

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

Overly Descended Parathyroid Adenoma.

<p>Parathyroid adenomas are the most common cause of primary hyperparathyroidism, accounting for the majority ...

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 Adenocarcinoma.

<p><strong><u>Sebaceous gland carcinoma occurs/presents primarily in the periocular region.</u></strong></p> ...

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 Carcinoma.

<p><strong><u>Parathyroid carcinoma is an extremely rare malignant endocrine neoplasm, with an increasing inci...

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 Thyroid Carcinoma.

<p><strong><u>Hürthle cell carcinoma of the thyroid, also known as oncocytic carcinoma, constitutes a rare for...

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

Endocrine

Poorly Differentiated Thyroid Carcinoma.

<p><strong>Poorly differentiated thyroid carcinomas (PDTC) constitute a rare type of thyroid cancer, with a re...

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

Colorectal

Ischemic Colitis in a Teenager with Spina Bifida.

<p><strong>Bowel dysfunction is described in 0.7-29.6% of children and adolescents, associated with functional...

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

Colorectal

Giant Anal Fibroma.

<p><strong>Fibromas are benign mesenchymal tumors, which are characterized by smooth nodules composed of fibro...

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.

Retroperitoneal & Pelvic

Proximal-Type Epithelioid Sarcoma.

<p><strong>Epithelioid sarcoma was first described in 1970 by Enzinger as a rare soft tissue sarcoma which cha...

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

Anal Epidermoid Cyst.

<p><strong>Epidermoid cysts</strong> are common cutaneous cysts characterized by the presence of benign, encap...

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

Endometriomas mimicking Abdominal Wall Soft Tissue Tumors.

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

Indeterminate Colitis.

<p><strong><u>The distinction between ulcerative colitis and Crohn's disease is typically based on the assessm...

Inditerminate 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 following Vomiting.

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

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 mimicking a Cyst of Thyroglossal Duct.

<p>Ectopic thyroid is an embryological abnormality of thyroid migration characterized by the presence of thyro...

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 with Preservation of the Right Inferior Hepatic Vein.

<p>The performance of hepatectomies has increased in recent decades, not only because of the demonstrated impr...

Appendix

Appendiceal Diverticulitis.

<p><strong>Appendiceal diverticulosis was first described by Kelynack in 1893</strong>. <strong><u>Appendiceal...

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

Rare Syndromes & Systemic

Malignant Transformation of a Polyp in a patient with Peutz-Jeghers Syndrome.

<p><strong><u>Peutz-Jeghers syndrome is a rare inherited disease with autosomal dominant transmission, charact...

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 Water-Clear cell Parathyroid Adenomas.

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

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.

<p>Impaction of a coprolith, causing perforation of the cecum is a rare cause of acute abdominal pain in adult...

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 Stump Mesh Erosion following Sacrocolpopexy.

<p><strong>Suspension of the vaginal vault, is an essential component of reconstructive surgery for the manage...

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 a Patient with Type II Diabetes Mellitus.

<p><strong>Diabetic mastopathy was first described by Soler and Khardori in 1984, as a constellation of clinic...

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 Pseudo-obstruction of the Colon.

<p><strong><u>Acute pseudo-obstruction of the colon, also known as Ogilvie's syndrome, is a condition characte...

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.

Colorectal

Giant Villous Adenoma - McKittrick-Wheelock Syndrome.

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

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

Stomach & Esophagus

Late Gastroparesis following Gastrectomy and Adjuvant Radiotherapy.

<p><strong><u>Gastroparesis is a syndrome caused by gastric stasis that is not related to mechanical obstructi...

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.

<p><strong><u>Crohn's disease is a chronic inflammatory disease of unknown etiology, characterized by periods ...

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.

<p><strong>Colitis cystica profunda is a rare and unusual benign lesion of the colon and rectum, characterized...

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.Two Types of Achalasia in the same patient.

<p><strong>Achalasia of the esophagus is a rare disorder caused by obstruction at the gastroesophageal junctio...

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

Spleen

Spontaneous Splenic Rupture.

<p><strong><u>Spontaneous splenic rupture was first described by Rokitansky in 1861 and by Atkinson in 1874 an...

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.

Vascular & Trauma

Idiopathic Spontaneous Intraperitoneal Hemorrhage.

<p><strong><u>Idiopathic spontaneous intraperitoneal hemorrhage is a rare and often fatal condition, historica...

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

Endocrine

Atypical Parathyroid Adenoma.

<p>Primary hyperparathyroidism is one of the most common causes of hypercalcemia. It is an endocrine disorder ...

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.

Distant Metastases

Small Βowel Οbstruction caused by Μetastatic Urothelial Carcinoma of the Urinary Bladder.

<p style="text-align: justify;">Urothelial carcinoma of the urinary bladder is among the most common malignanc...

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

Colorectal

Bilateral Mucotomy for Rectal Stenosis following Stapled Haemorrhoidectomy.

<p><strong>Although most surgeons inform their patients that the staples of the circular stapler after a Longo...

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.

Infections & Sepsis

Intra-abdominal Abscesses attributed to Streptococcus Oralis.

<p><strong>Streptococcus oralis is a Gram-positive bacterium of low virulence, which is a commensal of the ora...

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

Late Endorectal Mesh Migration following Rectopexy.

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

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

Breast

Male Breast Cancer.

<p><strong><u>Male breast cancer is a relatively rare disease, accounting for less than 1% of all male cancer ...

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

<p></p><p><strong>Chronic parathyroiditis is an exceptionally rare inflammatory condition of the parathyroid g...

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

Infections & Sepsis

Fulminant Clostridium Difficile Enteritis after Restorative Proctcolectomy.

<p><strong><u>C. difficile infection is related/associated with pseudomembranous colitis caused by antibiotic ...

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

Hernia & Abdominal Wall

Bilateral Rectus Sheath Hematomas following administration of Low-Molecular-Weight Heparin.

<p>Antiplatelet agents have been widely used during hemodialysis in uremic patients. The most commonly used me...

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.

Vascular & Trauma

Left Portal Hypertension.

<p><strong><u>The development of left portal hypertension constitutes a rare clinical condition, which is very...

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